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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

Mitchell v. New York City Transit Authority

A bus driver sought workers’ compensation benefits for a herniated lumbar disk, attributing it to 22 years of operating buses. The Workers’ Compensation Board denied his claim, ruling he did not sustain an occupational disease arising from employment. Although his neurosurgeon's note linked the condition to employment, the neurosurgeon later declined to definitively establish causality. The Board found the medical proof insufficient. The appellate court affirmed the Board’s decision, finding its conclusion supported by the record.

occupational diseasecausal relationshipmedical evidenceWorkers' Compensation Boardbus driverlower back painherniated lumbar diskneurosurgeonwitness credibilityappellate review
References
4
Case No. MISSING
Regular Panel Decision

Claim of Casiano v. CCIP/Union Settlement Home Care

In March 2001, claimant sustained a work-related back injury. Neurosurgeon Richard J. Radna recommended and performed decompression surgery despite the workers' compensation carrier denying preauthorization for the procedure. Both a Workers’ Compensation Law Judge and the Workers’ Compensation Board subsequently ruled that the surgery was not medically necessary, thereby absolving the carrier of liability for its cost. Claimant and Radna appealed this determination to the appellate court. Radna's appeal was dismissed due to lack of standing, and the Board's decision was affirmed, as it was within its purview to resolve the conflicting medical evidence presented by Radna and the carrier's neurosurgeon regarding the necessity of the surgery.

Workers' Compensation LawMedical NecessitySurgical ProcedurePreauthorization DenialNeurological InjuryConflicting Medical OpinionsAppellate ReviewStanding IssueCarrier LiabilityBack Injury
References
3
Case No. 2023-07-5993
Regular Panel Decision
Mar 12, 2025

Mansell, Gary v. Southeast Personnel Leasing, Inc.

Employee Gary Mansell sustained a back injury and received treatment until his physician, Dr. Vance, declared him at maximum medical improvement (MMI) and halted temporary disability benefits. Months later, Mansell's pain recurred, leading to further medical care and a referral to a neurosurgeon, which the employer subsequently denied after briefly reinstating benefits. The trial court mandated the resumption of temporary disability payments and authorized the neurosurgeon referral. However, the Appeals Board reversed the order compelling additional temporary benefits, determining that Mansell had not provided expert medical evidence to show the initial MMI declaration was premature or incorrect. The Board affirmed the order in all other respects and remanded the case for further proceedings.

Workers' CompensationTemporary Disability BenefitsMaximum Medical ImprovementBack InjuryMedical ImpairmentTreating Physician OpinionNeurosurgeon ReferralAppellate ReviewBurden of ProofExpert Medical Evidence
References
8
Case No. 2015-07-0008
Regular Panel Decision
Jun 02, 2015

Boshers, Michael W. v. City Of Camden

Michael W. Boshers, an employee of the City of Camden, filed a Request for Expedited Hearing after sustaining a work-related injury on August 29, 2014, while operating a City vehicle. He sought a panel of neurosurgeons, a referral denied by the City's workers' compensation carrier despite a recommendation from his authorized treating physician, Dr. Ken Berry. The City contended that Mr. Boshers failed to establish causation for the need for neurosurgical treatment. The Court found that Mr. Boshers was likely to prevail on the issue, given Dr. Berry's referral and the presumption of reasonableness for treatment by an approved physician. The Court ordered the City to provide a panel of neurosurgeons for evaluation and/or treatment of Mr. Boshers' injury.

Workers' CompensationMedical BenefitsExpedited HearingNeurosurgical ReferralCausationPre-existing ConditionMotor Vehicle AccidentAuthorized Treating PhysicianEmployer LiabilityEmployee Rights
References
6
Case No. 534917
Regular Panel Decision
Feb 09, 2023

Matter of Galdon v. Robert Basil Inc.

Claimant John Galdon, an autobody technician, filed a workers' compensation claim for a work-related back injury sustained on February 29, 2020. The employer and carrier disputed the claim, primarily citing a lack of timely notice. A Workers' Compensation Law Judge (WCLJ) found sufficient evidence for accident, notice, and causal relationship, awarding benefits, which the Workers' Compensation Board subsequently affirmed. On appeal, the Appellate Division, Third Department, upheld the Board's decision, determining that there was substantial evidence to support the finding that claimant provided adequate verbal notice to his employer shortly after the accident. The court also found substantial evidence for the causal relationship between Galdon's employment and his injury, based on his testimony and the consistent medical opinions of both his treating neurosurgeon, Michael Stoffman, and the carrier's examining neurosurgeon, Richard Kanoff.

