CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

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

Case No. ADJ722399 (SDO 0324979) ADJ1109167 (SDO 0339490)
Regular
Feb 07, 2011

SAMANTHA HOWE vs. SCRIPPS HEALTH, Permissibly Self-Insured

The Appeals Board denied defendant Scripps Health's petition for removal, upholding the WCJ's decision to deny a compel order for a QME examination. Scripps Health sought to compel an examination by Dr. Strauser regarding applicant Samantha Howe's pain management treatment. The Board ruled that Scripps Health's objection to the pain management treatment must be addressed through utilization review, not a QME evaluation, citing the *Sandhagen* Supreme Court decision. Therefore, Scripps Health is barred from using Labor Code section 4062 to dispute treatment recommendations for pain management.

Petition for RemovalQualified Medical EvaluationMedical ExaminationPain Management TreatmentUtilization ReviewLabor Code Section 4610Labor Code Section 4062Industrial InjurySurgical TechnicianDental Treatment
References
1
Case No. ADJ8094646
Regular
Jan 17, 2014

ALEJANDRINA BARRETO vs. OUT OF THE SHELL, SOUTHERN INSURANCE COMPANY, REPUBLIC INDEMNITY COMPANY, PHARMAFINANCE, LLC, HEALTHCARE FINANCE MANAGEMENT, LLC

This case involves lien claimants PharmaFinance and Healthcare Finance Management, and their representatives Landmark Medical Management and Brian Hall, who sought reconsideration of a decision disallowing their liens for medical treatment. The Appeals Board granted reconsideration solely to notice its intention to impose sanctions of up to $2,500 against the lien claimants and their representatives. This action is due to a pattern of allegedly filing petitions containing false statements about not receiving notices, which violates the Board's Rules of Practice and Procedure and Labor Code Section 5813. The Board found these claims not persuasive and indicative of a tactic to avoid responsibility.

Workers' Compensation Appeals BoardPetition for ReconsiderationSanctionsLien ClaimantsHearing RepresentativesIndustrial InjuryFindings and OrderCompromise and ReleaseNotice of IntentionLabor Code section 5813
References
0
Case No. ADJ982471 (LAO 0859620)
Regular
Apr 28, 2014

JUVENCIO TORRES-RAMOS vs. FELIX MARQUEZ, REDWOOD FREE INSURANCE COMPANY, BERKSHIRE HATHAWAY

The Workers' Compensation Appeals Board denied the defendant's petition for removal and dismissed the applicant's petition for reconsideration. The Board adopted the WCJ's report, finding that the defendant failed to show significant prejudice or irreparable harm to warrant removal. The applicant voluntarily withdrew their reconsideration petition after understanding that their pain management treatment request lacked the required authorization form. The case was referred to the Independent Medical Review (IMR) process for a decision on the applicant's need for pain management treatment.

WCABPetition for RemovalPetition for ReconsiderationIndependent Medical ReviewIMRsubstantial evidenceutilization reviewtimelyprimary treating physicianDWC Form PR-2
References
1
Case No. 526425
Regular Panel Decision
Nov 15, 2018

Matter of Gasparro v. Hospice of Dutchess County

Mary Ann Gasparro, a claimant with a permanent partial disability from a 1995 work injury, moved to Nevada. In 2016, her employer's workers' compensation carrier objected to payments for topical pain relief products, LidoPro and Terocin patches, prescribed by a Nevada pain management specialist. The Workers' Compensation Board reversed a Workers' Compensation Law Judge's ruling, deciding that New York's Medical Treatment Guidelines apply to out-of-state treatment for nonresident claimants, a departure from its prior decisions. The Board found the prescribed medications were not in accordance with the guidelines due to concomitant use and duration. The Appellate Division, Third Department, affirmed the Board's decision, deeming its change in course rational and its application of the guidelines to out-of-state treatment reasonable. The court concluded that the Board's finding of medical necessity and non-compliance with guidelines was supported by substantial evidence.

Workers' CompensationMedical Treatment GuidelinesOut-of-State Medical CareNonresident ClaimantsPain ManagementTopical Pain ReliefLidoProTerocin PatchesAppellate DivisionBoard Reversal
References
12
Case No. MISSING
Regular Panel Decision
May 14, 2014

Forest Rehabilitation Medicine PC v. Allstate Insurance

Plaintiff Forest Rehabilitation Medicine PC sued defendant Allstate to recover $3,490 for no-fault medical benefits provided to assignor Tracy Fertitta. The core issue was the medical necessity of "Calmare pain therapy" (scrambler therapy), a novel treatment. The court conducted a bench trial, hearing expert testimony from both sides. Dr. Ayman Hadhoud, for the defense, argued the treatment was not medically necessary, not cost-effective, and essentially a form of physical therapy. Dr. Jack D’Angelo, for the plaintiff, countered that the therapy, though new, had FDA approval, was used by the military, and reduced the assignor's pain levels. Applying the Frye standard, the court found the evidence regarding Calmare scrambler therapy reliable and ruled it was medically necessary for Ms. Fertitta's pain management. Consequently, judgment was awarded to the plaintiff, Forest Rehabilitation Medicine PC, for $3,490 plus attorney's fees and interest.

