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

Case No. ADJ7651955
Regular
Nov 08, 2012

ARTHUR LUCERO vs. CITY OF FRESNO, Permissibly Self-Insured, Administered by AMERICAN ALL RISK LOSS ADMINISTRATORS

This case concerns a dispute over the selection of a Qualified Medical Evaluator (QME) panelist in a workers' compensation claim. The applicant sought to remove Dr. Arora, arguing the defendant's notice to strike Dr. Cayton was insufficient. The applicant, a firefighter, alleged a heart and hernia injury. The Appeals Board denied the petition, agreeing with the WCJ that the defendant's notice of intent to strike was sufficient and timely under Labor Code section 4062.2(c).

Petition for RemovalPanel Qualified Medical EvaluatorNotice of Intent to StrikeLabor Code Section 4062.2Agreed Medical EvaluatorIndustrial InjuryHeart InjuryCardiovascular System InjuryHernia InjuryFirefighter
References
1
Case No. ADJ8835727
Regular
Oct 05, 2015

ELVIRA MAYA vs. WENTE VINEYARDS, ZENITH INSURANCE COMPANY

This case concerns the timeliness of a defendant's strike of a Qualified Medical Evaluator (QME) panel. The Appeals Board determined that the ten-day period to strike a QME from a panel, as per Labor Code section 4062.2(c), is extended by five days when service is by U.S. mail, consistent with Code of Civil Procedure section 1013(a). Consequently, the defendant's strike of Dr. Boyd was deemed timely, and the applicant must now be examined by the remaining panel member, Dr. Gardner. The prior WCJ decision finding the strike untimely was rescinded.

WCABReconsiderationRemovalPetition for RemovalPetition for ReconsiderationPQMEPanel QMELabor Code section 4062.2(c)Code of Civil Procedure section 1013(a)WCAB Rule 10507(a)(1)
References
3
Case No. ADJ8410459
Regular
Oct 22, 2019

DIETRA WALKER vs. YMCA METROPOLITAN LOS ANGELES

The Workers' Compensation Appeals Board (WCAB) granted the applicant's Petition for Reconsideration, overturning the trial judge's decision to strike a Qualified Medical Evaluator's (QME) report. The WCAB found no disqualifying conflict of interest for Dr. Gabriel, despite co-authored articles and past professional association with another dentist, Dr. Schames. Furthermore, the Board deemed the defendant's motion to strike Dr. Gabriel untimely due to a nearly three-year delay after his deposition. The case is affirmed with an amendment finding Dr. Gabriel free of conflict, and the defendant's motion is denied.

QMEconflict of interestdisqualifying conflict of interestlachesestoppelpetition for reconsiderationremovalmotion to strikeAOE/COEdeposition
References
4
Case No. ADJ7692621; ADJ7687042
Regular
May 17, 2012

FREDDY TORRES vs. SCOTT BROS DAIRY INC.; ILLINOIS MIDWEST SPRINGFIELD

This case involves a dispute over the selection of a Qualified Medical Evaluator (QME). The defendant attempted to strike a QME from the panel prematurely, violating Labor Code section 4062.2(c). The applicant's subsequent strike was timely, leaving only Dr. Katz on the panel. The Appeals Board denied the defendant's Petition for Removal, upholding the WCJ's order for an evaluation by Dr. Katz. The Board warned the defendant that denying benefits based on Dr. Katz's report would be at their peril.

Petition for RemovalQualified Medical EvaluationLabor Code Section 4062.2(c)QME PanelAgreed Medical EvaluatorStrike a NameTimely StrikePremature StrikeMedical DirectorDivision of Workers' Compensation
References
0
Case No. MISSING
Regular Panel Decision

In re the Claims of Noss

Claimants, employees of Lawrence Aviation Industries, Inc. and union members, commenced a strike in 1984. During the strike, they received weekly strike benefits from their union and later unemployment insurance benefits. The employer challenged these benefits, arguing that strike benefits were contingent on performing union duties, making claimants not 'totally unemployed,' and alleged willful misrepresentation. Both the Administrative Law Judge and the Unemployment Insurance Appeal Board found that the strike benefits were not conditional and no misrepresentation occurred. The appellate court affirmed the Board's decision, emphasizing that strike benefits not conditioned on services are not considered remuneration under 12 NYCRR 490.2 (b) and that the Board's factual findings, supported by substantial evidence, should not be disturbed.

Unemployment BenefitsStrike BenefitsTotal UnemploymentWillful MisrepresentationLabor UnionAdministrative LawJudicial ReviewSubstantial EvidenceConditional PaymentsNew York Labor Law
References
4
Case No. MISSING
Regular Panel Decision
Sep 29, 1999

Faele v. New York City Health & Hospitals Corp.

