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Case Law Database

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

Case No. ADJ3995122 (OAK 0343980)
Regular
Aug 13, 2013

ROSA GOMEZ vs. NOB HILL FOODS, YORK INSURANCE SERVICES

The Workers' Compensation Appeals Board granted removal to address the exclusion of sub rosa films and investigator testimony. The trial judge had excluded this evidence because it was disclosed late and not shown to treating doctors. However, the Board found that the defendant properly disclosed the evidence and investigators at the mandatory settlement conference per Labor Code § 5502(d)(3). The admissibility of the sub rosa films and investigator testimony is now deferred to the trial judge.

Sub rosa filmsremovalmandatory settlement conferencedisclosureevidence exclusioninvestigative reportsLabor Code section 5502petition for removalpetition for reconsiderationWorkers' Compensation Appeals Board
References
0
Case No. ADJ4617752 (VNO 0390167), ADJ1668605 (VNO 0470519)
Regular
Nov 01, 2010

ROBERT SCHENCK vs. COLIN CLINTON, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, RELIANCE INSURANCE COMPANY, AFFORDABLE QUALITY MOVING & STORAGE, STATE COMPENSATION INSURANCE FUND

This case involves applicant Robert Schenck's petition for reconsideration of a workers' compensation award. Schenck argued the judge erred by admitting sub-rosa video evidence and by not finding total disability based on Dr. Lavi's opinion. The Board denied the petition, finding the sub-rosa evidence was properly admitted and that Dr. Lavi's opinion lacked substantial evidentiary support for total disability. The Board affirmed the WCJ's reliance on defense medical reports finding permanent disability of 29% after apportionment.

SubrogationSub rosa evidenceMandatory Settlement ConferencePermanent DisabilityApportionmentWorkers' Compensation JudgeReconsiderationSubstantial EvidenceQualified Medical ExaminerDoctor-shopping
References
4
Case No. MISSING
Regular Panel Decision

Rosa v. Astrue

Ludina Rosa sought judicial review of the Commissioner of Social Security's final decision to deny her claim for Supplemental Security Income (SSI) benefits. Rosa had a complex administrative history, including multiple SSI applications and a prior decision by an Administrative Law Judge (ALJ) finding her disabled for a specific period but not for the period prior to October 1, 1986. The Commissioner moved to dismiss Rosa's complaint challenging the ALJ's pre-1986 disability finding. The court, presided over by a United States Magistrate Judge, reviewed the Commissioner's motion and found that the ALJ's decision was supported by substantial medical evidence, including findings from various doctors indicating Rosa's capacity for light work. Therefore, the Commissioner's motion to dismiss was granted.

Disability benefits appealSocial Security AdministrationSSI benefits denialFederal court reviewAdministrative Law Judge decisionResidual functional capacityMedical vocational guidelinesTreating physician rule exceptionSubstantial evidenceLight work capacity
References
20
Case No. 2022 NY Slip Op 05144
Regular Panel Decision
Sep 13, 2022

Rosa v. 47 E. 34th St. (NY), L.P.

This case involves an appeal regarding the summary judgment motions in a Labor Law action stemming from an electrical accident. Decedent Danny Rosa, an employee of June Electrical Corp., was electrocuted while working on an energized bus duct at a building managed by Bridgestreet Corporate Housing, LLC and owned by 47 East 34th Street (NY), L.P. and CIM Group, L.P. The Supreme Court initially granted summary judgment dismissing plaintiff's Labor Law §§ 240 (1) and 241 (6) claims but denied dismissal of Labor Law § 200 and common-law negligence claims. The Appellate Division modified the orders, reinstating the Labor Law §§ 240 (1) and 241 (6) claims against 47 East 34th, CIM, and Bridgestreet, finding issues of fact regarding whether Rosa was compelled to work on an energized bus duct and the supervision of the work. The court affirmed the denial of summary judgment for June Electrical Corp. on indemnification and contribution claims, noting the failure to eliminate factual issues regarding grave injury.

Electrical AccidentLabor Law ClaimsSummary JudgmentWorkplace SafetyBuilding ConstructionElectrocutionAppellate ReviewDuty of CareCommon-Law NegligenceIndustrial Code Violations
References
17
Case No. ADJ4707980 (VNO 0543260) ADJ3907003 (VNO 0543258) ADJ7500629
Regular
Apr 05, 2012

RAMON SALAZAR vs. CONSOLIDATED DISPOSAL SERVICE, ACE USA Administered By CANNON COCHRAN MANAGEMENT SERVICES INC.

