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

Case No. ADJ8233060, ADJ8237202
Regular
Aug 23, 2013

SYLVIA TORRES vs. TODD MACKEY dba CAREFREE PLANTS & DESIGN, PREFERRED EMPLOYER'S INSURANCE CO.

The Workers' Compensation Appeals Board dismissed the applicant's petition for reconsideration because the WCJ's order regarding a replacement panel was not a final decision. The Board denied the petition for removal, finding no substantial prejudice or irreparable harm, despite the PQME's late supplemental report. Applicant failed to formally request a replacement panel from the Medical Director as required by regulation. Therefore, the Board affirmed the WCJ's decision not to order a replacement panel and to schedule a supplemental evaluation with the original PQME.

WCABPetition for ReconsiderationPetition for RemovalPanel Qualified Medical EvaluatorPQMESupplemental ReportFindings of Fact and OrderWCJDeclaration of ReadinessReplacement Panel
References
5
Case No. ADJ10087769, ADJ10087742
Regular
Dec 01, 2016

JORGE HUERTA HUERTA vs. IL COLORE, INC.; ACE AMERICAN INSURANCE COMPANY, administered by BARRETT BUSINESS SERVICES

In this workers' compensation case, the defendant appealed the WCJ's issuance of PQME panels in a denied cumulative trauma claim (ADJ10087769), arguing it was improperly processed via an expedited hearing. The Appeals Board denied the petition for removal, finding that while an expedited hearing was inappropriate for a denied claim, the WCJ correctly treated it as a status conference. The Board noted that the defendant did not contest the underlying propriety of issuing PQME panels in the denied case, thus failing to demonstrate substantial prejudice or irreparable harm required for removal. The defendant's objection was primarily to the procedural method used, not the ultimate decision to issue the panels.

Petition for RemovalPanel Qualified Medical ExaminerExpedited HearingDenied ClaimAccepted ClaimCumulative TraumaSpecific InjuryDeclaration of ReadinessStatus ConferenceLabor Code Section 4060
References
2
Case No. ADJ10363674
Regular
Nov 17, 2016

RUBY BRADLEY vs. COUNTY OF SACRAMENTO DEPARTMENT OF HUMAN ASSISTANCE; Permissibly SelfInsured, Adjusted By COUNTY OF SACRAMENTO WORK COMP

The Workers' Compensation Appeals Board denied Ruby Bradley's petition for removal, upholding an order compelling her to attend a medical examination with a panel qualified medical evaluator (PQME). Bradley claimed due process violations regarding notice and a replacement PQME panel, but the Board found she failed to demonstrate significant prejudice or irreparable harm. The WCJ's report, incorporated by the Board, noted Bradley's own admission contradicted her claim of premature scheduling and highlighted a prior agreement to proceed with the original PQME. The Board also admonished Bradley's counsel for misleadingly omitting material facts, potentially constituting an abuse of the system.

Petition for RemovalCompelling AttendanceMedical ExaminationPanel Qualified Medical EvaluatorPQMEIndustrial InjuryNervous SystemPsychiatric InjuriesDue ProcessReplacement Panel
References
4
Case No. G107 435
Regular Panel Decision
Jun 02, 2023

Matter of Marku v. ABM Industries

This case concerns the claim of Denise Perry under the Workers' Compensation Law. The Workers' Compensation Law Judge (WCLJ) previously found that the employer, Adventist Home Care, established a violation of Workers' Compensation Law § 114-a by the claimant for willfully making false statements to obtain benefits. Consequently, the WCLJ disallowed indemnity benefits and imposed both mandatory and discretionary penalties. A Board Panel decision filed on February 17, 2022, affirmed the WCLJ's findings. The claimant subsequently filed an application for reconsideration on March 18, 2022, which the Board Panel reviewed. After considering the claimant’s arguments, the Board Panel determined that the application did not raise new issues or present new material evidence, nor did it demonstrate an erroneous statement of material fact or law in the prior decision. Therefore, the Board Panel, by a majority vote, affirmed its prior decision.

Workers' Compensation FraudFalse RepresentationIndemnity Benefits DisallowanceWCL § 114-a PenaltyApplication for Reconsideration DeniedBoard Panel AffirmationWillful MisrepresentationWorkers' Compensation Law Judge DecisionEmployer Established Violation
References
0
Case No. ADJ6792760, ADJ9284465
Regular
May 11, 2016

VILMA ALEMAN vs. FREDERICK'S OF HOLLYWOOD, THE HARTFORD GROUP, NORTH RIVER INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the defendant's Petition for Removal, upholding a prior order for a replacement Qualified Medical Evaluator (PQME). The Board found that the defendant failed to properly serve the applicant's attorney with the PQME panel notification, rendering the submitted medical reports inadmissible. This procedural defect meant the applicant was not afforded adequate time to strike a panel physician, thus violating statutory procedures. The Board emphasized that removal is an extraordinary remedy not to be granted without a showing of significant prejudice or irreparable harm.

