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Case Law Database

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

Case No. ADJ10343521
Regular
Jan 03, 2019

JESUS LOPEZ vs. CITY OF COMPTON

This case involves a firefighter's claim for workers' compensation benefits for heart trouble. The applicant, Jesus Lopez, was found to have sustained 54% permanent disability due to an industrial injury to his heart on December 17, 2015. The Workers' Compensation Appeals Board (WCAB) affirmed the administrative law judge's decision, relying on Labor Code section 3212, which presumes heart trouble in firefighters arises out of employment. The defendant, City of Compton, argued that the presumption was rebutted by evidence of non-industrial events and that the Qualified Medical Evaluator's opinion was not substantial medical evidence. However, the WCAB found that the defendant failed to provide substantial medical evidence to rebut the presumption, particularly in light of the anti-attribution clause in Labor Code section 3212.

Labor Code section 3212presumption of industrial causationheart troublefirefighter paramedicQualified Medical EvaluatorQMEsubstantial medical evidencedue processrebut the presumptionanti-attribution clause
References
7
Case No. ADJ9623149
Regular
Jun 25, 2018

ADAM PALSGROVE vs. CITY OF PALO ALTO, YORK RISK SERVICES GROUP, INC.

This case involves a firefighter diagnosed with basal cell carcinoma, claiming it's industrially caused under the Labor Code section 3212.1 presumption. The defendant employer attempted to rebut this presumption by arguing the cancer's latency period exceeded the applicant's employment duration. However, medical evidence indicated that cumulative exposure to UV light during employment contributed to the cancer's development. The Appeals Board granted reconsideration, finding the employer failed to rebut the presumption of industrial causation based on this medical evidence.

Labor Code 3212.1Firefighter presumptionBasal cell carcinomaIndustrial causationRebuttal of presumptionKnown carcinogenLatency periodCumulative effectUV light exposureMedical evidence
References
7
Case No. 2017 NY Slip Op 06121
Regular Panel Decision
Aug 10, 2017

Matter of Lavigne v. Hannaford Bros. Co.

The claimant's wife, a grocery store employee, died at work from cardiac arrest. The Workers' Compensation Board granted death benefits, finding a causal relationship between her death and employment, attributing it to work-related stress. The employer and its carrier appealed, arguing that medical evidence rebutted the presumption of compensability. Although the presumption was rebutted, the Appellate Division, Third Department, affirmed the Board's decision, finding that the claimant's internal medicine physician provided substantial evidence that work-related stress was a significant contributing factor to the decedent's sudden cardiac death.

Workers' CompensationDeath BenefitsCausal RelationshipCardiac ArrestWork-Related StressPresumption of CompensabilityUnwitnessed DeathMedical TestimonySubstantial EvidenceAppellate Review
References
11
Case No. MISSING
Regular Panel Decision

Cardno v. State

The petitioner, a police officer for the Port Authority, sought World Trade Center accidental disability retirement benefits after being diagnosed with colitis, which he attributed to his work at the WTC site on 9/11 and subsequent extended shifts at JFK. The Comptroller denied the application, finding that while the WTC presumption applied, it was rebutted by competent evidence, and the petitioner failed to establish a causal connection between his disability and his work at the WTC site. The court affirmed the Comptroller's determination, ruling that the work performed at JFK did not fall within the scope of the World Trade Center site presumption and that sufficient medical evidence existed to rebut the presumption for the WTC site work, thus upholding the denial of benefits.

World Trade Center benefitsaccidental disability retirementulcerative colitiscausationstatutory presumptionpolice officerCPLR article 78 proceedingmedical evidencestress-related illness9/11 workers
References
3
Case No. ADJ2262922 (SRO 0041418)
Regular
Jul 07, 2011

DEBBIE LEVINE vs. STARBUCKS, INC., GALLAGHER BASSETT SERVICES, INC.

The applicant sought reconsideration of a permanent disability rating of 42%, arguing the vocational expert's assessment of diminished future earning capacity (DFEC) was rebutted and that Labor Code section 4662 should apply for total disability. The Appeals Board denied the petition, finding that the applicant failed to present substantial evidence to rebut the DFEC, as she never sought employment and her vocational expert's opinion was largely attributed to economic factors. Furthermore, the Board found no basis for applying Labor Code section 4662, as the applicant's alleged permanent total disability was not supported by persuasive medical or vocational evidence. The applicant's unsupported claim of zero earning capacity was contradicted by medical opinions.

