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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

Fernekes v. Catskill Regional Medical Center

Plaintiff initiated an action alleging assault by a fellow patient, 'John Doe,' at Catskill Regional Medical Center (CRMC). The core dispute involved plaintiff's motion to compel discovery, specifically an incident report authored by nurse Barbara Blume and a deposition of incident coordinator Ann Korabik. The Supreme Court granted plaintiff's motion, ordering the disclosure of the report and Korabik's deposition. CRMC appealed, asserting the incident report was privileged under Public Health Law § 2805-Z and that this privilege was not waived by an employee's review. The appellate court affirmed the order for Korabik's deposition but reversed the disclosure of Blume's incident report, ruling that internal review did not constitute a waiver of privilege. The case was remitted to the Supreme Court for an in camera review to determine the report's privilege status under Public Health Law § 2805-Z.

DiscoveryIncident ReportMedical Records PrivilegePublic Health LawWaiver of PrivilegeIn Camera ReviewHospital LiabilityAssaultPatient SafetyCivil Procedure
References
20
Case No. G0291404
Regular Panel Decision
Mar 17, 2022

Matter of Toliver v. New York State Department of Corrections and Community Supervision

The claimant, Claude Dean, suffered a compensable right shoulder injury on July 10, 2019. A subsequent incident on February 23, 2021, led to a dispute regarding a causally related further disability to the same shoulder. The Workers' Compensation Law Judge (WCLJ) initially found no causal relationship for the 2021 incident and closed the case. However, conflicting medical evidence, specifically consultant reports from Dr. Lallana and Dr. Reback, presented differing opinions on the causal connection. Upon review, the Board Panel determined that the WCLJ's decision was premature due to an incomplete record and the absence of testimony, especially given the unresolved medical conflict. Consequently, the Board Panel rescinded the WCLJ's decision and restored the case to the trial calendar to further develop the record on the issue of causally related disability from the February 23, 2021 incident, and for the WCLJ to issue a new decision.

Right Shoulder InjuryCausally Related DisabilityConflicting Medical EvidenceWCLJ Decision RescindedCase Restored to Trial CalendarRecord DevelopmentAttorney AppealDate of Injury DisputeMedical Consultant ReportAdministrative Review
References
0
Case No. MISSING
Regular Panel Decision

Claim of Doersam v. Oswego County Department of Social Services

The dissenting opinion by Mikoll, J., with Levine, J., argues to affirm the Workers’ Compensation Board's decision that the claimant's heart attack was work-related. The dissent references a series of cases, including *Matter of Klimas v Trans Caribbean Airways* and *Matter of Masse v Robinson Co.*, establishing that work-related stress, without further physical incident, can constitute an accidental injury. The Board found the claimant's job consistently stressful, with specific incidents increasing this stress, exacerbating preexisting hypertension and worsening blood pressure, leading to a heart attack on November 26, 1982. The dissent contends that substantial evidence supports the Board's determination, citing testimony from the impartial specialist and the employer's medical expert which, despite not ruling out causality, acknowledged the role of stress. The opinion concludes that the Board rationally found that the claimant's demanding work and subsequent cardiac symptoms from a frightening incident caused the heart attack.

Heart AttackWork-Related StressCausalityDissenting OpinionSubstantial EvidenceOccupational InjuryHypertensionCardiac SymptomsBoard DecisionMedical Opinion
References
4
Case No. ADJ9639477, ADJ10028768
Regular
Mar 02, 2020

LEONIDAS HIDALGO vs. AKOP DIGITAL COPIER, INC., COPIER EXPO, INC., EMPLOYER'S COMPENSATION, STARR INSURANCE COMPANY (ILLINOIS MIDWEST MEADOWBROOK INSURANCE)

This case involves a dispute over whether the applicant sustained a specific or cumulative injury in 2013. The Appeals Board rescinded the Arbitrator's decision, finding the medical evidence regarding the injury's mechanism to be deficient and inconsistent. Specifically, the medical opinions on whether the injury was due to a single incident or repetitive activities were inconclusive. The matter is therefore returned to the trial level for further development of the medical record.

