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

Case No. 2022 NY Slip Op 00289
Regular Panel Decision
Jan 18, 2022

Matter of Personal-Touch Home Care of N.Y., Inc. v. City of N.Y. Human Resources Admin.

The Appellate Division affirmed the Supreme Court's judgment, which denied a petition to overturn a decision by the Office of Administrative Trials and Hearings Contract Dispute Resolution Board (CDRB). The CDRB had found that Personal-Touch Home Care's claim to use unspent Medicaid funds for fiscal year 2007 to offset workers' compensation assessment expenses from 2009-2010 was foreclosed. The court agreed that the State Department of Health (DOH) rationally interpreted its regulations, concluding that these retroactive assessments, levied due to financial mismanagement of a self-insurance trust, were not

Workers' CompensationMedicaid FundsSelf-Insurance TrustFiscal YearRetroactive AssessmentAdministrative LawAgency DeferenceContract DisputeHealth Care AgenciesFinancial Mismanagement
References
4
Case No. ADJ3609087 (LBO 0392035) ADJ1000696 (LBO 0332475)
Regular
Jul 20, 2017

Katherine Staudt vs. University of California Los Angeles, SEDGWICK CMS

This case involved the dismissal of the applicant's workers' compensation claims by the administrative law judge (WCJ) for failing to personally appear at a mandatory settlement conference. The applicant, represented by counsel who did attend, sought reconsideration, arguing that her attorney's presence satisfied the appearance requirement under Labor Code § 5700. The Workers' Compensation Appeals Board (WCAB) granted reconsideration, finding that while the applicant did not personally appear, her attorney's presence constituted a valid appearance. The WCAB rescinded the dismissal order, emphasizing the legal preference for hearings on the merits over dismissals.

WCABPetition for ReconsiderationOrder Dismissing CaseMandatory Settlement ConferenceApplicant's AppearanceAttorney AppearanceLabor Code Section 5700Section 5404.5Compulsory AppearanceNotice of Intent to Dismiss
References
1
Case No. ADJ10184700
Regular
Nov 29, 2017

JONATHAN PARKER vs. INDY FUEL HOCKEY, GREAT DIVIDE INSURANCE COMPANY

This case involves a defendant insurance company seeking reconsideration of a WCAB decision finding jurisdiction over a professional hockey player's injury claim. The defendant argued the WCAB lacked personal jurisdiction, but the Board denied reconsideration. The defendant waived its objection to personal jurisdiction by failing to timely raise it and instead engaging in discovery and litigating subject matter jurisdiction. Subsequent actions, such as filing a Declaration of Readiness to Proceed and participating in hearings without specifying a special appearance for personal jurisdiction, constituted a general appearance. Therefore, the WCJ's original decision finding jurisdiction was affirmed.

Workers Compensation Appeals BoardIndy Fuel HockeyGreat Divide Insurance CompanyADJ10184700Petition for ReconsiderationPersonal JurisdictionSubject Matter JurisdictionLabor Code 3600.5(a)Labor Code 5301Labor Code 5305
References
0
Case No. 526722
Regular Panel Decision
Apr 11, 2019

Matter of Persons v. Halmar Intl., LLC

Claimant Matthew Persons appealed a Workers' Compensation Board decision that found he violated Workers' Compensation Law § 114-a by exaggerating his condition and failing to disclose volunteer firefighter activities, leading to disqualification from future wage replacement benefits. The Appellate Division, Third Department, found the Board's decision was not supported by substantial evidence, as it was based on speculation, surmise, and mischaracterizations of claimant's activities and medical records. The court noted that claimant was forthcoming about his volunteer work and that video surveillance did not conclusively contradict his reported injuries. Consequently, the decision was reversed, and the matter was remitted to the Board for further proceedings.

Workers' Compensation LawFraudExaggerated ConditionVolunteer Firefighter ActivitiesWage Replacement BenefitsSubstantial EvidenceMedical TestimonyPsychiatric DisabilityVideo SurveillanceRemittal
References
6
Case No. RIV 0073693
Regular
Jun 18, 2008

BARBARA BARBULA vs. SUNRISE HEALTHCARE CENTERS, EMPLOYERS INSURANCE GROUP

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded an administrative law judge's order that required an attorney to personally pay $500 in costs. The WCAB found no evidence in the record of a specific order mandating that attorney's personal appearance, nor that a substitute attorney's appearance constituted a violation. Reconsideration was deemed an adequate remedy, thus the petition for removal was dismissed.

