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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

Claim of Good v. Town of Brutus

A claimant, employed as a court clerk since 2002, developed carpal tunnel syndrome and filed a workers’ compensation claim in 2007, which was established as an occupational disease. She was awarded a 25% schedule loss of use of the left hand. The employer’s workers’ compensation carrier sought apportionment of liability with her two most recent prior employers under Workers’ Compensation Law § 44. A Workers’ Compensation Law Judge and the Board denied this request, finding no medical evidence of the condition arising from prior employment. The Appellate Division affirmed the Board’s determination, stating that despite the claimant experiencing symptoms previously and an independent medical examiner suggesting apportionment, there was no objective medical proof that she contracted the condition while working for a previous employer. The court emphasized that the focus for apportionment is whether the claimant contracted the occupational disease during that specific employment.

Occupational DiseaseCarpal Tunnel SyndromeApportionment of LiabilityWorkers' Compensation Law § 44Prior EmployersMedical EvidenceIndependent Medical ExaminerSchedule Loss of UseWorkers' Compensation BoardAppellate Review
References
3
Case No. MISSING
Regular Panel Decision

Claim of Rafferty v. Four Corners, LLC

Claimant sustained two work-related back injuries, one in 1996 causing permanent partial disability and another in 2003 affecting his back and neck. A Workers’ Compensation Law Judge determined that claimant had a marked partial disability and apportioned it equally between both accidents. The Workers’ Compensation Board affirmed this apportionment decision, prompting the claimant's appeal. The Appellate Division affirmed the Board's finding, concluding that substantial medical evidence and the claimant's work history supported the application of apportionment for his current disability. The finding of apportionment, however, did not extend to medical treatment for the claimant's neck and upper right extremity.

ApportionmentDisabilityWorkers' Compensation AwardWork-Related InjuryBack InjuryNeck InjuryPermanent Partial DisabilityMedical EvidencePrior Compensable InjurySocial Security Disability Benefits
References
3
Case No. SFO 0459441
Regular
Mar 11, 2008

FRANK DEOME vs. CALIFORNIA MEDICAL CENTER, INNOVATIVE CLAIMS SOLUTIONS, INC.

The Workers' Compensation Appeals Board rescinded the previous award and returned the case for further proceedings because the record was insufficient to determine permanent disability and apportionment. The Board found that the WCJ's analysis of apportionment, particularly regarding a prior 1993 injury, was based on insufficient medical evidence and did not align with current legal standards. The case is remanded for further development of the medical record, potentially through an Agreed Medical Evaluation, and the WCJ will revisit all contentions after new evidence is presented.

WORKERS' COMPENSATION APPEALS BOARDDEOMECALIFORNIA MEDICAL CENTERINNOVATIVE CLAIMS SOLUTIONSINDUSTRIAL INJURYBACK SURGERYPERMANENTLY DISABLEDCOMPLEX REGIONAL PAIN SYNDROMEVOCATIONAL REHABILITATIONPERMANENT AND STATIONARY
References
8
Case No. MISSING
Regular Panel Decision

Queens Blvd. Medical, P.C. v. Travelers Indemnity Co.

The plaintiff, Queens Blvd. Medical, P.C., sought $950 in first-party no-fault benefits for biofeedback medical services provided to its assignor for lower back and chronic pain syndrome. The central issue at trial was the medical necessity of these services under Insurance Law § 5102 (a) (1). The plaintiff established a prima facie case with expert testimony from a board-certified neurologist affirming the medical appropriateness of biofeedback. The defendant insurance company failed to present admissible evidence to disprove medical necessity, as its expert was deemed incompetent to testify on biofeedback for back pain. Consequently, the court granted the plaintiff's motion for a directed verdict, awarding judgment for $950 along with statutory costs, interest, and attorney's fees.

No-fault benefitsMedical necessityBiofeedback treatmentExpert testimonyDirected verdictInsurance lawChronic pain syndromeBack injuryCPT codesBurden of proof
References
9
Case No. ADJ1332200 (LAO 0710157) ADJ1749454 (LAO 0753825) ADJ1723599 (LAO 0710158)
Regular
Nov 11, 2011

EARLIE CHAMBERLAIN vs. CEDAR SINAI MEDICAL CENTER

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior award, finding insufficient medical evidence to determine industrial psychiatric injury due to incomplete records requested by both treating physicians. The Board also noted the WCJ may have misapplied the *Benson* doctrine regarding apportionment of the psychiatric injury across three separate industrial incidents. The case is returned to the trial level for further proceedings to develop the medical record and properly address causation and apportionment issues.

