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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

Smith v. New York State & Local Retirement Systems

Petitioner, a taxpayer services representative, sustained a back injury in March 1981 while lifting forms, leading to a decline in attendance and eventual termination in November 1989. She applied for accidental and ordinary disability retirement benefits, both of which were denied by the Comptroller. The accidental disability claim was denied because the incident was not deemed an 'accident' under Retirement and Security Law § 63. The ordinary disability claim was denied as untimely, having been filed approximately six months after her termination, exceeding the 90-day limit stipulated by Retirement and Social Security Law § 62. The Supreme Court dismissed the challenge to the ordinary disability denial due to untimeliness and transferred the accidental disability challenge to this Court. This Court confirmed the Comptroller's determination on both counts, rejecting the petitioner's estoppel argument regarding the untimely ordinary disability application and finding substantial evidence to support the finding that the injury did not constitute an 'accident' within the meaning of the relevant law, as it resulted from ordinary employment duties without an unexpected event.

Disability Retirement BenefitsAccidental DisabilityOrdinary DisabilityUntimely ApplicationEstoppel Against GovernmentWork-Related InjuryBack InjuryDefinition of AccidentOrdinary Employment DutiesSubstantial Evidence Review
References
16
Case No. ADJ3192331
Regular
Feb 17, 2010

AURORA REALIVASQUEZ vs. TURBOT JET PRODUCTS, INC., STATE COMPENSATION INSURANCE FUND

The applicant sought reconsideration of a Workers' Compensation Appeals Board (WCAB) decision that awarded 50% permanent disability, apportioned from a prior award. The applicant argued the defendant failed to prove the prior award's disability overlapped with the current injury. The WCAB denied reconsideration, finding the defendant met its burden by demonstrating overlapping subjective factors of disability between the prior and current injuries, based on medical reports from Dr. Capen and Dr. Danzig. This overlap in disability affecting the same earning abilities justified the apportionment under Labor Code section 4664(b).

Workers' Compensation Appeals BoardReconsiderationFindings and AwardPermanent DisabilityApportionmentIndustrial InjuryNeck InjuryShoulder InjuryBimanual InjuryCumulative Trauma
References
4
Case No. MISSING
Regular Panel Decision
May 15, 2012

Hamzik v. Office for People with Developmental Disabilities

Plaintiff John J. Hamzik sued the Office for People with Developmental Disabilities (OPWDD) and several individual employees, alleging discrimination based on sex, age, and disability, as well as equal protection, due process, and retaliation claims under federal and state laws, including Title VII, ADEA, and ADA. Defendants moved to dismiss the amended complaint, and plaintiff cross-moved to file a second amended complaint. The District Court, finding that many claims were barred by Eleventh Amendment immunity or failure to exhaust administrative remedies, and that the remaining claims failed to state a plausible cause of action, granted the defendants' motion to dismiss. All federal claims were dismissed with prejudice, the cross-motion was denied as futile, and the remaining state law claims were dismissed without prejudice.

DiscriminationRetaliationDue ProcessEqual ProtectionTitle VIIADEAADAEleventh Amendment ImmunityAdministrative ExhaustionMotion to Dismiss
References
50
Case No. MISSING
Regular Panel Decision
Jul 24, 2002

In re the Claim of Miller v. North Syracuse Central School District

This case involves an appeal from a Workers' Compensation Board decision concerning overlapping workers' compensation awards. The claimant, a food services worker, filed two separate claims: one for occupational disease to her shoulders, leading to a schedule loss of use award, and another for bilateral carpal tunnel syndrome, which resulted in a temporary total disability award for the period from December 13, 1999, to February 14, 2000. The State Insurance Fund argued that the schedule loss of use award should be suspended for this period to prevent an overlap. Initially, a Workers’ Compensation Law Judge disagreed, but the Workers’ Compensation Board reversed, ruling in favor of suspending the schedule award. On appeal, the court reversed the Board's decision, clarifying that a schedule award is not allocable to a specific period of disability and therefore does not overlap with a temporary total disability award covering a limited timeframe. The court distinguished this from cases involving permanent disability awards. The matter was remitted to the Workers’ Compensation Board for recalculation of the claimant’s award.

Workers' CompensationSchedule Loss of UseTemporary Total DisabilityOverlapping AwardsEarning CapacityOccupational DiseaseCarpal Tunnel SyndromeShoulder InjuryAppellate ReviewRecalculation of Award
References
7
Case No. 2020 NY Slip Op 02301 [182 AD3d 821]
Regular Panel Decision
Apr 16, 2020

Matter of Community, Work, & Independence, Inc. v. New York State Off. for People with Dev. Disabilities

This case involves a CPLR article 78 proceeding initiated by Community, Work, and Independence, Inc. (petitioner) to challenge a determination affirming the objection to its proposed discharge of M.D., an individual with developmental disabilities, from day habilitation services. M.D.'s parents objected to the discharge, and an administrative hearing sustained their objection, a decision later affirmed by the Commissioner of the Office for People with Developmental Disabilities. The Appellate Division, Third Department, confirmed the Commissioner's determination, finding that the burden of proof was appropriately placed on the service provider. The court concluded that substantial evidence supported the finding that discharging M.D. was not reasonable, considering his needs, the lack of suitable alternative programs, and despite the petitioner's financial concerns. The court suggested that financial issues for service providers should be addressed by seeking increased funding rather than by discharging individuals.