No-Fault InsuranceMedical NecessityCalmare Pain TherapyScrambler TherapyNovel TreatmentFrye StandardExpert TestimonyPain ManagementFDA ApprovalCervical Radiculopathy
References
14
Case No. 2016 NY Slip Op 00302 [135 AD3d 572]
Regular Panel Decision
Jan 19, 2016

Domaszowec v. Residential Management Group LLC

Plaintiff Tracy Domaszowec's decedent died from a fall while cleaning a window on the 13th floor of an apartment building. The Appellate Division, First Department, modified a Supreme Court order, granting plaintiff's motion for partial summary judgment on her Labor Law § 240 (1) claim against Residential Management Group LLC and 40 Fifth Avenue Corporation (40 Fifth defendants), the building owner and manager. The court found the decedent was engaged in "commercial window washing," thereby making Labor Law § 240 (1) applicable. The court affirmed the dismissal of Labor Law § 202 against Veronica Bulgari and Stephen Haimo due to lack of exclusive control, and common-law negligence claims against T&L Contracting of N.Y., Inc. and Greenpoint Woodworking Inc. due to the lack of an exception to the contractual obligation rule. Issues of fact precluded summary judgment on negligence claims against Panorama Windows, Ltd., and the doctrine of res ipsa loquitur was deemed inapplicable to certain defendants.

Window cleaner fatalityScaffold LawSummary judgment appealAppellate Division First DepartmentCommercial vs. routine window washingLabor Law applicabilityContractual tort liabilityRes ipsa loquitur in negligencePunitive damages dismissalExpert witness evidence
References
8
Case No. MISSING
Regular Panel Decision
Oct 20, 1993

Olsen v. We'll Manage, Inc.

The case concerns an appeal by We'll Manage, Inc. from an order denying its cross motion for summary judgment in an action brought by plaintiff Gary Olsen under Labor Law §§ 240 and 241. We'll Manage, Inc. contended that Olsen was its special employee, providing evidence of direct supervision, work assignments, the right to fire him, and payment signed by its personnel, despite his wages being drawn from a general employer's account. The court found this established a special employment relationship. As Olsen received workers' compensation benefits from his general employer, he is statutorily barred from maintaining an action against the special employer. Consequently, the appellate court reversed the lower court's order, granted We'll Manage, Inc.'s cross motion, and dismissed the complaint against the appellant.

Special EmployeeWorkers' Compensation BarSummary JudgmentLabor LawDirect SupervisionControlAffidavitDeposition TestimonyGeneral EmployerAppellate Reversal
References
6
Case No. MISSING
Regular Panel Decision

Universal Acupuncture Pain Services, P.C. v. Lumbermens Mutual Casualty Co.

The New York court addresses a motion for reargument by Universal Acupuncture Pain Services, P.C. against Lumbermens Mutual Casualty Company concerning no-fault insurance claims. The central legal question is whether an expert witness's peer review report, created after a timely denial of a no-fault claim, can be admitted at trial, specifically under the Cirucci precedent regarding the specificity of denial grounds. The court grants the motion for reargument but upholds its initial ruling, which granted partial summary judgment on one of five claims. It clarifies that the expert's testimony must be strictly limited to the "concurrent or excessive care" ground initially stated by the insurer, excluding any new grounds like "medical necessity" not specified in the original denial. The court emphasizes that the issue of whether different treatment modalities constitute concurrent care for the same condition requires a trial for factual determination.

No-Fault InsurancePeer ReviewExpert Witness TestimonySummary Judgment MotionInsurance Law InterpretationSpecificity of DenialConcurrent Medical CareAcupuncture TreatmentChiropractic TreatmentPhysical Therapy
References
7
Case No. CA 12-01329
Regular Panel Decision
May 03, 2013

MULLIN, CARL D. v. WASTE MANAGEMENT OF NEW YORK, LLC

Carl D. Mullin, an employee of Riccelli Enterprises, Inc., sustained injuries after falling from a ladder at a Waste Management of New York, LLC facility. Mullin initiated an action against Waste Management, which subsequently filed a third-party claim against Riccelli for breach of contract. Waste Management alleged that Riccelli failed to name it as an additional insured on various required insurance policies, including workers' compensation, commercial general liability, and automobile liability. The Supreme Court granted Waste Management's motion for partial summary judgment on the breach of contract claim. The Appellate Division unanimously affirmed the Supreme Court's order, also upholding the denial of Riccelli's motion to introduce new evidence, deeming it untimely and unlikely to alter the determination.

Breach of ContractInsurance CoverageAdditional Insured ClauseSummary Judgment MotionAppellate AffirmationThird-Party LitigationPersonal InjuryWorkplace AccidentLadder FallContractual Indemnity
References
2
Case No. MISSING
Regular Panel Decision

57th Street Management Corp. v. Zurich Insurance

The plaintiff, 57th Street Management Corp., sought a judgment declaring that Zurich Insurance Company, the defendant, had a duty to defend and indemnify it in an underlying negligence action initiated by an injured employee, Isaac Wilner, and a subsequent third-party action by Bade Cab Corp. Wilner was injured in 1984, received workers' compensation benefits from a policy issued by Zurich, and later sued 57th Street Management Corp. and Bade Cab Corp. The action against 57th Street Management Corp. was dismissed due to Workers' Compensation Law § 11. Bade Cab Corp. then served a third-party summons on the plaintiff. The Appellate Division reversed the Supreme Court's order, granting Zurich's cross motion for summary judgment. The court found that the plaintiff failed to provide timely notice to Zurich of the personal injury action, vitiating coverage, and that notice of the workers' compensation claim did not serve as notice for subsequent actions.

Insurance CoverageDuty to DefendDuty to IndemnifySummary Judgment AppealTimely Notice RequirementWorkers' Compensation ExclusivityThird-Party LiabilityNew York Appellate LawEmployer's Liability InsuranceVitiation of Coverage
References
5
Showing 1-10 of 5,190 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational