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

Case No. ADJ4452274 (RIV 0073355)
Regular
Nov 29, 2010

JOHN MCCOY vs. COUNTY OF SAN BERNARDINO, PSD CHILD; COUNTY OF SAN BERNARDINO

The Workers' Compensation Appeals Board granted reconsideration, finding the WCJ erred in applying the good faith personnel action defense to the applicant's migraine headaches. While the WCJ correctly denied the psychiatric injury claim under Labor Code section 3208.3(h), the Board determined this defense does not bar compensation for temporary disability or medical treatment caused by the industrially-related migraines. The case is remanded for further proceedings to award benefits for the applicant's migraines as supported by the Agreed Medical Evaluator's findings.

Workers' Compensation Appeals BoardGood Faith Personnel Action DefenseLabor Code Section 3208.3(h)Agreed Medical EvaluatorMigraine HeadachesPsychiatric InjuryIndustrial RelationTemporary Total DisabilityCompensable PeriodMedical Treatment
References
1
Case No. MISSING
Regular Panel Decision

Rorick v. Colvin

Kortney Rorick sought judicial review of the Commissioner of the Social Security Administration's decision denying her application for Social Security Disability and Supplemental Security Income payments. This is Rorick's second attempt at judicial review, following a prior remand in "Rorick I". The current hearing officer again denied benefits, prompting Rorick to ask the Court to reverse or remand. The Court reviewed the hearing officer's findings on residual functional capacity, the severity of migraines, and the step-five determination. Ultimately, the Court found substantial evidence supported the hearing officer's conclusions, including the determination that Rorick's migraines were not a severe impairment, and that the use of medical vocational guidelines was permissible. The Court affirmed the Commissioner's decision and dismissed Rorick's complaint.

Social Security ActDisability BenefitsSupplemental Security IncomeJudicial ReviewResidual Functional CapacityMigraine HeadachesMental ImpairmentsTreating Physician RuleGlobal Assessment of Functioning (GAF)Vocational Expert
References
25
Case No. MISSING
Regular Panel Decision
Sep 29, 2014

Hairston v. Commissioner of Social Security

Denise M. Hairston, on behalf of her minor daughter S.N., sought judicial review of a final decision by the Commissioner of the Social Security Administration, which denied S.N.'s application for Supplemental Security Income (SSI) benefits. S.N. alleged disability due to various impairments, including migraine headaches, obesity, impulse control disorder NOS, and depressive disorder NOS, leading to functional limitations. The Administrative Law Judge (ALJ) found that S.N.'s impairments were severe but did not meet or medically equal a listed impairment, and functionally equaled only a "marked" limitation in the "caring for yourself" domain, thus denying benefits. The United States Magistrate Judge Frank Maas denied the Commissioner's motion for judgment on the pleadings, concluding that the ALJ's finding regarding S.N.'s health and physical well-being domain did not withstand scrutiny and required further fact-finding regarding the frequency and intensity of her migraines. The case was remanded to the Commissioner for further proceedings, including obtaining additional school and medical records, and ensuring the claimant's understanding and waiver of the right to counsel.

Social Security BenefitsSupplemental Security Income (SSI)Child DisabilityDepressive Disorder NOSMigraine DisorderObesityFunctional ImpairmentAdministrative Law Judge (ALJ)Judicial ReviewRemand Order
References
34
Case No. MISSING
Regular Panel Decision

Claim of Coleman v. Schenectady County Department of Social Services

A child support investigator filed for workers' compensation benefits, claiming work-related stress caused anxiety, migraines, hypertension, and insomnia. The employer's failure to file a prehearing conference statement led the Workers’ Compensation Law Judge to establish the claim, which the Workers’ Compensation Board affirmed. On appeal, the court determined that the claimant still needed to prove the stress was greater than that experienced by similarly situated workers. The submitted medical reports lacked this evidence. Consequently, the court reversed the Board's decision and remitted the case for further proceedings to develop the record on the compensability issue.

Workers' CompensationStress ClaimWork-Related InjuryWaiver of DefensesPrehearing ConferenceSubstantial EvidenceMedical ReportsAppellate ReviewRemittalAnxiety
References
7
Case No. MISSING
Regular Panel Decision

Matter of Strujan v. New York Hospital

The case involves appeals from decisions of the Workers’ Compensation Board regarding a claimant's 1997 work-related injury. A claim for consequential psychiatric injuries was denied in 2010, and the employer sought to transfer liability to the Special Fund for Reopened Cases under Workers’ Compensation Law § 25-a. While a WCLJ initially granted this transfer, the Board reversed, concluding the case was not 'truly closed' due to unresolved issues, including the claimant's alleged migraines. The court affirmed the Board's decision, finding substantial evidence to support that the case was not truly closed, thereby preventing the shift of liability to the Special Fund.

