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Case No. ADJ14627934

Regular

Apr 21, 2023

ELSA GARCIA JOFFRE GARCIA (Deceased) vs. U.S. BANK, OLD REPUBLIC

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior finding, remanding the case for further proceedings. The Board determined that the statutory presumption of industrial injury for COVID-19 did not apply as there was insufficient evidence of an "outbreak" at the applicant's workplace. Therefore, the applicant must now prove industrial causation without the benefit of this presumption. This requires substantial medical evidence to establish that the applicant contracted COVID-19 during the course of employment.

COVID-19industrial basispresumptionoutbreakAOE/COEmedical-legal evaluationPQMErebuttalsubstantial evidencedeath claim

References

Case No. MISSING

Regular Panel Decision

Abraham v. City of New York

This case involves an appeal concerning the liability of the City of New York and its Department of Health and Mental Hygiene in responding to a suspected tuberculosis outbreak at Our Lady of Lourdes School. Plaintiffs, comprising students, teachers, and their families, initiated a personal injury action against the school entities and the municipal defendants, alleging negligence in notification and allowing the school to reopen. The Supreme Court granted a motion to dismiss claims against the City and Department based on governmental immunity. The appellate court affirmed this dismissal, concluding that the city's actions were discretionary and thus protected by immunity, and that no special relationship, as defined by law, existed between the municipality and the plaintiffs to overcome this immunity.

Governmental ImmunityMunicipal LiabilityCommunicable Disease OutbreakTuberculosisPublic Health ResponseSpecial Relationship DoctrineDiscretionary ActMinisterial ActNegligencePersonal Injury

References

Case No. MISSING

Regular Panel Decision

Indian Harbor Insurance v. Factory Mutual Insurance

The Trustees of the University of Pennsylvania ("Penn") and Indian Harbor Insurance Company ("Indian Harbor") sued Factory Mutual Insurance Company ("FM") seeking a declaratory judgment regarding insurance coverage for damages Penn sustained at its veterinary hospital due to a Salmonella outbreak. FM moved to transfer the venue from the Southern District of New York to the Eastern District of Pennsylvania, citing convenience of parties and witnesses and the interests of justice. The Court considered factors such as the locus of operative facts being in Pennsylvania, the convenience of key witnesses like FM's adjuster, and the Eastern District of Pennsylvania's familiarity with the governing law and lighter docket. The Court ultimately granted FM's motion, finding that the balance of factors strongly favored transferring the case.

Venue TransferDeclaratory JudgmentInsurance Coverage DisputeProperty LossSalmonella OutbreakVeterinary HospitalForum Selection ClauseChoice of LawJudicial EconomyInter-district Transfer

References

Case No. MISSING

Regular Panel Decision

Gonzalez v. Barnhart

Plaintiff Julia Gonzalez initiated this action against the Commissioner of Social Security, asserting that her application for disability benefits and supplemental security income was improperly denied. Gonzalez, a 36-year-old former assembly line worker, claimed disability due to her HIV+/AIDS status, complicated by recurrent herpes simplex virus (HSV) outbreaks and chronic leg pain. The Administrative Law Judge (ALJ) had initially denied her application, concluding she retained the residual functional capacity to perform sedentary work. However, the District Court found that the ALJ committed errors by not properly evaluating Gonzalez's impairment under specific HIV listings (14.08D2a and 14.08N) of the Social Security Act and by failing to adequately credit the medical opinions of her treating physician, Dr. Amneris Luque. Consequently, the court granted Gonzalez's motion for judgment on the pleadings, reversed the Commissioner's decision, and remanded the case for the sole purpose of calculating and paying benefits.

Social Security ActDisability BenefitsSupplemental Security IncomeHIV/AIDSHerpes Simplex Virus (HSV)Residual Functional Capacity (RFC)Sedentary WorkTreating Physician RuleAdministrative Law Judge ErrorJudgment on Pleadings

References

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ELSA GARCIA JOFFRE GARCIA (Deceased) vs. U.S. BANK, OLD REPUBLIC

COVID-19industrial basispresumptionoutbreakAOE/COEmedical-legal evaluationPQMErebuttalsubstantial evidencedeath claim

Abraham v. City of New York

Governmental ImmunityMunicipal LiabilityCommunicable Disease OutbreakTuberculosisPublic Health ResponseSpecial Relationship DoctrineDiscretionary ActMinisterial ActNegligencePersonal Injury

Indian Harbor Insurance v. Factory Mutual Insurance

Venue TransferDeclaratory JudgmentInsurance Coverage DisputeProperty LossSalmonella OutbreakVeterinary HospitalForum Selection ClauseChoice of LawJudicial EconomyInter-district Transfer

Gonzalez v. Barnhart