Cumulative traumaSpecific injuryAgreed medical evaluator (AME)Qualified medical evaluator (PQME)ContributionApportionmentMechanism of injurySubstantial evidenceFindings and Order (F&O)Report and Recommendation on Reconsideration
References
11
Case No. MISSING
Regular Panel Decision

People v. Barto

The defendant was convicted after a jury trial in Seneca County Court for insurance fraud in the third degree, falsifying business records in the first degree, defrauding the government, and falsely reporting an incident in the third degree. The charges arose from the defendant, an acting Village Justice, falsely reporting an assault to police, allegedly to obtain prescription pain medication. Medical evidence presented by the prosecution, including the absence of injuries despite extensive testing, contradicted the defendant's account of being strangled and struck. The appellate court unanimously affirmed the judgment, rejecting the defendant's contentions regarding the legal sufficiency and weight of the evidence. The court found that the jury could reasonably conclude the defendant falsely reported the incident and caused a false workers' compensation form to be filed. The appellate court also found no reason to modify the sentence despite improper prosecutorial statements.

Insurance FraudFalsifying Business RecordsDefrauding GovernmentFalse ReportingAssault ClaimMedical EvidenceLegal SufficiencyWeight of EvidenceWorkers' CompensationJury Trial
References
8
Case No. SAC 0350983
Regular
Jan 18, 2008

MICHAEL A. ADAIR vs. STATE OF CALIFORNIA CDCR-FOLSOM, STATE COMPENSATION INSURANCE FUND

This case involves a correctional officer's claim for psychological injury stemming from workplace incidents. The defendant contested the finding of injury, arguing specific events were good-faith actions by supervisors. The Workers' Compensation Appeals Board denied reconsideration, upholding the Administrative Law Judge's finding that the incidents were not lawful, nondiscriminatory, good-faith actions. The Board gave great weight to the judge's credibility determination regarding the applicant's testimony and the inadequacy of investigations.

Workers' Compensation Appeals BoardReconsideration DeniedPsychiatric InjuryCorrectional OfficerDepartment of Corrections and RehabilitationFolsom PrisonState Compensation Insurance FundLabor Code Section 3208.3Good Faith Personal ActionsSkelley Hearing
References
3
Case No. ADJ14154023
Regular
Sep 26, 2022

COREY CASTILLO vs. CENTINELA STATE PRISON, CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied reconsideration of a decision finding a hernia injury sustained by a correctional officer to be compensable. While the specific statutory presumption for certain public safety officers did not apply, the Board affirmed the judge's finding that the applicant met their burden of proof. This was based on the substantial medical evidence from Dr. Woolf, who opined the hernia was caused by the applicant's heavy lifting and aggravated by a specific work incident. The claim was also found to be timely filed within the statute of limitations.

Workers' Compensation Appeals BoardCorey CastilloCentinela State PrisonCalifornia Department of Corrections and RehabilitationState Compensation Insurance FundPetition for ReconsiderationWCJ Reportsubstantial medical evidencePlace v. Workmen's Comp. Appeals Bd.industrial injury
References
2
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
Case No. ADJ8023073
Regular
Mar 08, 2018

ERIKA GOMEZ GONZALEZ vs. FRONT PORCH, permissibly self-insured

The Workers' Compensation Appeals Board granted reconsideration of the prior award finding industrial injury, including to the psyche and sexual dysfunction, stemming from an exploding electrical outlet. The Board affirmed the award, specifically ruling that the exploding outlet constituted a "sudden and extraordinary employment condition" exempting the applicant from the six-month employment rule for psychiatric injuries. However, the Board rescinded the specific EDD reimbursement amount and remanded that issue for further proceedings. A dissenting commissioner argued the incident was routine and the sexual dysfunction lacked objective evidence.

Labor Code section 3208.3(d)sudden and extraordinary employment conditionpsychiatric injurysexual dysfunctionEmployment Development Department (EDD) reimbursementsubstantial evidencemedical opiniondioxine electrical outlettemporary disability indemnitypermanent disability
References
1
Case No. ADJ7673518, ADJ7647749
Regular
Jan 23, 2015

ANA DE AYALA vs. AO-THE UNIVERSITY CORPORATION / CALIFORNIA STATE UNIVERSITY NORTHRIDGE

The Workers' Compensation Appeals Board granted reconsideration and reversed a prior ruling, finding the applicant sustained industrial injury to her neck. While the applicant testified to injuring her neck in a workplace incident and this was partially corroborated, the Board found insufficient evidence for other claimed injuries. The Board specifically disagreed with the administrative law judge's credibility assessment concerning the neck injury itself, relying on medical reports and testimony supporting the neck injury claim. The Board affirmed the denial of claims for all other alleged injuries, finding insufficient medical evidence to link them to the incident.

Petition for ReconsiderationFindings and OrderIndustrial InjuryNeck InjuryBack InjurySpine InjuryUpper ExtremitiesPsycheGastroesophageal SystemInternal System
References
1
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