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

Case No. ADJ3135090 (SAC 0355157) ADJ6834808
Regular
Sep 12, 2019

GUY LEE vs. UOP/MCGEORGE SCHOOL OF LAW, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Workers' Compensation Appeals Board affirmed the WCJ's decision denying benefits from the Subsequent Injuries Benefits Trust Fund (SIBTF). Applicant's prior stipulation dismissing claims for sleep disturbance, sexual dysfunction, and psychiatric injury bound him from pursuing these for SIBTF benefits. Even without those dismissals, applicant's permanent disability rating for the subsequent injury, after adjustments, did not meet the 35% threshold required for SIBTF eligibility. The WCJ's finding that the industrial injury was not the predominant cause of the claimed psychiatric injury also contributed to the denial.

Subsequent Injuries Benefits Trust FundLabor Code section 4751permanent partial disabilitystipulated dismissalpredominant causepsychiatric injurybilateral carpal tunneldiminished future earning capacityWCJWorkers' Compensation Appeals Board
References
4
Case No. MISSING
Regular Panel Decision

Ochal v. Television Technology Corp.

David Ochal suffered severe electrocution injuries in a work-related accident in February 1988. His personal injury action was settled by stipulation in November 1999, which included a structured settlement and an agreement by a third-party defendant to pay $50,000, waive a substantial workers' compensation lien, and cover pre-settlement medical bills. In May 2004, Ochal moved to enforce the stipulation, seeking payment for approximately $20,000 in medical bills and a pro rata share of litigation costs from the third-party defendant's workers' compensation carrier. The Supreme Court denied his motion, and Ochal appealed. The appellate court affirmed the denial, ruling that Ochal had breached the implied covenant of good faith and fair dealing by submitting medical bills 4.5 years post-settlement and that his claim for pro rata litigation costs lacked merit due to his failure to reserve this right during the settlement.

Structured SettlementStipulation of SettlementContract InterpretationImplied Covenant of Good Faith and Fair DealingWorkers' Compensation LienMedical BillsPro Rata Share of Litigation CostsAppellate ReviewBreach of ContractWaiver of Rights
References
10
Case No. ADJ2562434 (OAK 0287611) ADJ1551889 (OAK 0306392)
Regular
Dec 10, 2012

JOHN HENDERSON vs. AIRE SHEET METAL, SUBSEQUENT INJURIES BENEFITS TRUST FUND

This case concerns an applicant seeking benefits from the Subsequent Injuries Benefits Trust Fund (SIF) after sustaining two upper extremity injuries. The Workers' Compensation Appeals Board (WCAB) reconsidered the original award, finding that the applicant was not "permanently partially disabled" by the first injury prior to the second injury. Therefore, the WCAB determined that the SIF was not liable for benefits, as the applicant did not meet the threshold requirement for SIF eligibility under Labor Code section 4751 and relevant case law. The WCAB also amended the applicant's permanent disability to 89%, aligning with a prior stipulation.

Subsequent Injuries Benefits Trust Fundpermanent total disabilitypermanent partial disabilitylabor disablinghealing periodpermanent and stationarycumulative traumacontralateral upper extremitiesFerguson v. Industrial Accidents Commissionlabor market
References
4
Case No. ADJ2697898
Regular
Mar 06, 2013

ROBERT WALKER vs. SISKIYOU FOREST PRODUCTS, STATE COMPENSATION INSURANCE FUND, THE SUBSEQUENT INJURIES BENEFIT TRUST FUND

This case involves a Subsequent Injuries Benefit Trust Fund (SIBTF) claim where the applicant sustained industrial injuries to his left knee and right ankle, resulting in incontinence. The Board affirmed the finding of 41% permanent disability for the subsequent injury, finding the applicant eligible for SIBTF benefits under Labor Code § 4751(a) due to corresponding prior and subsequent injuries to opposite limbs. The Board amended the award to specify that the attorney's fee of 15% is calculated on the SIBTF weekly payments, not commuted as a lump sum upfront, to comply with statutory prohibitions. The Court also addressed apportionment, pre-existing disability, and the unreliability of stipulated percentages when SIBTF was not a party.

Subsequent Injuries Benefit Trust FundPermanent DisabilityApportionmentLabor Code Section 4751Industrial InjuryPre-existing DisabilityLabor-DisablingOpposite and Corresponding MemberCommutation of BenefitsVocational Expert
References
3
Case No. ADJ7917795
Regular
May 16, 2014

SANDRA DELGADO vs. KAISER PERMANENTE, PERMANENT INJURIES BENEFITS TRUST FUND

The Workers' Compensation Appeals Board (WCAB) granted reconsideration, rescinded the previous award, and returned the case for further proceedings. The WCAB found that the administrative law judge's (ALJ) finding of 100% permanent disability was not supported by substantial medical evidence. Furthermore, it was unclear if the subsequent injury solely caused the increased disability given stipulations regarding a prior injury's worsening. The WCAB directed the ALJ to ensure a proper record and make specific findings on all disputed issues, including permanent disability, the subsequent injury's contribution, and potential SIBTF credits.

