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

Case No. ADJ2430009
Regular
Feb 09, 2015

GIOVANNI SOSA vs. THE KROGER COMPANY, dba RALPHS GROCERY

Here's a concise summary for a lawyer: The Workers' Compensation Appeals Board granted reconsideration on petitions from both the applicant and defendant regarding a decision filed December 1, 2014. The applicant appealed findings on industrial medical conditions, the need for medical treatment, temporary and permanent disability, and attorney fees. The defendant contested the finding that obesity was aggravated by the industrial injury, the failure to apportion permanent disability to obesity, and the occupational group rating. Reconsideration is necessary to allow further study of the factual and legal issues for a just decision.

Workers' Compensation Appeals BoardReconsiderationPetitions for ReconsiderationIndustrial InjuryRight Knee InjuryInternal Systems InjuryLumbar Spine InjuryPsyche InjuryMedical TreatmentTemporary Disability
References
0
Case No. MISSING
Regular Panel Decision
Jun 29, 1998

Claim of A'Gard v. Major Builders Corp.

Claimant suffered a back injury in 1986, leading to a permanent partial disability. Years later, he developed significant obesity and diabetes, which he claimed were consequential to his original injury due to reduced physical activity and depression. The Workers’ Compensation Board disallowed this claim, and claimant appealed pro se, alleging procedural misconduct and civil rights violations. The appellate court affirmed the Board's decision, finding no support for the claimant's procedural contentions. Medical testimony provided substantial evidence that the claimant's diabetes and obesity were attributable to preexisting conditions rather than being consequential to the initial back injury.

Workers' CompensationPermanent Partial DisabilityDiabetesObesityConsequential InjuryMedical TestimonySedentary LifestyleGenetic PredispositionAppellate ReviewBoard Decision
References
2
Case No. MISSING
Regular Panel Decision

Claim of Johnson v. City School District

The claimant appealed a Workers’ Compensation Board decision from June 29, 1983, which found a continuing causally related moderate disability stemming from a January 20, 1976 accident. The appeal focused on whether substantial evidence supported the Board's determination, considering intervening injuries and the claimant's severe obesity as contributing factors. The record included conflicting medical opinions, but experts agreed obesity contributed to the original injury and continuing disability. The Board emphasized the testimony of the claimant’s attending orthopedist, who related the present condition to the 1976 incident. The court, finding substantial evidence in the record, affirmed the Board's decision.

Workers' CompensationDisabilityCausationMedical TestimonyObesityThoraco-lumbar sprainAppellate ReviewSubstantial EvidenceOrthopedistPrior Injury
References
2
Case No. MISSING
Regular Panel Decision
Aug 01, 1984

Claim of Furner v. Precision

This case involves an appeal from a Workers’ Compensation Board decision regarding a claimant's eligibility for disability benefits following gastroplasty and bilateral distal salpingectomy. The employer and insurance carrier argued that the surgery for morbid obesity was purely elective, therefore disqualifying the claimant from benefits. However, the Board found, supported by medical reports from the surgeon and other evidence, that the award of disability benefits was warranted. The court affirmed this decision, concluding that the Board had substantial evidence to determine that the claimant's excessive obesity falls within the scope of "injury" and "sickness" as defined in Workers’ Compensation Law § 201 (8) and that the surgery constituted a medically prescribed course of treatment.

Morbid ObesityDisability BenefitsGastroplastyBilateral Distal SalpingectomyElective SurgeryMedical NecessitySubstantial EvidenceWorkers' Compensation Board AppealMedical ReportsSickness Definition
References
3
Case No. MISSING
Regular Panel Decision
Feb 10, 2012

Claim of Laduke v. Schenectady Community Action Program

The Workers' Compensation Board initially found a self-insured employer entitled to reimbursement from the Special Disability Fund, citing the claimant's preexisting diabetes and obesity. The Special Disability Fund appealed this decision. The Appellate Division reversed, ruling that the employer failed to demonstrate the claimant's preexisting conditions hindered her job potential as required by Workers’ Compensation Law § 15 (8) (d). The court noted the claimant's diabetes was controlled by medication and had not affected her work ability prior to the injury. Furthermore, her obesity lacked a medical basis that would establish it as a permanent hindering condition, leading the court to conclude the Board's decision was not supported by substantial evidence.

