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Case Law Database

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

Case No. ADJ8252446
Regular
Sep 09, 2014

DANIEL MARTIN vs. CITY OF RICHMOND

The WCAB dismissed the defendant's petition for reconsideration because it challenged an interim order, not a final decision. The Board granted removal on its own motion to address the administrative law judge's finding that the defendant's utilization review (UR) suffered a material procedural defect. The WCAB rescinded the judge's decision, finding the UR was not procedurally defective, and determined the medical treatment dispute should be resolved through Independent Medical Review (IMR).

Workers Compensation Appeals BoardUtilization ReviewMaterial Procedural DefectIndependent Medical ReviewPetition for ReconsiderationRemoval on Board MotionDecision After RemovalFindings and OrderRequest for AuthorizationTreating Physician
References
7
Case No. CA 10-01067
Regular Panel Decision
Apr 01, 2011

TIMMONS, JOSEPH v. BARRETT PAVING MATERIALS, INC.

Joseph Timmons sustained injuries while working on property owned by Barrett Paving Materials, Inc., leading to a lawsuit alleging Labor Law violations. Barrett Paving then initiated a third-party action against Timmons' employer, Schneider Brothers Corporation, and a separate action against Colony Insurance Company. The Supreme Court granted Barrett's motion for summary judgment, dismissing the Labor Law claims in Action No. 1, and denied Colony's motion in Action No. 2, declaring Barrett an additional insured. The Appellate Division affirmed the lower court's judgment, concluding that Labor Law §§ 240(1), 241(6), and 200 were inapplicable to the facts of the case. The court also affirmed Schneider's duty to defend Barrett and Colony's obligation to provide coverage to Barrett as an additional insured.

Labor LawSummary JudgmentAppellate DivisionWorkers' Compensation LawIndustrial Code RegulationsCommon-Law NegligenceContractual IndemnificationAdditional Insured EndorsementConstruction Site SafetyGravity-Related Accidents
References
23
Case No. ADJ4274323 (ANA 0387677), ADJ1601669 (ANA 0388466)
Significant
Feb 27, 2014

Jose Dubon, Applicant vs. World Restoration, Inc. and State Compensation Insurance Fund

The Appeals Board held that disputes over the timeliness and procedural compliance of utilization review (UR) are legal issues for the WCAB to decide, not matters for independent medical review (IMR). A UR decision is invalid if it has material procedural defects, such as failing to review adequate medical records.

Workers' Compensation Appeals BoardUtilization ReviewIndependent Medical ReviewProcedural DefectsMedical NecessityEn Banc DecisionAdministrative Director's RulesSubstantial Medical EvidenceTimelinessMaterial Procedural Defects
References
16
Case No. ADJ4274323 (ANA 0387677), ADJ1601669 (ANA 0388466)
En Banc
Feb 27, 2014

JOSE DUBON vs. WORLD RESTORATION, INC.; STATE COMPENSATION INSURANCE FUND

The WCAB holds that it has jurisdiction over disputes regarding the procedural validity and timeliness of utilization review (UR) decisions, while Independent Medical Review (IMR) is solely for resolving medical necessity. A UR decision with material procedural defects is invalid, and in such cases, the WCAB, not IMR, will determine the medical necessity of the treatment.

Utilization ReviewIndependent Medical ReviewEn Banc DecisionWCAB JurisdictionProcedural DefectsMedical NecessityLabor Code Section 4610Substantial Medical EvidenceMaterial Procedural DefectsInvalid UR Decision
References
17
Case No. MISSING
Regular Panel Decision

Sciurca v. Chrysler Motor Corp.

This is a products liability action filed in federal court based on diversity of citizenship. The unnamed plaintiff, a mechanic employed by World Chrysler Plymouth Inc. in Brooklyn, New York, was injured when a 1986 Dodge Ramcharger, owned by Ronald Conforti, lurched forward while a co-worker attempted to start it in gear without depressing the clutch. The plaintiff sued Chrysler Motor Corp., the manufacturer of the Ramcharger, alleging strict products liability based on defective design and failure to warn. Chrysler and third-party defendant Conforti moved for summary judgment. The court denied Chrysler's motion, finding genuine issues of material fact regarding the alleged design defect (lack of an 'innerlock' device) and failure to warn. Conforti's motion for summary judgment was denied without prejudice due to procedural deficiencies, including a lack of admissible evidence and non-compliance with local rules.

Products LiabilityDesign DefectFailure to WarnSummary JudgmentProximate CauseStrict LiabilityAutomobile AccidentMechanic InjuryFederal JurisdictionNew York Law
References
14
Case No. MISSING
Regular Panel Decision

Sherman v. A.J. Pegno Construction Corp.

