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

Case No. CV-23-1229
Regular Panel Decision
Dec 12, 2024

In the Matter of the Claim of Percival Webster

Percival Webster, the claimant, sustained a work-related right knee injury in April 2018, leading to a 50% schedule loss of use (SLU) award for his right leg. In March 2020, while working as a correction officer, he incurred a compensable right hip injury. Following conflicting medical evaluations by Dr. John Ioia and Dr. Adam Soyer regarding the SLU attributable to the hip injury, a Workers' Compensation Law Judge (WCLJ) credited Dr. Ioia's testimony and awarded a 50% SLU for the right leg based solely on the hip injury. The employer's carrier appealed, arguing for an offset against the prior knee injury award under Matter of Genduso. However, citing Matter of Johnson, the Workers' Compensation Board affirmed the WCLJ's decision, finding that the claimant sufficiently demonstrated the hip and knee injuries were separate pathologies. The Supreme Court, Appellate Division, Third Judicial Department, affirmed the Board's decision, concluding that Workers' Compensation Law § 15 (7) allows for multiple SLU awards for successive injuries to the same body member if an increased loss of use from the subsequent injury is proven.

Schedule Loss of UseRight Leg InjuryHip InjuryKnee InjurySuccessive InjuriesMedical EvidenceIndependent Medical ExaminationWorkers' Compensation Board AppealAppellate Division DecisionJudicial Precedent
References
6
Case No. MISSING
Regular Panel Decision

Claim of Hilbrandt v. Village of Red Hook

The claimant, a volunteer emergency medical technician, was injured on August 26, 2005. Her initial workers’ compensation claim was established for left ankle/leg and consequential right shoulder injuries. In April 2008, she sought to amend her claim to include a consequential right hip injury. The Workers’ Compensation Law Judge (WCLJ) dismissed the right hip claim as time-barred under Workers’ Compensation Law § 28, a decision upheld by the Workers’ Compensation Board. On appeal, the court affirmed the Board's decision, finding that while Volunteer Firefighters’ Benefit Law § 41 should have been applied, the claim for the right hip injury was time-barred under either statute as it was a direct injury from the 2005 accident and not claimed until April 2008.

Volunteer Firefighters' BenefitsStatute of LimitationsTime-barred ClaimConsequential InjuryDirect InjuryRight Hip InjuryEmergency Medical TechnicianDutchess CountyMedical EvidenceAppellate Review
References
6
Case No. CV-23-1229
Regular Panel Decision
Dec 12, 2024

Matter of Webster v. Office of Children & Family Servs.

Claimant Percival Webster, who previously received a 50% schedule loss of use (SLU) award for his right leg due to a 2018 knee injury, sustained a second compensable injury to his right hip in March 2020. An independent medical examination by John Ioia, credited by the Workers' Compensation Law Judge (WCLJ), assessed a 50% SLU of the right leg solely attributable to the hip injury. The employer's carrier contended that the new award should be offset by the prior knee injury award, citing *Matter of Genduso*. However, the Workers' Compensation Board affirmed the WCLJ's decision, relying on *Matter of Johnson v City of New York*, which permits separate SLU awards for distinct injuries to the same body member if the claimant proves the second injury caused an increased loss of use independently. The Board found sufficient medical evidence to support the finding that the hip injury was a separate pathology warranting a distinct 50% SLU award, a decision which the Appellate Division affirmed.

Schedule Loss of UseWorkers' Compensation Board DecisionRight Hip InjuryRight Knee InjuryIncreased Loss of UseMedical Expert TestimonyIndependent Medical ExaminationOffsetting Disability AwardsStatutory InterpretationPrior Injury
References
6
Case No. 528152
Regular Panel Decision
Jan 09, 2020

Matter of Sbuttoni v. FOJP Serv. Corp.

Claimant Joseph Sbuttoni sought workers' compensation benefits for lower back and right hip injuries sustained in September 2016. While a Workers' Compensation Law Judge initially established the claim for both, the Workers' Compensation Board later rescinded the establishment for the right hip injury. Sbuttoni appealed this decision. The Board's determination was based on conflicting medical evidence from treating orthopedic surgeon Dr. Louis Rose, who opined a work-related hip injury, and independent medical examiner Dr. Lisa Nason, who concluded the hip pain was referred from the lumbar spine and not a direct injury. The Appellate Division affirmed the Board's decision, finding it supported by substantial evidence and deferring to the Board's resolution of medical conflicts.

Workers' Compensation BenefitsCausationHip InjuryLumbar Spine InjuryMedical Evidence ConflictAppellate DivisionSubstantial Evidence ReviewOrthopedic SurgeryReferred PainBoard Decision Affirmed
References
4
Case No. 529417
Regular Panel Decision
Feb 06, 2020

Matter of Johnson v. City of New York

Thomas Johnson, a patient care technician, sustained work-related knee injuries in a February 2006 fall. He subsequently sustained additional work-related injuries in November 2009 to his neck, back, shoulder, and hips, for which he received schedule loss of use (SLU) awards for his right arm, left leg, and right leg. The Workers' Compensation Board later ruled on the permanency of his 2006 injuries, finding an 80% SLU for his left leg and a 40% SLU for his right leg. However, the Board reduced these new awards by his previously received SLU awards for the 2009 injuries, resulting in a final 30% SLU for his left leg and a 0% SLU for his right leg. The Appellate Division affirmed the Board's decision, confirming that SLU awards for the knee and hip are encompassed within leg awards, and prior leg SLU awards must be deducted from subsequent leg SLU awards.

