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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 Smith v. Specialty Services, Inc.

Claimant, a construction foreman for Specialty Services, Inc., was injured while performing work for a church in Pennsylvania. Although Specialty filed a work-related accident report and its carrier began paying benefits, the carrier filed a notice of controversy over seven months after the Workers' Compensation Board indexed the case, exceeding the 25-day limit. The carrier argued that the late filing was due to surprise, mistake, and newly discovered evidence regarding the church's involvement, which claimant and Specialty allegedly failed to disclose. The Workers' Compensation Board refused to excuse the late filing, finding the carrier failed to demonstrate good cause. The appellate court affirmed the Board's decision, noting that the carrier had ample time to investigate and that belatedly obtained evidence is not a sufficient ground to excuse a late filing.

Workers' CompensationLate Notice of ControversyTimely FilingEmployer-Employee RelationshipInsurance CarrierGood CausePleading BarAppellate ReviewBoard DecisionStatutory Interpretation
References
2
Case No. ADJ3419685 (GRO 0029797)
Regular
Dec 10, 2000

MARLENA MOORE vs. ALBERTSONS, SPECIALTY RISK SERVICES

This case involves a Petition for Removal filed by Marlena Moore against Albertsons and Specialty Risk Services. The Workers' Compensation Appeals Board (WCAB) has reviewed the petition and the report from the workers' compensation administrative law judge. Consequently, the WCAB has denied the Petition for Removal. The decision incorporates the reasoning provided in the WCJ's report.

WORKERS' COMPENSATION APPEALS BOARDMARLENA MOOREALBERTSONSSPECIALTY RISK SERVICESPetition for RemovalWCJ reportdenial of removaladministrative law judgeADJ3419685GRO 0029797
References
0
Case No. MISSING
Regular Panel Decision

New York State Workers' Compensation Board v. Consolidated Risk Services, Inc.

The New York State Workers’ Compensation Board, acting as a governmental agency and successor in interest to several insolvent workers' compensation self-insured trusts, commenced an action against a third-party administrator (Consolidated Risk Services, Inc.), its employees, related corporate entities, insurance brokers (including Hickey-Finn & Co., Inc.), former trustees of one of the trusts (RITNY), and an actuarial firm (Regnier Consulting Group, Inc.). The plaintiff alleged misconduct and malfeasance by the defendants led to trust insolvencies and sought to recover accumulated deficits. The case involves cross appeals challenging the Supreme Court’s partial dismissal of the complaint, specifically concerning the timeliness of claims for breach of fiduciary duty, fraud, fraudulent inducement, breach of contract, and common-law indemnification, applying the repudiation and discovery rules for statute of limitations. The Appellate Division modified the Supreme Court's order by dismissing specific claims against Hickey-Finn & Co., Inc., broadening the temporal scope of breach of fiduciary duty claims against other defendants, and reinstating common-law indemnification claims against several RITNY trustees, affirming the order as modified and remitting the case.

Workers' CompensationBreach of Fiduciary DutyFraudFraudulent InducementBreach of ContractCommon-Law IndemnificationStatute of LimitationsRepudiation RuleDiscovery RuleTrust Insolvency
References
27
Case No. MISSING
Regular Panel Decision

Volt Technical Services Corp. v. Immigration & Naturalization Service

Plaintiff Volt Technical Services Corp. applied for H-2 visas for nuclear start-up technicians, which the Immigration and Naturalization Service (INS) denied, asserting the need was permanent, not temporary. After the denial was affirmed on appeal, Volt filed suit, alleging the INS's decision was arbitrary and capricious. The court upheld the INS's interpretation of the Immigration and Nationality Act § 101(a)(15)(H)(ii), which requires the employer's need for services to be temporary, not just the individual assignments. Finding that Volt demonstrated a recurring need for such technicians over several years, the court granted the INS's motion for judgment on the pleadings and denied Volt's.

Immigration LawH-2 visasNonimmigrant WorkersTemporary EmploymentImmigration and Nationality ActAdministrative Procedures ActDeclaratory Judgment ActAgency InterpretationJudicial ReviewNuclear Industry
References
5
Case No. WCK 0068998
Regular
Jan 22, 2008

LINDA FONTENOT vs. BARRETT BUSINESS SERVICES INC., PINNACLE RISK MANAGEMENT SERVICES

The Workers' Compensation Appeals Board (WCAB) rescinded sanctions imposed against Barrett Business Services Inc. (represented by Pinnacle Risk Management Services) and its adjustor, Chamber Medical Collections, Inc. (CMC), for failing to appear at a hearing. The WCAB found that CMC provided a reasonable excuse for its non-appearance, supported by a doctor's note, and deemed the sanctions disproportionate. The matter was returned to the trial level for further proceedings on other sanctions and the underlying lien claim.