Petition for RemovalJoint Findings and OrderPanel Qualified Medical EvaluatorPQMEDefective NoticeInadmissible Medical ReportsLabor Code Section 4062.2Improper ServiceAttorney NotificationStriking Process
References
2
Case No. MISSING
Regular Panel Decision

Matter of Burns v. New York State Workers' Compensation Board

Claimant sought workers' compensation benefits due to injuries from an automobile accident. As an employee of the Workers’ Compensation Board, his claim was processed through a neutral outside arbitration process. An arbitrator established his claim and average weekly wage. Claimant appealed, arguing his average weekly wage should have been calculated differently due to a recent promotion, as per Workers’ Compensation Law § 14 (2). An arbitration panel declined to address this argument because it was not raised before the arbitrator. The appellate court affirmed the panel's decision, citing that the panel could decline review of issues not previously raised, consistent with 12 NYCRR 300.13 [e] [1] [iii].

ArbitrationAverage Weekly WageWorkers' CompensationAppellate ReviewIssue PreservationAdministrative LawProcedural Due ProcessStatutory InterpretationWorkers’ Compensation Board
References
2
Case No. MISSING
Regular Panel Decision

Claim of Mulligan v. Workers' Compensation Board

The claimant, a former workers' compensation law judge, appealed the denial of reduced earning benefits, which stemmed from his claim that stress from his job caused him to voluntarily withdraw from the labor market. He had previously received benefits for a 1995 angina attack. An arbitrator and subsequent arbitration panel concluded that he voluntarily withdrew from the labor market, a determination the claimant contested, asserting his retirement was due to work-related stress. The court, led by Judge Carpinello, found substantial evidence supported the panel's decision, noting the claimant never complained of stress to supervisors, sought accommodations, or applied for disability retirement. The court affirmed the arbitration panel's decision, denying the claimant's appeal.

Voluntary Withdrawal from Labor MarketReduced Earning BenefitsWorkers Compensation BenefitsArbitration Panel DecisionSubstantial EvidenceDisability RetirementJob-Related StressAppellate ReviewLabor Market WithdrawalClaim Denial
References
8
Case No. ADJ7253987
Regular
Jun 29, 2012

Anna Medel vs. Employment Development Department, State Compensation Insurance Fund

The defendant sought reconsideration of an order granting the applicant a new Qualified Medical Evaluator (PQME). The defendant argued their communication with the PQME was not an ex parte violation and that the objection was untimely. The Board dismissed the reconsideration petition, finding the order was procedural, not final. The Board denied the removal petition, agreeing that the defendant's communication violated Labor Code Section 4062.3 by failing to serve the applicant 20 days prior to the PQME evaluation. Therefore, the applicant was correctly awarded a new PQME panel.

Workers' Compensation Appeals BoardPanel Qualified Medical EvaluatorPQMESection 4062.3Ex Parte CommunicationReconsiderationRemovalCumulative Trauma InjuryCervical SpineBilateral Upper Extremities
References
15
Case No. WCB No. G076 2707
Regular Panel Decision
Dec 09, 2021

Matter of Duncan v. John Wiley & Sons, Inc.

This Board Panel Decision concerns an appeal by the applicant, Joseph Lafayette, regarding a Workers' Compensation Law Judge's (WCLJ) finding on the causal relationship of his back injury. The applicant sustained injuries to his back, neck, and shoulder during his employment. The WCLJ had previously established a causal relationship for the neck and shoulder injuries but disallowed the claim for the back injury. Upon review, the Board Panel determined that the medical evidence in the record supports a causal relationship between the claimant's employment and his lower back injury. As a result, the Panel modified the WCLJ's decision to establish a causal relationship for the back injury, while affirming the other aspects of the original decision.

Workers' CompensationBack InjuryNeck InjuryShoulder InjuryCausal RelationshipMedical EvidencePanel ReviewWCLJ DecisionModificationAppeal
References
2
Case No. MISSING
Regular Panel Decision

Leone v. Columbia Sussex Corp.

Alfred Leone sustained injuries when a scaffold plank broke at a construction site owned and operated by Columbia Sussex Corp. He was an employee of Smith Glass Co., a subcontractor, and the scaffold was erected by another subcontractor, Panelized Systems, Ltd. Columbia Sussex Corp. appealed orders denying its motion to amend its answer with a Workers’ Compensation Law defense and denying summary judgment on its third-party complaint against Panelized. The appellate court reversed the denial to amend, finding a question of fact on whether Leone was a special employee of Columbia, thus allowing the Workers' Compensation defense to be asserted. However, the court affirmed the denial of summary judgment for indemnification against Panelized, ruling contractual indemnification inapplicable and common-law indemnification premature.

Personal InjuryScaffold AccidentWorkers' Compensation LawSpecial EmploymentAmended AnswerSummary JudgmentContractual IndemnificationCommon-Law IndemnificationSubcontractor LiabilityConstruction Accident
References
9
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