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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 Joyner v. Event Design Associates, Inc.

Claimant was retained by Event Design Associates, Inc. (EDA) to transport furniture and event props for a party. While en route to a hotel during this assignment, claimant was involved in an automobile accident and sustained serious injuries. Subsequently, claimant applied for workers' compensation benefits, asserting an employer-employee relationship with EDA. The Workers' Compensation Board ruled in favor of the claimant, finding that an employment relationship existed. EDA appealed this decision. The Appellate Division affirmed the Board's ruling, concluding there was substantial evidence to support the finding of an employer-employee relationship, based on factors such as EDA's control over the work, method of payment, and right to terminate.

Workers' CompensationEmployer-Employee RelationshipIndependent ContractorSubstantial EvidenceControl TestAppellate ReviewAutomobile AccidentNew YorkWorkers' Compensation BoardTemporary Employment
References
4
Case No. MISSING
Regular Panel Decision

Nautilus Insurance v. Matthew David Events, Ltd.

Nautilus Insurance Company sought a declaration that it was not obligated to defend or indemnify Matthew David Events (MDE) in a personal injury action brought by Timothy Shea. Shea, an employee of a subcontractor hired by MDE, was injured while working at an event planned by MDE. Nautilus disclaimed coverage due to MDE's failure to provide timely notice and an employee exclusion in the policy. The motion court denied Nautilus's summary judgment, finding the employee exclusion ambiguous. The appellate court reversed, holding that the employee exclusion, which broadly defined 'employee' to include those 'contracted for' the insured, clearly applied to Shea, an employee of MDE's subcontractor. The court concluded that Nautilus had met its burden in demonstrating the exclusion's applicability.

Insurance Coverage DisputeDeclaratory Judgment ActionEmployee Exclusion ClauseContract InterpretationSubcontractor Employee InjuryTimely Notice ProvisionSummary Judgment ReversalAppellate Court DecisionCommercial General Liability PolicyBodily Injury Claim
References
21
Case No. 2021 NY Slip Op 01347
Regular Panel Decision
Mar 04, 2021

Treacy v. Inspired Event Productions, LLC

Peter Treacy, a Teamsters' Union laborer, was injured on a loading dock when a crate fell on him while unloading materials for an event. He subsequently filed claims against multiple defendants under Labor Law §§ 240(1) and 241(6). The Supreme Court granted summary judgment to the defendants, dismissing Treacy's claims. On appeal, the Appellate Division, First Department, affirmed the lower court's decision, ruling that Treacy was not a covered worker under the Labor Law as his duties were limited to unloading materials on a permanent loading dock and he was not involved in the actual construction being performed at the site.

Worker injuryloading docksummary judgmentLabor Law § 240Labor Law § 241(6)construction workerscope of employmentappellate reviewTeamsters' Unionpremises liability
References
7
Case No. ADJ10544667
Regular
Nov 15, 2019

NEREYDA VARGAS vs. WELLS FARGO BANK NORTH AMERICA, OLD REPUBLIC INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration of a decision finding no industrial psychiatric injury. The Board found the original decision failed to conduct the multi-level analysis required by *Rolda v. Pitney Bowes, Inc.* concerning actual employment events and lawful, good faith personnel actions. The case is returned to the trial level for further development and analysis to determine if actual employment events predominated the injury and if any lawful personnel actions were a substantial cause. The Workers' Compensation Judge must specifically address all alleged events, medical evidence, and potential inconsistencies in the Qualified Medical Evaluator's reports.

psychiatric injurycumulative traumaRolda analysispredominant causelawful personnel actionnondiscriminatorygood faithactual events of employmentpredicate eventsmedical evidence
References
7
Case No. ADJ9700517
Regular
Oct 05, 2018

JEANNE WILLIAMS vs. CITY OF LOS ANGELES

The Appeals Board rescinded the prior award and returned the case to the trial level for further proceedings. The Board found the original decision on the good faith personnel action defense was unclear and required further development. Specifically, the WCJ must clarify which events constituted lawful, nondiscriminatory, good faith personnel actions. The parties will then need to re-address whether these specific actions were a substantial cause of the applicant's psychiatric injury with the medical evaluator.

Workers' Compensation Appeals BoardPSYCHE INJURYGOOD FAITH PERSONNEL ACTIONLABOR CODE §3208.3(H)TEMPORARY DISABILITYPANEL QUALIFIED MEDICAL EVALUATOR (PQME)DR. ELATROZYROLDA ANALYSISSUBSTANTIAL CAUSELAWFUL PERSONNEL ACTION
References
6
Case No. ADJ10837009
Regular
Jul 10, 2018

JOSE LOPEZ vs. WESTERN OILFIELDS SUPPLY CO., INC. dba RAIN FOR RENT

This case concerns an employee's workers' compensation claim for back and neck injuries allegedly sustained on May 15, 2013. The employer sought reconsideration of the judge's finding that the claim was not barred by the statute of limitations. The Appeals Board rescinded the findings and returned the case to the trial level. This is due to a lack of substantial evidence supporting the finding of a specific injury on the date claimed, requiring further development of the record regarding whether the injury was a specific event or cumulative trauma.

