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

Case No. 2020 NY Slip Op 02513 [182 AD3d 954]
Regular Panel Decision
Apr 30, 2020

Matter of Colon (Pd 10276, Inc.--Commissioner of Labor)

Nicanor Colon filed for unemployment insurance benefits after ceasing operation of his cleaning business, leading the Department of Labor to assess PD 10276, Inc., doing business as Jan-Pro Cleaning Systems of the Hudson Valley, for additional unemployment insurance contributions. An Administrative Law Judge initially ruled Colon an independent contractor, but the Unemployment Insurance Appeal Board reversed this decision, finding Colon and similarly situated individuals to be employees. PD 10276, Inc. appealed the Board's decision to the Appellate Division, Third Department. The Appellate Division affirmed the Board's determination, concluding that there was substantial evidence of an employment relationship based on the indicia of control exercised by Jan-Pro Cleaning over its unit franchisees, similar to findings in prior cases like Matter of Baez. The court highlighted requirements like certification, provision of supplies, periodic inspections, and noncompetition clauses as supporting the Board's conclusion.

Unemployment InsuranceIndependent Contractor StatusEmployment RelationshipFranchise AgreementAppellate ReviewSubstantial EvidenceJan-Pro Cleaning SystemsDepartment of LaborUnit FranchiseesLabor Law
References
6
Case No. ADJ7315205
Regular
Jul 08, 2010

JOSE H. HERNANDEZ vs. COVE BUILDERS, INC., STATE COMPENSATION INSURANCE FUND

This case involves a dispute over the calculation of permanent disability (PD) payments for an applicant with 100% PD. The defendant appealed an order that adjusted PD payments based on a calculation by T. Blair McGowan, arguing that McGowan's calculations incorrectly applied a 15% increase under Labor Code section 4658(d)(2) and improperly included cost of living adjustments (COLA) prior to the date of injury. The Board granted reconsideration, finding the 15% increase inapplicable to 100% PD cases. However, due to the unsettled legal status of COLA calculations following *Duncan v. WCAB*, the Board rescinded the prior order and remanded the case for further proceedings to determine the correct PD rate.

Workers' Compensation Appeals BoardReconsiderationClerical ErrorPermanent Disability RateLabor Code Section 4658(d)(2)Labor Code Section 4659(c)Cost of Living AdjustmentDate of Injury100% Permanent DisabilityPermanent Partial Disability
References
1
Case No. ADJ11147927
Regular
Oct 23, 2020

RAY SLAUGHTER vs. WALSH SHEA CORRIDOR CONSTRUCTORS, ESIS

The Workers' Compensation Appeals Board denied reconsideration of a decision that halted permanent disability (PD) advances. The applicant argued for continued advances due to ongoing temporary total disability and a lack of a definitive PD estimate, despite exhausting temporary disability benefits. The Board found no legal basis to order further PD advances and stated the applicant could conduct further discovery and present new evidence on the issue. The applicant failed to meet his burden of proof for continuing these advances.

Workers' Compensation Appeals BoardPermanent Disability AdvancesTemporary DisabilityPetition for ReconsiderationWCJ reportAdditional EvidenceLabor CodePermanent Disability IndemnityMedical OpinionPost-Surgical Condition
References
0
Case No. ADJ1834869
Regular
Feb 10, 2014

GREGORY CLEVELAND vs. CITY OF LOS ANGELES

The Workers' Compensation Appeals Board denied the employer's petition for reconsideration regarding permanent disability (PD) awarded to the applicant. The Board adopted the findings of the administrative law judge, noting the defendant's failure to cross-examine the rater on the calculation of PD, which included instructions to consider overlap of heavy lifting. Furthermore, the Board admonished the defendant for attaching documents to its petition in violation of board rules. The applicant was awarded PD based on restrictions from heavy lifting for his cervical spine and right shoulder.

WORKERS' COMPENSATION APPEALS BOARDCITY OF LOS ANGELESPERMISSIBLY SELF-INSUREDPETITION FOR RECONSIDERATIONDENIEDRATING INSTRUCTIONSOVERLAPVERY HEAVY LIFTINGAPPORTIONMENTLABOR CODE §4664
References
2
Case No. ADJ10518881
Regular
Mar 17, 2025

