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

Case No. ADJ3139011 (WCK 0039676) ADJ3737138 (WCK 0039682) ADJ2116694 (WCK 0039685)
Regular
Dec 09, 2008

Diane Pearson vs. Gray C Home Care, Republic Indemnity Company of America

The Workers' Compensation Appeals Board (WCAB) rescinded the original award and remanded the case for further proceedings to allow for full determination of all deferred issues. The WCAB agreed that the applicant is totally permanently disabled and ordered a new final decision addressing all outstanding issues, including potential cardiovascular injuries and medical necessity of mobility equipment, to clarify all injured body parts and potentially issue a non-apportioned award. This decision aims to ensure all relevant evidence is considered before a final determination of the applicant's entitlement to benefits.

Workers' Compensation Appeals BoardReconsiderationFindings Order and AwardAdministrative Law JudgePermanent DisabilityApportionmentLife PensionMedical NecessityDeep Vein ThrombosisStroke
References
0
Case No. ADJ10127263
Regular
Jun 14, 2018

SANTIAGO MALDONADO RODRIGUEZ vs. SUNRIDGE LANDSCAPE MAINTENANCE, AMERICAN CLAIMS MANAGEMENT, INC.

The Workers' Compensation Appeals Board (WCAB) dismissed Santiago Maldonado Rodriguez's Petition for Reconsideration. The petition sought review of a non-final "Notice of Intention to Disburse Attorney Fee," which the WCAB clarified is not an order. Petitions for reconsideration can only be filed from final orders, decisions, or awards that determine substantive rights or liabilities or threshold issues. As the notice was not a final order, the WCAB dismissed the petition.

Petition for ReconsiderationNon-Final OrderFinal OrderSubstantive RightLiabilityThreshold IssueInterlocutoryProcedural DecisionsEvidentiary DecisionsNotice of Intention to Disburse Attorney Fee
References
4
Case No. ADJ7396875
Regular
Oct 31, 2013

THERESIA TITTERINGTON vs. O'REILLY AUTO PARTS, HARTFORD INSURANCE COMPANY OF THE MIDWEST, GALLAGHER BASSETT SERVICES, INC.

The Workers' Compensation Appeals Board (WCAB) dismissed the applicant's petition for reconsideration. This dismissal occurred because reconsideration can only be sought from a final order, decision, or award that determines substantive rights and liabilities. Interlocutory procedural orders, such as pre-trial rulings on evidence or discovery, are not considered final orders and thus are not subject to reconsideration. Therefore, the petition was dismissed as it addressed a non-final, procedural matter.

Petition for ReconsiderationDismissal OrderInterlocutory OrdersFinal OrderSubstantive RightsLiabilitiesWorkers' Compensation Appeals BoardWCJLab. Code§ 5900
References
5
Case No. MISSING
Regular Panel Decision

Sheahan v. Brady

Plaintiff Danielle Sheahan, a white woman, was terminated from her position at the Internal Revenue Service (IRS) in April 1992, after being hired in May 1991. The defendant, the Secretary of the Treasury, claimed she was fired for submitting an altered college transcript. However, the plaintiff alleged racial and color discrimination, asserting that her mostly Black co-workers and supervisors conspired against her, fabricating the transcript alteration accusation. Sheahan pursued administrative remedies, first with the Merit Systems Protection Board (MSPB), which dismissed her complaint for lack of jurisdiction on October 16, 1992. Subsequently, she filed a charge with the Equal Employment Opportunity Commission (EEOC), which also dismissed her case on October 22, 1992, based on the erroneous belief that an MSPB appeal was still pending. Plaintiff then filed a civil suit in federal court on November 12, 1992. Critically, on November 9, 1992, the Treasury Department had filed a Request to Reopen the EEOC's October 22 decision. The court examined the requirements of Title VII of the Civil Rights Act, 42 U.S.C. § 2000e-16, specifically concerning the exhaustion of administrative remedies and the finality of EEOC actions. Under 29 C.F.R. § 1613.234, a timely request to reopen by either party renders an EEOC decision non-final for the purpose of initiating a civil action. Consequently, the defendant's request to reopen on November 9, 1992, made the EEOC's October 22 decision non-final before Sheahan filed her lawsuit on November 12, 1992. Therefore, the court concluded it lacked subject matter jurisdiction. The court granted the defendant's motion, dismissing the plaintiff's complaint without prejudice, and suggested that either party could renew a request to reopen the EEOC decision, anticipating it would be granted given the EEOC's original erroneous finding.

Federal employment discriminationTitle VIICivil Rights ActRacial discriminationColor discriminationWrongful terminationAdministrative exhaustionEEOC decision finalitySubject matter jurisdictionMotion to dismiss
References
11
Case No. MISSING
Regular Panel Decision

Huffman v. Lake City Contracting Corp.

Claimant Huffman sought workers' compensation benefits from Lake City Contracting Corporation. A referee found a 66% schedule loss of a left arm and dual insurance coverage by State Insurance Fund and USF&G. Both insurers contested coverage and the award's excessiveness. The Workers' Compensation Board affirmed the schedule award but found State Insurance Fund had no coverage and required further development on USF&G's liability, remanding the case. The employer and USF&G appealed this non-final Board decision. The Workers' Compensation Board then moved to dismiss these appeals on the grounds that its decision was interlocutory and non-appealable. The court granted the motion, dismissing the appeals, noting that non-final decisions are not appealable and protective notices of appeal are unnecessary in such instances.