This case involves two separate actions, the "Sherman Action" and the "Alexander Action," that were removed from the Supreme Court of the State of New York, County of New York, to federal court by defendants Ford Motor Co. and General Motors Corp. The plaintiffs, Moses and Leola Sherman, and John Alexander, sought damages for personal injuries allegedly caused by exposure to asbestos-containing materials. Defendants claimed federal jurisdiction based on complete diversity, asserting that a non-diverse defendant, Union Carbide (UC), was fraudulently joined. The Court found a lack of complete diversity at the time of removal and rejected the fraudulent joinder argument against UC, stating that post-removal settlements cannot cure a defective removal. Furthermore, the Alexander Action's removal was deemed procedurally defective due to the lack of consent from International Truck and Engine Corporation. Consequently, the Court granted both plaintiffs' motions to remand their respective actions back to the New York State Supreme Court. The Shermans' request for costs and attorneys' fees was denied, but Alexander's request was granted.

Asbestos exposurePersonal injuryRemoval jurisdictionDiversity jurisdictionFraudulent joinderRemand to state courtSubject matter jurisdictionRule of unanimityAttorneys' feesProduct liability
References
47
Case No. ADJ2661083 (AHM 0097587) ADJ2316310 (AHM 0088976)
Regular
Oct 06, 2014

GENEEN RODRIGUEZ vs. STATEK CORPORATION, ACE USA

This case involves defendant Statek Corporation's petition for reconsideration of an award granting applicant Geneen Rodriguez a spinal cord stimulator. The Administrative Law Judge found the utilization review (UR) determination materially defective due to communication issues and the reviewer's specialty. The Appeals Board granted reconsideration, rescinded the award, and found the UR determination was not materially defective. The Board concluded that any alleged defects were not significant enough to bypass the Independent Medical Review (IMR) process.

Utilization ReviewSpinal Cord StimulatorMaterially DefectiveIndependent Medical ReviewLabor Code Section 4610Medical NecessityCompetency of ReviewerInternal MedicineTimely CommunicationDubon v. World Restoration
References
2
Case No. MISSING
Regular Panel Decision

Matter of Campbell v. Interstate Materials Corporation

The claimant, an operating manager for Interstate Materials Corporation, suffered injuries to his neck, back, and knees in August 2006 and a second lower back injury in April 2008. A Workers' Compensation Law Judge initially classified the claimant with a permanent total disability and struck the independent medical examiner's report. The Workers' Compensation Board reversed this, finding the IME report improperly precluded due to the examiner's hospitalization and reclassified the claimant with a permanent partial disability, equally apportioned between the two accidents. The Appellate Division affirmed the Board's decision, finding no abuse of discretion in considering the IME report and that substantial evidence supported both the permanent partial disability classification and the equal apportionment of the disability.

Permanent Partial DisabilityPermanent Total DisabilityWorkers' Compensation BoardApportionment of DisabilityMedical EvidenceIndependent Medical Examination (IME)Cross-Examination RightsAbuse of DiscretionSubstantial EvidenceConflicting Medical Opinions
References
12
Case No. MISSING
Regular Panel Decision

Peckham v. Peckham Materials Corp.

This case involves an appeal by the defendant, Peckham Materials Corporation, in a wrongful death action. The plaintiff's decedent, John S. Peckham, was killed in a helicopter crash while a passenger in a company-owned helicopter. The defendant appealed an order from the Supreme Court, Westchester County, which granted the plaintiff's motion for partial summary judgment, striking the affirmative defense of workers' compensation. The Appellate Division reversed the order, holding that the Workers' Compensation Board has primary jurisdiction to determine the applicability of compensation benefits. The matter was remitted to the Supreme Court with instructions to defer the motion's disposition until the Workers' Compensation Board makes a final determination regarding the plaintiff's eligibility for benefits.

Wrongful DeathWorkers' CompensationPrimary JurisdictionSummary JudgmentAppellate ReviewHelicopter AccidentEmployer LiabilityJudicial DeferenceRemittalEstate Claim
References
4
Case No. 2020 NY Slip Op 00202 [179 AD3d 1277]
Regular Panel Decision
Jan 09, 2020

Matter of Angarano v. Crucible Materials Corp.

The claimant, Paul Angarano, appealed a Workers' Compensation Board decision that denied review of a Workers' Compensation Law Judge's ruling. The Board denied review because the claimant's counsel failed to properly complete the RB-89 form, merely referencing an attached brief for substantive information instead of filling out the required sections. The Appellate Division, Third Department, affirmed the Board's decision, stating that the Board acted within its discretionary authority in denying the application due to non-compliance with procedural formatting requirements for the RB-89 form.

Procedural ComplianceRB-89 FormApplication DeficiencyDiscretionary AuthorityWorkers' Compensation RegulationsAppellate ReviewAdministrative AppealFormal RequirementsDenial of ApplicationCase Law Affirmation
References
7
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