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Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. 2023 NY Slip Op 00466
Regular Panel Decision
Feb 02, 2023

Matter of Kennedy v. 3rd Track Constructors

Claimant Alastair Kennedy, an operating engineer, sustained work-related injuries in October 2019 after falling into a hole at a job site, filing for workers' compensation benefits for left shoulder, foot, and ankle injuries. The employer's carrier accepted the claim for foot and ankle but contested neck and left shoulder injuries, also raising a Workers' Compensation Law § 114-a violation. A Workers' Compensation Law Judge (WCLJ) and subsequently the Workers' Compensation Board found claimant's testimony regarding the accident and prior injuries not credible, denying the claims for neck and left shoulder injuries and imposing mandatory and discretionary penalties under Workers' Compensation Law § 114-a. On appeal, the Appellate Division, Third Department, affirmed the Board's findings regarding the non-causal relation of neck and left shoulder injuries and the mandatory penalty for misrepresentations. However, the Court reversed the discretionary penalty of total disqualification from future wage loss benefits, deeming it disproportionate to the offense, modifying and affirming the Board's decision as so modified.

Workers' CompensationInjury ClaimCredibility AssessmentMisrepresentationWorkers' Compensation Law § 114-a ViolationMandatory PenaltyDiscretionary PenaltyWage Loss BenefitsCausal RelationshipMedical Evidence
References
16
Case No. ADJ8403518, ADJ8928431
Regular
Dec 06, 2016

Marcia Ortiz vs. CITY AND COUNTY OF SAN FRANCISCO, INTERCARE

The Appeals Board affirmed the WCJ's findings for a right elbow injury and its 24% permanent disability award. However, for a left foot/ankle injury, the Board rescinded the finding of industrial sleep disorder due to lack of substantial medical evidence. The Board also amended the permanent disability rating for the left ankle injury, ultimately awarding 12% permanent disability based on the primary treating physician's opinion. This decision corrected Dr. Chen's flawed application of impairment rating guidelines and excluded the sleep disorder from compensable injury.

PQMEDr. Chensleep impairmentindustrial injurypermanent disabilityADJ8403518ADJ8928431WCJDr. MartinovskyAMA Guides
References
7
Case No. ADJ2697898
Regular
Mar 06, 2013

ROBERT WALKER vs. SISKIYOU FOREST PRODUCTS, STATE COMPENSATION INSURANCE FUND, THE SUBSEQUENT INJURIES BENEFIT TRUST FUND

This case involves a Subsequent Injuries Benefit Trust Fund (SIBTF) claim where the applicant sustained industrial injuries to his left knee and right ankle, resulting in incontinence. The Board affirmed the finding of 41% permanent disability for the subsequent injury, finding the applicant eligible for SIBTF benefits under Labor Code § 4751(a) due to corresponding prior and subsequent injuries to opposite limbs. The Board amended the award to specify that the attorney's fee of 15% is calculated on the SIBTF weekly payments, not commuted as a lump sum upfront, to comply with statutory prohibitions. The Court also addressed apportionment, pre-existing disability, and the unreliability of stipulated percentages when SIBTF was not a party.

Subsequent Injuries Benefit Trust FundPermanent DisabilityApportionmentLabor Code Section 4751Industrial InjuryPre-existing DisabilityLabor-DisablingOpposite and Corresponding MemberCommutation of BenefitsVocational Expert
References
3
Case No. MISSING
Regular Panel Decision
Jul 14, 1971

Claim of Brewer v. Thomas Foundry, Inc.

The claimant, who sustained a left foot and ankle injury in 1966 while employed by Aetna Window Cleaning Company, experienced a second incident in 1970. While working for Thomas Foundry, Inc., his left ankle gave out, causing him to fall and injure his back. The Workmen's Compensation Board found that this fall and back injury constituted an accidental injury under the law, resulting in disability. This finding was supported by substantial evidence. The appellate court affirmed the Board's decision.

Workers' CompensationAnkle InjuryBack InjuryAccidental InjuryEmployment InjuryPre-existing ConditionAppellate ReviewSubstantial EvidenceFoundry WorkerWindow Cleaning
References
3
Case No. MISSING
Regular Panel Decision
May 11, 1990

Claim of Johnson v. New York City Board of Education

This case involves an appeal from a decision and an amended decision of the Workers’ Compensation Board. The Board had ruled that the claimant sustained a consequential injury and subsequently restored the case to the trial calendar. The appellate court affirmed the Board's decision, finding that the claimant's physician's testimony, despite some lack of clarity, met the requirement of signifying a probability as to the cause of the injury and was supported by a rational basis. Specifically, the determination that the claimant’s left ankle fracture was a consequence of an earlier work-related ankle fracture, which left the ankle in a weakened condition, was supported by substantial evidence.

