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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 Joslin v. City of Albany Fire Department

The claimant appealed a Workers’ Compensation Board decision regarding the method of payment for his hearing loss benefits, specifically challenging the biweekly installment plan. The claimant argued that Workers’ Compensation Law § 49-bb, which governs occupational loss of hearing claims, mandated a different payment method. The court rejected this contention, asserting that Workers’ Compensation Law § 15 (3) (m), which covers schedule awards for hearing losses generally, and § 49-cc, which directs occupational loss of hearing compensation to align with § 15 (3), govern the payment. Consequently, the court affirmed that the claimant was entitled to biweekly scheduled payments, consistent with other schedule loss awards.

Hearing lossWorkers' CompensationOccupational diseaseSchedule awardBiweekly paymentsStatutory interpretationAppealCompensation benefitsWorkers' Compensation Board
References
2
Case No. MISSING
Regular Panel Decision

White v. Bowen

This class action, led by White v. Heckler, challenges the Secretary of Health and Human Services' method of calculating retroactive disability benefits for individuals eligible under both Titles II (OASDI) and XVI (SSI) of the Social Security Act. The plaintiff class, New York residents, argued that the Secretary's practice of first calculating SSI and then subtracting it from retroactive OASDI benefits violated federal regulations, various federal acts (Social Security Act, APA, FOIA, Federal Register Act), and the Fifth Amendment's Due Process clause. The court, however, upheld the Secretary's procedure. It found the method consistent with Congress's intent to prevent windfalls, not in violation of the anti-assignment provision of § 407, and determined the POMS guidelines were interpretative rules exempt from publication requirements. Consequently, the defendant's motion for judgment on the pleadings was granted, and the plaintiffs' motion for partial summary judgment was denied, resulting in the dismissal of the complaint.

Social Security ActDisability BenefitsSSIOASDIRetroactive BenefitsWindfall OffsetAdministrative Procedure ActFreedom of Information ActDue ProcessClass Action
References
15
Case No. MISSING
Regular Panel Decision

Claim of Marchese v. New York State Department of Correctional Services

Claimant, injured in October 1997, initially received full wages from their employer, then workers' compensation benefits after employment termination. Following an award of benefits in February 2000, a dispute arose regarding the payment of claimant's counsel fee. The Workers’ Compensation Board ruled that the fee should be paid in installments from continuing payments to the claimant, rather than from the portion reimbursing the employer. Claimant appealed this decision, arguing that continuing payments were subject to adjustment and thus not an award of compensation. The Appellate Division affirmed the Board's decision, emphasizing the Board's broad discretion under Workers’ Compensation Law § 24 and finding no unfairness in the payment method, as the award was sufficient to cover both employer reimbursement and the attorneys' lien.

Attorney FeesWorkers' Compensation LawLien on CompensationContinuing PaymentsBoard DiscretionAppellate ReviewEmployer ReimbursementAward Payment MethodStatutory InterpretationCounsel Fee
References
2
Case No. SRO 0122159
En Banc
Jun 09, 2005

Danny Nabors vs. Piedmont Lumber & Mill Company, State Compensation Insurance Fund

The Appeals Board held that when awarding permanent disability after apportionment, the correct method is to subtract the percentage of disability from a prior award from the overall percentage of current disability before calculating the indemnity owed.

SB 899apportionmentpermanent disabilityFuentesLabor Code section 4750Labor Code section 4663Labor Code section 4664en bancWCABWCJ
References
17
Case No. MON 252295, MON 204621, MON 204619, and MON 206491
Regular
Apr 29, 2008

MYRNA MORGAN vs. KAISER, Permissibly Self-Insured, LEXIN, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) rescinded the administrative law judge's (WCJ) decision regarding applicant Myrna Morgan's successive industrial injuries. The WCAB found that the WCJ improperly applied the monetary-value subtraction method for apportionment and that the *Wilkinson* doctrine is no longer generally applicable post-SB 899. The case is returned to the trial level for further development of the record and a new decision consistent with current apportionment law.

