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

Case No. ADJ7650286, ADJ7459699
Regular
May 03, 2016

MIGUEL RODRIGUEZ vs. LUANNE WELLS; CHUBB GROUP

This case involves two workers' compensation claims where the applicant sought reconsideration of a prior award. The applicant argued that his permanent disability award for a hernia was insufficient and that he should have received a finding of industrial injury to his left shoulder. The Appeals Board granted reconsideration, affirming previously awarded injuries to the low back, knees, psyche, and hernia. However, they rescinded the prior awards and deferred the issue of left shoulder injury, along with other related issues like permanent disability and further medical treatment for the shoulder, pending further proceedings at the trial level. The Board noted that while the shoulder injury was raised in amended applications and supported by some medical evidence, it was never formally adjudicated.

Workers' Compensation Appeals BoardPetition for ReconsiderationJoint Findings and AwardCumulative TraumaSpecific InjuryLandscaper/GardenerPermanent DisabilityFurther Medical TreatmentLeft Shoulder InjuryDr. Scott Rosenzweig
References
2
Case No. ADJ300802 (AHM 0109743) ADJ2310921 (AHM 0115931)
Regular
Nov 21, 2008

CHRISTOPHER SHIELDS vs. LAIDLAW TRANSIT; BROADSPIRE

The Appeals Board granted reconsideration, amending the original award to establish a permanent and stationary date of January 3, 2005, for applicant's abdominal hernia injuries. The Board deferred the issues of permanent disability and attorneys' fees, returning the case to the trial level for re-rating based on hernia/abdominal injuries rather than spinal injuries. The Board affirmed the finding of an industrial inguinal hernia injury, while also noting that the defendant did not provide evidence of unreasonable refusal of medical treatment for the hernias.

HerniaUmbilical herniaInguinal herniaLow back painPermanent and stationary dateTemporary total disabilityMedical treatmentAttorney's feesReconsiderationWorkers' Compensation Appeals Board
References
0
Case No. ADJ7006877
Regular
Jul 22, 2014

JANET PARKER vs. COSTCO WHOLESALE, SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves a defendant's petition to remove an order limiting discovery subpoenas. The defendant sought medical records related to the applicant's spine, left knee, hernia, pain syndrome, arthritis, and obesity, arguing relevance to claimed injuries. The applicant agreed to include left knee records but not other potentially unrelated conditions. The Appeals Board granted the petition, amended the order to include left knee records, and allowed parties twenty days to reach an informal agreement on other records, otherwise returning the matter to the trial level.

Petition for RemovalOrder Limiting Subpoenas Duces TecumSutter Regional Medical FoundationBay Spine Medical Associatesspineleft kneeherniapain syndromearthritisobesity
References
0
Case No. MISSING
Regular Panel Decision

In re the Claim of Sweet

A claimant, formerly a sewage treatment worker for a municipality, left his job and moved to Hawaii after receiving a conditional job offer at a tropical fish farm and his girlfriend's relocation there. Upon arrival, he discovered the position was no longer available. The Unemployment Insurance Appeal Board subsequently ruled that the claimant was disqualified from receiving unemployment insurance benefits, determining he had voluntarily left his employment without good cause. The appellate court affirmed the Board's decision, finding substantial evidence that the claimant failed to verify the job offer before moving and had primarily relocated for personal reasons without definite employment.

Unemployment benefitsVoluntary quitGood cause for leavingJob availabilityRelocation for personal reasonsDisqualification for benefitsAppellate reviewSubstantial evidenceMunicipality employmentHawaii job offer
References
0
Case No. ADJ8208235
Regular
Jun 25, 2013

MARIA T. SOTO vs. ROSANNA, INC.; BROADSPIRE

The applicant sought reconsideration of a Workers' Compensation Appeals Board (WCAB) decision that only recognized an inguinal hernia as an industrial injury. The applicant contended the WCAB erred by not finding industrial injuries to her right shoulder and lumbar spine, arguing the decision lacked substantial medical evidence. The WCAB denied reconsideration, adopting the administrative law judge's report which found the applicant failed to meet her burden of proof for shoulder and spine injuries due to a lack of contemporaneous medical records. The judge noted that while the hernia was compensable due to documented treatment, the subjective complaints for the shoulder and back lacked such support and were deemed unreliable.

WCABPetition for ReconsiderationFindings of Factindustrial injuryinguinal herniaright shoulderlumbar spinesubstantial medical evidencethird-party administratorreasonable probability of industrial causation
References
5
Case No. MISSING
Regular Panel Decision
May 09, 2006

Claim of Atkinson v. Joseph Baldwin Construction

This is an appeal from decisions of the Workers’ Compensation Board, filed March 29, 2006, and May 9, 2006, which clarified an earlier Board decision from April 23, 2002. The claimant sustained a compensable right shoulder injury in July 1998. Subsequently, the claimant alleged problems with his left shoulder were causally related to the 1998 accident. A Workers’ Compensation Law Judge (WCLJ) initially found no causal relationship for the left shoulder injury, a determination affirmed by the Board in April 2002, although the Board's decision ambiguously mentioned developing the schedule of loss of use for 'both arms.' Following further proceedings, the WCLJ reiterated the disallowance of the left arm claim. The Board then clarified its 2002 decision in 2006, stating that it had affirmed the finding of no causal relationship for the left arm and that only the right arm's schedule loss of use was to be developed. The Appellate Division found that the Board's 2006 decisions effectively amended its 2002 decision. Upon review, the court affirmed the Board’s determination, finding substantial evidence supported the conclusion of no causal relationship for the left arm, giving deference to the Board's credibility assessments and resolution of conflicting medical evidence. The court also rejected the argument that the issue of a consequential left shoulder injury remained open, as the Board's prior decision had disallowed any causally related left arm condition.

