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

Case No. MISSING
Regular Panel Decision

Agriculture Ins. Co., Inc. v. Ace Hardware Corp.

Plaintiff Agricultural Insurance Company, Inc., as assignee of injured worker Robert T. Treadway, Jr., moved for partial summary judgment on liability under N.Y. Labor Law § 240(1) against defendants Ace Hardware Corporation and Butler Construction Company. Treadway was severely injured when he fell from an elevated height at a construction site after the steel beam he was standing on collapsed. Although provided with a safety harness and line, these were attached to the very beam that failed, rendering them inadequate. The court granted the plaintiff's motion, concluding that the defendants violated § 240(1) by failing to provide proper protection and that this failure was the proximate cause of Treadway's injuries. The court rejected arguments regarding the admissibility of an accident report, a superceding cause (wind), and Treadway's contributory negligence.

N.Y. Labor LawSummary JudgmentLiabilityConstruction AccidentElevated WorkSafety DevicesProximate CauseContributory NegligenceHearsay ExceptionParty Admission
References
31
Case No. MISSING
Regular Panel Decision

United Spinal Ass'n v. Board of Elections in the City of New York

Plaintiffs United Spinal Association and Disabled in Action brought an action against the Board of Elections in the City of New York (BOE) under Title II of the Americans with Disabilities Act and Section 504 of the Rehabilitation Act, alleging pervasive access barriers at poll sites. The Court previously denied a preliminary injunction. Both parties subsequently moved for summary judgment. The Court found no genuine dispute of material fact regarding the existence of pervasive and recurring accessibility barriers and deemed the BOE's accommodation methods insufficient. Consequently, the Court granted the plaintiffs' motion for summary judgment on liability and denied the defendants' cross-motion. The case is now referred to a Magistrate Judge for the determination of the appropriate remedy.

AccessibilityVoting RightsAmericans with Disabilities ActRehabilitation ActPoll SitesSummary JudgmentDisability DiscriminationBoard of ElectionsMeaningful AccessReasonable Accommodation
References
26
Case No. MISSING
Regular Panel Decision

Claim of Flynn v. Ace Hardware Corp.

A claimant, a forklift operator for Ace Hardware Corporation, suffered a neck injury and stopped working in April 2004, filing for workers' compensation benefits in June 2004. Initially, a Workers’ Compensation Law Judge established the claim, but the Workers’ Compensation Board reversed this, finding the claimant failed to provide timely notice to the employer within 30 days as required by Workers’ Compensation Law § 18. The appellate court affirmed the Board's decision, noting that the employer was not informed of a work-related injury until June 30, 2004, and the claimant did not demonstrate that the delay was not prejudicial to the employer. The court found substantial evidence supported the Board's determination.

Timely NoticeWorkers' Compensation LawEmployer PrejudiceWork-Related InjuryAppealBoard Decision30-Day Notice PeriodFamily Medical Leave ActDisability BenefitsSubstantial Evidence
References
3
Case No. ADJ7170139, ADJ7176930
Regular
Mar 22, 2017

ROBERT GAONA vs. CAPITAL BUILDERS HARDWARE, SOUTHERN INSURANCE COMPANY, ENDURANCE REINSURANCE CORPORATION OF AMERICA

This case involves Robert Gaona's workers' compensation claims against Capital Builders Hardware and their insurers. The Court of Appeal previously annulled its writ of review and remanded the case to the Workers' Compensation Appeals Board (WCAB). The WCAB has now affirmed its prior decision from March 24, 2016, which dismissed the defendants' Petition for Reconsideration and denied their Petition for Removal. Therefore, the original Joint Findings and Orders issued by the WCJ on June 5, 2015, stand affirmed.

Workers' Compensation Appeals BoardRemittiturCourt of AppealPetition for ReconsiderationPetition for RemovalJoint Findings and OrdersAdministrative Law JudgeAnnulledAffirmedSubstitution of Commissioner
References
1
Case No. ADJ3925996 (FRE 0180480) ADJ360469 (FRE 0198851)
Regular
Oct 01, 2012

MICHAEL AKINS vs. THE SALVATION ARMY, Permissibly Self-Insured

In this workers' compensation case, the defendant, The Salvation Army, seeks to deny liability for applicant Michael Akins' recommended spinal surgery. While Akins sustained industrial injuries to his neck and back in 1998 and 2001, a subsequent non-industrial car accident in 2008 displaced hardware from his prior industrial surgery. The Board found that the industrial injury was a substantial contributing factor to the need for the current surgery, even though the non-industrial accident was the "most proximate cause." Therefore, the defendant remains liable for the recommended surgical intervention.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and OrderIndustrial InjurySpinal SurgeryPrimary Treating PhysicianNon-Industrial Motor Vehicle CollisionIntervening EventAgreed Medical ExaminerCausation
References
1
Case No. ADJ367320 (VNO 0476303) ADJ566883 (LAO 0740861)
Regular
Jun 16, 2015

