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

Case No. ADJ10274905
Regular
Feb 09, 2018

Wade Hoag vs. Greenwood Homes, Inc, Twin City Fire Insurance Company

This case involved a workers' compensation claim for Wade Hoag, who sustained a severe injury resulting in paraplegia. The initial decision found the injury compensable but questioned the appropriateness of modifying the applicant's parents' home in Ohio for accommodation. The parties subsequently entered into a Compromise and Release agreement resolving all claims. The Appeals Board reviewed and approved this agreement, awarding the applicant $2,650,000.00, with a portion allocated for future medical treatment via a self-administered trust.

Workers' Compensation Appeals BoardWade HoagGreenwood HomesInc.Twin City Fire Insurance CompanyADJ10274905Opinion and Decision After Reconsiderationapprentice carpenterparaplegiaOhio residence modification
References
0
Case No. ADJ7303882
Regular
Sep 11, 2014

ANTONIA HUERTA vs. HUENEME SCHOOL UNIFIED DISTRICT, YORK RISK SERVICES GROUP

This case concerns a hospital's claim for additional payment for an injured worker's lengthy rehabilitation stay following paraplegia after epidural injections. The hospital argued its services were exempt from the Official Medical Fee Schedule due to extraordinary circumstances and the necessity of specialized rehabilitation. The Workers' Compensation Appeals Board adopted the Administrative Law Judge's recommendation, denying the employer's petition for reconsideration. The Board found the ALJ's reasoning regarding reasonable treatment under the fee schedule and the justification for additional payment, including interest, was sound.

Workers' Compensation Appeals BoardPetition for ReconsiderationAdministrative Law JudgeReport and RecommendationStipulationsCustodianUpper ExtremitiesBackHipsLower Extremities
References
0
Case No. ADJ9917545
Regular
Nov 30, 2018

Richard Ray vs. Jed Francis, Inc., Zurich American Insurance Group, American Claims Management

The Workers' Compensation Appeals Board denied a petition for reconsideration, upholding the finding that Richard Ray sustained an industrial injury. This injury, originating from an eye incident, led to a MRSA infection, epidural abscess, paraplegia, and severe permanent impairments. Medical evidence from IME Dr. Feinberg, Dr. Edington, and Dr. Baum established a medical probability that the initial eye injury caused the subsequent severe cascade of medical conditions. The Board affirmed the WCJ's credibility determination regarding the applicant's testimony, finding no substantial contrary evidence.

Workers' Compensation Appeals Boardindustrial causationepidural abscessMRSAparaplegiasubstantial medical evidenceindependent medical evaluatorarising out of and in the course of employmentmedical sequelaeapportionment
References
0
Case No. ADJ9170309
Regular
Nov 03, 2025

Miguel Mosqueda vs. City of Clearlake

Applicant Miguel Mosqueda sought reconsideration of a July 25, 2025 decision which found his injuries were not caused by the employer's serious and willful misconduct or violation of safety orders. Mosqueda, a maintenance worker, suffered catastrophic injuries, including paraplegia, after falling from a ladder while trimming a tree for the City of Clearlake. He contended that the employer violated several Cal. Code Regs., tit. 8 sections related to safety, training, and equipment. The Workers' Compensation Appeals Board, adopting the WCJ's report, denied the petition for reconsideration, concluding that the employer's actions did not constitute serious and willful misconduct and that no alleged safety violation was the proximate cause of the accident.

Serious and willful misconductPetition for reconsiderationFindings and OrderViolation of statuteViolation of safety orderCal. Code Regs. tit. 8 § 3203Cal. Code Regs. tit. 8 § 3276(d)(1)Cal. Code Regs. tit. 8 § 3276(e)(15)Cal. Code Regs. tit. 8 § 3421(b)Cal. Code Regs. tit. 8 § 3421(d)
References
1
Case No. MISSING
Regular Panel Decision
May 04, 2005

Miraglia v. H & L Holding Corp.

This case involves a plaintiff who was impaled by a steel bar, resulting in paraplegia and associated complications, while working. A jury awarded the plaintiff substantial damages for past and future pain and suffering, and future medical expenses. The Supreme Court, Appellate Division, modified the judgment, reducing the award for future medical expenses and conditionally vacating the award for future pain and suffering. A new trial was ordered for future pain and suffering damages unless the plaintiff accepts a reduced amount. The court affirmed liability under Labor Law § 240 (1), rejecting the recalcitrant worker defense and stating that comparative negligence does not diminish a defendant's liability under this law.

