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

Case No. ADJ4258585 (OXN 0130492) ADJ220258 (OXN 0130487)
Regular
Apr 17, 2018

ENRIQUE HERRERA vs. MAPLE LEAF FOODS, U.S. FIRE INSURANCE COMPANY, ALEA NORTH AMERICAN INSURANCE COMPANY

This notice informs parties that the Workers' Compensation Appeals Board (WCAB) intends to admit its rating instructions and a disability rater's recommended permanent disability rating into evidence. The WCAB previously granted reconsideration for further study. Parties have seven days to object to the rating instructions or the recommended rating, with specific procedures for addressing objections. If no timely objection is filed, the matters will be submitted for decision thirty days after service.

WORKERS' COMPENSATION APPEALS BOARDPermanent Disability RatingDisability Evaluation UnitRating InstructionsRecommended Permanent Disability RatingJoint RatingReconsiderationObjectionRater Cross-ExaminationRebuttal Evidence
References
0
Case No. MISSING
Regular Panel Decision
Nov 29, 2001

Claim of Caiazza v. Eastman Kodak Co.

The claimant, a former machinist, developed skin cancer in 1990 and later lung and brain cancers in 2000, attributed to occupational exposure. Following his retirement in 2001, the employer conceded the lung and brain cancers were consequential to the initial skin cancer. A Workers' Compensation Law Judge (WCLJ) found the claimant permanently totally disabled and awarded weekly benefits of $300, based on the original skin cancer disablement date of February 27, 1986. The claimant sought Workers' Compensation Board review, arguing for an April 24, 2000 disablement date (diagnosis of lung/brain cancers) to receive higher benefits of $400/week. The Board affirmed the WCLJ's decision, citing the claimant's prior stipulation to modify the original claim for consequential injuries and established law that such awards are measured by rates at the time of the original injury. The appellate court affirmed the Board's decision, finding it was not unreasonable to rely on the claimant's agreement and that the award rate was supported by substantial evidence.

Occupational DiseaseWorkers' Compensation BenefitsDate of DisablementBenefit Rate CalculationConsequential InjurySkin CancerLung CancerBrain CancerPermanent Total DisabilityAppellate Review
References
4
Case No. MISSING
Regular Panel Decision

Matter of Williams v. Preferred Meal Systems

Claimant, a driver, suffered injuries to his right knee and back in 2009 while making a delivery, leading to an established workers' compensation claim. The claim was later amended to include consequential adjustment disorder, and the Workers' Compensation Board ultimately found that claimant had sustained a permanent total disability from May 2012 onward. The employer, workers’ compensation carrier, and policy administrator appealed this decision, arguing that further proof was needed regarding claimant's vocational and functional capacity. The court affirmed the Board's decision, holding that extensive evidence of vocational and functional capacity is not required when medical proof demonstrates a permanent total disability and inability to engage in any gainful employment, as benefits continue for life in such cases. The court found substantial evidence in the opinions of treating and independent medical examination orthopedists to support the finding of permanent total disability.

Workers' CompensationPermanent Total DisabilityWage-Earning CapacityMedical ProofVocational CapacityFunctional CapacityAppellate ReviewNew York LawDisability BenefitsClaimant Rights
References
4
Case No. MISSING
Regular Panel Decision

Claim of Harrington v. L.C. Whitford Co.

The claimant, a construction worker, experienced a severe exacerbation of pre-existing asthma after exposure to burning lead paint fumes in June 1996. A certified pulmonologist, Richard Evans, determined the exposure caused a permanent and total disability. A Workers' Compensation Law Judge (WCLJ) found an accidental injury causing permanent and total disability, which the Workers' Compensation Board affirmed in August 2001. The employer and carrier appealed, arguing the condition was pre-existing and only temporarily aggravated. The appellate court affirmed the Board's decision, finding substantial evidence to support that the work-site exposure significantly exacerbated the claimant's stabilized asthma, leading to a permanent and total disability.

Workers' CompensationPermanent Total DisabilityAsthma ExacerbationOccupational ExposureLead Paint FumesPre-existing ConditionMedical Expert TestimonySubstantial EvidenceAppellate ReviewIndustrial Accident
References
14
Case No. MISSING
Regular Panel Decision

Claim of VanDermark v. Frontier Insurance

In this workers' compensation appeal, the employer and its carrier challenged two decisions by the Workers’ Compensation Board concerning a claimant's permanent total disability. The claimant sustained a back injury in 1998 and was initially found to have a permanent partial disability. However, the Board later modified the award, concluding the claimant had a permanent total disability after August 2004, a finding supported by the testimony of her treating orthopedic surgeon despite conflicting medical evidence. The employer also contested the denial of their applications for reconsideration and/or full Board review, arguing insufficient evidence and an abuse of discretion. The appellate court affirmed the Board's decisions, deferring to its resolution of conflicting medical evidence and finding no arbitrary or capricious action in denying reconsideration, as no new evidence was presented.

