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

Case No. 525358
Regular Panel Decision
Jun 07, 2018

Matter of Busat v. Ramapo Manor Nursing Ctr.

Claimant, a food service worker, suffered work-related injuries to his back, neck, and right shoulder in 1997, receiving workers' compensation benefits. In 2014, claimant resumed treatment for his right shoulder and was found to have a 50% temporary disability. During a vacation, he underwent an unrelated cardiac procedure, which prevented him from receiving medical clearance for planned shoulder surgery due to ongoing heart medication. The Workers' Compensation Board initially ruled that claimant's departure from employment was unrelated to his disability and that he failed to remain attached to the labor market. The Appellate Division, Third Department, found the Board's reasoning contradicted by consistent medical evidence indicating claimant's inability to obtain shoulder surgery clearance due to his cardiac condition. Consequently, the court reversed the Board's decisions and remitted the matter for further proceedings.

Workers' CompensationDisability BenefitsLabor Market AttachmentMedical ClearanceCardiac ConditionShoulder InjuryBoard ReconsiderationAppellate ReviewMedical EvidenceCausation
References
3
Case No. SFO 0425862 SFO 0425863
Regular
May 14, 2008

William Bishop vs. IGC POLYCOLD SYSTEMS, ROYAL & SUN ALLIANCE

This case involves a workers' compensation applicant claiming injury to his right shoulder and seeking a new vocational rehabilitation plan. The Appeals Board affirmed the WCJ's denial of a new vocational plan and the finding of no industrial injury to the right shoulder. However, they reversed the WCJ to award benefits resulting from right shoulder surgery, deeming it a consequence of the compensable left shoulder injury.

Workers' Compensation Appeals BoardReconsiderationVocational Rehabilitation PlanIndustrial InjuryRight ShoulderLeft ShoulderTemporary DisabilityQualified Medical EvaluationCausationNon-Industrial
References
8
Case No. LAO 0857845
Regular
Oct 12, 2007

NATIVIDAD URIAS vs. VISHAY TRANSDUCERS, LIBERTY MUTUAL INSURANCE COMPANY

This case involves a workers' compensation applicant seeking further medical treatment for admitted industrial injuries to her right shoulder and bilateral upper extremities. The Workers' Compensation Appeals Board granted reconsideration to clarify the scope of awarded medical treatment. The Board affirmed the need for a right carpal tunnel release surgery as recommended by the applicant's physician but reversed the award of arthroscopic shoulder surgery, finding it premature without a specific recommendation or request for authorization.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardExpedited HearingFurther Medical TreatmentArthroscopic Shoulder SurgeryCarpal Tunnel ReleasePrimary Treating PhysicianQualified Medical EvaluatorUtilization Review
References
0
Case No. MISSING
Regular Panel Decision

Lawliss v. Quellman

Plaintiff sustained a right shoulder injury at work, leading his orthopedic specialist to recommend immediate surgery for a ruptured biceps. However, his employer's workers' compensation carrier disputed the need for surgery and mandated an independent medical examination (IME) by the defendant, an orthopedic specialist. The defendant reported to the carrier that surgery was unnecessary, advocating physical therapy instead. This advice resulted in the carrier denying surgery, and the plaintiff's subsequent physical therapy proved ineffective, as did delayed surgery, allegedly causing an 80% loss of shoulder use. Consequently, plaintiff initiated a medical malpractice action against the defendant, asserting that the negligent advice given during the IME caused the detrimental delay in his treatment. The Supreme Court denied the defendant's motion for summary judgment, a decision which the appellate court affirmed, citing the presence of factual questions regarding an implied physician-patient relationship, negligence, and foreseeable reliance.

medical malpracticeindependent medical examinationphysician-patient relationshipsummary judgmentworkers' compensationappellate decisionorthopedic injurynegligent advicedelayed surgeryloss of use
References
10
Case No. MISSING
Regular Panel Decision
Sep 07, 2004

Claim of Senecal v. Allied Bendix

Claimant sustained a work-related left shoulder injury in 1991, leading to surgery in 1992 and retirement in 1995. In 2002, he sought workers' compensation benefits for a consequential right shoulder injury, claiming it resulted from favoring his left shoulder. While a Workers' Compensation Law Judge initially established a causally related consequential injury, a Board panel reversed this decision. The Appellate Division affirmed the Board's ruling, finding substantial evidence that the right shoulder condition, which manifested 10-11 years post-initial injury and 7 years post-retirement, was consistent with natural aging and not causally related to the prior work injury.

