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

Case No. ADJ9977290, ADJ9977906
Regular
Oct 20, 2016

REBECCA MUBVAKURE vs. STARBUCKS COFFEE COMPANY, permissibly self-insured; administered by, SEDGWICK CMS

The Workers' Compensation Appeals Board (WCAB) rescinded a judge's decision disallowing most of a lien claimant's bill. The original decision failed to consider whether the defendant waived billing objections and lacked proper findings based on admitted evidence. The WCAB remanded the case for further proceedings, requiring the judge to admit evidence and make findings consistent with applicable law. This includes addressing the lien claimant's waiver arguments and the defendant's obligations regarding objections to medical-legal expenses.

Workers' Compensation Appeals BoardReconsiderationLien ClaimantBurden of ProofLabor Code section 3202.5WCAB Rule 10451.1(f)(1)(A)Petition for Determination of Non-IBR Medical Legal DisputeMedical Legal ExpenseExplanation of ReviewPrimary Treating Physician
References
7
Case No. 12-CV-656(LJV)(LGF)
Regular Panel Decision

Davis v. 2191 Niagara St., LLC

This case addresses the defendants' objections to a Magistrate Judge's Report and Recommendation and an appeal of his Decision and Order, arising from a Fair Labor Standards Act claim. The central issue is whether New York Labor Law § 196-d, which prohibits employers from retaining gratuities or purported gratuities, is preempted by the Internal Revenue Code (IRC) or the FLSA. The District Court affirmed the Magistrate Judge's findings, concluding that compliance with both federal and state law is possible, particularly by providing a required disclosure to customers. The court found no impossibility or obstacle preemption. Consequently, the defendants' motion for judgment on the pleadings was denied, and the case was recommitted for further proceedings.

Fair Labor Standards ActNew York Labor LawGratuities RetentionService Charges DistributionFederal PreemptionSupremacy ClauseInternal Revenue Code ComplianceMagistrate Judge ReviewMotion for Judgment on PleadingsStatutory Interpretation
References
22
Case No. MISSING
Regular Panel Decision

Claim of Washington v. Montefiore Hospital

Claimant, a mechanical engineer, sustained a work-related injury and received initial workers' compensation benefits. The employer later contested further disability, leading to a Workers' Compensation Law Judge (WCLJ) order for medical expert depositions, including one from the employer's expert, Robert Orlandi. Claimant's counsel objected to Orlandi's telephone deposition but failed to formally challenge the notice or raise a specific objection to the oath administration during the deposition. Orlandi's testimony, taken via telephone with the court reporter in New York and Orlandi in Connecticut, concluded that the claimant was no longer disabled. Both the WCLJ and the Workers' Compensation Board credited Orlandi's testimony, finding the claimant waived objections to the deposition's procedural irregularities. The Appellate Division affirmed the Board's decision, ruling that the claimant's failure to make a timely and specific objection to the oath's administration during the deposition constituted a waiver, thus allowing the Board to properly rely on Orlandi's evidence.

Workers' CompensationMedical TestimonyDeposition ProcedureWaiver of ObjectionCPLROath AdministrationDisability AssessmentAppellate ReviewExpert WitnessProcedural Irregularities
References
2
Case No. ADJ3653158 (MON 0338459)
Regular
Jul 16, 2010

SOBEYDA M. LOPEZ (JARKINS) vs. J&M SALES, INC., ARGONAUT INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted the defendant's petition for reconsideration, finding that the WCJ improperly rescinded her prior decision. Lien claimants' petition for reconsideration was denied as it was untimely filed, making the WCJ's initial December 16, 2009 decision final. The WCAB rescinded the WCJ's subsequent orders of January 27, 2010, and April 28, 2010, thereby reinstating the December 16, 2009 decision which disallowed the lien claimants' claims. The WCAB also found the lien claimants' objection to the WCJ's intent to submit on the record to be untimely filed.

Workers' Compensation Appeals BoardPetition for ReconsiderationLien ClaimantsWCJ AuthorityRescission of OrderTimeliness of FilingLabor Code Section 5903Jurisdictional Time LimitFinal OrderBoard Rule 10859
References
10
Case No. ADJ2218706 (VNO 0501260) ADJ1058308 (VNO 0482296)
Regular
Apr 19, 2010

DONNA DeRUSSY vs. ANTELOPE VALLEY HEALTH CARE SYSTEM, TRAVELER'S INSURANCE, SAFETY NATIONAL, FRONTIER INSURANCE

This case concerns appeals from a workers' compensation judge's decision regarding liability for cumulative trauma injury. The Appeals Board granted reconsideration to clarify the determination of the date of injury under Labor Code § 5412, which is crucial for assigning liability to the insurer covering the last year of exposure. The Board found the WCJ's decision lacked sufficient clarity and specific findings regarding disability and knowledge of causation. Therefore, the prior decision was rescinded, and the case was returned for further proceedings to make clear findings consistent with established legal principles.

