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Case Law Database

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

Case No. MISSING
Regular Panel Decision

Claim of Lewis v. Stewart's Marketing Corp.

A claimant sustained serious injuries in 1997 and was awarded workers' compensation benefits. In 2008, a dispute arose regarding the permanency and degree of disability, with conflicting medical reports submitted by the claimant (permanent total disability) and the employer (moderate partial disability). The Workers' Compensation Law Judge denied the employer's request to cross-examine the claimant and his physician, subsequently ruling that the claimant had a permanent total disability. Upon appeal, the Workers’ Compensation Board affirmed this decision. The appellate court reversed the Board's decision, emphasizing that denying the employer's timely request for cross-examination was improper, especially given the conflicting medical evidence, and remitted the matter for further proceedings.

Workers’ CompensationDisability AssessmentPermanent Total DisabilityIndependent Medical ExaminationCross-Examination RightsProcedural Due ProcessConflicting Medical EvidenceRemittalAppellate ReviewBoard Decision Reversal
References
3
Case No. ADJ1880658
Regular
Feb 09, 2011

CLAIRE COATS vs. STATE COMPENSATION INSURANCE FUND

The applicant sought reconsideration of a WCJ's decision that denied her motion to strike a permanent disability rating and denied her request for cross-examination of the rater. The Appeals Board granted reconsideration, finding that the applicant was improperly denied her due process right to cross-examine the rater. The Board rescinded the WCJ's decision and returned the case to the trial level for a new WCJ to conduct further proceedings and issue a new decision, allowing consideration of the applicant's other contentions. This procedural error regarding the cross-examination right necessitated the remand.

Workers' Compensation Appeals BoardClaire CoatsState Compensation Insurance FundFindings and Award and OrderSenior Claims AdjusterIndustrial InjuryPermanent DisabilityMotion to StrikeCross-examinationRater
References
1
Case No. ADJ2951251 (LBO 0388783) ADJ405202 (LBO 0388784)
Regular
Aug 16, 2010

MARIANA CONTRERAS, MARIANA CONTRERAS MADRIGAL vs. 99 CENTS STORES, Permissibly Self-Insured, Administered By SOUTHERN CALIFORNIA RISK MANAGEMENT ASSOCIATES

The Workers' Compensation Appeals Board granted reconsideration because the defendant was denied due process. The defendant timely filed a petition to cross-examine the disability rater and submit rebuttal evidence electronically. However, the administrative law judge was unaware of this filing and issued a decision without allowing the defendant the opportunity to cross-examine the rater. Consequently, the Board rescinded the prior award and returned the case for further proceedings.

Workers' Compensation Appeals BoardPermissibly Self-InsuredSouthern California Risk Management AssociatesFindings and AwardPermanent DisabilityDisability Evaluation SpecialistReconsiderationElectronic Adjudication Management SystemDue ProcessAgreed Medical Examiner
References
5
Case No. ADJ887948 (SRO 0103492) ADJ4222536 (SRO 0103500) ADJ3891200 (SRO 0103496)
Regular
Oct 04, 2010

RICHARD CARROLL vs. CONSOLIDATED FREIGHTWAYS, INC., Permissibly Self-Insured, Reinsured By RELIANCE, In Liquidation, Adjusted By CALIFORNIA INSURANCE GUARANTEE ASSOCIATION

The Workers' Compensation Appeals Board granted reconsideration and rescinded prior awards due to a due process violation. The applicant was denied the opportunity to cross-examine the Disability Evaluation Unit rater when the WCJ simultaneously issued decisions and the recommended rating. This prevented applicant's right to object or seek rebuttal evidence before submission for decision. The case is returned to the trial level for further proceedings, including potential rater cross-examination, and a new decision.

Workers' Compensation Appeals BoardReconsiderationFindings Award and OrdersJoint Findings and AwardWCJDisability Evaluation UnitRating InstructionsDue ProcessCross-examinationRater
References
3
Case No. MISSING
Regular Panel Decision
May 17, 2004

Claim of Patterson v. Empire Blue Cross & Blue Shield

The claimant sustained physical and psychological injuries on September 11, 2001, during the evacuation of her workplace at World Trade Center Tower One in Manhattan. In March 2003, the employer moved to discontinue benefits, arguing that claimant no longer had a work-related disability. A Workers’ Compensation Law Judge (WCLJ) ordered depositions of medical experts. Claimant’s attorney failed to appear for the deposition of the employer’s orthopedic expert. Consequently, the WCLJ ruled that the claimant waived her right to cross-examine the expert and found no further work-related disability after May 12, 2003. The Workers’ Compensation Board affirmed this decision, which the claimant subsequently appealed. The Appellate Division affirmed the Board’s determination, citing substantial evidence supporting the finding of no further disability and concluding that the WCLJ did not abuse its discretion in denying an adjournment for cross-examination.