Workers' CompensationConsequential InjuryRight Shoulder PainLeft Shoulder InjuryCausationMedical EvidenceDegenerative ChangesSpecial Fund for Reopened CasesAppellate ReviewSubstantial Evidence
References
1
Case No. MISSING
Regular Panel Decision

North Shore University Hospital v. State Human Rights Appeal Board

This proceeding involved a review of an order from the State Human Rights Appeal Board, which affirmed a finding by the State Division of Human Rights that the petitioners had discriminated against complainant Essie Morris. The discrimination stemmed from the petitioners' failure to accommodate Morris's observance of the Sabbath and her subsequent employment termination, violating Executive Law § 296(10). The court found substantial evidence supporting the Division's finding that petitioners improperly placed the burden on Morris to find assignment swaps. It emphasized an employer's affirmative duty to reasonably accommodate religious beliefs. The petitioners also failed to demonstrate exemption from Executive Law § 296(10) under paragraphs (b) and (c). Consequently, the order was confirmed, and the petitioners' appeal was dismissed.

Religious DiscriminationSabbath ObservanceEmployment TerminationReasonable AccommodationExecutive Law § 296State Human Rights LawEmployer ResponsibilitySubstantial Evidence ReviewJudicial Review of Administrative OrderPetition Dismissal
References
3
Case No. ADJ1445862
Regular
Mar 22, 2011

Stuart Rubin vs. Delta Air Lines/ACE American Insurance as administered by ESIS

This case concerns an employee's cumulative trauma claim against Delta Airlines for injuries to his spine, right shoulder, and right knee. The defendant sought reconsideration of the original award, arguing the claim was barred by the statute of limitations and the medical evidence did not support injury to the shoulder and knee. The Appeals Board granted reconsideration, rescinded the original award, and returned the matter for further proceedings. The Board found that the earlier medical report, relied on by the defendant, may not have been based on a complete history and that Dr. Green's apportionment was specifically for surgeries, not necessarily cumulative trauma to the shoulder and knee.

Cumulative traumaStatute of limitationsAgreed Medical ExaminerPetition for reconsiderationFindings and AwardLabor Code section 5405Medical evidenceApportionmentTollingClaim form
References
5
Case No. MISSING
Regular Panel Decision
Jan 24, 2005

Claim of Jones v. New York State Department of Correction

The claimant, a bus driver for the New York City Department of Correction, sustained work-related injuries to her right shoulder and back in September 1998. After surgery in 1999, she sought treatment in 2001 for left shoulder pain, alleging it was a consequential injury from favoring her right shoulder. While a Workers’ Compensation Law Judge initially found a causally related consequential injury, the Workers’ Compensation Board reversed this decision. The Appellate Division affirmed the Board's decision, emphasizing the Board's authority to make its own factual findings and resolve conflicting medical evidence. The Board found the self-insured employer’s medical consultant more credible than the claimant’s physician, and its decision was supported by substantial evidence.

Workers' Compensation Board DecisionAppellate DivisionCausal RelationshipConsequential InjuryCredibility of WitnessesConflicting Medical EvidenceShoulder InjuriesBus DriverNew York City Department of CorrectionAffirmed Decision
References
3
Case No. MISSING
Regular Panel Decision

Cluett, Peabody & Co. v. New York State Division of Human Rights

This case addresses whether an arbitration proceeding, which determined a job classification was not discriminatory under a collective bargaining agreement but explicitly stated it lacked authority to rule on Human Rights Law violations, bars a subsequent proceeding before the State Division of Human Rights. Employees Betty Lingle and Joan Skinner initially filed a grievance and later complaints with the State Division of Human Rights alleging sex discrimination after their termination. Following an arbitration decision that denied relief but did not address Human Rights Law issues, their employer, Cluett, Peabody & Co., Inc., sought a judgment declaring the Division lacked jurisdiction due to election of remedies. The court, presided over by John W. Sweeny, J., held that the arbitration did not constitute an election of remedies precluding the State Division from proceeding, as the arbitrator had no authority to decide Human Rights Law issues. Consequently, the employer's motion to dismiss the complaint was granted, allowing the Human Rights Commission to continue with the employees' complaints.

DiscriminationSex DiscriminationHuman Rights LawArbitrationCollective Bargaining AgreementExclusive RemedyJurisdictionState Division of Human RightsSeniority RightsElection of Remedies
References
3
Case No. ADJ1498961
Regular
Sep 23, 2010

DALE ARNOLD vs. RALPH'S AKA KROGER

This case involves an applicant's claim for workers' compensation benefits for a right shoulder injury. While the initial award recognized industrial injury to the applicant's left shoulder, right elbow, and right forearm, the defendant sought reconsideration, arguing the right shoulder injury was not work-related. The Appeals Board granted reconsideration, finding the applicant failed to meet the burden of proof for the right shoulder injury. They disagreed with the primary treating physician's opinion and found the agreed medical evaluator's opinion more persuasive, ultimately reversing the finding for the right shoulder.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardCumulative TraumaIndustrial InjuryLeft ShoulderRight ElbowRight ForearmRight ShoulderPrimary Treating Physician
References
0
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