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

Case No. ADJ1991870
Regular
Sep 07, 2010

TOM DRENNAN vs. SUPERIOR INSPECTION SERVICES, FIREMAN'S FUND INSURANCE COMPANY

This case involves an employer's petition for reconsideration of a WCJ's award finding industrial injury to the applicant's left knee, both hips, and gastrointestinal system as consequential to an admitted right knee injury. The defendant argues that a prior 2005 WCJ decision denying consequential injury to the left knee and hips is res judicata. The Appeals Board granted reconsideration, amending the award to remove the left knee and hip injuries, holding that the 2005 decision was final and the five-year time limit to reopen under Labor Code sections 5410 and 5804 had passed. The finding of consequential injury to the gastrointestinal system and 29% permanent disability remain affirmed.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardCompensable ConsequencesRes JudicataIndustrial InjuryLeft KneeHipsGastrointestinal SystemPermanent Disability
References
2
Case No. 2020 NY Slip Op 06428 [188 AD3d 1389]
Regular Panel Decision
Nov 12, 2020

Matter of Rybka v. Central N.Y. Psychiatric Ctr.

William Rybka, the claimant, appealed a decision by the Workers' Compensation Board regarding a schedule loss of use (SLU) award for a 2017 left hip injury. Rybka had a pre-existing 17.5% SLU to his left leg from a 2005 injury. For the 2017 injury, a medical examiner found a 30% SLU to the left hip, which a Workers' Compensation Law Judge (WCLJ) determined to be an overall 30% SLU of the left leg. The WCLJ then deducted the prior 2005 SLU, resulting in a 12.5% SLU award for the 2017 claim. The Workers' Compensation Board affirmed this decision, and the Appellate Division, Third Department, upheld the Board's interpretation and application of relevant precedent, affirming the SLU award.

Workers' CompensationSchedule Loss of Use (SLU)Left Leg InjuryLeft Hip InjuryPrior Injury DeductionAppellate ReviewMedical Examiner ReportWorkers' Compensation BoardPrecedent (Matter of Genduso)Third Department (Appellate Division)
References
5
Case No. ADJ3203306 (LAO 0871862)
Regular
Jul 13, 2011

Vanessa Bruce vs. SOUTHWEST HEALTHCARE MEDICAL, TRAVELERS

The applicant sought reconsideration of a Workers' Compensation Appeals Board (WCAB) decision that found industrial injury to the lumbar spine but denied injury to the internal systems and sleep disorder. The applicant argued the WCJ erred by ignoring a stipulation for injury to the left lower extremity, hip, and buttocks, and by rejecting evidence of an industrially-caused sleep disorder. The WCAB granted reconsideration, amended the findings to include injury to the left lower extremity, left hip, and buttocks, but otherwise affirmed the original decision, finding no industrial basis for the sleep disorder.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardIndustrial InjuryLumbar SpineInternal SystemsSleep DisorderLeft Lower ExtremityLeft HipButtocks
References
2
Case No. MISSING
Regular Panel Decision
Sep 23, 1988

Claim of Edmondson v. State Insurance Fund

The claimant, a payroll clerk, sustained a left hip injury after tripping at work in 1981, leading to multiple surgeries including a hip fusion and removal of the femoral head and neck, resulting in an 80% schedule loss of use of her left leg. The employer sought to apportion the disability due to a preexisting condition of avascular necrosis and a prior hip injury. However, the Workers' Compensation Board determined the 80% schedule loss was solely related to the compensable accident, a finding affirmed on appeal based on medical testimony that the orthopedic surgeon opined the preexisting condition was nondisabling and not progressive at the time of the accident.

Workers' CompensationHip InjurySchedule Loss of UseAvascular NecrosisApportionmentPreexisting ConditionMedical TestimonyOrthopedic SurgeryCausationState Insurance Fund
References
3
Case No. 529417
Regular Panel Decision
Feb 06, 2020

Matter of Johnson v. City of New York

Thomas Johnson, a patient care technician, sustained work-related knee injuries in a February 2006 fall. He subsequently sustained additional work-related injuries in November 2009 to his neck, back, shoulder, and hips, for which he received schedule loss of use (SLU) awards for his right arm, left leg, and right leg. The Workers' Compensation Board later ruled on the permanency of his 2006 injuries, finding an 80% SLU for his left leg and a 40% SLU for his right leg. However, the Board reduced these new awards by his previously received SLU awards for the 2009 injuries, resulting in a final 30% SLU for his left leg and a 0% SLU for his right leg. The Appellate Division affirmed the Board's decision, confirming that SLU awards for the knee and hip are encompassed within leg awards, and prior leg SLU awards must be deducted from subsequent leg SLU awards.

