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

Case No. ADJ4258585 (OXN 0130492) ADJ220258 (OXN 0130487)
Regular
Apr 17, 2018

ENRIQUE HERRERA vs. MAPLE LEAF FOODS, U.S. FIRE INSURANCE COMPANY, ALEA NORTH AMERICAN INSURANCE COMPANY

This notice informs parties that the Workers' Compensation Appeals Board (WCAB) intends to admit its rating instructions and a disability rater's recommended permanent disability rating into evidence. The WCAB previously granted reconsideration for further study. Parties have seven days to object to the rating instructions or the recommended rating, with specific procedures for addressing objections. If no timely objection is filed, the matters will be submitted for decision thirty days after service.

WORKERS' COMPENSATION APPEALS BOARDPermanent Disability RatingDisability Evaluation UnitRating InstructionsRecommended Permanent Disability RatingJoint RatingReconsiderationObjectionRater Cross-ExaminationRebuttal Evidence
References
0
Case No. ADJ3793506 (LBO 0329885)
Regular
Jun 18, 2014

LYDIA QUINONES vs. STAR RING/CALIFORNIA INDEMNITY INSURANCE COMPANY as administered by GALLAGHER BASSETT SERVICES, INC.

The Appeals Board granted the defendant's petition for reconsideration of a prior award. The defendant argued its due process rights were violated by the denial of a supplemental QME report and challenged the 100% permanent disability finding and other awards. The Board intends to admit specific applicant expert reports into evidence, subject to objection. A ruling on the merits of the petition will follow a review of any objections.

Petition for ReconsiderationFindings and AwardVocational ExpertHome Health CarePermanent DisabilityQualified Medical EvaluatorDue ProcessSupplemental ReportSubstantial EvidenceAdmitted Evidence
References
2
Case No. ADJ11213816
Regular
Dec 02, 2019

KIM MAILANGKAY vs. PATTON STATE HOSPITAL, STATE COMPENSATION INSURANCE FUND

In this Workers' Compensation Appeals Board case, the applicant's petition for reconsideration was denied. The Board adopted the WCJ's reasoning, which found that the applicant failed to present objective evidence to support her psychiatric injury claim, as required by Labor Code section 3208.3 and the holding in *Verga v. Workers' Comp. Appeals Bd*. The Board also gave significant weight to the WCJ's credibility determinations, noting the opportunity to observe witnesses' demeanor and finding no evidence to overturn those findings. Therefore, the petition for reconsideration was denied based on the lack of substantiated objective evidence and the WCJ's credible findings.

Workers' Compensation Appeals BoardPatton State HospitalState Compensation Insurance FundPetition for Reconsideration DeniedPsychiatric InjuryActual Events of EmploymentObjective EvidenceHarassmentPersecutionVerga v. Workers' Comp. Appeals Bd.
References
2
Case No. MISSING
Regular Panel Decision

Claim of Howe v. New York State Department of Corrections

The case involves an appeal by a claimant's employer and its workers' compensation insurance carrier challenging a $500 penalty imposed by the Workers' Compensation Board. The Board found that the carrier interposed objections to the claimant's benefits claim without just cause. The appellate court affirmed the penalty, holding that "just cause" under Workers' Compensation Law § 25 (2) (c) requires an objective rational basis and relevant, objective, and reasonable evidence to support controverting a claim. A subjective good-faith belief alone is insufficient. The court found that despite opportunities, the carrier failed to provide factual evidence to disprove the claim, relying instead on supposition and unfounded hope.

Workers' Compensation PenaltyJust CauseCarrier ObjectionsEmployer LiabilityStatutory InterpretationObjective Rational BasisGood-Faith BeliefEvidence RequirementsAppellate ReviewBoard Decision Affirmation
References
2
Case No. MISSING
Regular Panel Decision

In Re Bennett

The Chapter 13 debtor, Ernest Bennett, objected to a $34,821 proof of claim filed by Ernest Crute, stemming from a dispute over renovation work Bennett performed on Crute's house in Mount Vernon, New York. Both parties offered conflicting testimonies regarding the existence of a written contract, the scope of work, quality, and financial responsibilities. The court found that Bennett successfully rebutted Crute's initial claim. Crute then failed to prove his claim by a preponderance of credible evidence, citing issues with contract authenticity, lack of proof for expenses, and uncorroborated testimony. Consequently, the court granted the debtor's motion to expunge the claim.

