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

Case No. MISSING
Regular Panel Decision

What Happened in Felix vs. Weber Metals Reconsideration?

Plaintiff Sharon K. Pulos sought judicial review of the Commissioner of Social Security's final decision denying her application for disability insurance benefits. Plaintiff alleged disability due to multiple impairments including a brain tumor, liver transplant, diabetes, and depression, with an onset date of February 1, 2008. An Administrative Law Judge (ALJ) found Plaintiff not disabled, concluding her impairments were not severe enough to significantly limit basic work activities during the relevant period. The District Court affirmed the Commissioner's decision, finding it supported by substantial evidence and free from legal error, and denied Plaintiff's motion for judgment on the pleadings.

Social Security ActDisability Insurance BenefitsALJ DecisionSubstantial EvidenceSeverity StandardCognitive ImpairmentPsychological ImpairmentBrain SurgeryLiver TransplantDiabetes
References
23
Case No. MISSING
Regular Panel Decision

How Did the WCAB Rule in Hardgrove vs. Intercon Security?

Plaintiff Patricia A. Pender brought an employment discrimination suit against her former employer, District Council 37 (DC 37), alleging termination due to disability in violation of the Americans with Disabilities Act (ADA) and New York law. Pender, who had undergone a liver transplant, was terminated after a medical leave and a temporary modified assignment, with DC 37 claiming she could not perform the essential functions of her Council Representative job. An arbitrator, after an extensive grievance proceeding, had previously found in favor of DC 37, concluding Pender was unable to perform her duties even with accommodations. The court, affording significant weight to the arbitrator's decision and considering Pender's own admissions of disability, found insufficient evidence for a jury to conclude she could perform her job. Therefore, the court granted DC 37's motion for summary judgment, dismissing the complaint.

Employment DiscriminationDisability DiscriminationAmericans with Disabilities ActSummary JudgmentArbitrationCollective Bargaining AgreementReasonable AccommodationEssential Job FunctionsSocial Security DisabilityArbitrator's Decision Weight
References
19
Case No. 07-CV-2634; 07-CV-4841
Regular Panel Decision
Apr 05, 2010

What Did the WCAB Decide in Cuadra vs. Community Home Care?

Plaintiff Anthony Price, a pro se inmate, alleged deliberate indifference to his serious medical needs at Nassau County Correctional Center, violating his Eighth Amendment rights under 42 U.S.C. § 1983. Price claimed incorrect medication dosage for renal disease, failure to be tested for a kidney transplant, and inadequate treatment for shoulder pain against Sheriff Edward Reilly, Kim Edwards, Perry Intal, Mary Sullivan, Dr. Benjamin Okonta, and Nassau University Medical Center. The court granted defendants' motion for summary judgment regarding the medication dosage and all claims against Sheriff Reilly. However, the motion was denied concerning the kidney transplant request and shoulder pain claims, as genuine issues of material fact remained. The court also addressed the exhaustion of administrative remedies, finding defendants failed to establish plaintiff's non-exhaustion for the kidney transplant claim.

Eighth AmendmentDeliberate IndifferenceMedical NeedsPrisoner RightsSummary JudgmentKidney DiseaseRenal FailureDialysisShoulder PainInmate Grievance
References
70
Case No. SRO 108858
Regular
Aug 13, 2008

How Were Death Benefits Handled in Bocanegra vs. Sun-Gro Commodities?

The Workers' Compensation Appeals Board (WCAB) denied the defendant's petition for reconsideration, upholding the finding of industrial injury to the applicant's liver. However, the WCAB granted the lien claimant's petition, rescinding the established date of injury as December 1994. The case is returned to the trial level for further proceedings to determine the correct date the applicant first suffered a compensable disability from the liver injury.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderLabor Code §5402Labor Code §5412Date of InjuryIndustrial InjuryCompensable DisabilityHepatitis CLiver Disease
References
0
Case No. 2015-01-0023, 2018-01-0003, 2018-01-0008
Regular Panel Decision
Dec 04, 2019

Can a WCJ Be Disqualified for Appearance of Bias?

Johnny Johnston, an employee of Siskin Steel & Supply Co./Reliance Steel & Aluminum Co. for nearly 40 years, filed claims for liver, cardiac, and kidney conditions, alleging occupational exposure to heavy metals. The court consolidated three claims related to different dates of injury but the same occupational exposure. The primary issue was whether his conditions arose primarily out of and in the course of employment. The court, after considering conflicting expert testimonies, found that Mr. Johnston's work exposed him to heavy-metal contaminants, which accumulated in his system and primarily caused his liver, cardiac, and kidney conditions. Consequently, the court awarded Mr. Johnston medical benefits for ongoing treatment and permanent partial disability benefits amounting to 265.5 weeks or $172,832.00, to be paid in weekly or biweekly installments.