Plaintiff Rosemary Faele, a nurse at Coney Island Hospital, sustained an eye irritation and received brief examinations from defendants Dr. Barry Eppinger and Dr. An-nan Das in the hospital's emergency room. Her condition worsened, and she was later diagnosed with a severe eye infection by a private ophthalmologist. Though compensated via Workers' Compensation, Faele and her husband initiated a medical malpractice action against the doctors and the New York City Health and Hospitals Corporation. The Supreme Court dismissed the complaint by granting summary judgment to the defendants. The appellate court affirmed this decision, ruling that a sufficient nexus existed between Faele's employment and the alleged malpractice, thereby precluding a common-law malpractice claim and limiting her recourse to Workers' Compensation.

Medical MalpracticeWorkers' Compensation PreclusionSummary Judgment AffirmationEmployment-Related InjuryHospital LiabilityEmergency Medical TreatmentAppellate Division DecisionPersonal InjuryDoctor-Patient NexusConey Island Hospital
References
4
Case No. MISSING
Regular Panel Decision
Feb 28, 1977

Staten Island Rapid Transit Operating Authority v. International Brotherhood of Electrical Workers, Local 922

This case involves an appeal from a judgment that enjoined unions representing employees of the Staten Island Rapid Transit Operating Authority (SIRTOA) from striking. SIRTOA, a public benefit corporation operating a commuter rail line in New York, argued that its employees, as public employees, are prohibited from striking under the New York State Taylor Law. The defendant unions contended they were governed by the federal Railway Labor Act, which permits strikes. The court affirmed the injunction, determining that SIRTOA's minimal connection to interstate commerce, primarily a single daily freight run, was outweighed by the State's compelling interest in preventing public employee strikes and ensuring essential commuter rail service for Staten Island residents.

Strike InjunctionPublic EmployeesRailway Labor ActTaylor LawInterstate CommerceState SovereigntyCommuter RailCollective BargainingNew York State LawFederal Preemption
References
7
Case No. ADJ1029045 (LAO 0790607)
Regular
Sep 21, 2012

ELVIRA CABRAL vs. ACCURIDE INTERNATIONAL, INC., SEDGWICK CLAIMS MANAGEMENT

The Workers' Compensation Appeals Board (WCAB) dismissed the applicant's Petition for Reconsideration because the administrative law judge's (WCJ) order striking Dr. Windler's reports was an evidentiary ruling, not a final order dispositive of substantive rights. The WCAB also denied the applicant's Petition for Removal, finding no evidence of significant prejudice or irreparable harm required for this extraordinary remedy. The WCAB concluded the WCJ's report sufficiently explained the bases for striking the reports, curing any technical defect regarding Labor Code section 5313. Therefore, the applicant's request to overturn the ruling on Dr. Windler's reports was denied.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for Removalsubstantial evidenceDr. Windler's reportsstricken from the recordnon-industrial personal injuryLabor Code section 5313final orderadmissibility of evidence
References
7
Case No. MISSING
Regular Panel Decision

Johnson v. New York Hospital

Plaintiff, a registered nurse, filed an action under Section 504 of the Rehabilitation Act against The New York Hospital, its President Dr. David Skinner, and Assistant Director of Nursing Mr. Jody Sklar, alleging unlawful employment termination due to an alcoholism relapse. The plaintiff objected to a protective order preventing Dr. Skinner's deposition, while defendants sought to dismiss claims against individual defendants. The court granted dismissal against Mr. Sklar but denied it for Dr. Skinner, finding that individuals responsible for discriminatory decisions can be liable under the Act, especially those in positions to accept federal funds. Consequently, the protective order against deposing Dr. Skinner was set aside.

Rehabilitation Actemployment discriminationdisability rightsalcoholismindividual liabilitycorporate responsibilityprotective orderdiscoverymotion to dismiss
References
9
Case No. MISSING
Regular Panel Decision

Evans v. United States

Charles Evans sued the United States of America for negligence under the Federal Tort Claims Act and New York's No-Fault Insurance Law, seeking damages for personal injury from a motor vehicle accident and property damage. The defendant moved for summary judgment, and also to strike an affidavit from the plaintiff's chiropractor, Dr. Marie G. Gerard. The Court denied the motion to strike, finding Dr. Gerard to be a treating physician whose affidavit was admissible. However, the Court granted the defendant's motion for summary judgment, concluding that the plaintiff failed to demonstrate a "serious injury" under New York law and did not provide sufficient evidence to rebut the defendant's causation arguments regarding pre-existing injuries or to explain the gap in treatment. Additionally, the plaintiff's claim for property damage was dismissed due to insufficient evidence of actual damages.

NegligenceFederal Tort Claims ActMotor Vehicle AccidentSerious InjuryNo-Fault Insurance LawSummary JudgmentPre-existing ConditionsMedical EvidenceChiropractic CareCervical Spine Injury
References
84
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