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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

Bennett v. Roman Catholic Diocese of Rockville Centre

In this workers' compensation case, the claimant appealed a decision from the Workers’ Compensation Board. The Board ruled that the claimant's cervical spine injury claim was barred by Workers’ Compensation Law § 28 because it was filed more than two years after the 2010 work-related accident, which initially caused back and leg injuries. Although the claimant argued that a carrier's payment for a 2010 CT scan constituted an advance payment of compensation, the court disagreed, noting the CT scan did not reveal neck abnormalities at the time and subsequent treatment focused on other injuries. The Appellate Division affirmed the Board's decision, concluding that substantial evidence supported the finding that the neck injury claim was untimely.

Workers' CompensationStatute of LimitationsTimeliness of ClaimNeck InjuryBack InjuryAdvance Payment of CompensationIndependent Medical ExaminationAppellate DivisionNew YorkWorkers' Compensation Board Appeal
References
5
Case No. ADJ1088522 (RIV 0015524)
Regular
Jan 03, 2013

SAMANTHA VAN DUINHOVEN vs. SPA HOTEL & CASINO, CALIFORNIA CASUALTY, Administered by GAB ROBINS NORTH AMERICA

This case involved an applicant who claimed industrial injury to her neck, back, left shoulder, psyche, and associated chronic pain syndrome, resulting in a finding of permanent total disability. The defendant sought reconsideration, arguing the medical evidence did not support injury to the low back or a diagnosis of chronic pain syndrome. The Appeals Board reversed the findings on the low back and chronic pain syndrome, finding no substantial evidence to support them. Consequently, the applicant's permanent disability award was amended to 70%, based on ratings for her neck, left shoulder, and psyche.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardPermanent Total DisabilityChronic Pain SyndromeAgreed Medical EvaluatorQualified Medical EvaluatorMedical Record ReviewIndustrial InjuryPermanent Disability Indemnity
References
0
Case No. ADJ488924 (SDO 0329999), ADJ226519 (SDO 0302236), ADJ2353553 (SDO 0250184), ADJ4021935 (SDO 0269434)
Regular
Dec 10, 2020

Craig Stevens vs. Subsequent Injuries Benefits Trust Fund

The Workers' Compensation Appeals Board (WCAB) rescinded a previous order denying benefits from the Subsequent Injuries Benefits Trust Fund (SIBTF). Applicant Craig Stevens sought SIBTF benefits for a claimed subsequent cumulative trauma injury to his neck ending April 2, 2009, with a compensable consequence injury to his right shoulder and low back. The WCAB found the medical evidence regarding the causation, date of injury, and permanent disability ratings for the alleged subsequent injuries, as well as prior injuries, to be insufficient and inconsistent. The case was returned to the trial level for further development of the record, including obtaining new medical opinions to clarify the various injuries and establish SIBTF eligibility thresholds.

Subsequent Injuries Benefits Trust FundSIBTF eligibilitycumulative trauma injurycompensable consequence injurypermanent disabilityapportionmentmedical evidencecausationfurther development of the recordLabor Code section 4751
References
9
Case No. ADJ466190 (STK 0151971) ADJ1336532 (STK 0151973) ADJ2603667 (STK 0151974)
Regular
Apr 21, 2009

Rosie Matz vs. GALT JOINT UNION ELEMENTARY SCHOOL

This case involves Rosie Matz seeking reconsideration of a Workers' Compensation Appeals Board (WCAB) decision regarding a May 8, 1997 injury. The WCJ awarded 17% permanent disability for a low back and neck injury but found no permanent disability for a May 16, 1995 low back injury. Matz contended the WCJ erred by not awarding permanent disability for a claimed left knee injury sustained in the 1997 incident. However, the WCAB denied reconsideration because prior final determinations had already established that Matz did not sustain industrial injury to her knees. Therefore, the issue of knee injury was precluded from further litigation under the doctrine of law of the case.

Rosie MatzGalt Joint Union Elementary SchoolPetition for ReconsiderationFindings and AwardPermanent DisabilityApportionmentLow Back InjuryNeck InjuryLeft Knee InjuryCumulative Trauma
References
1
Case No. SAC 256953, SAC 256954, SAC 256955
Regular

CAROL TORREZ vs. SUPERSHUTTLE, CLARENDON NATIONAL INSURANCE

This case involves cross-petitions for reconsideration concerning an applicant's workers' compensation claims for upper back/neck, low back, and upper extremity injuries sustained as an airport shuttle driver. The Appeals Board granted both applicant's and defendant's petitions, largely affirming the WCJ's findings but amending several clerical and factual errors. Key amendments include correcting defendant identification, clarifying stipulation regarding the low back injury, adjusting attorney fees and liens, and crediting EDD payments against temporary disability indemnity.