Appeal DismissalInterlocutory DecisionNon-final OrderCoverage DisputeSchedule Loss AwardProtective Notice of AppealAppellate ProcedureInsurance CoverageMotion PracticeJudicial Review
References
1
Case No. MISSING
Regular Panel Decision

Graham v. Heckler

Plaintiff Vanetta Graham sought judicial review of a final decision denying her claim for federal disability insurance benefits and supplemental security income. The District Court found that the Administrative Law Judge (ALJ) erred by mechanically applying the medical-vocational "grid" rules to determine disability. The court highlighted that exclusive reliance on the grid is inappropriate when a claimant, like Ms. Graham, has significant non-exertional impairments, such as environmental restrictions to dust and fumes. The court reversed the Secretary's decision and remanded the case, instructing the ALJ to make clearer findings regarding the combined effect of all of Ms. Graham's impairments on her residual functional capacity.

Disability benefitsSocial Security ActAdministrative Law JudgeResidual Functional CapacityNon-exertional impairmentsExertional limitationsGrid rulesSedentary workRemandJudicial review
References
15
Case No. MISSING
Regular Panel Decision

Matter of Losardo v. Baxter Healthcare Corporation

Claimant, a truck driver, sought workers' compensation benefits for a back injury he alleged occurred in October 2007 while unloading a truck. A Workers’ Compensation Law Judge initially established the claim, but the Workers’ Compensation Board reversed this decision, finding insufficient credible medical evidence to support a work-related injury. The claimant subsequently appealed the Board's decision. The Appellate Division affirmed the Board's ruling, noting that medical records and testimony from treating physicians contradicted the claim of a work-related accident, instead suggesting a pre-existing condition and a non-work related injury at home. The court upheld the Board's broad authority to resolve credibility and draw inferences, concluding that its decision was supported by substantial evidence.

Back InjuryTruck DriverCompensable InjuryMedical EvidenceCredibilitySubstantial EvidenceAppellate ReviewDisability BenefitsWork-Related InjuryClaimant Testimony
References
4
Case No. MISSING
Regular Panel Decision

Lewis v. Colvin

Plaintiff Donna Lewis sought judicial review of the Commissioner of Social Security's final decision denying her applications for Disability Insurance Benefits and Supplemental Security Income. The District Court identified multiple errors made by the Administrative Law Judge (ALJ), specifically in evaluating medical evidence and the plaintiff's credibility. The ALJ improperly weighed reports from a non-examining consultant and a consultative examiner, and used boilerplate language in assessing Lewis's subjective complaints without sufficient specificity. The court concluded that these deficiencies provided a reasonable basis to doubt whether the appropriate legal standards were applied. Consequently, Lewis's motion for judgment on the pleadings was granted, the Commissioner's decision was vacated, and the case was remanded for further administrative proceedings.

Disability Insurance BenefitsSupplemental Security IncomeSocial Security ActALJ ErrorResidual Functional CapacityAppeals CouncilPsychiatric Review TechniqueMedical EvidenceCredibility DeterminationMental Impairments
References
30
Case No. ADJ4648071 (AHM 0111231)
Regular
May 05, 2010

JOYCE SIMON vs. COUNTY OF ORANGE, Permissibly Self-Insured, adjusted by YORK INSURANCE SERVICES GROUP, INC.

The Workers' Compensation Appeals Board (WCAB) dismissed Joyce Simon's petition for reconsideration because it was filed from a non-final interlocutory order, not a final decision that determined substantive rights. The WCAB also denied her petition for removal, finding no showing of substantial prejudice or irreparable harm. The decision relies on established legal definitions of "final" orders in workers' compensation proceedings. Removal was denied as reconsideration would be an adequate remedy if an adverse final decision later issues.

Petition for ReconsiderationFinal OrderSubstantive RightInterlocutory OrderRemovalWCJ's Report and RecommendationSubstantial PrejudiceIrreparable HarmInadequate RemedyWorkers' Compensation Appeals Board
References
8
Case No. MISSING
Regular Panel Decision

Barriger v. Bowen

This memorandum decision and order addresses an application for attorney's fees by plaintiff Bessie L. Barriger, following a court reversal of a Social Security Administration decision that awarded her past-due benefits. Barriger sought fees under both 42 U.S.C. § 406(b) and the Equal Access to Justice Act (EAJA), with the defendant Secretary of Health and Human Services challenging certain billed hours. The court ruled that hours spent on a default motion, which directly related to the substantive claim due to the government's delay, were compensable, and found the time spent on the fee application reasonable. However, clerical tasks such as mailing and serving were deemed non-compensable. The court further clarified that the fee limitation under § 406 does not restrict EAJA recovery, establishing a protocol for attorneys to refund the smaller amount to the client when both fee awards are received. The final award for EAJA fees was $3,244.89, with administrative fees to be disbursed separately.

Attorney's FeesEAJASocial Security BenefitsContingency FeeDefault JudgmentJudicial ReviewFee ApplicationPrevailing PartyStatutory InterpretationFederal Court
References
13
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