JOSE RAMIREZ vs. QUALITY SCALES UNLIMITED, INSURANCE COMPANY OF THE WEST

Applicant Jose Ramirez sought reconsideration of a Findings and Awards (F&A) issued on December 17, 2024, which determined a 40% permanent disability (PD) rating, notably excluding any psychiatric component. Ramirez contended that this rating was inadequate, citing inconsistent PQME reports with higher PD ratings, unaddressed surgical scars, the omission of a psychiatric component despite claims of a catastrophic injury, and newly discovered evidence. The Workers' Compensation Appeals Board (WCAB) granted reconsideration, ruling that the Workers' Compensation Judge's (WCJ) initial decision lacked sufficient explanation for the PD rating and the catastrophic injury determination. Additionally, the WCAB found that the WCJ improperly relied on an inadmissible consultative rating determination. As a result, the WCAB amended the F&A to defer the issues of permanent disability impairment rating and attorney's fees, while otherwise affirming the WCJ's decision.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardsPermanent DisabilityPQMEAMA GuidesCatastrophic InjuryPsychiatric ComponentLabor Code Section 5909Electronic Adjudication Management System (EAMS)
References
16
Case No. STK 0193177 STK 0193178
Regular
Feb 29, 2008

LESLIE CHOW vs. CENTRO MART, INC., SPRINGFIELD INSURANCE COMPANY

The Workers' Compensation Appeals Board dismissed the defendant's petition for reconsideration of the original May 1, 2007 decision as untimely. The Board denied reconsideration of the December 6, 2007 amended decision, finding that the changes made were clerical corrections to TD and PD rates, not substantial judicial modifications. Therefore, the defendant's arguments regarding the timeliness and merits of the amended decision were rejected.

WCABPetition for ReconsiderationFindings of FactAwardOrderWorkers' Compensation Judge (WCJ)Average Weekly WagePermanent Disability (PD)ApportionmentTemporary Disability (TD)
References
6
Case No. ADJ962557 (LBO 0527074)
Regular
Feb 28, 2012

GUILLERMINA OCHOA vs. INTERCONTINENTAL ART, INC., STATE COMPENSATION INSURANCE FUND

In this workers' compensation case, the Appeals Board rescinded a WCJ's decision allowing the defendant to offset $24,078.74 in TD and PD overpayments against future medical expenses. The Board found that allowing such a credit would undermine the purpose of providing necessary medical treatment and noted the defendant's significant delay in pursuing restitution. The Board's decision emphasizes that credit against future medical treatment is not strongly favored and is subject to equitable considerations and the discretion of the Board.

Workers' Compensation Appeals BoardPetition for ReconsiderationTemporary DisabilityPermanent DisabilityOverpaymentCreditFuture Medical TreatmentRes JudicataEquitableLabor Code Section 4909
References
0
Case No. ADJ4630593 (SBR 0315128)
Regular
Jan 25, 2012

GEORGE MONTAGUE vs. GAF LEATHERBACK, ZURICH PRIMARY

This case involves a defendant's petition for removal, which the Workers' Compensation Appeals Board denied. The defendant sought to overturn an order requiring production of specific checks and TD/PD payment information. The Board affirmed the order, finding production of cancelled checks necessary to verify payments and clarify discrepancies. Further, the Board determined that current documentation was insufficient to assess interest payments, and the applicant must have the opportunity to review and comment on the provided data. The matter is returned to the trial level for further proceedings.

Petition for RemovalOrder Vacating SubmissionDirecting Development of RecordTemporary Disability IndemnityPermanent Disability IndemnityInterest CalculationsThird-party administratorsGallagher BassettCrawford and CompanySupplemental Findings and Award
References
0
Case No. ADJ8136512 ADJ8136526
Regular
Apr 30, 2019

SOLANGE TUCKER vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS and REHABILITATION, PAROLE and COMMUNITY SERVICES

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration of a prior award. The original award found applicant sustained industrial injuries to her shoulder, knees, psyche, hypertension, headaches, and a sleep disorder, resulting in 73% permanent partial disability. The defendant argued against the findings regarding the sleep disorder, temporary disability, and the overall PD rating. The Board affirmed the WCJ's findings, finding substantial evidence supported the award for sleep disorder and temporary disability, and that the psychiatric impairment did not subsume the sleep disorder impairment.

Workers' Compensation Appeals BoardJoint Findings and AwardPetition for ReconsiderationIndustrial InjuryRight ShoulderRight KneeLeft KneePsycheHypertensionSleep Arousal Disorder
References
7
Case No. ADJ8714466 & ADJ8128174
Regular
Mar 27, 2015

Christian Alegria vs. Laboratory Corporation of America, ACE American Insurance Company

Here's a concise summary for a lawyer: This case involves a petition for reconsideration filed by Lab Corp and its insurer, ACE American Insurance, challenging a Workers' Compensation Appeals Board (WCAB) award of 25% permanent disability and medical treatment. The defendants argued the award was improperly based on work restrictions and that the Permanent Disability (PD) rating should have solely relied on Dr. Reynolds' report. The WCJ's report, adopted by the WCAB, denied reconsideration. The WCJ found evidence of work modifications and accommodated restrictions, and deemed both Dr. Newman's and Dr. Reynolds' reports substantial, justifying a rating based on the range of evidence.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ ReportCumulative InjuryBilateral Upper ExtremitiesPermanent DisabilityPPDMedical TreatmentWork RestrictionsPanel QME
References
0
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