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

Case No. ADJ3691698 (SFO 0463767)
Regular
May 22, 2009

FAITH LATIMER vs. CALIFORNIA PACIFIC MEDICAL CENTER; permissibly self-insured

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration regarding an injury sustained by applicant Faith Latimer. The defendant sought to introduce new evidence of a subsequent injury and diagnostic testing, claiming it impacted applicant's credibility and the prior decision. However, the Board found the defendant failed to meet the requirements for newly discovered evidence under WCAB Rule 10856, as they did not demonstrate how the evidence could not have been discovered earlier or its effect on the prior findings. The Board concluded the new evidence would not alter the decision awarding temporary disability and medical treatment for the initial injury.

Workers' Compensation Appeals BoardPetition for ReconsiderationReopeningIndustrial InjuryRight ShoulderLow BackNeckLeft ShoulderCompensable ConsequenceTotal Temporary Disability
References
1
Case No. MISSING
Regular Panel Decision
Oct 03, 2002

Depew v. Lancet Arch, Inc.

This case involves an appeal from a Workers’ Compensation Board decision that denied the claimant's application for reconsideration and/or full Board review. Previously, the Board had found that the claimant did not sustain an accidental injury in the course of employment and denied workers’ compensation benefits. The claimant sought to reopen the matter based on "newly discovered evidence," including a coworker's testimony from a discrimination suit and medical reports prepared after the case was closed. The court affirmed the Board's denial, concluding that the "newly discovered evidence" did not meet the standards set forth in 12 NYCRR 300.14, as the coworker's information was not new, and the medical evidence was not shown to be unavailable at the original hearings. The court limited its review to whether the denial of reconsideration was arbitrary and capricious or an abuse of discretion.

Workers’ Compensation BoardAppealReconsiderationFull Board ReviewNewly Discovered EvidenceCausally Related DisabilityProcedural StandardsMedical EvidenceAbuse of DiscretionArbitrary and Capricious
References
4
Case No. CV-22-1860
Regular Panel Decision
Feb 13, 2025

Matter of Sanders v. NYU Langone Hosps.

Claimant Ronnie G. Sanders, a utility worker, sought workers' compensation benefits for alleged neck and back injuries from a work accident. The Workers' Compensation Law Judge and subsequently the Workers' Compensation Board disallowed the claim, citing inconsistencies in testimony and a lack of credible medical evidence linking the injuries to the work incident. Key medical reports, including one from an independent medical examiner, found no causal relationship. Claimant's application for reconsideration or full Board review, based on newly obtained medical documents, was denied by the Board on the grounds that the evidence was not "newly discovered" and could have been presented earlier. The Appellate Division, Third Department, affirmed the Board's decision, finding no arbitrary or capricious action or abuse of discretion.

Workers' CompensationMedical EvidenceCredibilityReconsiderationFull Board ReviewNewly Discovered EvidenceCausal RelationshipAppellate ReviewAbuse of DiscretionUtility Worker
References
5
Case No. ADJ1129988 (LAO 0846398)
Regular
Jan 27, 2017

GENEVIEVE CLAVREUL vs. GLENDALE ADVENTIST MEDICAL CENTER, ADVENTIST HEALTH

This case involves an applicant's petition for reconsideration of a WCJ's order terminating liability for temporary disability. The WCJ found the applicant permanent and stationary based on the Agreed Medical Evaluator's (AME) opinion, despite the applicant's claims of pending shoulder surgery. The Appeals Board denied reconsideration, upholding the WCJ's decision due to the applicant's inconsistent testimony regarding surgery delays and failure to provide evidence of the alleged surgery or its complications. Furthermore, the petition was procedurally deficient, lacking proper service, specific legal arguments, and evidence of newly discovered material.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrdersPetition to Terminate LiabilityTemporary DisabilityAgreed Medical Evaluator (AME)Permanent and Stationary StatusMedical TreatmentRight Shoulder SurgeryCredibility Determinations
References
4
Case No. ADJ9255010
Regular
Dec 01, 2014

