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

Case No. MISSING
Regular Panel Decision

Main Evaluations, Inc. v. State

The claimant, Main Medical Evaluations, entered into contracts with the New York State Office of Temporary and Disability Assistance (OTDA) to perform consultative medical evaluations. OTDA terminated these contracts, alleging the claimant failed to disclose professional disciplinary proceedings against its chief medical officer, Arvinder Sachdev, and submitted false information during the bidding process. Following the dismissal of its claim in the Court of Claims, the claimant appealed. The appellate court affirmed the lower court's judgment, concluding that OTDA had legitimate grounds for termination due to the claimant's misrepresentations and failure to report substantial contract-related issues concerning Sachdev's integral role. Additionally, the court rejected the claimant's equal protection argument, finding no evidence of selective enforcement based on impermissible considerations.

Contract TerminationProfessional MisconductFalse RepresentationEqual ProtectionGovernment ContractsAppellate ReviewBreach of ContractMedical LicensingAdministrative ProceedingsDue Diligence
References
5
Case No. MISSING
Regular Panel Decision

55th Management Corp. v. Goldman

This case addresses whether an out-of-court statement made to a court evaluator in an Article 81 guardianship proceeding is protected by absolute privilege, thereby defeating a defamation claim. The defendant, a tenant, made allegedly defamatory remarks about a landlord to a court evaluator during the evaluator's investigation for a guardianship proceeding. The court considered if the remarks were pertinent, if a statement to a court evaluator is considered part of a judicial proceeding, and if the speaker had standing. The court found the remarks pertinent, extended the absolute privilege to statements made to court evaluators given their role as court agents, and affirmed the defendant's standing as a potential witness. Consequently, the defendant's motion to dismiss the defamation complaint was granted.

DefamationAbsolute PrivilegeJudicial ProceedingsCourt EvaluatorGuardianshipMental Hygiene Law Article 81Tenant-Landlord DisputeMotion to DismissCPLR 3211 (a) (7)Scope of Privilege
References
44
Case No. ADJ119309 (OAK 0332713) ADJ1352097 (OAK 332714)
Regular
Aug 09, 2011

KEN LAWHN vs. FARMERS INSURANCE, HELMSMAN MANAGEMENT

The Workers' Compensation Appeals Board dismissed the applicant's petition for reconsideration of the WCJ's order compelling a neuropsychological evaluation. The Board determined the WCJ's order was an interim discovery ruling, not a final decision on substantive rights, making it ineligible for reconsideration. The applicant's petition for removal was also denied, adopting the WCJ's reasoning for the original order. The applicant had argued the evaluation was an invasion of privacy and unnecessary as neuropsychological health was not at issue.

Workers' Compensation Appeals BoardNeuropsychological QME evaluationNon-industrial closed head injuryOpen labor marketPetition for ReconsiderationPetition for RemovalFindings and OrderDiscovery orderInterim orderSubstantive rights
References
4
Case No. ADJ11995067
Regular
Jul 25, 2025

ADELINA PEREZ vs. KYONG AE YUN, CHONG MYON YUN, ZENITH INSURANCE COMPANY

Applicant Adelina Perez sought removal of a May 9, 2022, Findings & Order (F&O) by a workers’ compensation administrative law judge (WCJ), which found Dr. Marcel Ponton's medical-legal report inadmissible and ordered his replacement, arguing Dr. Ponton was a treating physician to whom Labor Code section 4062.3 did not apply. The Workers' Compensation Appeals Board (WCAB) treated the petition as one for reconsideration and found that Dr. Ponton was indeed a treating physician, not a panel-selected medical-legal evaluator, rendering section 4062.3 inapplicable. Consequently, the WCAB rescinded the WCJ's F&O, substituted new findings affirming Dr. Ponton's role as a treating physician, and ordered his continuation as the medical-legal neuropsychological evaluator.

RemovalReconsiderationLabor Code section 4062.3Ex parte communicationMedical-legal evaluatorTreating physicianMPNNeuropsychological assessmentTraumatic brain injuryAdmissibility of evidence
References
17
Case No. MISSING
Regular Panel Decision

In re Carew

The court considered two child abuse petitions filed by the Suffolk County Department of Social Services against a father, based on unsworn statements from his three and five-year-old children. The respondent father moved for psychiatric evaluations of the children and their mother to defend against the allegations, citing the need for expert assessment of the children's credibility. The court balanced the children's welfare against the father's right to a fair trial, noting the unique challenges of corroborating out-of-court statements in Article 10 proceedings. The court granted the father's request to the extent of ordering a validation interview for both children, stipulating a court-designated examiner if parties could not agree. The request for the mother's examination was denied due to insufficient justification.

