CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

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

Case No. ADJ11053430; ADJ14397522
Regular
Jun 23, 2025

MICHAEL FISHEL vs. RICK'S LUBE AND COMPLETE AUTO, OAK RIVER INSURANCE COMPANY

Applicant Michael Fishel, an auto mechanic, sustained an injury to his back and other body parts on August 18, 2017, while employed by Rick's Lube and Complete Auto, insured by Oak River Insurance Company. The case involved extensive litigation concerning the necessity of lumbar spine surgery and the waiver of the Utilization Review/Independent Medical Review process, leading to the appointment of Dr. Laura Hatch. The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration, rescinding and substituting a prior Findings and Award. The Board's decision clarified Dr. Hatch's appointment date and the scope of her evaluation, ultimately upholding the award for the applicant's lumbar spine surgery based on Dr. Hatch's medical opinions.

AOE/COEUR/IMRRegular PhysicianStipulationPetition for ReconsiderationFindings and AwardLabor Code Section 5701Lumbar Spine SurgeryQualified Medical EvaluatorPrimary Treating Physician
References
23
Case No. ADJ10679103
Regular
Dec 14, 2017

LARRY SYKES vs. THE ANSCHUTZ CORPORATION, STARR INDEMNITY & LIABILITY COMPANY

The Workers' Compensation Appeals Board granted reconsideration of a prior finding of industrial injury to the applicant's lumbar spine. The Board found that the existing medical reporting from Dr. Hong, Dr. Jamasbi, and the PQME Dr. Schofferman did not constitute substantial evidence to support this lumbar spine injury finding. Therefore, the case is returned to the trial level to develop the record further on the lumbar spine injury issue.

Workers' Compensation Appeals BoardPetition for ReconsiderationIndustrial InjuryCervical SpineThoracic SpineLumbar SpineStagehandSecurity OfficerMedical Treatment RecordsSubstantial Evidence
References
0
Case No. ADJ10384099
Regular
Jan 29, 2018

RODOLFO RODRIGUEZ vs. ROBERT BOSCH AFTERMARKET DIVISION, ZURICH NORTH AMERICA

The Appeals Board granted reconsideration to amend the finding of fact, clarifying that the applicant sustained a compensable injury to his lumbar spine arising out of and occurring within the course of employment. While medical evidence supported the lumbar spine injury, the Board deferred the issue of lower extremities as an injured body part for further development. This decision affirmed the original finding regarding the lumbar spine, based on applicant's credible testimony and medical opinions from Drs. Hutchinson and Schaffzin.

AOE/COELumbar spineLower extremitiesPetition for ReconsiderationFinding of FactWCJMedical evidencePreexisting conditionAggravationLighting up
References
14
Case No. AD10769216
Regular
Dec 13, 2019

Richard Hovannisian vs. UCLA, Permissibly Self-Insured, Administered By SEDGWICK CMS

The WCAB granted reconsideration and deferred issues of lumbar spine injury and permanent disability from a prior award. The WCJ's decision relied on a QME report that failed to establish industrial causation for the lumbar spine injury and lacked sufficient explanation for departing from AMA Guides methodology for permanent disability ratings. The Board found these deficiencies meant the decision was not based on substantial medical evidence. Further proceedings are required for the QME to adequately address causation, rating methodology, and lumbar spine classification.

WCABPetition for ReconsiderationFindings of Fact & Awardindustrial injurylumbar spinepermanent disabilitysubstantial medical evidencedue processDisability Evaluation Unitpanel qualified medical evaluator
References
4
Case No. 2024 NY Slip Op 00599 [224 AD3d 428]
Regular Panel Decision
Feb 06, 2024

Matter of New Millennium Pain & Spine Medicine, P.C. v. Garrison Prop. & Cas. Ins. Co.

This case involves two appeals by New Millennium Pain & Spine Medicine, P.C. against Garrison Property & Casualty Insurance Company and GEICO Casualty Company. New Millennium sought to vacate master arbitration awards that denied its claims for no-fault benefits for medical services. The Supreme Court denied these applications. The Appellate Division, First Department, affirmed the Supreme Court's decisions, stating that an arbitrator's award will not be set aside unless it is irrational. The court also addressed the argument regarding a 20% wage offset in no-fault benefits, finding it unavailing under Insurance Law § 5102 (b). Ultimately, New Millennium was not entitled to attorneys' fees as it was not the prevailing party.

No-fault benefitsarbitration awardvacaturinsurance lawwage offsetappellate reviewmedical servicesno-fault policy exhaustionattorneys' feesCPLR Article 75
References
8
Case No. ADJ8413521
Regular
Apr 13, 2020

STEVEN KING vs. COUNTY OF SAN BERNARDINO

This Workers' Compensation Appeals Board case involves applicant Steven King's claims for injury arising out of and occurring in the course of employment, including bilateral shoulders, lumbar spine, cardiac system, hernia, skin disorder, hearing loss, and hypertension. The Board affirmed the finding of injury AOE/COE and the hypertension rating but remanded the case for further development of the record regarding the applicant's lumbar spine impairment. The administrative law judge's prior rejection of the Agreed Medical Examiner's (AME) supplemental opinion on lumbar spine disability was deemed an improper disregard of substantial medical evidence.

