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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

O'Keefe v. General Accident Insurance

Plaintiff Violet O'Keefe initiated an action against General Accident Insurance Company, alleging disparate treatment and retaliation based on age and sex, violating Title VII, ADEA, and New York Human Rights Law. O'Keefe claimed a discriminatory work environment and unlawful termination following her refusal of a proposed job transfer. The defendant argued O'Keefe's performance was poor and the transfer was a lateral move. The District Court denied the defendant's motion for summary judgment regarding the federal discrimination and retaliation claims, finding a genuine issue of material fact existed as to whether General Accident's reasons for termination were pretextual. However, the Court granted summary judgment for the defendant on the state law claims, declining to exercise pendent jurisdiction.

DiscriminationAge DiscriminationSex DiscriminationTitle VIIADEARetaliationSummary JudgmentEmployment LawPretextPrima Facie Case
References
19
Case No. ADJ118892 (VNO 0442877) ADJ1041834 (VNO 0436039)
Regular

TAMARA O'KEEFE vs. COSTCO WHOLESALE, INC.

This order denies Costco Wholesale's petition for reconsideration in the workers' compensation case of Tamara O'Keefe. The Workers' Compensation Appeals Board (WCAB) adopted the report of the workers' compensation administrative law judge (WCJ) as its reasoning for denial. The specific grounds for denial are detailed within the WCJ's report, which is incorporated by reference. Therefore, the WCAB has upheld the prior decision and denied the employer's request for review.

ADJ118892VNO 0442877ADJ1041834VNO 0436039O'KeefeCostco WholesaleSedgwick CMSDeny ReconsiderationWCJ ReportAppeals Board
References
0
Case No. ADJ3765992 (SRO 0132531) ADJ2072207 (SRO 0140061)
Regular
Apr 29, 2009

Lorraine O'Keefe vs. Surgical Staff North, Inc., CAL COMP, In Liquidation, CIGA, Adjusted by BROADSPIRE, COMMUNITY HOSPITAL OF MONTEREY PENINSULA, Permissibly Self-Insured, Adjusted by CLAIMS MANAGEMENT, INC. (ADJ3765992), QUEEN OF THE VALLEY HOSPITAL, Permissibly Self-Insured, Adjusted by SEDGWICK CLAIMS MANAGEMENT SERVICE (ADJ2072207)

This case involves applicant Lorraine O'Keefe's workers' compensation claims for left knee injury. The Workers' Compensation Appeals Board denied reconsideration of the finding that applicant sustained an industrial injury on December 15, 1999, while employed by Community Hospital of the Monterey Peninsula (CHOMP). However, the Board granted reconsideration regarding attorney fees, rescinding the prior award against CHOMP. The issue of CHOMP's liability for applicant's attorney fees under Labor Code section 4064(c) will be returned for further proceedings due to insufficient notice.

Workers' Compensation Appeals BoardSurgical Staff NorthCal CompCIGACommunity Hospital of Monterey PeninsulaClaims Management Inc.Queen of the Valley HospitalSedgwick Claims Management ServiceFindings Award OrdersPetition for Reconsideration
References
0
Case No. MISSING
Regular Panel Decision

O'KEEFE v. Bowen

Josephine O’Keefe and Louis Scheibeler, patients at Belair Nursing Home, sought Medicare Part A benefits for post-hospital extended care, which were denied by the Secretary of Health and Human Services. They initiated a proceeding under 42 U.S.C. § 405(g) and 1395ff(b) to review these final determinations. The court determined that the absence of a physician's certification, a prerequisite for benefits under Medicare regulations, compelled the affirmance of the denial of benefits. The decision highlighted that neither the initial hospital physicians nor the Belair Nursing Home physicians provided the required daily skilled nursing care certification. The court also examined the role of DMS-1 forms, primarily used for Medicaid, and the challenges faced by Utilization Review Committees in New York due to the scarcity of appropriate intermediate care facilities.

Medicare BenefitsPost-Hospital Extended CareSkilled Nursing CarePhysician CertificationDenial of BenefitsUtilization Review CommitteeMedicaid ActCustodial CareHealth and Human ServicesRegulatory Compliance
References
3
Case No. ADJ3765992 (SRO 0132531)
Regular
Apr 06, 2011

LORRAINE O'KEEFE vs. SURGICAL STAFF NORTH, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, BROADSPIRE SERVICES for CAL COMP, COMMUNITY HOSPITAL OF MONTEREY PENINSULA, CLAIMS MANAGEMENT, INC.

The Workers' Compensation Appeals Board (WCAB) granted reconsideration on Community Hospital of Monterey Peninsula's (CHOMP) petition regarding a penalty assessed for delayed payment to CIGA. The WCAB amended the prior order, ruling that CHOMP is not liable for a Labor Code section 5814 penalty because this section applies only to delays in payments to injured workers, not to reimbursements between defendants. However, the WCAB affirmed the prior finding that CHOMP engaged in bad-faith litigation tactics, upholding sanctions under Labor Code section 5813. The final order also clarified the amount owed to CIGA and affirmed the attorney's fees awarded to the applicant's counsel.

Workers Compensation Appeals BoardSurgical Staff NorthCalifornia Insurance Guarantee AssociationCommunity Hospital of Monterey PeninsulaUnreasonable DelayBad Faith LitigationLabor Code Section 5814Labor Code Section 5813Labor Code Section 4064(c)Permanent Disability
References
2
Case No. ADJ3765992
Regular
Feb 22, 2010

LORRAINE O'KEEFE vs. SURGICAL STAFF NORTH, INC., CIGA by its servicing facility BROADSPIRE SERVICES, for CALCOMP in liquidation, COMMUNITY HOSPITAL OF MONTEREY PENINSULA, Permissibly Self-Insured, CLAIMS MANAGEMENT INC.

This case involves a defendant's petition for reconsideration of a decision filed January 28, 2010. The Workers' Compensation Appeals Board has granted reconsideration to thoroughly review the factual and legal issues presented. This allows for further study of the record to ensure a just and reasoned decision. All future communications regarding this matter should be directed to the Office of the Commissioners in San Francisco.

WORKERS' COMPENSATION APPEALS BOARDReconsiderationPetition for ReconsiderationSurgical Staff NorthCIGACommunity Hospital of Monterey PeninsulaAdj3765992SRO 0132531Decision After ReconsiderationOffice of the Commissioners
References
0
Case No. SRO 0126020
Regular
Nov 05, 2007

Nicholas Wilson vs. PRESTIGE ACURA, ST. PAUL TRAVELERS INSURANCE

The Workers' Compensation Appeals Board granted reconsideration to award an additional attorney's fee of $12,631.00, to be commuted from the applicant's life pension, finding the WCJ's initial award of $16,739.40 was unreasonable. The Board found that *O'Keefe v. Workers' Comp. Appeals Bd.* does not prohibit fees from a life pension and that the applicant's attorney's significant efforts, responsibility, and results warranted a higher fee. The Board also clarified that proper notification to the applicant regarding the fee increase was given.

Workers Compensation Appeals BoardPetition for ReconsiderationAttorney's FeeLife PensionPermanent DisabilityGuardian ad LitemCognitive LossSkull FractureSeizure SyndromeVertigo
References
2
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