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Case Law Database

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

Case No. MISSING
Regular Panel Decision

Claim of Keselman v. New York City Transit Authority

Claimant, injured in 1986, initially established a right shoulder injury. The Workers’ Compensation Board affirmed this but denied a causally related neck injury in 1996. After another application in 1998 alleging a worsened neck condition, the Workers’ Compensation Law Judge found a causally related neck injury and permanent partial disability, awarding benefits from February 5, 1998, which the Board affirmed. Separately, the Board also ruled the employer was entitled to credit schedule payments against disability payments made after February 5, 1998. The court affirmed both decisions, finding substantial evidence supported the deterioration of the neck injury post-1996 and that schedule awards are independent of actual disability periods, thus allowing the employer's credit.

Workers' CompensationPermanent Partial DisabilitySchedule AwardDisability PaymentsNeck InjuryRight Shoulder InjuryCausally Related InjuryReopening CaseMedical EvidenceMRI
References
7
Case No. ADJ2759696 (VNO 0492027)
Regular
Oct 11, 2010

WOON YOUNG PARK vs. FILM PAYMENT SERVICES, INC., CHARTIS INSURANCE

The Board granted reconsideration, rescinding the WCJ's decision on the defendant's credit for overpaid temporary disability. The defendant is allowed credit for temporary disability payments made from March 26, 2009, to June 3, 2009, at the temporary disability rate. Further credit is granted for payments made from June 4, 2009, to December 7, 2009, at the permanent disability rate of $185.00 per week. The Board denied further credit due to insufficient evidence regarding post-AME report overpayments.

Petition for ReconsiderationPermanent DisabilityTemporary DisabilityCreditStipulated AwardAgreed Medical ExaminationPermanent and StationarySection 4909Abuse of DiscretionDue Process
References
0
Case No. OAK 0336357 OAK 0336358
Regular
Aug 05, 2008

MARSHALL HOLDER vs. UNICO SERVICES, STATE COMPENSATION INSURANCE FUND

This case concerns an applicant with two shoulder injuries that resulted in overlapping temporary disability. The Appeals Board reversed the WCJ's award of ongoing temporary disability, finding that Labor Code section 4656(c)(1) limits payments to 104 weeks within two years of the *first* temporary disability payment. Therefore, the applicant is entitled to temporary disability indemnity for two years from April 5, 2005, and not thereafter.

Temporary disability indemnityconcurrent temporary disabilityLabor Code section 4656(c)(1)Hawkins v. Amberwood ProductsFoster v. Workers' Comp. Appeals Bd.date of commencement of temporary disability paymentaggregate disability paymentstwo-year limitationbilateral shoulder injuryleft shoulder injury
References
2
Case No. ADJ91 04682
Regular
Mar 15, 2016

NOEL CERVANTES vs. UCLA MEDICAL CENTER, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and awarded lien claimant Liberty Life Assurance reimbursement for $3,940.85 in short-term disability payments. The WCAB found that the lien claimant provided sufficient notice of its payments to UCLA Medical Center before UCLA paid overlapping temporary disability benefits. Legibility of a reimbursement agreement was deemed irrelevant when the parties stipulated to the payments made. Therefore, UCLA Medical Center was ordered to reimburse Liberty Life Assurance for these benefits under Labor Code section 4903.1.

Labor Code section 4903.1(a)Lien claimantPetition for ReconsiderationGroup disability policyReimbursement AgreementOverlapping disability paymentsNotice of lienTemporary disability benefitsShort-term disability paymentsCompromise and Release Agreement
References
1
Case No. ADJ7995938
Regular
Sep 04, 2015

SUSANA LOPEZ vs. STATE OF CALIFORNIA, DEPARTMENT OF INDUSTRIAL RELATIONS, OFFICE OF THE DIRECTOR, RTWS, Legally Uninsured, Adjusted By STATE COMPENSATION INSURANCE FUND/STATE CONTRACT SERVICES

The Workers' Compensation Appeals Board granted reconsideration to clarify attorney's fees related to temporary disability. The Board deferred the issue of additional temporary disability to ensure compliance with the 104-week limit and overlapping payments. Attorney fees of 12% will be calculated on any newly awarded temporary disability and paid from the permanent disability award if no temporary disability funds remain. The Board otherwise affirmed the previous award, including the 15% increase in permanent disability under Labor Code section 4658(d) based on applicant's unrebutted testimony about lack of modified work.