Developmental DisabilityHCBS WaiverDischarge ServicesAdministrative HearingBurden of ProofSubstantial EvidenceFinancial ConcernsService ProviderMedicaid FundingAutism Spectrum
References
7
Case No. ADJ2212207 (STK 0188509)
Regular
Dec 17, 2008

Burl Gene Condit vs. CITY OF MODESTO, Permissibly Self-Insured

In this case, the applicant sought reconsideration of a workers' compensation award that significantly reduced his permanent disability benefits due to apportionment based on prior injuries. The Workers' Compensation Appeals Board granted reconsideration, finding the trial judge erred by placing the burden on the applicant to prove lack of overlap. The Board clarified that under Labor Code section 4664, the defendant bears the burden of proving that prior permanent disability overlaps with the current disability. Consequently, the case was returned to the trial level for further proceedings on the issue of overlap.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardPermanent DisabilityApportionmentLabor Code Section 4664Prior AwardsOverlapBurden of ProofKopping v. Workers' Comp. Appeals Bd.
References
2
Case No. MISSING
Regular Panel Decision

Bullard v. St. Mary's Hospital

Claimant, a secretary at St. Mary's Hospital, developed rheumatoid arthritis, resulting in a permanent partial disability. The Workers' Compensation Board ruled it an occupational disease and awarded compensation. Liability was apportioned among three employers: Rochester Savings Bank, Woodward Health Center, and St. Mary's Hospital. The Special Disability Fund (SDF) was deemed liable for benefits after the initial 104-week disability period. SDF appealed, contending its reimbursement should be limited to St. Mary's Hospital's one-third share. The court affirmed the Board's decision, holding that Workers' Compensation Law § 44 makes the last employer (St. Mary's) responsible for total compensation, and Workers' Compensation Law § 15 (8) (d) requires SDF to fully reimburse the employer's carrier, Sedgwick James, for benefits paid after 104 weeks.

Occupational DiseaseRheumatoid ArthritisPermanent Partial DisabilityApportionmentSpecial Disability FundReimbursementWorkers' Compensation LawLast Employer LiabilityInsurance CarrierWorkers' Compensation Board
References
0
Case No. ADJ3351309 (LBO 0383773)
Regular
Jul 27, 2017

JOSE ALDANA vs. FAIRMOUNT TIRE AND RUBBER, CRUM & FORSTER, STATE COMPENSATION INSURANCE FUND

Here's a summary of the case in four sentences for a lawyer: The Workers' Compensation Appeals Board denied Crum & Forster's petition for reconsideration, upholding the finding of 100% permanent disability for Jose Aldana's 2006 industrial injury. The Board granted SCIF's petition to correct a clerical error, amending the award to designate Crum & Forster as the solely liable insurer. Crum & Forster's arguments regarding the vocational expert's report and potential disability overlap with a prior 2004 eye injury were rejected. The Board affirmed that Aldana is entitled to the full 100% permanent disability award as the claimed overlap disability was not established.

Permanent Total DisabilityAgreed Medical ExaminersAMA GuidesLabor Code Section 4664(c)(1)Newman v. Workers' Comp. Appeals. Bd.Kopping v. Workers' Comp. Appeals. Bd.Apportionment to CausationOverlapping DisabilitiesVocational ExpertFindings of Fact and Award
References
4
Case No. ADJ10763960
Regular
May 20, 2019

DENNIS ROMERO vs. COUNTY OF SAN DIEGO

This case involves a workers' compensation appeal where the defendant, County of San Diego, sought reconsideration of an award granting the applicant, Dennis Romero, permanent disability. The defendant argued that the administrative law judge improperly overlapped factors of disability when assessing the applicant's $94\%$ permanent disability rating. The Appeals Board denied reconsideration, adopting the judge's report which found that the qualified medical evaluator considered factors beyond shortness of breath, such as left ventricular hypertrophy and lightheadedness, when determining impairments for hypertensive and coronary heart disease. The Board also cited legal precedent that the multiple disabilities rating schedule accounts for any overlap.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings Award and OrderDeputy SheriffIndustrial InjuryHeart InjuryHypertensionPermanent DisabilityHypertensive Heart DiseaseCoronary Heart Disease
References
1
Case No. SFO 0479038
En Banc
Oct 26, 2005

JACK C. STRONG vs. CITY & COUNTY OF SAN FRANCISCO

This en banc decision holds that Labor Code section 4664 requires apportionment of overlapping permanent disabilities from prior awards, even when involving different body regions. It establishes that the defendant must prove the prior award exists, after which the disability is conclusively presumed to exist, and the burden shifts to the applicant to disprove that the old and new disabilities overlap in their effect on the ability to compete and earn.

SB 899Labor Code section 4664apportionmentpermanent disabilityoverlapping disabilitiesprior awardconclusively presumedburden of proofrebuttable presumptionunique factors of disability
References
54
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