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

Case No. ADJ7877096
Regular
Jan 23, 2017

OGANES KARDZHYAN vs. DR. PEPPER SNAPPLE GROUP, CHARTIS INSURANCE CO./AIG CLAIM SERVICES

The Workers' Compensation Appeals Board granted the applicant's petition for reconsideration, finding the WCJ failed to address the substantiality of Dr. Pietruszka's opinion regarding industrial causation for psoriatic arthritis, diabetes, and headaches. The Board amended the WCJ's findings to include previously established injuries and returned the matter for further proceedings. The WCJ is directed to consider Dr. Pietruszka's opinion and develop the record on orthopedic injuries. This decision is not final and allows for future reconsideration of the WCJ's new ruling.

Petition for ReconsiderationMedical OpinionPsoriatic ArthritisDiabetesHeadachesIndustrially CausedSubstantial Medical EvidenceDevelop the RecordOrthopedic InjuriesPsyche
References
2
Case No. 2025 NY Slip Op 04554 [241 AD3d 514]
Regular Panel Decision
Aug 06, 2025

Guarniero v. City of Yonkers

Michael J. Guarniero, an employee of the City of Yonkers, developed psoriatic arthritis and requested a reasonable accommodation: reassignment to a custodial position at a senior citizen center. The City denied his request, leading Guarniero to sue for employment discrimination under the New York State Human Rights Law. The Supreme Court initially granted the City's motion for summary judgment, dismissing the complaint. However, the Appellate Division reversed this decision, ruling that the City failed to demonstrate it had engaged in a good-faith interactive process to assess Guarniero's needs and the reasonableness of his requested accommodation.

Employment DiscriminationDisability DiscriminationReasonable AccommodationPsoriatic ArthritisNew York State Human Rights LawExecutive Law § 296Summary JudgmentInteractive ProcessAppellate ReviewEmployer Duty
References
4
Case No. MISSING
Regular Panel Decision

Francese v. Shalala

Plaintiff Randy Francese sought judicial review of a final decision by the Secretary of Health and Human Services, denying his application for disability insurance benefits. Francese, a former firefighter, alleged disability due to a back injury sustained in 1991, exacerbated by psoriatic arthritis. His application was denied by an Administrative Law Judge (ALJ) and subsequently by the Appeals Council. The District Court affirmed the Secretary's determination, concluding that the ALJ correctly followed the established five-step sequential process for evaluating disability claims. The court found substantial medical evidence from multiple examining physicians supporting the ALJ's conclusion that Francese was capable of performing sedentary work, despite being unable to return to his previous occupation as a firefighter. The court denied the plaintiff's motion for judgment on the pleadings and granted the defendant's motion.

Disability Insurance BenefitsSocial Security ActJudicial ReviewSedentary WorkResidual Functional CapacityMedical EvidenceTreating Physician RuleSubstantial EvidenceAppeals CouncilAdministrative Law Judge
References
10
Case No. ADJ8032740
Regular
Sep 17, 2014

LAURA RAMIREZ vs. LOYOLA MARYMOUNT UNIVERSITY, TRAVELERS

This case involved a custodian injured on the job, causing admitted industrial injury to her knee and lumbar spine. The Administrative Law Judge apportioned 50% of the permanent disability to pre-existing arthritis, a decision the applicant contested. The Workers' Compensation Appeals Board denied reconsideration, finding the apportionment supported by medical evidence indicating the industrial injury and pre-existing arthritis jointly necessitated knee replacement surgery. This aligns with precedent requiring apportionment to all causative factors, including underlying pathology.

ApportionmentPre-existing arthritisIndustrial injuryPermanent disabilityWCJPetition for reconsiderationLabor Code 4663PQMEOrthopaedic surgeonArthroplasty
References
4
Case No. WCK 0067792
Regular
Sep 20, 2007

ERNEST J. WILLIAMS vs. PINKERTON SECURITY, ESIS

This case involves an applicant who sustained an industrial injury to his right knee. The defendant sought reconsideration of the original award, arguing the judge erred in denying credit for temporary disability overpayments and in failing to apportion permanent disability to pre-existing arthritis. The Appeals Board granted reconsideration, rescinded the original award, and returned the matter for further proceedings. The Board found that apportionment to prior arthritis, even if it necessitated knee replacement surgery, is required under current law and that the Agreed Medical Evaluator's opinion on apportionment was sufficient.