Workers Compensation Appeals BoardReconsiderationFindings Award and OrdersIndustrial InjuryPsycheUpper ExtremitiesLower ExtremitiesSpineStipulations with Request for AwardPermanent Disability
References
9
Case No. ADJ3076919 (VNO 0553962)
Regular
Aug 30, 2010

SANTIAGO CARRERAS vs. CITY OF TORRANCE

This case denies the defendant's petition for reconsideration regarding a workers' compensation award. The defendant sought to apportion a prior 20% permanent disability award for hypertension from 1994 against the applicant's current 73% permanent disability award for hypertensive heart disease and bilateral knee injuries. The Board found the defendant failed to prove overlap between the two disabilities because they were rated under different standards and methods. Therefore, the prior award could not be subtracted from the current award under Labor Code section 4664.

WCABSantiago CarrerasCity of TorrancePetition for ReconsiderationFindings and Awardhypertensive heart diseasebilateral kneespermanent disabilityLabor Code section 4664apportionment
References
3
Case No. FRE 231905
Regular
Aug 06, 2007

DONALD VAN NESS vs. CLOVIS UNIFIED SCHOOL DISTRICT, PSI, Administered By TRISTAR RISK MANAGEMENT

The Workers' Compensation Appeals Board rescinded a prior award, returning the case to the administrative law judge for recalculation of permanent disability indemnity and attorney fees. This decision was based on the California Supreme Court's ruling in *Brodie v. Workers' Comp. Appeals Bd.*, which clarified that the "subtracting percentages from percentages" method remains the proper approach for permanent disability apportionment post-Senate Bill 899. The Board directed the judge to apply *Brodie* and conduct further proceedings as needed.

Workers' Compensation Appeals BoardDonald Van NessClovis Unified School DistrictTristar Risk ManagementOpinion and Decision After ReconsiderationLabor Code section 4664apportionmentpermanent disabilityFindings and AwardErickson v. Kaiser Permanente
References
4
Case No. ADJ8867364
Regular
Nov 09, 2016

MANYA PRYBYLA vs. STATER BROS. MARKET, THE HARTFORD

In this workers' compensation case, the Appeals Board granted reconsideration to address disputes over permanent disability and apportionment, as well as a claim for future medical treatment. The Board found that the Agreed Medical Examiner's apportionment, based on subjective factors rather than the strict subtraction method required by the AMA Guides and SB 899, was legally insufficient. Therefore, the Board deferred the issues of permanent disability, apportionment, attorney fees, and further medical treatment, returning the case to the trial level for further development of the record and a new decision.

Workers' Compensation Appeals BoardReconsiderationFindings Award and OrderIndustrial InjuryPermanent DisabilityApportionmentFuture Medical TreatmentAgreed Medical Examiner (AME)Whole Person Impairment (WPI)DRE Rating Method
References
0
Case No. ADJ277378 (OAK 0321116)
Regular
Jan 04, 2010

RANDALL MINVIELLE vs. COUNTY OF CONTRA COSTA / CONTRA COSTA FIRE

The Workers' Compensation Appeals Board denied reconsideration, affirming the finding that the applicant sustained industrial injury to his back on November 22, 2004, resulting in 31% permanent disability without apportionment. The employer sought to subtract a prior 1992 award of 27.5% permanent disability under Labor Code section 4664. However, the Board found that the defendant failed to prove "overlap" because the two injuries were rated using different standards (PDRS for the prior injury and AMA Guides/ROM method for the current injury). Since the permanent disability from both injuries could not be calculated under the same standard, apportionment was not permitted.

Workers' Compensation Appeals BoardRandall MinvielleCounty of Contra CostaContra Costa Firelegally uninsuredfirefighterindustrial injuryback injurypermanent disabilityapportionment
References
11
Case No. MISSING
Regular Panel Decision
Apr 13, 1983

Heitner v. Government Employees Insurance

This case clarifies the method for calculating "first party benefits" in no-fault automobile insurance claims concerning lost earnings. The Appellate Division reversed a Special Term decision, holding that disability benefits, along with the 20% lost-earnings deduction, should be subtracted from the claimant's gross lost monthly earnings, not from the statutory $1,000 lost-earnings ceiling. The court emphasized that the $1,000 limit represents the maximum recovery from the insurance carrier, and this interpretation prevents unwarranted windfalls to insurance companies while ensuring claimants receive intended benefits. This aligns with the consumer-oriented legislative intent of the no-fault provisions to compensate accident victims for economic loss without double recovery.

No-fault insurancedisability benefits deductionlost earningsinsurance lawstatutory interpretationbasic economic lossfirst-party benefitswage-loss calculationautomobile accident claimcollateral source offset
References
12
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