Workers' CompensationBack InjuryTimely NoticeCausal RelationshipSubstantial EvidenceAppellate ReviewCredibility DeterminationDisc HerniationMedical OpinionEmployer Knowledge
References
9
Case No. MISSING
Regular Panel Decision
Oct 30, 2001

Claim of Cool v. TP Brake & Muffler, Inc.

Claimant, an automobile mechanic, injured his lower back in August 1997 and later participated in a demolition derby. He filed for workers' compensation, and a WCLJ initially awarded benefits without apportionment. The Workers' Compensation Board, however, directed further proceedings and subsequently apportioned claimant's disability 40% to the work incident and 60% to the demolition derby, based on neurosurgeon Ronald Naumann's testimony. The Appellate Division affirmed the Board's decision, finding its determination of apportionment to be supported by substantial medical evidence.

ApportionmentWorkers CompensationBack InjuryDemolition DerbyCausationMedical EvidenceSubstantial EvidenceAppellate ReviewTreating PhysicianNeurosurgeon
References
5
Case No. 2014-07-0018
Regular Panel Decision
Feb 09, 2015

Chambers, Dustin v. Advantage Resourcing

Dustin Chambers filed for an expedited hearing to determine entitlement to medical and temporary disability benefits after sustaining a back injury at Advantage Human Resources. The Court found that Mr. Chambers properly reported his injury and is entitled to a panel of neurosurgeons for evaluation, overturning Advantage's denial based on an internal determination. However, the claim for temporary disability benefits was denied at this interlocutory stage due to a lack of medical proof establishing a causal connection between the injury and disability, pending a causation opinion from the selected panel physician.

Workers' CompensationBack InjuryExpedited HearingMedical BenefitsTemporary DisabilityCausationPre-existing ConditionEmployee CredibilityEmployer LiabilityPanel of Physicians
References
5
Case No. ADJ3699477 (OAK 0345390)
Regular
Jul 05, 2011

GARY TOMEI vs. BAY ALARM COMPANY, TRAVELERS PROPERTY AND CASUALTY INSURANCE COMPANY

This case involves an applicant seeking authorization for cervical surgery, which was denied based on the treating physician's request not being properly formatted per AD Rule 9792.6(o). The Appeals Board granted reconsideration, finding the initial denial was due to the applicant's attorney adding a notation to the physician's report instead of the physician clearly marking it as a spinal surgery authorization request. The Board rescinded the original award, deferring the cervical surgery issue and ordering an expedited second opinion from a designated orthopedic surgeon or neurosurgeon.

Workers' Compensation Appeals BoardGary TomeiBay Alarm CompanyTravelers Property and Casualty Insurance CompanyADJ3699477Opinion and Order Granting Reconsiderationcervical surgerylumbar spineAdministrative Director Rule 9792.6(o)treating physician
References
1
Case No. MISSING
Regular Panel Decision
Jan 21, 1998

Claim of Zugibe v. Cornell & Co.

Claimant, an ironworker, sustained a broken wrist on October 5, 1992, during the course of his employment. The case was established for this injury. Subsequently, a neurosurgeon issued a report on September 20, 1994, diagnosing neck and back pain causally related to the 1992 accident, and this report was filed with the Workers’ Compensation Board on November 4, 1994. The Board ruled that the claim for neck and back injuries was time-barred by Workers’ Compensation Law § 28, as the report was filed more than two years after the accident. The Appellate Division affirmed the Board's decision, concluding it was supported by substantial evidence.

Workers' Compensation Law § 28Timeliness of ClaimStatute of LimitationsMedical Report FilingAccident DateNeck and Back InjuriesBroken WristSubstantial EvidenceAppellate ReviewNeurosurgeon Report
References
4
Case No. 2016-03-0298
Regular Panel Decision
Nov 28, 2016

Hollis, Alicia v. Komyo America

Ms. Aliceia Hollis, an employee of Komyo America, filed a Request for Expedited Hearing regarding a January 18, 2016 work injury where car hoods fell on her, allegedly causing an L4-5 disc herniation. The court found Ms. Hollis did not provide sufficient evidence to conclude she is likely to prevail at a hearing on the merits that her herniated disc arose primarily out of and in the course and scope of her employment. Despite concerns about the initial treating physician's opinion, Ms. Hollis failed to provide a compelling rebuttal from the neurosurgeon. Consequently, her requests for medical and temporary disability benefits were denied at this time.

Workers' CompensationExpedited HearingMedical BenefitsTemporary DisabilityLumbar Disc HerniationCausationPre-existing ConditionTreating Physician PresumptionMedical EvidenceCredibility
References
5
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