MIREYA MEDRANO vs. CALIFORNIA OFFICE MAINTENANCE, REPUBLIC, REPUBLIC UNDERWRITERS INSURANCE COMPANY

The Workers' Compensation Appeals Board denied Mireya Medrano's petition for reconsideration to set aside an approved Compromise and Release agreement. Medrano claimed the settlement was procured by fraud and she discovered new evidence. The Board adopted the WCJ's report finding no evidence of fraud, as Medrano failed to meet the required elements. Furthermore, the alleged "newly discovered evidence," a medical report, was not deemed material or previously undiscoverable, as she was aware of the underlying diagnoses and had access to similar information prior to the settlement.

WCABPetition for ReconsiderationCompromise and ReleaseFraudNewly Discovered EvidenceAOE/COELabor Code § 3600(a)(10)Administrative Law JudgeWCJRepublic Underwriters Insurance Company
References
0
Case No. MISSING
Regular Panel Decision
Jul 13, 2005

Claim of Haas v. Gross Electric

Claimant appealed a Workers’ Compensation Board decision from July 13, 2005, which denied his claim for benefits, finding no causally related injury. The claim stemmed from a December 17, 2002, work-related motor vehicle accident. Initially, a Workers’ Compensation Law Judge found the claim established based on medical expert opinions linking a back injury to the accident. However, this determination was rescinded after the carrier submitted newly discovered evidence—medical records from claimant’s primary care physician, Thomas Coppens—revealing prior back injuries and that the current problems began while wrapping presents on December 24, 2002. Subsequent medical opinions became ambivalent or changed, leading to the disallowance of the claim by a Workers’ Compensation Law Judge, a decision later affirmed by the Board. The Appellate Division affirmed the Board's decision, concluding it was supported by substantial evidence in the record.

Motor Vehicle AccidentBack InjuryCausation DisputeMedical Expert OpinionPrior Medical HistoryNewly Discovered EvidenceSubstantial Evidence ReviewClaim DisallowanceAppellate AffirmationBoard Decision
References
1
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. SAC 347248
Regular
Jul 24, 2008

Jan Michael Brazil vs. FARMERS RICE COOPERATIVE

The Workers' Compensation Appeals Board denied Jan Michael Brazil's petition for reconsideration of a prior finding that he did not sustain an industrial injury to his left eye. Brazil sought to introduce newly discovered medical evidence, but failed to demonstrate it was unavailable or undiscoverable with due diligence prior to the mandatory settlement conference. The Board noted that one of the already admitted medical reports referenced the evidence Brazil now sought to submit.

Workers' Compensation Appeals BoardJan Michael BrazilFarmers Rice CooperativePetition for ReconsiderationIndustrial InjuryLeft Eye InjuryNewly Discovered Medical EvidenceMandatory Settlement ConferenceLabor Code section 5502Pre-trial Conference Statement
References
0
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. ADJ11072332
Regular
Jan 03, 2023

CHETAN THAKER vs. AON HEWITT CORPORATION, CNA CLAIM PLUS, INC., SEGWICK CLAIMS MANAGEMENT SERVICES, INC., THE HARTFORD

The Workers' Compensation Appeals Board denied the petitioner's Petition for Reconsideration. The Board adopted the findings of the Workers' Compensation Judge (WCJ), who concluded that the applicant failed to prove an industrial injury arose out of and occurred in the course of employment (AOE/COE). The WCJ found that the reports of the Qualified Medical Evaluator (QME), Dr. Pretsky, constituted substantial medical evidence, despite the petitioner's disagreements regarding the diagnosis. Furthermore, the petitioner failed to provide sufficient justification for newly discovered evidence or specific arguments regarding factual or statutory errors.

WORKERS' COMPENSATION APPEALS BOARDPETITION FOR RECONSIDERATIONDENIEDWCJ REPORTSUPPLEMENTAL PLEADINGSUBSTANTIAL MEDICAL EVIDENCEPQMEPSYCHE INJURYAOE/COELABOR CODE
References
8
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