The Appeals Board granted removal, rescinding the WCJ's order for a sanctions hearing and the appearance of the defendant's claims examiner. While acknowledging the duty to disclose evidence before a trial, the Board found no authority requiring pre-expedited hearing disclosure of sub rosa films, thus negating grounds for sanctions. The Board also determined an affidavit from the claims examiner would suffice, making her live appearance unnecessary. The order for the sub rosa films to be sent to the Agreed Medical Examiner was affirmed.

sub rosa filmsexpedited hearingsanctionsPetition for RemovalAgreed Medical Examinertemporary disability indemnitymedical treatmentclaims examineraffidavitLabor Code section 5813
References
4
Case No. ADJ387595 (VNO 0552648)
Regular
Jul 12, 2016

JOEL CARDENAS vs. ML ELECTRIC WORKS, INC, ZURICH AMERICAN INSURANCE COMPANY, ZURICH NORTH AMERICA

The Workers' Compensation Appeals Board granted the defendant's petition for removal, modifying a prior order by an administrative law judge. The Board removed the issues of penalty, costs, and sanctions related to the disclosure of sub rosa video and surveillance logs from trial consideration. However, the Board affirmed the remainder of the judge's order, which had compelled the defendant to serve the sub rosa materials and produce the claims adjuster and documents at trial. This decision aimed to prevent further discovery beyond the mandatory settlement conference cutoff while still requiring disclosure of the surveillance evidence.

Sub rosa videoPetition for RemovalMandatory Settlement ConferenceDiscovery cut-offDue processIrreparable harmClaims adjusterLabor Code section 5502(d)(3)PenaltySanctions
References
0
Case No. ADJ924734 (MON 0299710)
Regular
Feb 07, 2014

VARDAN ESSAIAN vs. CAD FABULOUS, INC., STATE FARM CALIFORNIA WORKERS' COMPENSATION CLAIMS

The Workers' Compensation Appeals Board granted reconsideration of an award of 100% permanent disability, finding the evidence did not justify an unapportioned award. The Board cited concerns regarding the apportionment of psychiatric disability and the impact of sub rosa video evidence on the applicant's claimed limitations. The case is remanded for further development of the record, specifically regarding the psychiatric AME's apportionment reasoning and the vocational experts' conclusions in light of the video evidence.

Workers' Compensation Appeals BoardReconsiderationAmended Findings of Fact and AwardPermanent DisabilityApportionmentCumulative TraumaAgreed Medical ExaminerPsychiatryOrthopedicsSub Rosa Video
References
3
Case No. ADJ3128963 (AHM 0129527)
Regular
Aug 29, 2014

OMAR ROSAS vs. LAURENCE-HOVENIER, INC., CALIFORNIA CONTRACTORS' NETWORK administered by AMERICAN CLAIMS MANAGEMENT

This case involves a lien claim for home health care services provided to Omar Rosas. The lien claimant, Tayde Perez, contended that the services were reasonably required and that recent case law supported developing the record on the employer's receipt of a prescription. The Workers' Compensation Appeals Board denied the petition for reconsideration, adopting the WCJ's report. The WCJ found no substantial medical evidence supporting the necessity of the home health care services, and that even if the services were deemed necessary, Labor Code §4600(h) barred recovery as there was no evidence the employer received a prescription prior to 2013.

Petition for ReconsiderationLien ClaimantHome Health Care ServicesReasonably RequiredMedical EvidenceLabor Code §4600(h)Physician's PrescriptionNeri HernandezBurden of ProofCompromise and Release
References
1
Case No. ADJ6970400
Regular
Jun 25, 2019

BETHANY NYBAKKEN vs. LANCASTER SCHOOL DISTRICT

The Appeals Board granted reconsideration to formally admit the defendant's *sub rosa* video and specific exhibits into evidence, as initially intended by the judge. Despite the defendant's arguments regarding fraud, outdated medical evidence, and inadequate vocational testimony, the Board affirmed the judge's finding of permanent total disability. The Board accorded significant weight to the judge's credibility assessment of the applicant. The defendant's supplemental brief was rejected for procedural reasons.

WCABPetition for ReconsiderationFindings and AwardPermanent Total DisabilitySub Rosa VideoAdmissibility of EvidenceCredibility DeterminationObsolete Medical EvidenceApportionmentVocational Expert
References
5
Case No. ADJ10988072
Regular
Jun 24, 2019

JOUZETTE POLK LUSTER vs. RECOLOGY, CORVEL SACRAMENTO

The Workers' Compensation Appeals Board granted the applicant's petition for reconsideration, rescinded the initial decision, and returned the case for further proceedings. The WCJ had denied the claim based on the applicant's perceived lack of credibility due to discrepancies between her deposition testimony and sub rosa video evidence. However, the Board found that the applicant's credibility issues did not definitively overcome the medical opinions of the Qualified Medical Evaluator. The Board also clarified that the applicant's deposition was properly admitted into evidence as she indicated she would refuse to testify if called.

WCABPetition for ReconsiderationFindings of Fact and Orderindustrial injuryAOE/COEdeposition transcriptsub rosa videomedical evidencePQME reportcredibility
References
0
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