Workers' CompensationConstruction AccidentLabor Law 240(1)Personal InjuryDamages AwardFuture Medical ExpensesPain and SufferingAppellate ReviewJury VerdictParaplegia
References
10
Case No. MISSING
Regular Panel Decision

Pellerin v. New York State Department of Correction

Claimant, a Correction Officer, suffered a compensable back injury in 1980, resulting in a lump-sum payment. In 1990, he fell from a tree stand while hunting, sustaining a severe back injury that rendered him paraplegic. His application to the Workers’ Compensation Board to reopen his claim due to a consequential injury and a change in condition was granted. The employer and its insurance carrier appealed, contending that the claimant's action in climbing a tree stand constituted an unreasonable, intervening act. The court affirmed the Board’s decision, finding substantial evidence to support that the claimant's prior injury caused his leg to give out, leading to the consequential paraplegia. The court concluded that claimant's actions were reasonable given his perceived medical condition.

Workers' CompensationConsequential InjuryPermanent Partial DisabilityLump-sum PaymentParaplegiaCausationIntervening ActTree Stand FallAppellate ReviewSubstantial Evidence
References
4
Case No. MISSING
Regular Panel Decision

Hilton v. Truss Systems, Inc.

A 23-year-old truck driver, the claimant, suffered paraplegia from a fall while working and was deemed permanently totally disabled by the Workers' Compensation Board. He later settled a third-party action for $185,422.05, and the compensation carrier waived its lien of approximately $70,000. The central issue was whether this lien waiver also extended to the carrier's right to offset the claimant's future compensation benefits against the third-party recovery. Citing Matter of Robinette v Meyer Sign Co., the court emphasized that carriers must explicitly and unambiguously state if they intend to preserve their offset rights. Due to the absence of such a categorical statement, the Board's decision was reversed, and the matter was remitted for further proceedings consistent with this ruling.

Workers' CompensationThird-Party SettlementLien WaiverOffset RightsFuture BenefitsPermanent Total DisabilityJudicial InterpretationStatutory ConstructionAmbiguityRemand
References
2
Case No. MISSING
Regular Panel Decision

Ogle v. State

This case involves a claimant who filed for medical malpractice and negligence against the State of New York, alleging that delayed treatment for tuberculosis during his incarceration led to paraplegia. The Court of Claims initially denied the State's motion to dismiss, applying the continuous treatment doctrine. On appeal, the higher court reversed this decision, asserting that the doctrine's application requires a relevant relationship between treating physicians or a continuous relationship between the claimant and initial physicians, rather than merely all providers being state employees. The court found questions of fact regarding the relevant relationship between the medical facilities involved (Ogdensburg, Samaritan, Upstate) that need to be determined by the Court of Claims. Therefore, the order of the Court of Claims was reversed, and the matter was remitted for further proceedings to determine the applicability of the continuous treatment doctrine.

medical malpracticenegligencecontinuous treatment doctrinetuberculosisspinal cord injuryparaplegiacorrectional facility inmatestatute of limitationsquestions of factappellate review
References
14
Case No. 531898
Regular Panel Decision
Oct 07, 2021

Matter of Narine v. Two Bros. for Wholesale Chicken Inc.

Claimant Budram Narine, a butcher, suffered severe injuries in a motor vehicle accident, leading to a workers' compensation claim against Two Brothers for Wholesale Chicken Inc. and its insurer, Norguard Insurance Company. The carrier initially denied the claim but later withdrew its objections, only seeking an independent medical examination (IME) for additional injury sites. After the Workers' Compensation Law Judge (WCLJ) established the claim for paraplegia and a frozen right shoulder and directed an IME, the carrier failed to comply and subsequently appealed. The Workers' Compensation Board affirmed the WCLJ's decisions, denying the carrier's application for review due to its failure to preserve issues and noncompliance with regulations, and upholding the amendment of the claim to include a frozen right shoulder and the preclusion of an IME due to the carrier's lack of timely action.

Workers' CompensationMotor Vehicle AccidentSpinal FracturesQuadriplegiaFrozen ShoulderIndependent Medical ExaminationProcedural RulesBoard ReviewDue ProcessWaiver
References
14
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