Workers' Compensation Appeals BoardDonna DeRussyAntelope Valley Health Care SystemTravelers InsuranceSafety NationalFrontier Insurancecumulative traumadate of injuryLabor Code §5500.5Labor Code §5412
References
2
Case No. MISSING
Regular Panel Decision

Rubin v. Valicenti Advisory Services, Inc.

This case addresses objections filed by defendants Valicenti Advisory Services, Inc. and Vincent R. Valicenti against a Magistrate Judge's decision. The Magistrate Judge had granted plaintiff Geoffrey S. Rubin leave to amend his answer to include counterclaims. Rubin, acting as a pension plan trustee, had initially sued VAS for alleged imprudent investment decisions. In response, VAS filed third-party claims against Rubin. Rubin's proposed counterclaims concerned the mismanagement of his personal account by VAS, arguing they were compulsory and related back to the original filing. District Judge Larimer, applying both 'clearly erroneous' and 'de novo' review standards, affirmed the Magistrate Judge's decision, finding that the notice requirement for relation back was satisfied given the connection between the management of the Plan's assets and Rubin's personal account highlighted in the third-party complaint. The objections were thus denied, and the Magistrate Judge's ruling allowing the amendment was upheld.

ERISAInvestment ManagementFiduciary DutyCounterclaimsAmended PleadingsRelation Back DoctrineCompulsory CounterclaimsStatute of LimitationsDistrict Court ReviewMagistrate Judge Decision
References
50
Case No. MISSING
Regular Panel Decision

Claim of Zechmann v. Canisteo Volunteer Fire Department

This case involves an appeal from decisions of the Workers’ Compensation Board regarding death benefits. The claimant's decedent had applied for these benefits. The Board determined that the claim was not barred by Workers’ Compensation Law § 123, making the Special Fund for Reopened Cases liable for the payments under Workers’ Compensation Law § 25-a. The appeals court affirmed the Board’s decision and amended decision, holding that the Special Fund is responsible for the payment of death benefits.

Death BenefitsWorkers' CompensationSpecial FundReopened CasesAppealsStatutory InterpretationLiabilityClaimantDecedentBoard Decision
References
0
Case No. MISSING
Regular Panel Decision

Claim of Iamiceli v. American Telephone & Telegraph

The case involves an appeal from a Workers' Compensation Board decision regarding an employer's entitlement to reimbursement. The claimant suffered a right arm injury in 1987. A Workers’ Compensation Law Judge (WCLJ) initially awarded schedule loss of use and credited the self-insured employer for $6,144.30. Claimant’s counsel objected to this reimbursement. The Workers’ Compensation Board later found that the employer had failed to make a timely written or oral request for reimbursement prior to the award, and thus was not entitled to it. The employer appealed this finding. The Appellate Division affirmed the Board's decision, reiterating that reimbursement under Workers’ Compensation Law § 25 (4) (a) requires a timely request before the compensation award is made.

Workers' Compensation LawReimbursementTimely RequestSchedule Loss of UseEmployer LiabilityBoard DecisionAppellate ReviewProcedural ComplianceCompensation Award
References
3
Case No. ADJ8 140254
Regular
Mar 25, 2016

JOSHUA HAMILTON vs. FRESNO COUNTY SHERIFF'S DEPARTMENT, AMERICAN ALL-RISK LOSS ADMINISTRATORS

The Workers' Compensation Appeals Board granted reconsideration of a decision that denied liability for applicant's spinal surgery. The applicant argued the defendant improperly denied benefits based on an unsigned objection to the treating physician's recommendation. The Board found the defendant's objection may not have been timely initiated, a point not raised at trial. Therefore, the Board rescinded the prior decision and returned the case to the trial level for further proceedings and evidence regarding the timeliness of the objection.

WCABspinal surgerytemporary disabilityLabor Code section 4850Labor Code section 4062(b)objection to treating physiciansecond opinion processutilization reviewtimelinerescinded
References
2
Case No. MISSING
Regular Panel Decision
Nov 17, 2005

Nikolic v. Regent Wall Street Hotel

The claimant sustained work-related physical injuries and a subsequent psychiatric condition. A Workers’ Compensation Law Judge allowed reports from a Serbian neuropsychiatrist to establish continuing psychiatric disability, despite objections from the employer and carrier concerning the doctor's credentials. The Workers’ Compensation Board, in an amended decision, rejected the objection to the Serbian doctor's report and found no prejudice to the carrier regarding a compensation award made prior to an independent medical examination. The appeals court affirmed the Board's decision, ruling that the carrier waived the right to object by not cross-examining the doctor, and that the Board had continuing jurisdiction to amend its initial decision.

foreign health care provider reportpsychiatric conditionadmissibility of evidenceWorkers’ Compensation Boardcontinuing jurisdictionwaiver of objectionindependent medical examinationappellate reviewNew York Workers' Compensationmedical credentials
References
10
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