WCABReconsiderationStatute of LimitationsEquitable TollingEquitable EstoppelLabor Code Section 5405Cumulative TraumaSpecific InjuryNotice of RightsDetrimental Reliance
References
3
Case No. ADJ7847320
Regular
Nov 25, 2014

KAREN ROTAN vs. CITY OF LONG BEACH

This case concerns a psychiatric injury claim where the applicant argued that employment events were the predominant cause. The Workers' Compensation Appeals Board (WCAB) granted reconsideration, finding that the Agreed Medical Evaluator's opinions supported the applicant's contention. The WCAB rescinded the original decision and substituted new findings. This establishes that the actual events of employment were the predominant cause of the applicant's psyche injury. The case is returned to the WCJ for further proceedings, specifically to determine if a good faith personnel action defense applies.

Workers' Compensation Appeals BoardPSYCHE INJURYARISING OUT OF AND OCCURRING IN THE COURSE OF EMPLOYMENT (AOE/COE)PREDOMINANT CAUSEAGGREED MEDICAL EVALUATOR (AME)GOOD FAITH PERSONNEL ACTIONLABOR CODE SECTION 3208.3RECONSIDERATIONFINDINGS OF FACT AND ORDERS (F&O)SUBSTANTIAL EVIDENCE
References
4
Case No. ADJ8789952
Regular
Nov 16, 2017

LISA STROTHER vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS AND REHABILITATION, STATE COMPENSATION INSURANCE FUND

This case involves Lisa Strother's claim for psychiatric injury due to cumulative trauma as a correctional officer. The Appeals Board granted reconsideration because the Agreed Medical Evaluator's (AME) report lacked specificity regarding the actual employment events causing the psyche injury and failed to properly apportion permanent disability. The Board found the AME's opinion on causation was not adequately detailed to determine if work events were the predominant cause. Therefore, the matter was returned to the trial level for further development of the record on these critical issues.

Workers' Compensation Appeals BoardLisa StrotherState of California Department of Corrections and RehabilitationLegally UninsuredState Compensation Insurance FundADJ8789952Fresno District OfficePetition for ReconsiderationFindings of Fact and AwardCorrectional Officer
References
2
Case No. ADJ3007917 (SAC 0360257) ADJ2678306 (SAC 0360255) ADJ1603912 (SAC 0364515) ADJ2464840 (SAC 0360256) ADJ4004410 (SAC 0360258) ADJ7144350
Regular
Apr 29, 2011

CARLLIE WILLIAMS vs. DEPARTMENT OF TRANSPORTATION, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted the applicant's petition for removal, finding that the Department of Transportation violated a prior stipulated settlement with the applicant. The settlement required the DOT to remove specific documents from the applicant's personnel file, and these documents were deemed irrelevant to the workers' compensation proceedings. The Board amended the prior order to explicitly prohibit the DOT from using these removed documents for any purpose in the applicant's workers' compensation claims. While the DOT cannot use these specific documents, they are still permitted to present witness testimony regarding the underlying events.

Petition for removalState Personnel Boardstipulated settlementpersonnel filepsychiatric injuryactual events of employmentgood faith personnel actionLabor Code section 3208.3vitiateevidence
References
1
Case No. ADJ7583495, ADJ7084199, ADJ7084203
Regular
Nov 07, 2011

PEDRO GANDARA vs. CITY OF BAKERSFIELD

The Workers' Compensation Appeals Board (WCAB) affirmed the Workers' Compensation Administrative Law Judge's (WCJ) decision that the applicant's claim for a specific injury on June 15, 2004, was not barred by the statute of limitations. The applicant filed his claim shortly after obtaining medical reports attributing a portion of his disability to this specific incident, which occurred as a witnessed event. The defendant's argument that notice was not required due to lack of lost time or initial medical treatment was rejected. The WCAB found that the claim conformed to proof and adopted the WCJ's reasoning.

WORKERS' COMPENSATION APPEALS BOARDPEDRO GANDARACITY OF BAKERSFIELDADJ7583495ADJ7084199ADJ7084203OPINION AND DECISION AFTER RECONSIDERATIONFindings of Fact and Joint Awardsolid waste equipment operatorright wrist and shoulder
References
2
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