Subsequent Injuries Benefits Trust FundPetition for ReconsiderationFindings and AwardPermanent DisabilityApportionmentSubstantial Medical EvidenceLabor Code section 4753Agreed Medical EvaluatorWCJWorkers' Compensation Appeals Board
References
8
Case No. ADJ7412016
Regular
May 10, 2011

DORIS CORTES vs. BANK OF THE WEST, ESIS

This case involves an applicant who sustained bilateral wrist and elbow injuries but experienced no lost time from work. The applicant stipulated to zero permanent disability, though the WCJ ordered an Almaraz/Guzman assessment, which the defendant sought to rescind. The Appeals Board granted the petition for removal, rescinded the WCJ's order, and will approve the stipulations unless the applicant objects within twenty days. The Board found the stipulations adequate based on the record and the applicant's continued employment.

WCABPetition for RemovalAlmaraz/Guzman assessmentStipulations with Request for Awardpermanent disability ratingobjective findings of impairmentqualified medical evaluator (QME)American Medical Association Guidesmandatory settlement conference (MSC)rescinded order
References
2
Case No. MISSING
Regular Panel Decision
Aug 10, 2004

Claim of Mickens v. New York City Transit Authority

The claimant suffered a work-related injury in 1993 and subsequently filed a claim for workers' compensation benefits. A stipulation agreement between the claimant and employer, which adjusted weekly awards and set future payments, was approved by a Workers’ Compensation Law Judge. The claimant appealed this decision to the Workers’ Compensation Board, asserting the stipulation's invalidity, inadequate legal representation, and excessive counsel fees. The Board upheld the WCLJ's decision and denied the claimant's request for reconsideration. The appellate court affirmed the Board's decisions, finding the stipulation binding and the counsel fee award within the Board's discretion, and no abuse of discretion in denying reconsideration.

Stipulation AgreementCounsel FeesBoard ReviewAppellate ReviewPsychological ImpairmentsWork-related InjuryDecision AffirmedDiscretionary PowersLegal RepresentationBenefit Adjustment
References
6
Case No. MISSING
Regular Panel Decision

Claim of Eddy v. Rochester-Genesee Regional Transportation Authority

Two employees of the Regional Transit Service sustained injuries in July 1994 while playing on an employer-sponsored softball team. The Workers' Compensation Board ruled that these injuries were causally related to their employment, leading the employer to appeal the decisions. The court evaluated whether the employer "sponsored" the team through overt encouragement and control, as stipulated by Workers' Compensation Law § 10 (1). Evidence presented, including employer-funded uniforms with logos, promotional materials displayed at the workplace, and significant managerial control over the Sunshine Fund which financed the team, supported the finding of sufficient employer sponsorship. Consequently, the court affirmed the Board's decision, concluding that the injuries arose out of and in the course of employment and entitled the claimants to workers' compensation benefits.

Workers' CompensationEmployment InjuriesOff-duty Athletic EventEmployer SponsorshipEmployee MoraleSoftball TeamCausally Related DisabilitiesAppellate ReviewWorkers’ Compensation BoardScope of Employment
References
7
Case No. MISSING
Regular Panel Decision
Jun 25, 2002

Barreiros v. JJR Associates, Inc.

This case concerns an appeal by a third-party defendant following the denial of its motion for summary judgment to dismiss a third-party complaint in a personal injury action. The appellate court reversed the Supreme Court's order, granting the motion and dismissing the complaint. The court found that the third-party defendant successfully demonstrated that the plaintiff's injuries, though serious, did not constitute 'grave' injuries under Workers’ Compensation Law § 11. Additionally, it was established that the third-party defendant had fulfilled the insurance requirements stipulated in the parties' agreement. Therefore, the Supreme Court's initial denial of the summary judgment motion was deemed erroneous.

Personal InjurySummary JudgmentThird-Party ComplaintWorkers' Compensation LawGrave InjuryAppellate ReviewMotion GrantedOrder ReversedInsurance ComplianceSuffolk County
References
6
Case No. ADJ624341 (SDO 0320867)
Regular
Jan 21, 2011

MICHAEL LALOR vs. CITY OF SAN DIEGO

This case involves a firefighter who claimed cumulative trauma injury to multiple body parts. The parties stipulated to a single cumulative trauma injury, but the WCJ issued separate permanent disability awards, contrary to the stipulation and the *Benson* precedent regarding individual injury determination. The Appeals Board granted reconsideration, rescinded the WCJ's decision, and returned the matter for further proceedings, emphasizing the binding nature of the parties' stipulation to a single cumulative trauma injury. The Board also directed re-evaluation of causation for hypertension and noted potential impairment from asthma.

Workers' Compensation Appeals BoardCity of San Diegofirefighter/fire captaincumulative traumamultiple body partspermanent disabilityapportionmenthypertensiontuberculosispulmonary/asthma
References
7
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