Workers' Compensation Appeals BoardPetition for ReconsiderationAmended Findings and Awardinjury arising out of and occurring in the course of employmentbilateral shoulderslumbar spinecardiac systemherniaskin disorderhearing loss
References
8
Case No. ADJ13002649, ADJ13002697
Regular
Oct 20, 2025

LORENZO TORRES vs. KOOS MANUFACTURING COMPANY, INC.; SAFETY NATIONAL CASUALTY COMPANY

The Workers' Compensation Appeals Board denied defendant's Petition for Reconsideration of a Joint Findings and Award (F&A) issued on July 21, 2025. The F&A, authored by a Workers' Compensation Judge, found that applicant Lorenzo Torres sustained injuries arising out of and in the course of employment (AOE/COE) to his lumbar spine and psyche (ADJ13002649), with the psychological injury not precluded by a good faith personnel action defense, resulting in temporary partial disability and 14% permanent disability to the lumbar spine. Additionally, applicant sustained AOE/COE injuries to his right and left shoulders (ADJ13002697), leading to 3% and 4% permanent disability respectively. Defendant challenged these findings, arguing insufficient evidence for the psyche injury, unjustified temporary partial disability, a lower lumbar spine impairment, and no industrial shoulder injury. The Appeals Board reviewed the matter, including the WCJ's Report and Recommendation, and found the WCJ's conclusions to be supported by substantial evidence. Consequently, the Board affirmed the original F&A and denied the reconsideration petition.

AOE/COEGood Faith Personnel Action DefensePsychological InjuryLumbar Spine InjuryShoulder InjuryTemporary Partial DisabilityPermanent DisabilityApportionmentQualified Medical EvaluatorSubstantial Evidence
References
11
Case No. 2022 NY Slip Op 06530 [210 AD3d 1269]
Regular Panel Decision
Nov 17, 2022

Matter of Nunez v. Young Men's Christian Assn. of Greater N.Y.

Fernando Nunez, a maintenance worker, sustained work-related injuries in July 2018. Following an at-home incident in March 2019 that he claimed exacerbated his condition, a Workers' Compensation Law Judge initially awarded him indemnity benefits. However, the Workers' Compensation Board later modified this decision, ruling that Nunez failed to provide sufficient and credible evidence of a causally-related disability after March 24, 2019, and denied authorization for lumbar spine surgery. Nunez appealed both Board decisions. The Appellate Division affirmed the Board's findings, emphasizing the Board's authority to resolve factual issues and evaluate the credibility of medical evidence, especially when based on incomplete claimant histories, thereby upholding the denial of further benefits and surgery.

CausationDisability BenefitsMedical EvidenceBoard ReviewAppellate ReviewHerniated DiscLumbar SpineIndependent Medical ExaminationIncomplete Medical HistoryCredibility of Evidence
References
9
Case No. MISSING
Regular Panel Decision

Claim of Porter v. New York State Electric & Gas Corp.

The claimant, who sustained head, neck, and back injuries in 2004, had a workers' compensation case established for occupational disease, with 22.5% liability for neck and back injuries apportioned to the incident. After experiencing continued back problems and being diagnosed with severe biforaminal stenosis, the Chair authorized an MRI in 2010 and lumbar spine surgery in 2011. The workers’ compensation carrier sought to transfer liability to the Special Fund for Reopened Cases under Workers' Compensation Law § 25-a, a request initially denied by a WCLJ but granted by the Board, which found the April 27, 2011 order authorizing surgery constituted a 'true closing' of the case. The Special Fund appealed the Board's decision, arguing against the transfer of liability. The appellate court affirmed the Board's decision, concluding that substantial evidence supported the finding that the case was truly closed, thereby shifting liability to the Special Fund.

Workers' Compensation Law § 25-aSpecial Fund for Reopened CasesLiability ShiftClosed CaseTrue ClosingMedical AuthorizationLumbar Spine SurgeryCervical Spine MRIOccupational DiseaseApportionment
References
8
Case No. ADJ790852
Regular
Apr 05, 2016

LAURA BREITIGAN vs. COUNTY OF RIVERSIDE

The Workers' Compensation Appeals Board granted the applicant's petition for reconsideration, amending the award to include attorney fees on accrued unpaid permanent disability benefits and correcting clerical errors. The Board denied the defendant's petition for reconsideration, upholding the finding of 100% permanent disability and injury to the lumbar spine. The defendant was also admonished for filing a document exceeding the page limit without prior permission. The applicant, a nurse, sustained industrial injuries to her thoracic spine, lumbar spine, and psyche.

Workers' Compensation Appeals BoardLaura BreitiganCounty of RiversideFindings and Awardindustrial injurythoracic spinelumbar spinepsychepermanent disabilityapportionment
References
0
Showing 1-10 of 1,180 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational