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Case Law Database

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

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The Workers' Compensation Appeals Board rescinded the previous award and returned the case for further proceedings because the record was insufficient to determine permanent disability and apportionment.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
Jan 03, 2005

Roberts v. El-Hajal

Plaintiff initiated a medical malpractice lawsuit, alleging that defendant Marlene El-Hajal negligently failed to diagnose a rare seizure disorder in her infant son. The complaint also sought to hold defendant E.J. Noble Hospital vicariously liable for El-Hajal's actions. The Supreme Court granted summary judgment to the hospital, concluding that El-Hajal was an independent contractor and the hospital lacked legal authority to supervise her medical practice. Plaintiff appealed this decision, additionally asserting that a hospital-employed nurse, Joy Markwick, was negligent for not recording and reporting telephone calls. The appellate court affirmed the Supreme Court's judgment, finding no evidence of an employer-employee relationship between the hospital and El-Hajal during the relevant period, and dismissing the claims against the nurse due to insufficient evidence.

Medical MalpracticeVicarious LiabilityIndependent ContractorSummary JudgmentHospital LiabilityPhysician NegligenceNurse NegligenceSeizure DisorderEmployer-Employee RelationshipAppellate Review
References
13
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. MISSING
Regular Panel Decision

Legal Aid Society v. Association of Legal Aid Attorneys

The Legal Aid Society sought a preliminary injunction against the Association of Legal Aid Attorneys and its officers to prevent the disciplining of striking union members who crossed picket lines. The plaintiff also claimed tortious interference and a civil rights conspiracy under 42 U.S.C. § 1985(3) on behalf of itself, non-striking attorneys, and indigent clients. The District Court denied the injunction, finding several impediments to success on the merits. These included the NLRB's primary jurisdiction, the Norris-LaGuardia Act's prohibitions, and the plaintiff's lack of standing for third-party claims. Furthermore, the court determined that the conspiracy allegations under Section 1985(3) were conclusory and lacked substantial merit.

Labor DisputePreliminary InjunctionUnion DisciplinePicket LinesNational Labor Relations Act (NLRA)Norris-LaGuardia ActStanding (Law)Conspiracy (Law)Civil Rights (42 U.S.C. § 1985(3))Tortious Interference
References
32
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. ADJ2337190 (LAO 0829672) ADJ3193895 (LAO 0829673) ADJ187762 (LAO 0829674)
Regular
Apr 21, 2009

OLIVIA HUERTA vs. GMP LABORATORIES, STATE COMPENSATION INSURANCE FUND

This case involves a lien claimant, Dr. Elena Konstat, seeking reconsideration of a Workers' Compensation Appeals Board decision that limited reimbursement for her medical-legal reports. The Board found that the original decision erred in disallowing two of Dr. Konstat's three medical-legal reports. The Board clarified that the Official Medical Fee Schedule for treatment rates does not apply to medical-legal expenses, and the testimony of the defendant's lien negotiator was not substantial evidence. Consequently, the Board granted reconsideration, rescinded the original finding, and substituted a new finding allowing reimbursement for all three of Dr. Konstat's medical-legal reports, with the exact amounts, penalties, and interest to be determined.

Medical-legal lienReconsiderationFindings and AwardIndustrial injuryNervous system injuryPsycheLicensed clinical psychologistMedical-legal expensesOfficial Medical Fee Schedule (OMFS)Compromise and Release (C&R)
References
1
Case No. MISSING
Regular Panel Decision

Goldberg v. Edson

The plaintiffs appealed two orders from the Supreme Court, Rockland County. The first order, dated January 5, 2006, granted summary judgment to defendants Page Edson and the County of Rockland, dismissing the complaint against them regarding claims of legal and medical malpractice. The second order, dated January 23, 2006, granted summary judgment to defendant Elizabeth O’Connor, dismissing the complaint against her for legal malpractice. The appellate court affirmed both orders, finding that Edson and the County were immune from liability under Social Services Law § 419 for reporting suspected child abuse and removing a child, and that O’Connor was not negligent in her legal services.

Legal MalpracticeMedical MalpracticeSummary JudgmentChild Abuse ReportingSocial Services LawImmunityMandated ReportersAppellate ReviewGood FaithNegligence
References
6
Case No. MISSING
Regular Panel Decision
Oct 17, 2012

Douyon v. NY Medical Health Care, P.C.

Plaintiff Gabrielle Douyon sued Seymour Schneider, N.Y. Medical Health Care, P.C., Faraidoon Daniel Golyan, M.D., and Kourosh Golyan, alleging unfair debt collection practices under the FDCPA and NY GBL § 349, along with intentional infliction of emotional distress and negligence. The lawsuit stemmed from attempts to collect an alleged medical debt following Douyon's emergency heart surgery performed by Dr. Golyan. Both parties sought summary judgment. The court granted Plaintiff partial summary judgment on FDCPA violations related to statutory disclosures and a threatening voicemail. However, many other FDCPA and NY GBL claims were denied due to factual disputes, and the intentional infliction of emotional distress claim was dismissed for lack of medical evidence, with negligence claims partially allowed to proceed on the basis of fear for physical safety.

Fair Debt Collections Practices ActNew York General Business Law § 349Debt CollectionSummary JudgmentEmotional DistressNegligenceAgency RelationshipVicarious LiabilityFreelance Debt CollectorUnfair and Deceptive Practices
References
105
Case No. ADJ11255525
Regular
Dec 02, 2019

GWENDOLYN JOHNIGAN vs. UC DAVIS MEDICAL CENTER

This case involves an applicant denied workers' compensation benefits for industrial injury to her right leg and knee, with the Workers' Compensation Appeals Board (WCAB) denying her petition for reconsideration. The WCAB adopted the administrative law judge's finding that the applicant did not sustain industrial injury, relying on a panel qualified medical evaluator's opinion that the work duties were insufficient to cause an injury. The applicant argued the medical evidence was not substantial and sought further development of the record. However, the WCAB found the applicant failed to meet her burden of proof with substantial medical evidence. A dissenting opinion argued the medical evidence was insubstantial and required further development.

Petition for ReconsiderationPanel Qualified Medical EvaluatorOrthopedistSubstantial Medical EvidenceFurther DevelopmentSupplemental ReportingDeposition TestimonyIndustrial InjuryRight LegRight Knee
References
4
Case No. ADJ9539091
Regular
Sep 23, 2016

MARY RAMSGARD vs. PACIFIC VINEYARD COMPANY, INSURANCE COMPANY OF THE WEST

The Workers' Compensation Appeals Board denied reconsideration, affirming the WCJ's finding that applicant's L3-4 back injury was not industrially caused, based on Dr. Sharma's opinion. Dr. Sharma's opinion was found to be substantial evidence, utilizing the correct legal standard of reasonable medical probability and supported by the applicant's pre-existing back issues. The Board also upheld the 20% apportionment of permanent disability to non-industrial causes, finding it supported by credible evidence, including prior medical reports and applicant's inconsistent testimony. Applicant's petition failed as her contentions regarding the medical opinion's legal theory and factual basis were not substantiated.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardAdministrative Law JudgeApplicantDefendantPacific Vineyard CompanyInsurance Company of the WestPermanent DisabilityApportionment
References
10
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