WCABPinkerton SecurityErnest J. Williamsindustrial injuryright lower extremitypermanent disabilityapportionmenttemporary disability overpaymentAgreed Medical EvaluatorAME
References
8
Case No. MISSING
Regular Panel Decision
Nov 30, 2015

Claim of Gramza v. Buffalo Board of Education

Claimant, a teacher, sustained a work-related injury to his left shoulder and neck in 2005 and was subsequently classified with a permanent partial disability. The employer sought reimbursement from the Special Disability Fund, citing the claimant's preexisting medical conditions, including rheumatoid arthritis and hypertension. The Workers' Compensation Board granted this application, prompting an appeal from the Fund. The court affirmed the Board's decision, finding substantial evidence that the claimant's rheumatoid arthritis was a permanent condition restricting hand use and hindering general employability. An independent medical reviewer's opinion further supported that the claimant's overall disability was significantly greater due to the combined effect of both conditions.

Workers' CompensationSpecial Disability FundReimbursementPreexisting ImpairmentRheumatoid ArthritisPermanent Partial DisabilityMaterially and Substantially Greater DisabilityGeneral EmployabilityIndependent Medical ReviewerAppellate Division
References
6
Case No. GRO 0029816, GRO 0029817
Significant

Marlene Escobedo vs. Marshalls, CNA Insurance Co.

The Appeals Board affirmed the WCJ's decision to apportion 50% of the applicant's permanent disability to a preexisting degenerative arthritis, holding that Labor Code section 4663, as amended by SB 899, permits apportionment based on causation from non-industrial factors supported by substantial medical evidence.

SB 899apportionmentcausationpermanent disabilitypreexisting arthritismedical evidencesubstantial evidenceLabor Code section 4663compensable consequenceQME
References
58
Case No. GRO 0029816, GRO 0029817
En Banc

Marlene Escobedo vs. Marshalls, CNA Insurance Co.

The Appeals Board affirmed the WCJ's decision, holding that under Labor Code section 4663 as amended by SB 899, apportionment of permanent disability is based on causation and may include pre-existing, non-industrial conditions like degenerative arthritis, provided there is substantial medical evidence to support the percentage of non-industrial causation.

SB 899ApportionmentCausationPermanent DisabilityPreexisting ConditionDegenerative ArthritisSubstantial Medical EvidenceMedical ProbabilityLabor Code Section 4663Compensable Consequence
References
56
Case No. SAC 296205
Regular
Jun 11, 2008

EDWARD A. CASEY vs. CITY OF FULLERTON

This case involved a firefighter/paramedic seeking increased permanent disability for knee injuries. The Appeals Board denied reconsideration, upholding the administrative law judge's decision. The judge's decision was based on the agreed medical examiner's opinion, which apportioned 30% of the permanent disability to non-industrial factors, including a prior knee injury and the natural progression of arthritis.

ApportionmentAgreed Medical Evaluator (AME)Permanent DisabilityCausationLabor Code Section 4663Labor Code Section 4664Firefighter/ParamedicKnee InjuryTotal Knee ReplacementOsteoarthritis
References
0
Case No. ADJ9781209
Regular
Aug 03, 2015

PABLO QUIJADA vs. GENERAL PRODUCTION SERVICE OF CALIFORNIA, INC, ZURICH

This case involves Pablo Quijada's workers' compensation claim for a left wrist and hand injury sustained while employed as a well puller. The initial ruling denied the claim, citing pre-existing arthritis, but the Appeals Board granted reconsideration. The Board found sufficient evidence that Quijada's employment was a contributing cause to his injury, overturning the original decision. The matter is now returned for further proceedings on the extent of his industrial injury.

Well pullerIndustrial injuryLeft wristLeft handSlip and fallOil rigPre-existing arthritisDegenerative joint diseaseUlnar impaction syndromeCausation
References
3
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