Occupational DiseaseHeavy Metal ExposureLiver DiseaseCardiac DiseaseKidney DiseasePermanent Partial DisabilityWorkers' Compensation AwardExpert Medical TestimonyCausation AnalysisHair Test Reliability
References
9
Case No. ADJ6801375
Regular
Jul 13, 2010

What Were the Key Rulings in Torrez vs. SuperShuttle?

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded a prior award. The WCAB found that the applicant was not entitled to medical treatment outside the employer's Medical Provider Network (MPN) for a meniscus transplant or graft. The applicant failed to follow the required procedures for obtaining a second and third opinion within the MPN before seeking treatment from an out-of-network physician. Therefore, the WCAB concluded there was no showing that treatment outside the MPN was justified under the relevant rules.

Workers' Compensation Appeals BoardMedical Provider NetworkMPNFurther Medical TreatmentSports Medicine DoctorMedical Meniscus TransplantGraft ProcedureDr. Patrick O'MearaDr. John DeSantisSubspecialist
References
2
Case No. ADJ376655 (SJO 0257571)
Regular
Dec 26, 2014

Why Was Removal Denied in Rush vs. California Correctional Institution?

In this workers' compensation case, the Appeals Board reversed a prior decision denying an employer's appeal of an Independent Medical Review (IMR) determination. The Board found the IMR determination for a knee cartilage transplant was plainly erroneous and acted in excess of the Administrative Director's powers. This was due to a direct contradiction between the IMR's finding of medical necessity and its stated rationale. Consequently, the Board granted the employer's appeal and remanded the case for a new IMR review by a different reviewer.

Workers' Compensation Appeals BoardIndependent Medical Review (IMR)Utilization Review (UR)Labor Code section 4610.6(h)Plainly erroneous findingsExpert opinionMedical necessityCartilage transplantRight kneeRemand
References
0
Case No. ADJ9525033
Regular
May 10, 2019

What Did the WCAB Clarify in Ontiveros vs. Savers Stores?

This case involves an appeal by the defendant, Department of Food and Agriculture, regarding the calculation of permanent disability ratings for applicant Kimberly Barry's cumulative trauma injury. The defendant contests the method used to combine the applicant's multiple body part impairments, arguing the Combined Values Chart (CVC) should have been used instead of simple addition. The Appeals Board granted reconsideration to further develop the medical record. The Board requires clarification from the Qualified Medical Evaluator on the most accurate method for combining the applicant's kidney and liver impairments.

Workers Compensation Appeals BoardPetition for ReconsiderationFindings and AwardDepartment of Food and AgricultureState Compensation Insurance FundKimberly BarryAgricultural TechnicianCumulative Trauma InjuryPermanent DisabilityApportionment
References
4
Case No. ADJ10917168 (MF)
Regular
Oct 21, 2019

Why Was Reconsideration Denied in Gomez vs. Dorothy Stevens?

This case concerns an applicant seeking reconsideration of a Workers' Compensation Appeals Board decision denying a right knee meniscal transplantation. The judge found the requested treatment did not fall within presumptively correct Medical Treatment Utilization Standards (MTUS) or present sufficient scientific evidence to rebut the presumption. Applicant argued the physician's report constituted scientific evidence and supported medical necessity, but the Board affirmed the denial. The Board found the applicant failed to meet the burden of proof by a preponderance of scientific medical evidence for treatment outside MTUS guidelines.

Workers' Compensation Appeals BoardPetition for ReconsiderationJoint Findings of Factindustrial injuryright knee meniscal transplantationUtilization Review (UR)Medical Treatment Utilization Standards (MTUS)Labor Code sections 4604.55307.27medically necessary
References
4
Case No. MISSING
Regular Panel Decision

Why Was Reconsideration Dismissed in Sabino vs. Johnson Pump Company?

The decedent, a photographic darkroom technician for 30 years, developed cancer of the pancreas, gallbladder, and liver, dying at age 51. An Administrative Law Judge initially denied workers' compensation benefits, but the Workers’ Compensation Board reversed, finding the cancer was an occupational disease caused by prolonged exposure to darkroom chemicals. The employer and insurance carrier appealed, arguing insufficient evidence of causation and exposure. The court affirmed the Board's decision, citing substantial evidence from medical experts who linked the decedent's cancer to chemical exposure and noting that such chemicals were commonly used in photographic development.

Occupational DiseaseCancerChemical ExposureDarkroom TechnicianCausationExpert TestimonyAppellate ReviewAdministrative LawMedical OpinionIndustrial Hazard
References
7
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