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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
Jul 03, 2003

Claim of Dinneny v. Phoenicia Fire District

In February 1994, a volunteer firefighter for the Phoenicia Fire District was injured after falling on ice. Initial total disability payments were rescinded by the Workers' Compensation Board in 1996. The claimant then filed a new claim asserting posttraumatic stress disorder (PTSD) as a result of the 1994 injury. The Board denied this claim in 2003, determining that the PTSD was not causally related to the 1994 accident but rather to a separate violent attack in 1995. The Appellate Division affirmed the Board's decision, concluding it was supported by substantial evidence and that the Board properly assessed conflicting medical testimony.

Volunteer FirefighterPTSDCausal RelationshipMedical TestimonySubstantial EvidenceWorkers' Compensation BoardAppealDisability BenefitsFirefighter InjuryRescinded Benefits
References
4
Case No. 2015-01-0098
Regular Panel Decision
Aug 01, 2016

Johnson, Joshua v. Family Dollar Stores, Inc.

This expedited hearing concerned Joshua Johnson's request for payment of past and ongoing psychiatric treatment for Post-Traumatic Stress Disorder (PTSD), which he attributed to a workplace stabbing incident. The employer, Family Dollar Stores, Inc., contended that Mr. Johnson's treating physician, Dr. Phillip Smith, never referred him for psychiatric care as required by law, and that medical records did not substantiate his claims of reporting PTSD symptoms. The Court found Mr. Johnson's testimony regarding his symptoms lacked credibility due to inconsistencies with medical records that indicated a pre-existing PTSD condition. Although Dr. Erica Skidmore, a psychologist Mr. Johnson consulted independently, diagnosed him with PTSD related to the incident, her opinion was deemed unreliable because Mr. Johnson failed to disclose his pre-existing PTSD during her evaluation. Consequently, the Court denied Mr. Johnson's request for medical benefits for psychiatric treatment, concluding he was unlikely to prevail on the merits.

PTSDWorkers' CompensationExpedited HearingMedical BenefitsPsychiatric TreatmentCausationPre-existing ConditionCredibilityEmployee TestimonyMedical Records
References
6
Case No. MISSING
Regular Panel Decision
Jan 10, 2013

Claim of Launer v. Euro Brokers

The claimant, a former corporate bond broker, developed posttraumatic stress disorder (PTSD) after the September 11, 2001 attacks at the World Trade Center. He filed a workers' compensation claim, which was established for PTSD, and was initially granted reduced earnings benefits. However, the employer and its workers’ compensation carrier appealed this decision. A panel of the Workers’ Compensation Board and subsequently the full Board determined that the claimant's reduction in earnings was not causally related to his compensable PTSD. The appellate court affirmed the Board's decision, finding substantial evidence to support that the claimant's reduced earnings were not due to his disability, particularly given his continued engagement in his profession for over seven years post-9/11 and the lack of medical opinion stating he was incapable of performing his job due to PTSD-related concentration issues.

PTSD9/11Reduced EarningsPermanent Partial DisabilityWorkers' CompensationCausal RelationshipMedical OpinionIndependent Medical ExaminationAppellate ReviewBoard Decision
References
8
Case No. MISSING
Regular Panel Decision

Claim of Zucker v. Port Authority of New York & New Jersey

The claimant sought workers' compensation benefits for smoke inhalation and posttraumatic stress disorder (PTSD) stemming from the February 1993 World Trade Center bombing. While a Workers' Compensation Law Judge initially established the claim, the Workers’ Compensation Board later denied the PTSD claim as time-barred. The appellate court affirmed the Board's decision, noting that the claim was filed more than two years after the injury, exceeding the statutory limit. The court also determined that the employer's actions, such as crediting sick leave or offering voluntary group therapy, did not constitute advance payments in recognition of liability to waive the time-bar. Furthermore, the court found the PTSD to be a direct injury, not consequential, thus upholding the application of the two-year statute of limitations.

Workers' CompensationStatute of LimitationsTime-Barred ClaimPosttraumatic Stress Disorder (PTSD)World Trade Center BombingAdvance PaymentsWaiverDirect InjuryNew York LawAppellate Decision
References
16
Case No. MISSING
Regular Panel Decision
Jan 08, 2002

Claim of Palma v. New York City Department of Corrections

The claimant, a Vietnam veteran and former correction officer, sustained injuries in 1975 and was awarded workers' compensation benefits. His case was later reopened to address consequential posttraumatic stress disorder (PTSD), but a Workers' Compensation Law Judge (WCLJ) and the Board attributed his PTSD to his Vietnam service, not his employment assault. Claimant's subsequent application for a rehearing and/or reopening of the claim, based on new psychiatric reports from 1999 and 2000, was denied by the Board on January 8, 2002. The Board concluded that the claimant failed to demonstrate the medical evidence was unavailable earlier or indicated a change in his psychiatric condition. This appeal challenged the Board's denial of the rehearing application, rather than the underlying PTSD claim. The court affirmed the Board's decision, finding no arbitrary, capricious, or abusive discretion in the denial of the application.