Workers' Compensation Appeals BoardSupershuttleClarendon National InsuranceCIGACalifornia Compensation Insurance Companyindustrial injuryupper backnecklow backcumulative trauma
References
0
Case No. MISSING
Regular Panel Decision

Claim of Neal v. Blue Circle Cement

The claimant, a laborer, suffered a compensable back injury in November 1998 and returned to work after eight months. In January 2002, he sustained another back injury. A Workers’ Compensation Law Judge determined that the January 2002 injury was an aggravation of the prior 1998 injury, assigned disability levels from January 2002 to April 2003, and found no compensable lost time thereafter. The Workers’ Compensation Board affirmed this decision. The Appellate Division found substantial evidence, including medical testimony and MRI comparisons, to support the Board’s determination regarding the aggravation of the injury and the disability levels. The court also upheld the Board's prerogative to resolve conflicting medical evidence and make credibility determinations, particularly in light of evidence that the claimant exaggerated his symptoms.

Workers' CompensationBack InjuryAggravation of InjuryDisability LevelsMedical EvidenceCredibility AssessmentEmployer LiabilityJudicial ReviewAppellate DivisionAdministrative Law
References
4
Case No. 534955
Regular Panel Decision
Feb 16, 2023

In the Matter of the Claim of Victor Martinez

Victor Martinez, a construction worker, was injured on November 11, 2020, when his right hand was caught between a cantilever pin and a concrete post. He filed a claim for workers' compensation benefits, including injuries to his neck and back, in addition to his right upper extremity. A Workers' Compensation Law Judge (WCLJ) initially established the claim only for injuries to his right forearm and wrist, disallowing the neck and back claims. However, the Workers' Compensation Board modified this determination, amending the claim to include the neck and back injuries. The employer and its workers' compensation carrier appealed the Board's decision, arguing against the causal relationship of the neck and back injuries. The Supreme Court, Appellate Division, Third Judicial Department, affirmed the Board's decision, finding it supported by substantial evidence and deferring to the Board's assessment of medical witness credibility and its factual findings.

Construction InjuryWorkers' Compensation BenefitsCausality DeterminationNeck and Back InjuriesSubstantial EvidenceMedical Opinion CredibilityAppellate ReviewWork AccidentBoard Decision AffirmationOrthopedist Testimony
References
8
Case No. MISSING
Regular Panel Decision

Claim of Sale v. Helmsley-Spear, Inc.

Claimant, an electrician, sought workers' compensation benefits for neck, back, and right shoulder injuries allegedly sustained during employment. Despite an initial ruling favoring some claims, a Workers' Compensation Board panel later required additional medical evidence for the neck injury. The claimant failed to provide the necessary proof, leading to the disallowance of claims for neck and back injuries. The Board affirmed this decision and denied reconsideration. The appellate court upheld the Board's findings, emphasizing the claimant's unmet burden to establish a causal relationship between the injuries to his neck and back and his employment through competent medical evidence.

Workers' Compensation BenefitsCausal RelationshipMedical EvidenceNeck InjuryBack InjuryShoulder InjuryAppellate ReviewBurden of ProofReconsideration DeniedBoard Decision Affirmed
References
2
Case No. WCB No. G076 2707
Regular Panel Decision
Dec 09, 2021

Matter of Duncan v. John Wiley & Sons, Inc.

This Board Panel Decision concerns an appeal by the applicant, Joseph Lafayette, regarding a Workers' Compensation Law Judge's (WCLJ) finding on the causal relationship of his back injury. The applicant sustained injuries to his back, neck, and shoulder during his employment. The WCLJ had previously established a causal relationship for the neck and shoulder injuries but disallowed the claim for the back injury. Upon review, the Board Panel determined that the medical evidence in the record supports a causal relationship between the claimant's employment and his lower back injury. As a result, the Panel modified the WCLJ's decision to establish a causal relationship for the back injury, while affirming the other aspects of the original decision.

Workers' CompensationBack InjuryNeck InjuryShoulder InjuryCausal RelationshipMedical EvidencePanel ReviewWCLJ DecisionModificationAppeal
References
2
Case No. ADJ1220987 (SJO 0262634)
Regular
Nov 17, 2010

RICHARD GILLISPIE vs. PLASTECH, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Subsequent Injuries Benefits Trust Fund (SIBTF) appealed an award of benefits to an applicant with a pre-existing disability, arguing a subsequent industrial back injury did not cause pathology in the opposite leg as required by statute. The Appeals Board affirmed the award, finding that Labor Code section 4751 only requires the subsequent injury to "affect" the opposite member, not necessarily cause direct pathology. Evidence showed the applicant's low back injury caused verified radiculopathy and impaired leg function, meeting the statutory requirement. The Board found SIBTF's legal arguments unpersuasive and the WCJ's findings supported by substantial evidence.

Subsequent Injuries Benefits Trust FundLabor Code section 4751industrial injurylow backradiculopathypermanent disabilityopposite and corresponding memberpathologyAMA GuidesDRE category III
References
2
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