Schedule Loss of UseKnee InjuriesHip InjuriesLeg ImpairmentPrior SLU Award DeductionAppellate Division ReviewIndependent Medical ExaminationTreating Physician ReportPermanent Impairment GuidelinesWork-related Accident
References
9
Case No. ADJ10667998
Regular
Mar 21, 2019

GRECIA ALFARO vs. APPLE, INC., SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves an applicant who sustained admitted injuries to her thoracic spine and left arm after a slip and fall at work. The applicant also claimed industrial injury to her psyche and right hip, which the employer contested. The Workers' Compensation Appeals Board (WCAB) denied reconsideration of the judge's finding that the applicant did not sustain an industrial injury to her right hip. The WCAB deferred to the judge's credibility determination, noting that the applicant's reporting of hip pain was inconsistent and poorly documented by treating physicians. The Board also cited that one physician's opinion can constitute substantial evidence, even if it conflicts with other medical opinions.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJCredibility DeterminationSubstantial EvidencePhysician's OpinionAdmitted InjuryDenied InjuryRight HipPsyche
References
3
Case No. ADJ8045546
Regular
Jul 29, 2013

THOMAS FORD III vs. WASTE MANAGEMENT, ACE AMERICAN INSURANCE CO.

This case involves a haul truck driver's claim for a low back and right hip injury against Waste Management. The defendant sought reconsideration, arguing the applicant's right hip condition was nonindustrial due to childhood surgeries and a prior car accident, citing a PQME's opinion. The Workers' Compensation Appeals Board granted reconsideration to correct clerical errors in the original award. They affirmed the finding of industrial injury to the right hip, finding the primary treating physician's opinion more persuasive than the PQME's, and amended the award to specify temporary disability indemnity and EDD lien reimbursement. Issues of future temporary disability, permanent disability, and apportionment remain deferred.

Industrial injuryLow back injuryRight hip injuryLeft hip injuryHaul truck driverCumulative traumaQualified medical evaluatorPrimary treating physicianSubstantial medical evidenceTemporary disability indemnity
References
0
Case No. ADJ10802406
Regular
Sep 23, 2022

DAVID STEINHAUER vs. CITY OF SIMI VALLEY

The Workers' Compensation Appeals Board granted reconsideration of the WCJ's award finding applicant sustained injury AOE/COE to multiple body parts. The Board affirmed the finding of injury to most body parts but deferred the issue of right hip injury due to lack of substantial medical evidence. The Board also ruled that applicant is not entitled to further temporary disability benefits as his employment was terminated for violating company policy after he returned to modified work. The matter was returned to the WCJ for further proceedings to develop the record regarding the right hip injury and to defer permanent disability and attorney fees.

AOE/COEPetition for ReconsiderationQualified Medical ExaminerPermanent DisabilityTemporary DisabilityRight Hip InjuryLumbar SpineDrug Test TerminationModified WorkReturn to Work
References
7
Case No. 533203
Regular Panel Decision
Oct 06, 2022

Matter of Cotterell v. Trinity Health Corp.

Claimant, Meggan Cotterell, sustained a lower back injury in 2015 while working for Trinity Health Corporation. Later, a right hip injury was found to be causally-related to the original work injury. The employer and carrier argued the hip injury claim was untimely under Workers' Compensation Law § 28, which mandates claims be filed within two years of the accident. The Workers' Compensation Board affirmed the claim amendment, crediting the treating orthopedist's testimony that initial hip pain was confused with low back symptoms and the hip labral tear was diagnosed later. The Appellate Division affirmed the Board's decision, finding that medical reports indicating hip pain filed within two years, coupled with the delayed diagnosis, provided substantial evidence to support the Board's determination that the amendment was not time-barred.

Workers' CompensationHip InjuryLabral TearTimelinessWorkers' Compensation Law § 28CausationMedical EvidenceOrthopedist TestimonyAppellate ReviewBoard Decision
References
7
Case No. 2019 NY Slip Op 05820
Regular Panel Decision
Jul 25, 2019

Matter of Ellis v. First Student, Inc.

Claimant, Kevin Ellis, a school bus driver, sustained work-related injuries in November 2014 when struck by a vehicle. His initial claim for workers' compensation benefits was established for injuries to his back, left hip, and left knee. The Workers' Compensation Board later amended the claim to include causally-related injuries to his right knee and right shoulder, based on medical evidence and testimony. The employer and its carrier appealed this decision. The Appellate Division, Third Department, affirmed the Board's decision, finding substantial evidence to support the Board's determination that the injuries to the right knee and right shoulder were causally related to the work accident, crediting the testimony of orthopedist Charles Peralo over the conflicting opinion of physician Harvey Siegel.

Workers' CompensationCausally Related InjuryRight KneeRight ShoulderSchool Bus DriverSubstantial EvidenceMedical TestimonyCredibilityAppellate ReviewAmendment of Claim
References
13
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