Workers' CompensationSpecial FundReopened CasesTrue ClosureLiability ShiftMigrainesPsychiatric InjuryConsequential InjuryBoard DecisionAppellate Review
References
9
Case No. 535539
Regular Panel Decision
Aug 03, 2023

In the Matter of the Claim of Zemira Sakanovic

Zemira Sakanovic appealed a Workers' Compensation Board decision denying her claim for a causally-related psychological injury stemming from work-related stress. Sakanovic experienced anxiety, stress, and elevated blood pressure after a text-based Skype conversation with her supervisor, leading to an emergency room visit and diagnoses of hypertension and migraine. The Board, affirming a WCLJ, ruled that her work-related stress was not greater than that experienced by similarly situated workers and that no physical injury resulted from the alleged increase in stress. The Appellate Division, Third Judicial Department, affirmed the Board's decision, deferring to the factual finding that the pressures encountered by Sakanovic were not exceptional. Consequently, the court upheld the denial of her claim for workers' compensation benefits.

Workers' CompensationPsychological InjuryWorkplace StressCausal RelationshipAppellate ReviewHypertensionAnxietyMental HealthGood-Faith Personnel DecisionSimilarly Situated Workers
References
20
Case No. E2015-01653-COA-R3-CV
Regular Panel Decision
Aug 31, 2016

Eric G. Glasgow v. K-VA-T Food Stores, Inc.

Eric G. Glasgow sued K-VA-T Food Stores, Inc. in a premises liability action after suffering injuries from a fall in a grocery store restroom. Glasgow alleged negligence, claiming a handrail detached from the wall, causing him to fall and develop chronic migraines. A jury initially awarded $350,000 in damages, which the trial court reduced to $250,000. K-VA-T Food Stores, Inc. appealed, arguing the reduced award lacked material evidence. The Court of Appeals of Tennessee at Knoxville affirmed the trial court's judgment, concluding that material evidence, including Glasgow's significant lifestyle changes and permanent predisposition to pain, supported the damages award.

Premises liabilityPersonal injuryJury verdictCompensatory damagesMigrainesPost-concussion syndromeNegligenceAppellate reviewMaterial evidenceRemittitur
References
9
Case No. MISSING
Regular Panel Decision
Nov 09, 2016

Kollmer v. Jackson Tennessee Hospital Co., LLC

Denise Kollmer sued Regional Hospital of Jackson for employment discrimination under the Americans with Disabilities Act (ADA), alleging wrongful termination after a drug test. Kollmer claimed her prescribed medication (Fioricet, containing butalbital) caused a false positive for phenobarbital, which she denied ingesting. She also argued the drug test constituted an illegal medical examination under the ADA. The court granted the defendant's motion for summary judgment, ruling that Kollmer failed to establish a prima facie case for disability discrimination or failure to accommodate because she could not show the employer knew of her alleged disability (migraine headaches) prior to the termination decision. The court also rejected the illegal medical examination claim as improperly raised at the summary judgment stage.

Employment DiscriminationAmericans with Disabilities ActADASummary JudgmentDrug TestingFalse PositivePhenobarbitalButalbitalMedical ExaminationDisability Discrimination
References
17
Case No. 2018-05-1146
Regular Panel Decision
Sep 06, 2019

Polk, Cornelius v. Sundowner Mgmt. Group

This case involved Cornelius Polk, an employee who sustained a head injury during a robbery and sought Botox injections for intractable chronic migraines, as recommended by his authorized physician, Dr. Elizabeth Null. His employer, Sundowner Management Group, and its carrier, Security National Insurance Co., denied the injections based on utilization review reports, citing a lack of medical necessity and deviation from treatment guidelines. The Court found that Mr. Polk failed to demonstrate entitlement to the benefits at this stage, as the recommended treatment did not meet specific guideline requirements for prior first-line medications. The Court also criticized Sundowner for violations of utilization review rules, referring the matter to the penalty unit, and denied Mr. Polk’s request for attorney fees at this expedited hearing.

Workers' CompensationExpedited HearingMedical NecessityBotox InjectionsChronic MigraineUtilization ReviewAttorney FeesHead InjuryPTSDTreatment Guidelines
References
4
Case No. MISSING
Regular Panel Decision

Matter of Bland v. Gellman, Brydges & Schroff

This case involves consolidated appeals from several decisions by the Workers’ Compensation Board concerning a claimant. The appeals address issues such as a variance request for aquatic therapy for thoracic outlet syndrome, the causal relationship of fibromyalgia and myofascial pain syndrome, the degree of partial impairment and loss of wage-earning capacity, entitlement to Botox therapy for migraines, and reimbursement for medical and travel expenses. The Court affirmed the Board's findings regarding the application of Shoulder Injury Medical Treatment Guidelines, the denial of aquatic therapy, the lack of causal relationship for fibromyalgia, the 50% loss of wage-earning capacity, and the denial of reconsideration for medical/travel expenses and labor market attachment. One appeal related to fibromyalgia care and Botox therapy was dismissed as the claimant was no longer aggrieved.

Workers' CompensationAppellate ReviewAquatic TherapyThoracic Outlet SyndromeFibromyalgiaMyofascial Pain SyndromeWage-Earning CapacityMedical Treatment GuidelinesVariance RequestReconsideration
References
23
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