Workers Compensation Appeals BoardReconsiderationSanction OrdersLien ClaimantFailure to AppearWCJPetition for ReconsiderationTimelinessReasonable ExcuseDoctor's Statement
References
0
Case No. ADJ1885105 (LAO 0822725)
Regular
May 15, 2012

SCOTT SIMONS vs. SUPERHEAT SERVICES, INC/INSPERITY, KEMPER INSURANCE, SEDGWICK CMS/ SPECIALTY RISK SERVICES

The Appeals Board granted reconsideration and rescinded the prior award, finding no unreasonable delay in the provision of medical treatment. Applicant failed to establish a delay in the provision of home care or transportation services as no bills had been submitted to the defendant. The issue of the reasonable value of home health care services was deferred pending a bill submission and potential negotiation between the parties. The Board emphasized the need for better communication between the parties to avoid further litigation.

Workers' Compensation Appeals BoardReconsiderationUnreasonable DelayMedical TreatmentHome Health CareTransportationPenaltyLabor Code Section 5814Petition for ReconsiderationFindings and Award
References
0
Case No. ADJ10108024
Regular
Jun 21, 2018

SUSAN N. GALLEGO vs. IHSS - CALIFORNIA DEPARTMENT OF SOCIAL SERVICES, Legally Uninsured, Administered by YORK RISK SERVICES GROUP

The Workers' Compensation Appeals Board granted the defendant's Petition for Reconsideration to correct the employer's identity. The Board amended the Findings of Fact to accurately reflect the employer as "IHSS - California Department of Social Services, Legally Uninsured, Administered by York Risk Services Group." This amendment supersedes the previous identification of the employer. Otherwise, the original Findings of Fact remain affirmed.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of FactLegally UninsuredYork Risk Services GroupJointly EmployedIHSSCalifornia Department of Social ServicesAdministrative Law JudgeDecision After Reconsideration
References
0
Case No. MISSING
Regular Panel Decision

Americredit Financial Services, Inc. v. Oxford Management Services

AmeriCredit Financial Services, Inc. (AmeriCredit) commenced an action to confirm an arbitration award against Oxford Management Services (OMS). OMS cross-moved to vacate the award, alleging the arbitrator exceeded his powers by dismissing a counterclaim and manifestly disregarded the law. The arbitrator had dismissed OMS's counterclaim for spoilation of evidence. The Court affirmed the arbitrator's decision, finding he did not exceed his authority under the RSA by dismissing the counterclaim or by interpreting the contract terms regarding account termination. The Court also found no manifest disregard for the law, concluding the arbitrator's decision was rationally supported by the record. Consequently, AmeriCredit's motion to confirm the award was granted, and OMS's motion to vacate was denied.

Arbitration Award ConfirmationArbitration Award VacaturFederal Arbitration ActManifest Disregard of LawArbitrator PowersSpoilation of EvidenceContract InterpretationCollection Agency DisputeSummary ProceedingJudicial Review of Arbitration
References
41
Case No. ADJ10062283
Regular
Jan 08, 2016

MARIA CARVALHO vs. IN-HOME SUPPORTIVE SERVICES, CALIFORNIA DEPARTMENT OF SOCIAL SERVICES, YORK RISK SERVICES GROUP, INC.

The Workers' Compensation Appeals Board denied York Risk Services Group's petition for reconsideration of a $\$ 200.00$ sanction. The sanction was imposed for York's failure to appear at a hearing for which it was properly served by mail. York failed to provide good cause for its non-appearance, and its assertion of resolving issues telephonically did not excuse the failure to appear. The Board upheld the WCJ's finding that the notice was properly served and no reasonable excuse was offered.

Workers' Compensation Appeals BoardSan Jose District OfficePetition for ReconsiderationOrder Imposing SanctionsFailure to AppearGood CauseNotice of HearingService by MailElectronic Adjudication Management SystemPresumption of Receipt
References
0
Case No. ADJ793678 (OAK 0338326)
Regular
Sep 07, 2010

ARMENDO CASAS vs. LOS ANGELES CHEMICAL and EXCESS SPECIALTY INSURANCE, GAB ROBINS, BRENNTAG and EXCESS SPECIALTY INSURANCE, SPECIALTY RISK SERVICES

This case involves a petition for reconsideration by Excess Specialty Insurance regarding a workers' compensation award. The original award found the applicant sustained a cumulative trauma injury ending November 2, 2006, but deferred key issues like sleep disorder, permanent disability, and liens. The Board granted reconsideration, rescinded the original award, and returned the case for a new decision at the trial level. The Board believes piecemeal adjudication should be avoided and all issues should be decided concurrently after further development of the record.

Cumulative traumaThoracic spineLumbar spinePsycheSleep disorderGastrointestinal disorderSexual dysfunctionPermanent disabilityEmployment Development Department lienPetition for Increase in Compensation
References
0
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