Workers' Compensation LawCausal RelationshipLeft Shoulder InjuryRight Shoulder InjuryMedical EvidenceCredibility AssessmentAppellate ReviewBoard ClarificationAmended DecisionSchedule Loss of Use
References
6
Case No. 534614
Regular Panel Decision
Feb 16, 2023

In the Matter of the Claim of Joseph Marcellino

The case involves an appeal from a Workers' Compensation Board decision concerning claimant Joseph Marcellino's eligibility for a schedule loss of use (SLU) award for permanent injuries to his left elbow and left thumb. Following an April 2015 accident, Marcellino had established claims for multiple injuries, undergoing surgery in 2016. Conflicting medical opinions arose between his treating orthopedic surgeon, Dimitro Christoforou, who assessed significant SLU percentages, and the carrier's orthopedic surgeon, Peter Spohn, who found minimal or no SLU for the left hand, wrist, and thumb. A Workers' Compensation Law Judge (WCLJ) credited Spohn's opinion, awarding 15% SLU for the left wrist but no permanency for the left elbow or left thumb. The Workers' Compensation Board affirmed this decision. On appeal, the Appellate Division, Third Judicial Department, affirmed the Board's decision, reiterating that the Board has the discretion to resolve conflicting medical opinions and reject medical evidence even without opposing proof, finding their determination supported by substantial evidence.

Workers' Compensation LawSchedule Loss of UsePermanent Partial DisabilityMedical EvidenceConflicting Medical OpinionsCredibility AssessmentAppellate DivisionWorkers' Compensation BoardOrthopedic InjuriesElbow Injury
References
7
Case No. 2020 NY Slip Op 06434 [188 AD3d 1403]
Regular Panel Decision
Nov 12, 2020

Matter of Liuni v. Gander Mtn.

Claimant Joseph D. Liuni sustained a left distal bicep tendon rupture in 2007, resulting in a 22.5% schedule loss of use (SLU) award for his left arm. In 2014, he established a workers' compensation claim for his right shoulder, which was later amended in 2016 to include a consequential injury to his left shoulder. A physician determined a 27.5% SLU for the left arm due to the 2016 injury, which, when combined with the prior award, totaled an overall 50% SLU. The Workers' Compensation Board modified a WCLJ's determination, ruling that the bicep and shoulder injuries are not eligible for separate SLU awards as they both fall under awards for the left arm. Consequently, the Board deducted the 2007 22.5% SLU from the 2016 27.5% SLU, resulting in a 5% SLU award for the left arm. The Appellate Division affirmed the Board's decision, emphasizing that Workers' Compensation Law § 15 (3) limits SLU awards to statutorily enumerated members and that separate awards for subparts of a body member would constitute an unauthorized monetary windfall.

Schedule Loss of Use (SLU)Workers' CompensationAppellate DivisionThird DepartmentLeft Arm InjuryBicep Tendon RuptureShoulder InjuryPrior Award DeductionMonetary WindfallStatutory Interpretation
References
5
Case No. MISSING
Regular Panel Decision
Dec 05, 2003

In re the Claim of Kohen

The claimant, a social worker, filed a complaint against her employer with the Division of Human Rights alleging religious harassment. Despite continued problems, including a high-risk pregnancy, she resigned in June 2003, citing dissatisfaction with the work environment and unfair treatment. The Unemployment Insurance Appeal Board disqualified her from receiving unemployment insurance benefits, concluding she voluntarily left without good cause. The court affirmed this decision, reiterating that dissatisfaction with one's working environment does not constitute good cause for leaving employment.

Unemployment BenefitsVoluntary ResignationGood CauseWork EnvironmentHarassmentPregnancyAppealSocial WorkerDissatisfactionUnfair Treatment
References
2
Case No. MISSING
Regular Panel Decision

In re the Claim of Elkan-Moore

The case involves a claimant's appeal from a decision by the Unemployment Insurance Appeal Board, which ruled she was disqualified from receiving benefits due to voluntarily leaving her employment without good cause. The claimant, a museum director for five years, contended she resigned due to distress over allegations by a former Board of Trustees president and ongoing harassment from staff. However, the court found that issues with co-workers do not constitute good cause for leaving. An investigation had cleared the claimant of the allegations, and the Board was actively working to resolve the situation and retain her. The court ultimately affirmed the Board's decision, concluding that the claimant left her job due to general dissatisfaction with work conditions.

Unemployment InsuranceVoluntary QuittingGood CauseJob DissatisfactionWorkplace HarassmentBoard of TrusteesEmployer-Employee RelationsAppellate ReviewBenefit DisqualificationClaimant Appeal
References
5
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