Workers' CompensationAppealConsequential InjuryAnkle FractureMedical EvidencePhysician TestimonySubstantial EvidenceAppellate AffirmationWork-Related InjuryMedical Causation
References
3
Case No. CV-23-0524
Regular Panel Decision
Oct 10, 2024

Matter of Becker v. United Cerebral Palsy Assoc.

Claimant Sofia Becker injured her right ankle in December 2000, leading to an established workers' compensation claim and consequential injuries to her left wrist and both knees with assigned schedule loss of use. In September 2021, claimant fell at home, injuring her left elbow, and sought to amend her claim to include this as a consequential injury. A Workers' Compensation Law Judge (WCLJ) initially found prima facie medical evidence for the consequential injury but later disallowed the claim, a decision affirmed by the Workers' Compensation Board (Board). The Board determined the left elbow injury was a regular, unrelated slip-and-fall accident, lacking a consequential causal relationship to her prior established injuries. The Appellate Division, Third Department, affirmed the Board's decision, finding it supported by substantial evidence due to the absence of medical opinion linking the elbow injury to prior compensable injuries and conflicting independent medical examination findings.

Workers' CompensationConsequential InjuryCausationMedical EvidenceSchedule Loss of UseSlip and FallBoard DecisionAppellate ReviewCredibility AssessmentOrthopedic Injury
References
7
Case No. ADJ10419162
Regular
Jul 20, 2018

RONALD VICTOR vs. CITY OF PASADENA, ADMINSURE, INC.

This case involves an applicant claiming injury to multiple body parts resulting from a motor vehicle accident. The defendant contested the claim, arguing the accident occurred during a non-compensable lunch break and that a specific medical expert's opinion negated injury to the applicant's left ankle. The Board affirmed the original Findings and Order, ruling that the defendant waived the lunch break defense by not rejecting the claim within 90 days and that the medical expert's testimony was not substantial evidence on the AOE/COE issue. The Board found sufficient medical evidence and applicant testimony to support the left ankle injury as compensable.

AOE/COELabor Code section 5402presumption of compensability90-day rulelunch hour defensetrier of factsubstantial evidencecomplex regional pain syndrome (CRPS)orthopedic evaluationpodiatrist
References
0
Case No. ADJ417505 (STK 173008)
Regular
Oct 07, 2008

MARSHA CRISWELL vs. COUNTY OF STANISLAUS

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior award of left ankle surgery for applicant Marsha Criswell. The Board found no substantial medical evidence connecting Criswell's current ankle condition to her 2000 industrial injury, noting the ankle injury resolved and a new injury occurred in 2005. Therefore, the applicant failed to meet her burden of proof for industrial causation of the current ankle problem.

Workers' Compensation Appeals BoardReconsiderationMedical CausationIndustrial InjuryLeft Ankle SurgeryAgreed Medical ExaminerTreating PhysicianPreponderance of the EvidenceReasonable Medical ProbabilityLay Testimony
References
8
Case No. CV-23-0524
Regular Panel Decision
Oct 10, 2024

In the Matter of the Claim of Sofia Becker

Claimant Sofia Becker appealed a Workers' Compensation Board decision denying her request to amend an established claim for a consequential left elbow injury. Becker previously sustained a work-related right ankle injury in 2000, which led to established consequential injuries to her left wrist and both knees, with various schedule loss of use awards. In 2021, she fell at home, injuring her left elbow, and sought to link this to her prior compensable conditions. Both a Workers' Compensation Law Judge and the Board found the fall to be an unrelated slip-and-fall accident, determining she failed to prove a causal relationship between the elbow injury and her established claims. The Appellate Division affirmed the Board's decision, concluding that substantial evidence supported the Board's finding due to a lack of competent medical evidence establishing a causal connection.

Workers' CompensationConsequential InjuryLeft Elbow InjuryRight Ankle InjurySchedule Loss of Use (SLU)CausalityMedical EvidenceAppellate ReviewBoard Decision AffirmedSlip-and-Fall
References
7
Case No. ADJ7467262
Regular
Mar 15, 2018

OLGA ACOSTA vs. MOTEL 6, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Workers' Compensation Appeals Board granted reconsideration of a prior award of Subsequent Injuries Benefits Trust Fund (SIBTF) benefits to Olga Acosta. The Board found the medical evidence supporting the award, particularly Dr. Chen's opinion on the applicant's left ankle injury and resulting permanent total disability, insufficient. Specifically, the Board noted the absence of stress X-rays needed to support the AMA Guides rating for ligamentous instability and a lack of documentation for the pre-existing conditions contributing to total disability. Therefore, the matter was returned to the trial level for further development of the medical record.

Subsequent Injuries Benefits Trust FundSIBTFpermanent total disabilityopposite and corresponding memberlabor disablingsubstantial medical evidenceAMA Guidesstress x-rayCompromise and Release AgreementAgreed Medical Examiner
References
2
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