Workers' Compensation Appeals BoardCedars Sinai Medical Centernursing communications technicianindustrial injurybilateral kneesbackteethjawdenturesleft upper extremity
References
2
Case No. MISSING
Regular Panel Decision

Claim of Cummins v. North Medical Family Physicians

A claimant sustained a work-related back injury and sought continued medical treatment, which was initially authorized. Disputes over authorization led the claimant to retain an attorney. A Workers’ Compensation Law Judge authorized continued medical treatment but denied counsel fees, stating no "money passing" occurred. The Workers' Compensation Board upheld this decision. The claimant appealed, arguing the Board unconstitutionally applied Workers’ Compensation Law § 24, misinterpreted the statute regarding fee payment from medical benefits, and abused its discretion. The appellate court affirmed the Board's decision, ruling that counsel fees must be paid from "compensation," defined as a money allowance, and medical benefits are not considered "compensation" for this purpose, thus finding no abuse of discretion.

Workers' CompensationCounsel FeesAttorney FeesMedical TreatmentStatutory InterpretationConstitutional LawLienCompensation DefinitionAppellate ReviewBoard Decision
References
3
Case No. ADJ268422 (MON 0326162-MF) ADJ1140304 (MON 0329012)
Regular
Jul 06, 2016

DAWN LEAH GURITZKY vs. REGENTS OF THE UNIVERSITY OF CALIFORNIA, SANTA MONICA UCLA MEDICAL CENTER

The Workers' Compensation Appeals Board granted reconsideration of a previous award finding the applicant 100% permanently disabled due to two industrial injuries. The defendant argued the judge erred by not properly applying apportionment to non-industrial factors, as required by law and supported by medical opinions. The Board found the medical evidence, particularly Dr. Friedman's, lacked sufficient apportionment analysis and the vocational evaluator's reasoning on total disability needed further clarification. The case was returned to the trial level for further development of the record on these issues.

Workers' Compensation Appeals BoardPetition for ReconsiderationJoint Findings and AwardPermanent DisabilityApportionmentLabor Code section 4663Benson v. The Permanente Medical GroupDr. David FriedmanLuis Mas Ph.D.vocational evaluator
References
2
Case No. MISSING
Regular Panel Decision

Rechenberger v. Nassau County Medical Center

Edward Rechenberger suffered hip fractures and underwent two operations at Nassau County Medical Center in May 1982. Following a re-injury and later diagnosis, he learned the surgical hardware was improperly implanted, leading to further operations. Mr. Rechenberger sought leave to serve a late notice of claim against the medical center. The Supreme Court initially denied the motion, but the Appellate Division reversed this decision, finding that the hospital had actual knowledge of the essential facts of the claim within the statutory 90-day period through its own medical records. The court concluded that the delay in serving the notice of claim was not substantially prejudicial to the hospital, and thus, granted the petitioners leave to serve the late notice of claim.

Medical MalpracticeLate Notice of ClaimNassau CountyHip FractureSurgical ErrorContinuous Treatment DoctrineActual NoticePrejudiceAppellate ReviewMunicipal Corporation
References
11
Case No. MISSING
Regular Panel Decision
Feb 10, 2017

Mitchell v. SUNY Upstate Medical University

Plaintiff Robbie Mitchell sued SUNY Upstate Medical Center for alleged Title VII violations, including race discrimination and retaliation, after experiencing a series of adverse employment actions. These actions included reassignment, disciplinary notices (NODs), a mandatory medical examination, a formal counseling memorandum, a verbal dispute, and eventual termination. The defendant moved for summary judgment, arguing the plaintiff failed to establish a prima facie case for most claims and that their actions were based on legitimate, non-discriminatory reasons. The court granted summary judgment in favor of SUNY Upstate Medical Center, concluding that the plaintiff failed to provide sufficient evidence of discrimination or that retaliation was the but-for cause of the challenged employment actions, and consequently, the case was closed.

Title VIICivil Rights ActEmployment DiscriminationRetaliationSummary JudgmentAdverse Employment ActionMcDonnell Douglas FrameworkWorkplace ConductDisciplinary ActionPaid Administrative Leave
References
49
Case No. MISSING
Regular Panel Decision

Claim of Huss v. Tops Markets, Inc.

In 1985, claimant sustained a right shoulder injury while employed by Dunlop Tire, resulting in a permanent partial disability. In 1998, he re-injured the same shoulder while working for Tops Markets, Inc., leading to a new workers' compensation claim. An impartial specialist attributed 85% of the disability to the 1985 injury and 15% to the 1998 injury. Although a Workers' Compensation Law Judge initially rejected apportionment, the Board reversed and applied the 85/15 apportionment. Claimant appealed, contending apportionment was unwarranted due to his disclosure of the prior injury and lack of prior disability symptoms. The Appellate Division affirmed the Board's decision, finding substantial medical evidence to support the apportionment.

Workers' CompensationPermanent Partial DisabilityApportionmentPrior InjuryShoulder InjuryCausal RelationshipMedical Expert TestimonyBoard DecisionAppellate ReviewExacerbation
References
3
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