WCABPetition for RemovalPetition for ReconsiderationOrder of CostsAttorney AppearanceWCJ AuthorityLabor Code § 5813Cal. Code Regs.tit. 8§ 10561
References
3
Case No. ADJ8 453844
Regular
Jun 15, 2016

ISOBETH CABRERA vs. LABOR READY, ESIS

This case involves a lien claimant seeking reconsideration of a dismissed lien. The lien was dismissed because the claimant failed to appear at a lien conference and subsequently file a properly verified objection detailing the excusable neglect. While the Board granted reconsideration, it intends to affirm the dismissal unless the claimant provides a sworn affidavit from a person with personal knowledge explaining the circumstances of the failure to appear. This affidavit must sufficiently detail the mistake, inadvertence, surprise, or excusable neglect.

Workers' Compensation Appeals BoardLien claimantPetition for ReconsiderationOrder Dismissing LienNotice of Intention to Dismiss Lienverified objectionCode of Civil Procedure section 473Fox v. Workers' Comp. Appeals Bd.Beverly Hills Multispecialty Group Inc. v. Workers' Comp. Appeals Bd.failure to appear
References
6
Case No. ADJ7083577
Regular
Aug 02, 2012

JULIO BARRERA vs. ZARCOS TRUCKING, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and rescinded the trial judge's decision, returning the case for further proceedings. This action was based on the WCAB's finding that the lien claimant failed to comply with Rule 10562 by not having a person with settlement authority present by telephone during a conference. The WCAB clarified that telephone appearance alone is insufficient; a representative must appear in person or by attorney, and settlement authority must be available. This is not a final decision on the merits, and parties retain rights for future reconsideration.

Workers' Compensation Appeals BoardZarcos TruckingState Compensation Insurance FundADJ7083577Opinion and Order Granting ReconsiderationDecision After ReconsiderationWorkers' Compensation Administrative Law JudgeWCJLien ClaimantWCAB Rule 10562
References
1
Case No. ADJ2688453 (RDG 0198704) ADJ6688904 ADJ7542534
Regular
Jan 08, 2016

DERRICK BURFORD vs. COOK CONCRETE PRODUCTS, EVEREST NATIONAL INSURANCE COMPANY, AMERICAN CLAIMS MANAGEMENT, INC., CLARENDON NATIONAL INSURANCE COMPANY, SEABRIGHT INSURANCE COMPANY

Here is a summary of the case for a lawyer in four sentences: Defendant Everest National Insurance Company sought removal of a WCJ's order compelling their claims adjuster to personally appear at all future hearings. The Board granted removal, finding the order vague, overbroad, and that it would cause significant prejudice and irreparable harm to the defendant. The Board rescinded the order, ruling that the need for personal appearance should be determined on a hearing-by-hearing basis. The matter was returned to the WCJ for further proceedings, including an upcoming mandatory settlement conference.

Workers' Compensation Appeals BoardPetition for RemovalMandatory Settlement ConferenceWCJ OrderClaims Adjuster AppearanceSignificant PrejudiceIrreparable HarmOverbroad OrderAdministrative Law Judge DiscretionConsolidated Cases
References
0
Case No. ADJ7652044
Regular
Feb 23, 2015

Maria Gonzalez vs. Hoosier Plastic Fabrication, Inc., Pacific Compensation Insurance Company

The Workers' Compensation Appeals Board (WCAB) granted removal and rescinded a WCJ's notice of intention to sanction and dismiss a lien claimant's bill, as well as a personal appearance order. The WCAB found that the lien claimant was not given proper notice or opportunity to address the alleged failure to comply with Business & Professions Code section 22450, which requires professional photocopiers to be registered. The WCAB also determined that ordering the personal appearance of individuals not party to the matter and without proof of service constituted an abuse of discretion. The matter was returned to the WCJ for further proceedings consistent with due process and requiring evidence and legal briefing on the licensing issue.

WCABPetition for RemovalLien ClaimantSanctionsBusiness LicenseBusiness and Professions Code Section 22450Professional PhotocopierDue ProcessWCJHearing Representative
References
6
Case No. MISSING
Regular Panel Decision
May 25, 2012

Ali v. State

The claimant appeals from a judgment of the Court of Claims that dismissed their claim for personal injuries. The incident occurred on February 24, 2009, at the New York State Workers’ Compensation Board office when a security guard, reacting to news of his grandmother's death, punched a wooden bench causing it to fall on the claimant. The claimant subsequently filed a personal injury claim against the State of New York. The Court of Claims granted the defendant's application to dismiss the claim, determining that the security guard was acting solely for personal motives unrelated to his employment, and his conduct was not reasonably foreseeable by the defendant, thus precluding vicarious liability under the doctrine of respondeat superior.

Personal InjuryRespondeat SuperiorVicarious LiabilityScope of EmploymentForeseeabilityEmployee MisconductClaim DismissalCourt of Claims DecisionAppellate ReviewNegligence
References
7
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