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

Case No. ADJ7927652
Regular
Oct 25, 2016

Bozenna Kasperowicz vs. Metropolitan State Hospital, State Compensation Insurance Fund

This case involves an industrial injury to the applicant, a psychiatric technician, sustained on June 14, 2011, from a patient strike to the head. The Workers' Compensation Appeals Board (WCAB) granted reconsideration to address disputes over psychiatric impairment and a sleep disorder rating. The WCAB affirmed the original award but reduced the permanent disability rating from 76% to 70% by excluding the sleep dysfunction impairment. The WCAB found Dr. O'Brien's opinion on psychiatric impairment more persuasive than conflicting medical evaluations and determined Dr. Matos's opinion on sleep impairment lacked substantial medical evidence due to staleness.

WCABReconsiderationPsychiatric ImpairmentWhole Person ImpairmentGAF ScoreSleep DisorderSubstantial Medical EvidencePermanent DisabilityQualified Medical EvaluatorInsomnia
References
0
Case No. MISSING
Regular Panel Decision
May 17, 2016

United States v. Nesbeth

Chevelle Nesbeth was convicted by a jury for importation of cocaine and possession with intent to distribute. Senior District Judge Block rendered a non-incarceratory sentence of one-year probation, with special conditions including six months' home confinement and 100 hours of community service. The judge wrote this opinion to emphasize the importance of considering the numerous statutory and regulatory collateral consequences facing Nesbeth as a convicted felon, such as restrictions on employment, housing, and voting. These consequences were extensively balanced against 18 U.S.C. § 3553(a) factors to determine a just punishment. The opinion advocates for legal counsel and the Probation Department to proactively address collateral consequences in all future pre-sentence reports and sentencing proceedings.

Collateral ConsequencesSentencing ReformCriminal JusticeProbationary SentenceDrug Trafficking OffensesFelony ConvictionJudicial DiscretionFederal Sentencing GuidelinesRehabilitationRecidivism
References
55
Case No. MISSING
Regular Panel Decision

Pizzo v. Barnhart

Plaintiff Kathleen Pizzo appealed the Commissioner of the Social Security Administration's final determination denying her disability insurance benefits. The District Court reviewed the ALJ's decision, which had assigned no weight to the treating physician's opinion and significant weight to a consulting physician's report. The court found that the ALJ erred by failing to give appropriate weight to the treating physician's opinion, not adequately developing the administrative record to obtain missing medical notes, and giving undue weight to the consulting physician's report which did not explicitly support the capacity for sedentary work. Consequently, the Commissioner's determination was remanded for further administrative proceedings consistent with the District Court's decision, granting the plaintiff's motion for judgment on the pleadings to the extent of the remand and denying the Commissioner's cross-motion.

Social Security ActDisability Insurance BenefitsAdministrative Law JudgeTreating Physician RuleResidual Functional CapacitySedentary WorkMedical EvidenceRemandSubstantial EvidenceRecord Development
References
23
Case No. ADJ4235749 (PAS 0026168) ADJ3954705 (MON 0195253)
Regular
Sep 09, 2016

GREEN, STEPHANIE vs. STATE OF CALIFORNIA; DEPARTMENT OF TRANSPORTATION

The Workers' Compensation Appeals Board granted reconsideration of the WCJ's decisions regarding applicant Stephanie Green's back and psyche injuries from 1990 and 1995. The Board found that further development of the record is required on the issues of permanent disability and apportionment. Specifically, the orthopedic AME's opinions are stale and require re-examination, and both medical and vocational expert opinions need clarification on independent medical judgment regarding apportionment. The cases are returned to the trial level for further proceedings and new decisions by the WCJ.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardsIndustrial InjuryBack InjuryPsyche InjuryPermanent and Total DisabilityApportionmentOrthopedic AMEPsyche QME
References
6
Case No. MISSING
Regular Panel Decision

Formal Opinion No.

This opinion from the Chairman of the New York Workers' Compensation Board addresses the priority of income execution and income deduction orders, established by the 1985 Support Enforcement Act (CPLR §§ 5241, 5242), against other statutory deductions from workers' compensation awards. Historically, WCL § 33 provided broad exemptions for workers' compensation benefits. However, WCL §§ 206(2) and 25(4)(a) allow for reimbursement of disability insurers and employers for advance payments, respectively, and WCL § 24 establishes liens for attorneys' fees, traditionally enjoying highest priority. The 1985 Act amended WCL § 33 to make benefits subject to support enforcement and also stipulated that income executions and deduction orders take priority over other assignments, levies, or processes. The Board concluded that claims for attorneys' fees and reimbursements by disability insurance carriers and employers are to be deducted first from the workers' compensation award. The support enforcement remedies under CPLR §§ 5241 and 5242 then apply to the balance of the workers' compensation benefits paid to the employee. This approach ensures prompt payment to injured workers and prevents double payment issues.