CRISTINA UGARTE vs. FLINKMAN REALTY, ZENITH INSURANCE COMPANY

The Workers' Compensation Appeals Board (Appeals Board) reconsidered a prior decision that denied separate reimbursement for implanted hardware for lien claimant Pacific Hospital of Long Beach. The Appeals Board found that the WCJ misinterpreted regulations regarding hospital billing and reimbursement. Specifically, the Appeals Board determined that implanted hardware is separately reimbursable under section 9789.22(g) regardless of whether the inpatient services qualify as a cost outlier. Therefore, the Board rescinded the WCJ's decision and returned the case for further proceedings to calculate the correct payment for the implanted hardware.

Workers' Compensation Appeals BoardReconsiderationFindings and OrderLien claimantReimbursementImplanted hardwareOutlier feesRegulationsCost outlierInpatient hospital services
References
0
Case No. ADJ2320623
Regular
Oct 25, 2010

SAMIR SOLOMON vs. TRI VALLEY BUICK, PONTIAC, GMC, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION For CASUALTY RECIPROCAL EXCHANGE, In Liquidation

This case involves a workers' compensation claim for an automobile salesman injured on April 14, 2001, resulting in spinal and psychiatric injuries. The WCJ awarded temporary disability through June 22, 2004, 52¼% permanent disability, and further medical treatment for the psyche, but not the spine, denying defendant credit for civil damages. Both applicant and defendant sought reconsideration, arguing various evidentiary errors, particularly regarding the duration of temporary disability and the need for spinal treatment. The Appeals Board denied reconsideration of both petitions, affirming the WCJ's decision, though one Commissioner dissented, believing the applicant's temporary disability claim and spinal treatment need further development.

Workers' Compensation Appeals BoardIndustrial InjurySpine InjuryPsychiatric InjuryTemporary DisabilityPermanent DisabilityApportionmentMedical TreatmentCivil DamagesReconsideration
References
1
Case No. ADJ4480206 (POM 0274117)
Regular
Sep 23, 2008

JESUS MORALES vs. EXCEL CABINETS, INC., STATE COMPENSATION INSURANCE FUND

The Board granted reconsideration to clarify that the industrial injury includes the applicant's psyche, as stipulated, and requires related medical treatment. Defendant waived its right to object to the recommended spinal surgery due to failure to timely object per Labor Code Section 4062(b). The Board awarded updated diagnostic workup and the recommended spinal surgery, while affirming the need for further development on temporary disability and average weekly earnings.

WCABReconsiderationFindings and AwardSpinal SurgeryLabor Code Section 4062(b)Second Opinion ReportTreating PhysicianIndustrial InjuryPsycheTemporary Disability
References
4
Case No. ADJ3897698 (ANA 0370975)
Regular
Feb 03, 2010

CARLOS URREA vs. MLB INVESTMENTS dba B&E FEED & SUPPLY, TRUCK INSURANCE EXCHANGE

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a prior decision finding the defendant not liable for an applicant's back surgery and subsequent hardware removal. The WCAB ruled that while the initial surgery by Dr. Fonseca was deemed unreasonable and unnecessary, the defendant remains liable for the removal of hardware resulting from that surgery as a compensable consequence of the industrial injury. The WCAB rescinded the previous order and returned the case for further proceedings on the issue of credit for the applicant's civil malpractice settlement.

Workers' Compensation Appeals BoardIndustrial InjuryLow Back InjurySelf-Procured SurgeryCompensable ConsequenceMedical MalpracticeAgreed Medical EvaluatorReasonable and NecessarySurgical HardwareProximate Cause
References
3
Case No. ADJ4577451 (WCK 0063127) ADJ336675 (WCK 0063128)
Regular
Sep 10, 2013

EDUARDO GUERRA vs. POMEROY CORPORATION, TRAVELERS INSURANCE COMPANY

The Appeals Board granted reconsideration to review the WCJ's award of total temporary disability and future medical treatment, including spinal surgery. The Board rescinded the WCJ's decision because the record regarding the necessity of spinal surgery was not fully developed. Specifically, Dr. Harf's second opinion report was incomplete due to unobtained diagnostic tests, preventing a definitive recommendation on surgery. The case is returned to the trial level to further develop the medical evidence on the surgery issue and other deferred matters.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardTemporary Disability IndemnitySpinal SurgerySecond Opinion PhysicianUtilization ReviewPenaltiesDiscoveryDeclaration of Readiness to Proceed
References
6
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