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Case Law Database

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

Case No. MISSING
Regular Panel Decision
Oct 03, 2000

Claim of Schueler v. Mercy Hospital

Claimant, a nurse at Mercy Hospital, experienced recurring back pain in early 1997 from lifting nonambulatory patients. She was diagnosed with a central lumbar disc herniation, which her neurosurgeon attributed 75% to her work-related injury. A Workers’ Compensation Law Judge found the injury accidental, with proper notice and causal relationship, declaring the claimant totally disabled with 75% related to the work injury. The Workers’ Compensation Board affirmed this decision. The employer and carrier appealed, arguing the absence of a specific traumatic event negated an "accidental injury." The court affirmed the Board's decision, stating that an accidental injury can accrue gradually if tied to special workplace conditions and that resolving conflicting testimony is within the Board's purview.

Back injuryDisc herniationGradual onset injuryOccupational injuryWorkers' CompensationDisability apportionmentMedical testimonyAppellate reviewNurseLifting injury
References
3
Case No. MISSING
Regular Panel Decision

Santiago v. Bowen

The plaintiff, a 58-year-old man with an 8th-grade education and a history of physical labor, sought Supplemental Security Income (SSI) disability benefits after injuring his lumbar spine in 1986. His treating chiropractor, Dr. Serafín Izquierdo, opined he was totally disabled due to acute low back derangement, a possible herniated disc, and other related conditions. A consultative physician, Dr. Shu-mofsky, found minimal x-ray findings but noted severe pain during a straight leg raising test. The ALJ initially found the plaintiff capable of light work, a decision upheld by the Appeals Council. The District Court reversed this decision, ruling that the treating chiropractor's opinion on disability, within their field of expertise, should be given binding effect, especially when supported by evidence and not substantially contradicted. The court found Dr. Izquierdo's opinion uncontradicted and remanded the case for the calculation and disbursement of benefits.

Disability benefitsSupplemental Security Income (SSI)Chiropractor's opinionTreating physician ruleMedical evidenceLumbar spine injuryResidual functional capacityAdministrative Law JudgeAppeals CouncilReversal and remand
References
8
Case No. ADJ3649169
Regular
Feb 14, 2013

BRUCE LIBERTY vs. LOS ANGELES UNIFIED SCHOOL DISTRICT; Permissibly Self-Insured

This case concerns an applicant's petition for reconsideration of a Workers' Compensation Appeals Board (WCAB) order denying his claim for lumbar spine injury. The applicant alleged a lumbar injury from a physical therapy incident following a compensable cervical and shoulder injury. The WCAB denied reconsideration, adopting the WCJ's report which relied on the Agreed Medical Examiner's (AME) opinion. The AME found no industrial injury to the lumbar spine, citing a lack of contemporaneous evidence and a history of degenerative disc disease. The WCAB determined the applicant's presented "new" evidence was either previously reviewed or unpersuasive, upholding the original award.

Workers' Compensation Appeals BoardPetition for ReconsiderationDeniedBruce LibertyLos Angeles Unified School DistrictPermissibly Self-InsuredCase Number ADJ3649169Workers' Compensation Administrative Law JudgeAgreed Medical ExaminerLumbar Spine Injury
References
0
Case No. MISSING
Regular Panel Decision

Singletary v. Apfel

Plaintiff Sylvester M. Singletary appealed the Commissioner of Social Security's denial of disability insurance benefits, leading to this action under 42 U.S.C. § 405(g). The Court reviewed the final determination, including an Administrative Law Judge's decision, which the Appeals Council upheld. The central issue revolved around the ALJ's rejection of Singletary's treating physician's opinion of total disability, which the ALJ deemed unsupported by objective evidence, specifically the absence of disc herniation. The Court found that the ALJ arbitrarily substituted his lay opinion for competent medical evidence and ignored other objective findings like degenerative disc disease and disc bulging. Consequently, the Commissioner’s decision was not supported by substantial evidence, and the case was remanded solely for the calculation of benefits, with the plaintiff's motion for judgment on the pleadings granted.

Disability BenefitsSocial Security ActTreating Physician RuleSubstantial Evidence ReviewDegenerative Disc DiseaseChronic PainSpinal ImpairmentALJ ErrorRemandFederal Court Review
References
13
Case No. MISSING
Regular Panel Decision

Claim of Scalzo v. St. Joseph's Hospital

The claimant, a patient account representative, suffered a back injury (herniated L5-S1 disc and bulging discs) on May 18, 2000, after abruptly rising from her chair to avoid an object at work. Her claim for workers' compensation benefits was controverted by her employer and its carrier, arguing the injury was idiopathic. However, both a Workers' Compensation Law Judge and the Workers' Compensation Board found the accident established, relying on medical evidence, lay testimony, and the presumption under Workers’ Compensation Law § 21 (1). The employer appealed this decision. The appellate court affirmed the Board's decision, concluding that substantial evidence supported the finding that the injury arose out of and in the course of employment, and that credibility issues were for the Board to resolve.