Workers' CompensationSupport Enforcement ActIncome ExecutionIncome DeductionLien PriorityStatutory InterpretationDisability Benefits ReimbursementEmployer ReimbursementAttorneys' Fees PriorityCPLR 5241
References
9
Case No. ADJ2167155 (VNO 0443514)
Regular
Oct 17, 2013

Thomas David Williams vs. MAKENZIE ELECTRICAL INC., STATE COMPENSATION INSURANCE FUND

The Appeals Board remanded the case for further development of the record concerning the applicant's claimed injury to psyche/PTSD. The prior findings were not based on substantial evidence due to an inadequate medical history and stale opinions from the evaluating physician, Dr. Glaser. The Board ordered a new evaluation by an Agreed Medical Evaluator or a regular physician to address the complex psychological issues, including PTSD, substance abuse, and potential organic brain injury. After this evaluation, the matter will return to the judge for a new decision incorporating all relevant findings.

Workers' Compensation Appeals BoardReconsiderationPsyche/PTSDSubstantial EvidenceAgreed Medical EvaluatorLabor Code section 5701Findings and AwardWCJPermanent DisabilityApportionment
References
0
Case No. ADJ3755232 (VNO0493072)
Regular
Aug 29, 2013

AKHMADMIR ABDULMIR vs. MED-PHARMEX, INC., EVEREST NATIONAL INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded a prior award, finding that the applicant sustained industrial injury to his low back but not his kidneys or abdomen, and his occupation was a material handler/machine loader (group 460). The WCAB found that the opinions of the applicant's Qualified Medical Evaluator (QME) were not substantial evidence due to numerous discrepancies and an inadequate history. The WCAB also found the primary treating physician's (PTP) reports insufficient as they were stale, not based on an accurate history, and lacked review of all medical records. The case was returned to the WCJ for further proceedings on all other deferred issues.

Workers Compensation Appeals BoardPetition for ReconsiderationFindings Award and OrderPrimary Treating PhysicianTemporary DisabilityFurther Medical TreatmentApportionmentLabor Code section 4658(d)(2)Permanent DisabilityAttorney's Fees
References
0
Case No. ADJ8700541
Regular
Oct 17, 2019

ZAHRA STEPHENS vs. COX ENTERPRISES, INC.

The Appeals Board granted reconsideration to review the WCJ's finding of permanent and total disability based on the opinions of a psychologist, Dr. Windman, and a vocational expert, Mr. Wilkinson. The Board found that Dr. Windman's opinion lacked substantial evidence due to inconsistencies, inadequate record review, and conflicts with other medical opinions. Consequently, Mr. Wilkinson's vocational opinion, which relied heavily on Dr. Windman's findings, was also deemed not substantial evidence. The case is remanded to the trial level for further proceedings and a new determination of permanent disability.

Workers' Compensation Appeals BoardReconsiderationPermanent Total DisabilityMedical OpinionVocational ExpertSubstantial EvidencePQMENeurologistPsychologistOrthopedist
References
10
Case No. ADJ1142998 (RDG 0118288)
Regular
Aug 18, 2009

STEVE REYNOLDS vs. WYCKOFF LOGGING, STATE COMPENSATION INSURANCE FUND

This case concerns a defendant's petition for reconsideration of a prior Workers' Compensation Appeals Board (WCAB) decision. The WCAB had previously rescinded a finding that avascular necrosis was not a compensable consequence of the applicant's injury, finding the relied-upon medical opinion speculative. The defendant argues the WCJ correctly favored the opinion of Dr. Glancz over Dr. Barber. The WCAB denied reconsideration, reaffirming that Dr. Glancz's opinion was not substantial evidence due to repeated questioning of the injury mechanism, while Dr. Barber's opinion was persuasive and based on a complete history. Therefore, the WCAB maintained its prior decision that Dr. Barber's opinion constituted substantial evidence supporting the applicant's claim.

Avascular necrosiscompensable consequencesubstantial evidencemedical opinionworkers' compensation administrative law judgereconsiderationfindings and ordermedical treatmentindustrial basissubstantial evidence
References
1
Case No. MISSING
Regular Panel Decision

New York State National Organization for Women v. Pataki

This opinion addresses several motions following appeals in a class-action lawsuit challenging practices of the New York State Division of Human Rights. Plaintiffs' motion for curative notice relief is denied, as the Second Circuit had previously deemed similar requests without merit. Defendants' cross-motion to dismiss the entire action is denied because the permanent injunction against the 1995 Intake Rules, which were never appealed, remains in effect. Class member Abby Oshinsky's motion for reinstatement of her discrimination claims is denied, as the remaining aspect of the case does not provide a vehicle for her claims, making NYCHA's motion to intervene moot.

Due ProcessClass ActionPermanent InjunctionAdministrative PracticesProcedural DelaysNotice DeficienciesHuman Rights1995 Intake RulesSecond CircuitSupreme Court Review
References
6
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