Workers' Compensation Appeals BoardDeputy Labor CommissionerIndustrial InjuryLumbar SpinePsycheTemporary DisabilityPermanent DisabilityLabor Code Section 4658(d)Attorney's FeesPetition for Reconsideration
References
1
Case No. SAC 0340252
Regular
Oct 24, 2007

ROY HOWARD vs. MERCER STAFFING, aka AMERICAN STAFF RESOURCES, CASCADE NATIONAL INSURANCE, in liquidation, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION

This case concerns whether temporary disability payments should extend indefinitely after an industrial back and shoulder injury. The Appeals Board determined that Labor Code section 4656(c)(1) limits aggregate temporary disability payments to 104 weeks within a two-year period from the *first payment* of temporary disability, not the date disability is owed. Therefore, the award was amended to terminate payments on January 28, 2007, the two-year anniversary of the initial payment.

Labor Code section 4656(c)(1)temporary disability indemnitydate of commencement of temporary disability payment104 compensable weeksaggregate disability paymentspetition for reconsiderationFindings and AwardWorkers' Compensation Appeals Boardindustrial injurytruck driver
References
1
Case No. MISSING
Regular Panel Decision
Jun 20, 1986

Claim of Foglia v. New York City Housing Authority

The claimant, a New York City Housing Authority police officer, sustained a compensable knee injury in 1974. The case was reopened in 1983 due to increased disability, and the Special Fund for Reopened Cases was put on notice for potential liability under Workers' Compensation Law § 25-a. The issue was whether there was an advance payment of compensation, which would relieve the Special Fund from liability. The claimant testified that he retired in 1983 but had been on limited duty performing clerical work at full salary since 1982 due to his injury. The Workers' Compensation Board determined that these full salary payments for lighter work constituted an advance payment of compensation. The court affirmed the Board's decision, finding substantial evidence to support the determination that an advance payment of compensation relieved the Special Fund from liability.

Workers' Compensation BoardAdvance PaymentSpecial FundReopened CasesDisabilitySchedule LossPolice OfficerLimited DutySubstantial EvidenceFactual Determination
References
2
Case No. ADJ6464819 ADJ6463500
Regular
Apr 08, 2011

PRUDENCIO SATUMBAGA vs. LEPRINO FOODS, permissibly self-insured, administered by MATRIX ABSENCE MANANGEMENT, INC.

This case involves an applicant awarded temporary total disability for a low back injury. The defendant sought reconsideration, arguing the injury lacked credible evidence and that the Employment Development Department (EDD) lien was improperly handled. The Appeals Board granted reconsideration to address the EDD lien's overlap with the temporary disability award. Ultimately, the original award was affirmed, but with the temporary disability payments to be reduced by the EDD lien, and a partial permanent disability award was also made.

Workers' Compensation Appeals BoardPrudencio SatumbagaLeprino FoodsMatrix Absence ManagementADJ6464819ADJ6463500Opinion and Order Granting ReconsiderationFindings and Awardindustrial injurylow back
References
0
Case No. SDO 0328208
Regular
Mar 17, 2008

ARMANDO ADAME vs. AUTOMOTIVE ENGINEERED PRODUCTS, INC. (dba JBA HEADERS), ZENITH INSURANCE COMPANY

The Appeals Board clarified that for Labor Code section 4656(c)(1) purposes, the commencement of temporary disability payments is the date the employer first mails a temporary disability indemnity check, not when EDD benefits begin. Furthermore, EDD benefits, even if reimbursed by the employer, do not count towards the 104-week cap on temporary disability payments. Consequently, the employer's liability for further temporary disability payments extends from the date of the first actual indemnity payment until October 6, 2007.

Workers Compensation Appeals BoardArmando AdameAutomotive Engineered ProductsZenith Insurance CompanyLabor Code section 4656(c)(1)Temporary Total DisabilityTemporary Disability IndemnityEmployment Development DepartmentUnemployment Compensation DisabilityHawkins v. Amberwood Products
References
2
Case No. 2018 NY Slip Op 05652 [164 AD3d 1000]
Regular Panel Decision
Aug 02, 2018

Matter of Robinson v. Workmen's Circle Home

Barbara Robinson, a certified nurse's assistant, filed a claim for workers' compensation benefits for a work-related right shoulder injury in 2011. She received temporary disability payments totaling $133,807.48. In 2016, a Workers' Compensation Law Judge (WCLJ) awarded her a 42.50% schedule loss of use (SLU) to her right arm, amounting to $102,494.50, less prior payments. Robinson appealed the WCLJ's decision, arguing that the employer's carrier should not be credited for temporary partial disability payments against the SLU award. The Workers' Compensation Board disagreed, ruling that the carrier could credit all prior disability payments. The Appellate Division, Third Department, affirmed the Board's decision, finding no basis to differentiate between temporary total and temporary partial disability payments for credit purposes, thereby preventing an unjustifiable double recovery for the claimant.

Workers' CompensationSchedule Loss of UseTemporary Disability PaymentsCreditDouble RecoveryAppellate DivisionWork-Related InjuryRight Shoulder InjuryCarrier ReimbursementLegal Precedent
References
7
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