Diminished Future Earning Capacity2005 PDRSOgilvie IOgilvie IIrebuttalLabor Code section 4662permanent total disabilityvocational expertsubstantial evidenceAME
References
5
Case No. CV-23-1971
Regular Panel Decision
May 01, 2025

In the Matter of the Claim of Anthony Stabile

Claimant Anthony Stabile, a nurse, sought workers' compensation benefits after experiencing an unwitnessed cardiac arrest in his employer's parking lot. A Workers' Compensation Law Judge initially established the claim under the Workers' Compensation Law § 21 presumption. However, the Workers' Compensation Board reversed this decision, finding that the employer successfully rebutted the presumption with medical testimony linking the cardiac event to claimant's preexisting conditions. The Appellate Division affirmed the Board's decision, ruling that its findings were supported by substantial evidence and that claimant failed to prove a causal link between his condition and employment. The court emphasized that while the statutory presumption applies to unwitnessed accidents, it does not establish the occurrence of an accident itself and can be rebutted by contrary substantial evidence.

Workers' CompensationAccidental InjuryArising Out of EmploymentCourse of EmploymentUnwitnessed AccidentCardiac ArrestPreexisting ConditionsMedical EvidenceStatutory PresumptionRebuttal of Presumption
References
9
Case No. No. 46
Regular Panel Decision
May 16, 2024

In the Matter of the Claim of Justin Timperio

This case clarifies the operation of the rebuttable presumption set forth in Workers' Compensation Law § 21 (1). Justin Timperio, a first-year resident at Bronx-Lebanon Hospital, was severely injured during a mass shooting by a former employee with whom he had no prior contact. While a Workers' Compensation Law Judge and the Workers' Compensation Board initially found the injuries compensable, the Appellate Division reversed, arguing that the lack of evidence regarding the assailant's motivation rebutted the WCL § 21 (1) presumption. The Court of Appeals reversed the Appellate Division's decision, holding that a lack of evidence regarding the motivation for an assault does not rebut the presumption that an injury arising in the course of employment also arises out of employment. The Workers' Compensation Board's decision was therefore reinstated.

Workplace AssaultRebuttable PresumptionCourse of EmploymentArising Out of EmploymentWCL Section 21(1)Lack of EvidenceMotivation for AssaultAppellate Division ReversalCourt of Appeals DecisionMedical Staff Injury
References
14
Case No. MISSING
Regular Panel Decision
Jun 08, 2005

Claim of Marcus v. City of Troy

The claimant appealed a Workers’ Compensation Board decision from June 8, 2005, which determined that the death of her husband, a truck driver/sewer maintenance worker for the City of Troy, Department of Public Utilities, was not causally related to his employment. The decedent died suddenly while driving a company truck with a coworker. Initially, a Workers’ Compensation Law Judge awarded benefits, citing the presumption in Workers’ Compensation Law § 21 for deaths occurring during employment. However, the Board disagreed, finding the presumption rebutted by the employer’s evidence. The Appellate Division affirmed the Board's decision, concluding that the employer presented substantial medical evidence, based on the decedent's history of health issues, to support the determination that the death was unrelated to his employment, thereby successfully rebutting the presumption of compensability.

Workers' Compensation Law § 21Presumption of compensabilityCausationMedical EvidenceRebuttal evidenceUnexplained deathCardiac eventsEmployment-related deathBurden of proofAppellate review
References
4
Case No. MISSING
Regular Panel Decision

Claim of Barrington v. Hudson Valley Fruit Juice, Inc.

The claimant's decedent, a factory laborer, suffered an unwitnessed intracerebral hemorrhage at work and subsequently died. The employer controverted the claim for workers’ compensation death benefits. A WCLJ initially closed the case for lack of prima facie medical evidence, but a subsequent WCLJ reopened and found sufficient medical evidence based on the presumption of compensability in Workers’ Compensation Law § 21 (1). The Workers’ Compensation Board then rescinded this decision, ruling that claimant's medical reports did not constitute prima facie evidence of a causal relationship. On appeal, the Court found that the Board erred in requiring prima facie medical evidence in this unwitnessed death case, compelling the application of Workers’ Compensation Law § 21 (1) presumption. The Court also noted that the employer had not presented evidence to rebut this presumption. The decision of the Board was reversed, and the matter was remitted for further proceedings.

Workers' CompensationIntracerebral HemorrhageUnwitnessed DeathPresumption of CompensabilityCausal RelationshipPrima Facie Medical EvidenceBoard ErrorReversalRemittalDeath Benefits Claim
References
11
Case No. MISSING
Regular Panel Decision

Anthony v. Nemec

Plaintiff, a former employee, commenced an action alleging gender discrimination under the Human Rights Law, claiming she was terminated because she was a woman of childbearing age intending to become pregnant and take maternity leave. The Supreme Court initially found an inference of discrimination, but the appellate court determined that this inference was rebutted by defendant's evidence that the position was filled by another woman of childbearing age who also became pregnant and was accommodated. The court found no competent evidence of discriminatory intent, stating that plaintiff's claims relied on insufficient statistical evidence and uncorroborated allegations. Consequently, the appellate court concluded that defendant's motion for summary judgment should have been granted due to the absence of sufficient evidence to demonstrate unlawful discrimination.

gender discriminationemployment terminationpregnancy discriminationmaternity leaveHuman Rights Lawsummary judgmentprima facie caseunlawful discriminationrebuttalchildbearing age
References
2
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