Workers' CompensationDisabilityMedical Expert TestimonyWaiver of Cross-ExaminationAdjournmentAppellate ReviewSeptember 11World Trade CenterNew York StateWorkers' Compensation Board
References
7
Case No. ADJ6544795
Regular
Mar 28, 2011

JENNIFER GONZALEZ vs. CAL POLY POMONA ASI, SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves a defendant seeking reconsideration of a workers' compensation award due to a due process violation. The administrative law judge issued a decision without allowing the defendant to object to or cross-examine the Disability Evaluation Unit (DEU) rater. The Appeals Board granted reconsideration, rescinded the original award, and returned the matter to the trial level. This is to allow the defendant the opportunity to cross-examine the DEU evaluator, thereby ensuring due process.

WCABPetition for ReconsiderationFindings and AwardDEU RatingCross-examinationDisability Evaluation UnitDue ProcessIndustrial InjuryPermanent DisabilityMedical Treatment
References
4
Case No. ADJ3234790 (VNO 0443319) ADJ4252592 (VNO 0411668)
Regular
Nov 29, 2010

HARRY P. WINSTON vs. CITY OF LOS ANGELES, Permissibly Self-Insured

The Workers' Compensation Appeals Board granted reconsideration of a prior award due to a due process violation. The defendant was denied the opportunity to cross-examine the Disability Evaluation Unit rater after objecting to their rating, which is a procedural due process right. Consequently, the Board rescinded the prior award and returned the case to the trial level for further proceedings, including the opportunity for cross-examination. The Board noted that a new WCJ would need to be assigned due to the original judge's retirement.

Workers Compensation Appeals BoardFindings and AwardReconsiderationAdministrative Law JudgePolice OfficerBilateral KneesLumbar SpineCervical SpineGERDBilateral Carpal Tunnel
References
3
Case No. MISSING
Regular Panel Decision
Apr 15, 1983

American White Cross Laboratories, Inc. v. North River Insurance

Vincent Yeager, an employee of American White Cross Laboratories, Inc. (American), was injured during employment, leading to a lawsuit against a machine manufacturer, who then brought a third-party action against American for indemnification. American was covered by both a workers’ compensation policy from the State Insurance Fund and a general liability policy from North River Insurance Co. North River disclaimed liability, citing exclusions for workers’ compensation obligations and bodily injury to employees. American then initiated a fourth-party action against North River for contribution. The Supreme Court initially denied American's summary judgment motion and granted North River's cross-motion to dismiss, with leave to replead for indemnification. This court reversed, holding that North River's exclusions do not insulate it from American’s claims because the employer's liability to a third-party tort-feasor for an employee's injury arises from equitable apportionment, not directly from workers' compensation law, thus granting American's motion for summary judgment and denying North River's cross-motion.

Insurance coverage disputeGeneral liability policyWorkers' compensation exclusionContribution between tort-feasorsIndemnificationSummary judgmentFourth-party actionDole-Dow doctrineEquitable apportionmentEmployer liability
References
2
Case No. 2024 NY Slip Op 00844 [224 AD3d 1079]
Regular Panel Decision
Feb 15, 2024

Matter of Cross v. New York State Dept. of Corr. & Community Supervision

Brenda Cross, the claimant, established a workers' compensation claim for knee and ankle injuries from a 2020 work accident. The employer's carrier required her to use contracted providers for diagnostic testing. After an approved MRI for her right ankle was performed by a non-contracted provider, the carrier objected to payment. The WCLJ and Workers' Compensation Board sided with the carrier but found claimant not responsible for the bill. Cross appealed, but the Appellate Division, Third Department, dismissed the appeal, ruling that Cross lacked standing as she was not aggrieved, since she was not responsible for the medical bill and any dispute over reimbursement rates was between the provider and the carrier.

Workers' Compensation ClaimMedical Bill DisputeDiagnostic TestingContracted ProvidersStanding (Law)Aggrieved PartyAppeal DismissedWorkers' Compensation Board DecisionAppellate DivisionMedical Reimbursement
References
2
Case No. MISSING
Regular Panel Decision

Schairer v. Schairer

The wife filed a motion to disqualify the law firm of Sari Friedman, P.C. from representing her husband in their ongoing divorce proceedings, citing a conflict of interest. This conflict stemmed from Ms. Friedman's prior representation of the court-appointed custody forensic expert in his own divorce case in 1995. The husband cross-moved to disqualify the same forensic expert, alleging potential bias against police officers and Ms. Friedman's previous representation of the expert. The court found a clear appearance of a conflict of interest, as Ms. Friedman could not effectively cross-examine her former client, the expert, without potentially using privileged confidential information. Consequently, the court granted the wife's motion to disqualify Sari Friedman, P.C. and denied the husband's cross-motion, determining that any claims of bias against the expert could be addressed during trial.

DivorceAttorney DisqualificationConflict of InterestForensic ExpertCustodySpousal DisputeProfessional EthicsConfidentialityLegal RepresentationJudicial Opinion
References
10
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