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Case Law Database

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

Case No. ADJ7308922
Regular
Apr 22, 2013

ARTURO CARO vs. JAX MARKET 3, FIREMAN'S FUND

The Workers' Compensation Appeals Board granted reconsideration of an order dismissing a lien claim, finding that the lien claimant's representative misrepresented facts regarding payment of a lien activation fee. Despite the claimant's verified petition claiming payment was made and evidence presented, the Board's own search and the WCJ's report confirmed non-payment. Consequently, the Board issued a notice of intention to impose sanctions up to $2,500 against Qualified Billing & Collections and Diego Plasencia for bad-faith actions and false statements.

Lien Activation FeeLabor Code Section 4903.06WCJ Order Dismissing LienPetition for ReconsiderationVerified PetitionMisrepresentation of FactsBad Faith ActionsWCAB Rule 10561Labor Code Section 5813Sanctions
References
0
Case No. MISSING
Regular Panel Decision

Emspak v. Conroy

The defendants moved for a further bill of particulars regarding item 30 and requested the entire bill be verified by a union officer. The plaintiff's attorney acknowledged the omission for item 30 was an oversight and agreed to provide it. He argued his self-verification was proper under subdivision 3 of rule 99 of the Rules of Civil Practice, citing the plaintiff's absence from the county, and claimed defendants waived objection by not returning the bill within 24 hours. The court clarified that Rules 10 and 11 do not apply to verification. While an attorney can verify a bill of particulars under rule 117, the court ruled that merely stating the party is out of county is insufficient; the attorney must also detail the basis of their knowledge, especially given a prior order requiring an oath for inability to furnish particulars. The motion for a further bill was granted.

Bill of particularsVerificationAttorney verificationRules of Civil PracticeWaiverMotionCourt procedurePleadingSufficiency of verification
References
3
Case No. MISSING
Regular Panel Decision
Jun 09, 2011

In re the Certification as Qualified Adoptive Parents Pursuant to Domestic Relations Law § 115-d

This case concerns Joanna K. and Scottye K.'s application to waive the mandatory certification as qualified adoptive parents for Jeremiah B., the biological son of Careese B. The K.s received physical custody of Jeremiah shortly after his birth in March 2009, prior to obtaining the required judicial certification, thereby violating New York's adoption statute. The court reviewed the convoluted history, including Careese B.'s judicial consent to adoption and the K.s' temporary custody order. However, the court denied the waiver application, emphasizing the critical importance of pre-placement certification to protect children and prevent unregulated transfers of custody. The decision stated that the petitioners failed to show good cause for waiver and that a retroactive approval of non-compliance would undermine legislative intent, although the K.s retain legal and physical custody pending the adoption petition.

Adoption Law CompliancePrivate-Placement Adoption RequirementsPre-Placement CertificationWaiver Application DenialChild Welfare LegislationFamily Law ProcedureJudicial DiscretionStatutory InterpretationParental Fitness StandardsCustody Transfer
References
9
Case No. ADJ4070560
Regular
Mar 11, 2010

Lawrence Ware vs. Abrazo Del Sol, Inc., Zenith Insurance Company

The WCAB affirmed the judge's award of $2,625.00 to lien claimant Dr. Gabriel for a medical-legal report, reducing his billed amount by $875.00. The Board found that the doctor's report did not qualify as a Qualified Medical Evaluation and that the lien claimant failed to meet his burden of proving the reasonableness of the full billed amount, particularly regarding the time spent on report preparation. While defendants did not strictly follow objection procedures, their challenge to the report's reasonableness was considered, and the WCJ's discretionary reduction was upheld. Consequently, the lien claimant's petition for reconsideration was denied.

Medical-legal expensesLien claimantReconsiderationWCJOfficial Medical Fee ScheduleLabor Code Section 4622(a)Compromise and ReleaseConsequential injuryDental reportingQualified Medical Evaluator
References
7
Case No. MISSING
Regular Panel Decision

Hojnowski v. Buffalo Bills, Inc.

David Hojnowski, a former equipment manager for the Buffalo Bills, sued his former employer alleging age discrimination under the Age Discrimination in Employment Act, New York State Human Rights Law, and violations of the Employee Retirement Income Security Act. The Buffalo Bills moved to dismiss the claims and compel arbitration, citing an arbitration clause in Hojnowski's employment contract. Hojnowski contended that the arbitration agreement was unenforceable due to the absence of arbitration rules and unconscionability. The court determined that the arbitration rules were sufficiently incorporated into the agreement and that the contract was not unconscionable. Consequently, the court granted the Bills' motion, compelling Hojnowski to arbitration and dismissing his complaint.