Workplace InjuryBack InjuryHerniated DiscBulging DiscWorkers' Compensation BenefitsAccident Arising Out of EmploymentCourse of EmploymentPresumption of Arising Out of EmploymentCredibility IssueSubstantial Evidence
References
6
Case No. 531582
Regular Panel Decision
May 13, 2021

Matter of Matteliano v. Trinity Health Corp.

Caitlyn Matteliano, a nurse assistant, suffered work-related back, knee, and leg injuries in 2015 and 2018. Her treating orthopedic surgeon, Franco Vigna, requested authorization for multi-level lumbar fusion surgery and an external bone growth stimulator due to persistent pain and degenerative disc disease, despite conservative treatments. The employer denied this request based on an independent medical examination by Anthony Leone, who deemed the surgery aggressive and inappropriate given the lack of instability. A Workers' Compensation Law Judge initially denied the request, but the Workers' Compensation Board approved it. The employer appealed, and the Appellate Division, Third Department, affirmed the Board's decision, finding substantial evidence in Vigna's testimony to support the surgery's authorization under medical treatment guidelines for degenerative disc disease where non-surgical management has failed.

Workers' CompensationLumbar Fusion SurgeryMedical Treatment GuidelinesDegenerative Disc DiseaseDiscogenic Back PainIndependent Medical ExaminationPrior AuthorizationAppellate ReviewNurse AssistantWork Injury
References
9
Case No. MISSING
Regular Panel Decision

Claim of Avila v. St. Francis Hospital

In this Workers' Compensation case, the claimant, an orderly, sustained a low back injury in 1965 while employed by St. Francis Hospital. Initially diagnosed with a lumbo-sacral strain and an unstable back, a lump-sum settlement was approved in 1969 based on a mild causally related partial disability. Nearly a decade later, in 1978, the claimant applied to reopen the settlement due to severe leg pain and a confirmed extruded disc at L5-S1, requiring a laminectomy. The Workers’ Compensation Board reversed a Law Judge's finding, determining that there was a change in condition and degree of disability not contemplated at the time of the original settlement. The Special Fund for Reopened Cases appealed this decision, arguing against the reopening. The Appellate Division affirmed the Board's decision, citing that the definitive change from a mild disability to a herniated disc requiring surgery was an uncontemplated medical condition change, justifying the reopening under Workers’ Compensation Law § 15 (5-b).

Reopened CaseLump-Sum SettlementPermanent Partial DisabilityHerniated Lumbar DiscLaminectomyChange of ConditionUncontemplated Medical ConditionWorkers' Compensation Board DecisionAppellate ReviewMedical Evidence
References
2
Case No. MISSING
Regular Panel Decision

Mitchell v. New York City Transit Authority

A bus driver sought workers’ compensation benefits for a herniated lumbar disk, attributing it to 22 years of operating buses. The Workers’ Compensation Board denied his claim, ruling he did not sustain an occupational disease arising from employment. Although his neurosurgeon's note linked the condition to employment, the neurosurgeon later declined to definitively establish causality. The Board found the medical proof insufficient. The appellate court affirmed the Board’s decision, finding its conclusion supported by the record.

occupational diseasecausal relationshipmedical evidenceWorkers' Compensation Boardbus driverlower back painherniated lumbar diskneurosurgeonwitness credibilityappellate review
References
4
Case No. MISSING
Regular Panel Decision
Nov 29, 1979

Claim of Wolf v. Exxon Corp.

The Workers' Compensation Board found that the claimant sustained an accidental injury arising out of and in the course of employment on November 5, 1975, after lifting two projectors and a screen, which led to a diagnosis of a herniated disc at L4-L5. The board also excused the statutory written notice requirement, citing an unwitnessed accident, prompt medical attention, and no prejudice to the self-insured employer, who had timely knowledge of the claimant’s hospitalization. The court affirmed the board's decision, concluding that it was supported by substantial evidence in all respects.

back painherniated discL4-L5accidental injurycourse of employmentstatutory notice excusedunwitnessed accidentprompt medical attentionself-insured employersubstantial evidence
References
0
Case No. MISSING
Regular Panel Decision
Jun 23, 1978

Keefer v. Norton Co.

This case involves an appeal from a decision by the Workers’ Compensation Board. The Board found that the claimant suffered an occupational disease, specifically a herniated disc, due to repetitive lifting of heavy belts during employment. The Board determined that the employment acted upon the claimant's condition to cause a disability that previously did not exist, referencing Perez v. Pearl-Wich Co. The appellate court affirmed the Board's decision, concluding that it was supported by substantial evidence. Costs were awarded to the Workers’ Compensation Board against the employer and its insurance carrier.

Occupational DiseaseHerniated DiscRepetitive LiftingWorkers' Compensation BoardAppellate ReviewDisability CausationSubstantial EvidenceBoard Decision AffirmedEmployment-Related Injury
References
3
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