Schedule Loss of UseKnee InjuriesHip InjuriesLeg ImpairmentPrior SLU Award DeductionAppellate Division ReviewIndependent Medical ExaminationTreating Physician ReportPermanent Impairment GuidelinesWork-related Accident
References
9
Case No. MISSING
Regular Panel Decision

Nayal v. HIP Network Services IPA, Inc.

Dr. Christine Nayal initiated a class action against HIP Network Services IPA, Inc., alleging breach of contract, unjust enrichment, and a violation of New York General Business Law § 349. As a practicing psychologist, Nayal claimed that HIP, a health maintenance organization, failed to provide timely and adequate reimbursement, including interest, for services rendered under their agreement. HIP responded by filing a motion to compel arbitration, citing a clause in their contract, or, alternatively, seeking dismissal of the claims. The Court, presided over by Judge Victor Marrero, evaluated the enforceability of the arbitration provision. Finding no procedural or substantive unconscionability under New York law, the Court granted HIP's motion to compel arbitration for all claims, subsequently dismissing the entire action without prejudice.

Arbitration AgreementUnconscionabilityClass Action WaiverFederal Arbitration ActNew York General Business LawContract DisputeBreach of ContractUnjust EnrichmentMotion to Compel ArbitrationDismissal Without Prejudice
References
34
Case No. MISSING
Regular Panel Decision

Claim of Banner v. Anheuser-Busch Companies

Claimant, a forklift operator, sought workers' compensation benefits for right knee and left hip injuries sustained in December 2005. After an initial award, the Workers' Compensation Board rescinded benefits, concluding that the disabling hip condition (avascular necrosis of the left femoral head) was not causally related to the work injury, based on an impartial specialist's report and other medical testimony. On appeal, the Court affirmed the Board's decision, finding that the Board's resolution of conflicting medical opinions on causation was supported by substantial evidence. The Court also found that the omission of claimant's testimony minutes was not reversible error, as the Board had ample medical evidence to consider.

Workers' Compensation AppealCausationAvascular NecrosisHip InjuryKnee InjuryConflicting Medical OpinionsSubstantial EvidenceWorkers' Compensation Board DecisionMedical EvidenceAppellate Review
References
8
Case No. 525196
Regular Panel Decision
Apr 26, 2018

Matter of Derouchie v. Massena W. Wc Smelter

Claimant Gerry J. Derouchie sustained injuries on February 18, 2015, including to his right knee and left hip, after stepping into a pothole on his employer's premises. He filed for workers' compensation benefits, and his case was established for multiple injuries. Having prior injuries and surgeries, claimant sought authorization for total right knee and left hip replacement surgeries, which the employer and carrier denied. A Workers' Compensation Law Judge (WCLJ) granted the authorization, and the Workers' Compensation Board affirmed, finding a causal relationship between the February 2015 accident and the need for surgeries. The Appellate Division, Third Department, affirmed the Board's decision, citing substantial evidence and deference to the Board's assessment of medical witness credibility.

Workers' Compensation BenefitsCausal RelationshipKnee Replacement SurgeryHip Replacement SurgeryPreexisting ConditionsAggravation of InjuryMedical AuthorizationSubstantial EvidenceCredibility AssessmentAppellate Review
References
10
Case No. ADJ9799720
Regular
Jan 29, 2016

HOWARD GARNER vs. DEPARTMENT OF CORRECTIONS AND REHABILITATION, legally uninsured; STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration to correct a transcription error, amending the findings to reflect an injury to the applicant's left "little" toe instead of the left "middle" toe. The applicant's petition for reconsideration was denied, as the Board found no evidence to support claims of injury to his hand, hip, or a deformed left little toe, and the medical examiner did examine the relevant body part. The decision affirmed the findings of no permanent disability or need for further treatment for the left little toe.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of FactInmate LaborerPanel Qualified Medical ExaminerTranscription ErrorLeft Little ToePermanent Partial DisabilityFurther Medical TreatmentDepartment of Corrections and Rehabilitation
References
0
Case No. MISSING
Regular Panel Decision
Apr 20, 2009

Claim of Kot v. Beth Ameth Home Attendant Service

The claimant, a home care attendant, applied for workers' compensation benefits after sustaining injuries, including a left hip injury, while attempting to lift a patient in April 2004. Initially, the claim was established for other injuries, but a Workers’ Compensation Law Judge later found the hip injury causally related. However, the Workers’ Compensation Board reversed this decision, relying partly on an impartial specialist's opinion that the hip injury stemmed from a preexisting inflammatory arthritis rather than the work incident. The Appellate Division affirmed the Board's decision, concluding that the specialist's and an independent medical examiner's opinions constituted substantial evidence to support the finding that the hip injury was not causally related to the employment.

Workers' CompensationHip InjuryCausationPreexisting ConditionMedical OpinionImpartial SpecialistAppellate ReviewSubstantial EvidenceInflammatory ArthritisAvascular Necrosis
References
5
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