Arbitration AgreementEmployment LawAge DiscriminationERISANew York State Human Rights LawMotion to DismissContract EnforceabilityUnconscionability DefenseFederal Arbitration ActNFL Commissioner
References
25
Case No. ADJ8485371
Regular
Dec 01, 2014

MICHAEL (MIKE) STRATTON vs. SAN DIEGO CHARGERS, ZENITH NORTH AMERICA, BUFFALO BILLS

The Workers' Compensation Appeals Board reconsidered a prior decision regarding Michael Stratton's cumulative injury claim against the San Diego Chargers and Buffalo Bills. While the original judge found Stratton's claim against the Bills timely, the Board reversed this, determining it was barred by the statute of limitations. The Board found that neither employer breached a duty to notify Stratton of his workers' compensation rights at the time of his employment. Therefore, the statute of limitations was not tolled, and Stratton's claim against the Buffalo Bills is dismissed.

WCABStatute of LimitationsLabor Code Section 5405Date of InjuryTollingCumulative InjuryProfessional Football PlayerSan Diego ChargersBuffalo BillsZenith North America
References
17
Case No. ADJ10261156
Regular
May 24, 2018

RAUL BOMBARDLY vs. CITY OF FRESNO SANITATION DEPT, RISICO CLAIMS MANAGEMENT FRESNO

The Workers' Compensation Appeals Board granted reconsideration and rescinded the judge's order for defendant to pay $\$4,812.50$ plus interest to a Qualified Medical Evaluator (QME). The Board found that the record lacked admitted evidence to support the order, including the QME's reports and bills. Defendant argued the dispute should be resolved via Independent Bill Review (IBR) as the QME allegedly double-billed for reviewing records. The Board remanded the case for further proceedings to develop the record, acknowledging defendant's argument may have statutory merit.

Panel Qualified Medical EvaluatorPQMEMarcus Vaughn DCRisico Claims ManagementCity of Fresno Sanitation DeptPetition for ReconsiderationOrder Re: Reimbursement of PQME ChargesIndependent Bill ReviewIBRLabor Code section 4622
References
1
Case No. MISSING
Regular Panel Decision
Apr 21, 2004

Zenteno v. Geils

The defendants appealed an order from the Supreme Court, Westchester County, which granted the plaintiff's motion to restore a personal injury action to the trial calendar and for leave to serve a supplemental bill of particulars. The Appellate Division affirmed the order, finding that the plaintiff demonstrated a meritorious cause of action and a reasonable excuse for delay, citing extensive medical evaluations and difficulties obtaining authorization from the Workers’ Compensation Board. The court also determined that the defendants were not prejudiced by the restoration. Furthermore, an alleged agreement to proceed to arbitration was deemed unenforceable due to non-compliance with CPLR 2104 "open court" requirements. Finally, the Supreme Court's decision to grant leave for a supplemental bill of particulars was upheld, as it pertained to continuing consequences of existing injuries rather than new ones, aligning with CPLR 3043 [b].

Personal InjuryTrial Calendar RestorationSupplemental Bill of ParticularsArbitration Agreement EnforcementCPLR 2104CPLR 3043Medical ExaminationsWorkers' Compensation IssuesAppellate ReviewProcedural Motion
References
20
Case No. MISSING
Regular Panel Decision
Oct 08, 2009

D'Elia v. City of New York

The plaintiff appealed an order from the Supreme Court, Queens County, concerning personal injuries sustained while working as a surveyor. The original order granted summary judgment to defendants on common-law negligence and Labor Law §§ 200 and 241(6) claims, and denied the plaintiff's cross-motion to amend his bill of particulars to include a violation of 12 NYCRR 23-1.23. The appellate court modified the order, granting the plaintiff's cross-motion for leave to amend his bill of particulars and denying summary judgment to defendants on the Labor Law § 241(6) claim. However, the court affirmed the dismissal of common-law negligence and Labor Law § 200 claims, finding defendants lacked supervisory authority over the plaintiff's work. The case involved an alleged fall on a steeply inclined slope made of loosely compacted dirt and rocks at a construction site.

Personal InjuryLabor LawSummary JudgmentBill of Particulars AmendmentConstruction Site AccidentWorkplace SafetyIndustrial Code ViolationNegligenceAppellate ReviewEarthen Slope Fall
References
13
Case No. ADJ13768010
Regular
May 06, 2025

ROBERT NICHOLS vs. COMCAST, ACE AMERICAN INSURANCE COMPANY

Robert Nichols, the applicant, sustained injuries while employed by Comcast. A petition for reconsideration was filed regarding whether the medical treatment received by the applicant qualified as pre-admission or emergency services, and the defendant's alleged failure to conduct a second bill review. The Workers' Compensation Appeals Board denied the petition for reconsideration, concurring with the WCJ's report that the lien claimant did not provide sufficient evidence to demonstrate that the treatment fell under pre-admission or emergency status. The Board also noted that the issue concerning the defendant's non-response to the second bill review was not a contested matter at the trial.

PETITION FOR RECONSIDERATIONLABOR CODE SECTION 5909ELECTRONIC ADJUDICATION MANAGEMENT SYSTEM (EAMS)TRANSMISSION DATEREPORT AND RECOMMENDATIONLIEN CLAIMANTPRETREATMENT SERVICESEMERGENCY SERVICESMEDICARE PROSPECTIVE PAYMENT SYSTEMSECOND BILL REVIEW
References
7
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