Child AbuseFamily Court ActPsychiatric EvaluationChild CredibilityHearsay TestimonyCorroboration RequirementDue ProcessParental RightsSuffolk CountyUnsworn Statements
References
5
Case No. ADJ519728
Regular
Aug 08, 2011

LOWELL BAPTISTE vs. METROPOLITAN TRANSIT AUTHORITY

The Workers' Compensation Appeals Board granted reconsideration of a prior award finding industrial injury and temporary total disability dating back to 2000. The Board found that the medical opinion relied upon by the workers' compensation judge was not substantial evidence due to staleness, lack of complete records, and insufficient specialization. To ensure a fair resolution, the Board ordered new evaluations by independent orthopedic and psychiatric physicians, who will report on all outstanding medical issues.

Workers' Compensation Appeals BoardReconsiderationCompelling Medical EvaluationsTemporary Total DisabilityIndustrial InjuryOrthopedicsPsychiatrySubstantial EvidenceMedical OpinionWCJ
References
2
Case No. ADJ10356570
Regular
Oct 20, 2017

SYRUS YARBROUGH vs. SOUTHERN GLAZER'S WINE AND SPIRITS, TRUMBALL INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted applicant Syrus Yarbrough's Petition for Removal, rescinding a previous order compelling him to attend an Agreed Medical Evaluator (AME) appointment. The WCAB found that Labor Code section 4067, relied upon by the judge, did not apply as applicant had not yet attended a formal AME evaluation. Furthermore, the WCAB clarified that Labor Code section 4062.2(f) only applies after an AME evaluation has occurred and does not preclude withdrawal from an AME agreement before such an evaluation. The WCAB noted that the applicant could still be ordered to see his regular physician or a Qualified Medical Evaluator.

Petition for RemovalAgreed Medical EvaluatorPetition to CompelMedical ExaminationSignificant PrejudiceIrreparable HarmLabor Code Section 4067Labor Code Section 4062.2(f)Withdraw from AMEWCAB
References
1
Case No. ADJ7688956
Regular
Jan 31, 2012

SHARON FRINK vs. SHASTA-TEHAMA-TRINITY JOINT COMMUNITY COLLEGE

The Workers' Compensation Appeals Board granted removal, rescinded prior orders, and returned the case for further proceedings. The issue was whether the applicant must attend a re-evaluation with the same Qualified Medical Evaluator (QME) after he moved his office a short distance. The Board found that Labor Code section 4062.3(j) requires parties to utilize the same QME for subsequent disputes if possible. They clarified that Administrative Director Rule 34(b) regarding the QME's office location applies only to initial evaluations, not re-evaluations. Therefore, the applicant's refusal to travel a short distance for re-evaluation was not grounds for a new panel QME.

Workers' Compensation Appeals BoardPetition for RemovalQualified Medical Examiner (QME)Re-evaluationLabor Code Section 4062.3(j)Administrative Director Rule 34(b)Administrative Director Rule 36(d)Medical Office LocationUnavailable QMECompel Attendance
References
9
Case No. ADJ4704159 (AHM 0120563) ADJ2217428 (AHM 0106492) ADJ2380068 (AHM 0102888)
Regular
Feb 07, 2011

ROSALIE SEE vs. REMAX REAL ESTATE, BENEFICIAL SERVICES; EMPLOYERS COMP GLENDALE

The applicant sought to remove a WCJ's order compelling a medical evaluation. Applicant argued a prior agreed medical evaluation with a defendant-approved evaluator should suffice, preventing a second evaluation. The Appeals Board denied removal, finding the applicant failed to demonstrate substantial prejudice or irreparable harm. Removal is an extraordinary remedy, and reconsideration will be adequate if necessary.

Petition for RemovalJoint Order Compelling AttendanceMedical EvaluationAgreed Medical Evaluator (AME)Highland Insurance CompanyExtraordinary RemedySubstantial PrejudiceIrreparable HarmReconsiderationWCJ
References
2
Case No. ADJ3465664 (AHM 0133582)
Regular
Jul 23, 2012

MARIA DUARTE vs. GREENFIELD CARE CENTER OF FULLERTON, CAREWEST CLAIMS MANAGEMENT, PEGASUS

The Workers' Compensation Appeals Board granted defendant's Petition for Removal, rescinding the WCJ's prior orders. The WCJ improperly ordered an Agreed Medical Evaluator (AME) to select additional specialists and obtain evaluations, exceeding his authority. The Appeals Board clarified that AMEs cannot designate additional evaluators and that further evaluations must follow statutory procedures. The case was returned to the trial level for further proceedings.

Petition for RemovalAgreed Medical Evaluator (AME)Qualified Medical Evaluator (QME)Off CalendarMandatory Settlement Conference (MSC)Ultra ViresRescind OrderDevelop the RecordAdministrative Director RuleLabor Code sections 4061 and 4062
References
0
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