Workers' Compensation LawPermanent Total DisabilityPermanent Partial DisabilityMedical EvidenceConflicting Medical OpinionsBoard's DiscretionReconsideration ApplicationFull Board ReviewAppellate ReviewSufficiency of Evidence
References
6
Case No. MISSING
Regular Panel Decision

Claim of Mearns v. Sunoco, Inc.

Claimant, an assistant manager at a convenience store, suffered severe psychological injuries including panic attacks and nightmares after being falsely accused and physically accosted by a police officer following a store break-in. She subsequently ceased working and filed for workers' compensation benefits. A Workers’ Compensation Law Judge initially ruled, and the Workers’ Compensation Board later upheld, that she had sustained a permanent total disability. Despite some conflicting medical opinions regarding the severity of her disability, the Board was found to have properly resolved the evidence in favor of the claimant. The Appellate Division affirmed the Board's decision, concluding it was supported by substantial evidence and that there was no basis to disturb the finding of permanent total disability.

permanent total disabilitypsychological traumaworkers' compensation appealmedical expert testimonyconflicting medical evidencepolice misconductworkplace incidentmental healthadministrative lawjudicial review
References
4
Case No. ADJ1584272
Regular
Dec 03, 2010

RICHARD SILVA vs. PAZIN & MYERS, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the finding of 100% permanent disability for the applicant's back and psyche injuries. The Board found that the workers' compensation judge properly applied the 1997 Schedule for Rating Permanent Disabilities due to pre-existing medical reports indicating permanent disability. Substantial evidence, including the Agreed Medical Examiner's opinion on permanent total disability and the applicant's treating psychologist's opinion, supported the 100% disability rating. The defendant failed to meet its burden to prove apportionment of the disability.

ADJ1584272FRE 0244029Pazin & MyersInc.State Compensation Insurance FundFindings and AwardSeptember 142010industrial injuryback
References
8
Case No. MISSING
Regular Panel Decision
Oct 14, 1999

Claim of Williams v. New York State Department of Transportation

The claimant, who suffered a work-related injury in 1988, initially received permanent partial disability benefits at a mild rate in May 1996. Dissatisfied with this assessment, the claimant appealed, presenting medical evidence suggesting a more severe disability. This led the Workers’ Compensation Board to restore the case to the trial calendar for further development of the record concerning the degree of disability post-May 6, 1996. Although two physicians testified, with one indicating a moderate disability and another a total disability, the Workers’ Compensation Law Judge (WCLJ) ultimately awarded benefits at a moderate partial disability rate. Upon the claimant's subsequent appeal, the Board ruled that the claimant was precluded from raising the issue of their degree of disability, citing regulatory provisions. The appellate court found that the Board had abused its discretion, as the issue was explicitly remanded by the Board previously, and the claimant was still aggrieved by the WCLJ's award despite an increase in benefits. Consequently, the court reversed the Board's decision and remitted the matter for further proceedings.

Workers' CompensationDisability AssessmentAppellate ReviewAbuse of DiscretionProcedural ErrorMedical EvidenceDegree of DisabilityRemittalNew York LawAdministrative Appeal
References
0
Case No. MISSING
Regular Panel Decision

Claim of Phillips v. Elmira City School District

The Workers' Compensation Board's decision, finding the claimant to have a permanent partial disability and awarding compensation for lost wages after retirement, was affirmed on appeal. The claimant, a school custodian, suffered multiple injuries from a fall, leading to his classification as permanently partially disabled. The causal relationship between the accident and the disability inferred that his post-retirement wage loss was due to physical limitations. The employer failed to prove that the loss of employment was solely due to unrelated economic or other causes.

Workers' CompensationPermanent Partial DisabilityLost WagesRetirement BenefitsCausally Related DisabilityAppellate DecisionAffirmed DecisionEmployer AppealMedical CausationEconomic Factors
References
2
Case No. MISSING
Regular Panel Decision

Claim of Martone v. Niagara Frontier Transportation Authority-Metro

In 2005 and 2007, a bus driver (claimant) suffered work-related neck and back injuries. Initially, a Workers’ Compensation Law Judge found him permanently totally disabled. However, the Workers’ Compensation Board modified this, determining he had a permanent partial disability with a 75% loss of wage-earning capacity based on medical evidence and other factors. The claimant appealed this decision, arguing a lack of substantial evidence for the partial disability finding. The Appellate Division affirmed the Board's decision, noting medical reports indicating submaximal efforts, high medication dosages, symptom magnification, and the ability to ambulate, which supported the finding of partial disability. The court also upheld the 75% loss of wage-earning capacity, finding it supported by substantial evidence after considering the claimant's impairment, work restrictions, age, education, and work experience.

Permanent Partial DisabilityWage-Earning CapacityChronic Pain SyndromeLumbar Spine SurgeryMedical EvidenceSubmaximal EffortsSymptom MagnificationAppellate ReviewBoard DecisionMedical Treatment Guidelines
References
2
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