Workers' Compensation Law § 15(8)(d)Special Disability FundReimbursement claimPreexisting medical conditionPermanent impairmentDiabetesObesityJob hindranceMedical opinionAppellate Division
References
12
Case No. MISSING
Regular Panel Decision

Garcia v. Astrue

This case involves Alfonso Garcia (Plaintiff) seeking Social Security benefits against Social Security Commissioner Michael J. Astrue (Defendant). The District Court adopted the Report-Recommendation of Magistrate Judge Victor E. Bianchini, which recommended denying the Defendant's motion for judgment on the pleadings and granting the Plaintiff's motion. The case is remanded to the Commission for further proceedings. The Magistrate Judge found the Administrative Law Judge (ALJ) committed several errors, including failing to adequately evaluate the opinions of treating physicians and a consultative examiner, not properly assessing a treating nurse practitioner's opinion, and failing to consider the impact of Plaintiff's obesity on his limitations. The District Court affirmed these findings, highlighting the need for further record development and proper assessment of medical evidence and the plaintiff's condition, including obesity.

Social Security benefitsdisability claimRFC assessmenttreating physician's opinionconsultative examinerobesity impactALJ errorsremand orderjudgment on pleadingsevidentiary record
References
47
Case No. MISSING
Regular Panel Decision
Jan 09, 1991

Claim of Ingham v. Oswego County

The claimant, a nursing assistant for Oswego County, sustained multiple injuries, including to the knee, back, wrist, and head, in an August 1979 accident while assisting a client. Over time, the claimant's condition deteriorated, leading to permanent total disability. A Workers’ Compensation Law Judge initially found a causally related disability for the knee and wrist, later amending it to include the low back and consequential obesity. The self-insured employer, Oswego County, appealed this decision, arguing the back injury claim was untimely and that the disability should be apportioned due to the claimant's prior back history and obesity. The Workers’ Compensation Board affirmed the WCLJ's decision, rejecting the County’s arguments by finding a waiver of the timeliness objection and substantial evidence supporting the aggravation of preexisting conditions as causally related to the 1979 accident, leading to total disability.

Permanent Total DisabilityCausally Related DisabilityAggravation of Preexisting ConditionWaiver of Section 28 DefenseTimeliness of Claim ObjectionConflicting Medical EvidenceSpinal InjuryObesity-Related DisabilityJoint InjuryEmployer Self-Insured
References
3
Case No. 528510
Regular Panel Decision
Jan 09, 2020

Matter of Rapaglia v. New York City Tr. Auth.

Robert G. Rapaglia, a bus driver, filed for workers' compensation benefits following an assault in 2015 which resulted in injuries to his face and neck, as well as posttraumatic stress disorder (PTSD) and major depression. His employment was subsequently terminated. Rapaglia sought classification as permanently totally disabled or, alternatively, with a total industrial disability. The Workers' Compensation Board classified him with a permanent partial disability, finding a 60% loss of wage-earning capacity, and deemed his request for total industrial disability premature. On appeal, Rapaglia contended that the 60% loss of wage-earning capacity finding was unsupported and that his obesity, limited education, and work experience were not adequately considered. The Appellate Division, Third Department, affirmed the Board's decision, citing substantial evidence for the permanent partial disability and the calculation of wage-earning capacity. The court also agreed that the issue of total industrial disability was premature and that Rapaglia's obesity was properly discounted as not causally related to the work injury.

Workers' CompensationPermanent Partial DisabilityLoss of Wage-Earning CapacityPosttraumatic Stress Disorder (PTSD)Major DepressionMedical ImpairmentVocational FactorsIndustrial DisabilityAppellate ReviewSufficiency of Evidence
References
10
Case No. STK 162499, STK 162500, STK 162501
Regular
Feb 15, 2008

SHARON A. HOLLINS vs. AC TRANSIT, Permissibly Self-Insured

The Workers' Compensation Appeals Board granted reconsideration and rescinded three findings of fact and awards. This action was taken because the original decisions failed to properly address apportionment issues, specifically concerning the applicant's obesity and a prior disability award. The cases are now returned to the trial level for further proceedings and new decisions by the judge.

ApportionmentAgreed Medical EvaluatorIndustrial InjuryPermanent DisabilityObesityPrior AwardLabor Code Section 4664Petition for ReconsiderationFindings and AwardsRescinded
References
1
Case No. ADJ9112665
Regular
Sep 18, 2017

SHERRY MITCHELL vs. SILGAN CONTAINER CORPORATION, ZURICH AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration to address the applicant's contention that the QME's apportionment opinion regarding knee disability lacked substantial evidence. The Board found that Dr. Pattison's opinion did not sufficiently explain how obesity contributed to the applicant's knee disability. Consequently, the Board affirmed the original award but deferred issues of permanent disability and attorney's fees, remanding the case for further proceedings with the QME to provide a more reasoned apportionment opinion.

Workers' Compensation Appeals BoardSilgan Container CorporationZurich American Insurance CompanyESISSherry MitchellADJ9112665Opinion and Order Granting Petition for ReconsiderationFindings and AwardQualified Medical EvaluatorThomas S. Pattison M.D.
References
3
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