Workers' CompensationAppealRehearingReopening ClaimPosttraumatic Stress Disorder (PTSD)Correction OfficerVietnam VeteranMedical EvidenceAbuse of DiscretionArbitrary and Capricious
References
3
Case No. 2017-08-0751; State File No. 15611-2016
Regular Panel Decision
Apr 15, 2019

Holdway, Terri v. Lakeside Behavioral Health Systems

This case concerns Terri Holdway, a nurse seeking workers' compensation benefits for a mental injury allegedly stemming from a patient assault in February 2016 at Lakeside Behavioral Health Systems. Ms. Holdway claimed PTSD, depression, and anxiety, but medical records indicated pre-existing mental health issues. The court heard conflicting expert testimonies from Dr. Melvin Goldin, who diagnosed PTSD, and Dr. Joel A. Reisman, who refuted the PTSD diagnosis, citing Ms. Holdway's return to work and lack of avoidance behavior. The court sided with Dr. Reisman, finding that Ms. Holdway did not prove her mental injury arose primarily from her employment. Consequently, the claim for mental injury benefits was denied, though ongoing medical benefits for her facial injury were awarded.

Mental Injury ClaimPTSD DenialWorkers' Compensation BenefitsNurse InjuryPatient AssaultPre-existing ConditionsExpert Medical TestimonyDSM 5 CriteriaCausation DisputeEmployment Stress
References
4
Case No. 526849
Regular Panel Decision
Dec 20, 2018

Vergine v. Phillips

In this appeal, plaintiffs Joanne Vergine and her husband challenged the Supreme Court's decision to deny their cross-motion to amend their bill of particulars to include posttraumatic stress disorder (PTSD) as a serious injury and to grant defendant's motion for summary judgment, dismissing the complaint. The central issue was whether a licensed clinical social worker (LCSW) is competent to diagnose PTSD for purposes of establishing a serious injury under Insurance Law § 5102 (d). The Appellate Division, Third Department, reversed the Supreme Court's order, concluding that an LCSW is indeed competent to render such an opinion. The court found that the LCSW's affidavit presented a genuine issue of material fact regarding Vergine's causally-related PTSD, thus warranting the denial of defendant's summary judgment motion and the granting of plaintiffs' cross-motion to amend.

PTSD diagnosisserious injury claimautomobile accident liabilitysummary judgment motionlicensed clinical social worker competencepsychological injurymedical evidenceappellate procedureInsurance Law § 5102(d)mental health professional
References
9
Case No. ADJ10903154
Regular
Apr 01, 2020

JEHUDA KNOBLER vs. LOS ANGELES UNIFIED SCHOOL DISTRICT, SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves a teacher claiming workers' compensation for PTSD after a student altercation. The Board overturned the initial finding, now recognizing the PTSD as arising out of and occurring in the course of employment. However, they affirmed the finding that the applicant was the initial physical aggressor under Labor Code section 3600(a)(7). This disqualifies him from receiving compensation benefits due to his role in initiating the physical confrontation.

AOE/COEinitial physical aggressorLabor Code section 3600(a)(7)posttraumatic stress disorderphysical altercationPQME reportstudent altercationwitness statementsadministrative leavetrier of fact
References
0
Case No. ADJ2167155 (VNO 0443514)
Regular
Oct 17, 2013

Thomas David Williams vs. MAKENZIE ELECTRICAL INC., STATE COMPENSATION INSURANCE FUND

The Appeals Board remanded the case for further development of the record concerning the applicant's claimed injury to psyche/PTSD. The prior findings were not based on substantial evidence due to an inadequate medical history and stale opinions from the evaluating physician, Dr. Glaser. The Board ordered a new evaluation by an Agreed Medical Evaluator or a regular physician to address the complex psychological issues, including PTSD, substance abuse, and potential organic brain injury. After this evaluation, the matter will return to the judge for a new decision incorporating all relevant findings.

Workers' Compensation Appeals BoardReconsiderationPsyche/PTSDSubstantial EvidenceAgreed Medical EvaluatorLabor Code section 5701Findings and AwardWCJPermanent DisabilityApportionment
References
0
Case No. ADJ984330 (MON 0320747)
Regular
Jan 26, 2015

CHRIS JENSEN vs. CALIFORNIA HIGHWAY PATROL, STATE COMPENSATION INSURANCE FUND

This case involves a workers' compensation applicant, a police officer, seeking reconsideration of a denial for increased benefits due to alleged serious and willful misconduct by the California Highway Patrol. The applicant claimed unsafe working conditions at a vehicle inspection facility led to his psychological injury (PTSD). However, the Board denied reconsideration, finding no evidence that the alleged misconduct at the facility proximately caused his PTSD, which medical evidence indicated predated his time there. Furthermore, the applicant failed to prove that employer representatives with sufficient authority knew of the specific dangerous conditions and deliberately failed to act.

Serious and willful misconductPetition for ReconsiderationCumulative traumaPsyche injuryPTSDCalifornia Highway PatrolPolice officerQualified Medical ExaminerSafety inspectionsHazardous work environment
References
5
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