BankruptcyChapter 13Proof of ClaimExpungementContract DisputeRenovationCredibilityBurden of ProofPreponderance of EvidenceWritten Contract
References
6
Case No. MISSING
Regular Panel Decision

Singletary v. Apfel

Plaintiff Sylvester M. Singletary appealed the Commissioner of Social Security's denial of disability insurance benefits, leading to this action under 42 U.S.C. § 405(g). The Court reviewed the final determination, including an Administrative Law Judge's decision, which the Appeals Council upheld. The central issue revolved around the ALJ's rejection of Singletary's treating physician's opinion of total disability, which the ALJ deemed unsupported by objective evidence, specifically the absence of disc herniation. The Court found that the ALJ arbitrarily substituted his lay opinion for competent medical evidence and ignored other objective findings like degenerative disc disease and disc bulging. Consequently, the Commissioner’s decision was not supported by substantial evidence, and the case was remanded solely for the calculation of benefits, with the plaintiff's motion for judgment on the pleadings granted.

Disability BenefitsSocial Security ActTreating Physician RuleSubstantial Evidence ReviewDegenerative Disc DiseaseChronic PainSpinal ImpairmentALJ ErrorRemandFederal Court Review
References
13
Case No. 535866
Regular Panel Decision
Jun 01, 2023

In the Matter of the Claim of Eleucadio Gallardo

Claimant Eleucadio Gallardo appealed a Workers' Compensation Board decision that denied his application for review due to non-compliance with 12 NYCRR 300.13(b). Gallardo sustained right leg injuries in September 2020 and filed a claim, with Charles J Kling Enterprises LLC and its carrier accepting liability as the employer. After a WCLJ established the claim and awarded benefits, Gallardo sought Board review, arguing Kling Enterprises was incorrectly named and submitting new evidence. The Board denied review, citing Gallardo's failure to object during the hearing and non-compliance with submission requirements for new evidence, specifically the lack of a sworn affidavit. The Appellate Division affirmed the Board's decision, finding no abuse of discretion as Gallardo failed to interpose an objection to the WCLJ's ruling and did not provide the required sworn affidavit for additional evidence.

Workers' Compensation Board ReviewAdministrative AppealFailure to ObjectNew Evidence Submission12 NYCRR 300.13Procedural ComplianceAppellate Division AffirmationEmployer IdentificationCarrier LiabilityWCLJ Decision
References
6
Case No. ADJ1856849
Regular
Aug 21, 2014

ROGELIO MERLOS vs. AJ SLENDERS DAIRY, ZENITH INSURANCE COMPANY

This Workers' Compensation Appeals Board (WCAB) notice indicates they are reconsidering a prior ruling that excluded defendant's exhibits A through M as irrelevant. The WCAB believes these exhibits may be relevant to the issues presented at trial. Absent timely written objection demonstrating good cause, these exhibits will be admitted into evidence. This decision will inform the final determination on the defendant's petition for reconsideration.

Petition for ReconsiderationExhibits A through MWCJNotice of Intention to Admit EvidenceWorkers' Compensation Appeals BoardWorkers' Compensation Administrative Law JudgeGood CauseWritten ObjectionDemonstration of Good CauseService of Notice
References
0
Case No. ADJ779674 (VNO 0477979)
Regular
Sep 21, 2012

CAESAR (CESAR) RIVAS vs. CITY OF LOS ANGELES

The Workers' Compensation Appeals Board (WCAB) is reconsidering a prior award in the case of Caesar Rivas v. City of Los Angeles. The WCAB intends to admit into evidence two previously marked-for-identification medical reports: one by Gary Halote and another by Dr. David Glaser. These reports were initially excluded due to objections but will now be admitted unless good cause to the contrary is shown within ten days. Upon expiration of this period, the case will be submitted for a decision after reconsideration.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardGary Halote reportDr. David Glaser reportNotice of Intention to Admit EvidenceMarked for IdentificationObjected to evidenceDecision After ReconsiderationPermissibly Self-Insured
References
0
Case No. ADJ7790883
Regular
Nov 01, 2012

MACARIO JAIMES vs. FS PRECISION TECH, TRAVELERS, STATE COMPENSATION INSURANCE FUND, PACIFIC COMPENSATION, HOME ASSURANCE

The Workers' Compensation Appeals Board granted reconsideration to obtain a hearing transcript and allow the defendant, Travelers Insurance, to submit correspondence. This correspondence, including a representation letter from applicant's attorney, is relevant to the presumed compensability of the applicant's industrial injury claim under Labor Code section 5402. The Board now intends to admit these documents into evidence unless a written objection with good cause is filed within 10 days. All future communications regarding this case must be submitted in writing to the Board's Commissioners.

Workers' Compensation Appeals BoardMacario JaimesFS Precision TechTravelersState Compensation Insurance FundPacific CompensationHome AssuranceChartisLabor Code section 5402presumption of compensability
References
0
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