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

Case No. MISSING
Regular Panel Decision

Claim of Bruzzese v. Guardsman Elevator Co.

In 1994, the claimant sustained head, neck, and back injuries at work, leading to an award for permanent partial disability, which included a wage expectancy adjustment under Workers’ Compensation Law § 14 (5). Following back surgery in 1998, the case was reopened, and the claimant was found to be temporarily totally disabled. Benefits for this temporary total disability were calculated based on the claimant's average weekly wage at the time of injury, without applying the wage expectancy adjustment. The claimant appealed, arguing that since the permanent partial disability preceded the temporary total disability, the wage expectancy adjustment should also apply to the latter period. The court disagreed, affirming the Workers’ Compensation Board's decision, citing established case law that Workers’ Compensation Law § 14 (5) is applicable only to awards for permanent partial disability and not temporary disability.

Wage expectancyTemporary total disabilityPermanent partial disabilityWorkers' Compensation benefitsBack injuryAppellate reviewDisability calculationWorkers' Compensation BoardAverage weekly wage
References
1
Case No. MISSING
Regular Panel Decision

Matter of Brady v. Northeast Riggers & Erectors

In March 2012, the claimant, a union construction laborer, sustained a work-related back and abdomen injury. A Workers' Compensation Law Judge (WCLJ) initially found the claimant attached to the labor market but deemed a total industrial disability finding premature because permanent disability had not yet been classified. The Workers’ Compensation Board upheld this determination. The claimant appealed, arguing the Board erred in declining to classify him with a temporary total industrial disability. The Court affirmed the Board's decision, asserting that a classification of temporary total industrial disability cannot be made without a prior determination of permanency.

Workers' CompensationIndustrial DisabilityPermanent DisabilityTemporary DisabilityLabor MarketAppellate DivisionBoard DecisionPremature DeterminationGainful EmploymentWork History
References
6
Case No. ADJ4606826 (SJO 0265682)
Regular
Jul 01, 2009

WILBERT LEE vs. COCA-COLA BOTTLING CO., Permissibly Self-Insured, Adjusted By SEDGWICK CMS

In this workers' compensation case, the Board rescinded its prior decision and found the applicant entitled to temporary total disability indemnity. This indemnity is awarded for the period between November 21, 2007, and January 28, 2008, when the applicant was medically deemed unable to work. However, the applicant is estopped from receiving temporary disability indemnity for periods of temporary partial disability due to refusing modified work without good cause. The Board affirmed its finding that the applicant is not entitled to temporary disability for periods of partial disability for the reasons stated in its earlier opinion.

Workers' Compensation Appeals BoardReconsiderationTemporary Disability IndemnityModified WorkEstoppelAgreed Medical EvaluatorPrimary Treating PhysicianTemporary Total DisabilityTemporary Partial DisabilityOdd Lot Doctrine
References
4
Case No. LAO 855766
Regular
Jul 16, 2007

JUAN L. FLORES vs. HEDENBERG, INC., dba IHOP, STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration to address the defendant's petition to terminate temporary total disability indemnity. While the defendant's initial petition had procedural defects, including failing to adhere to filing deadlines and content requirements, the Board found that Labor Code section 4700 dictates no liability for temporary disability benefits exists beyond the date of the applicant's death. Consequently, the Board rescinded the prior order and issued a new order terminating the defendant's liability for temporary total disability indemnity as of February 20, 2007, the date of the applicant's death.

Workers' Compensation Appeals BoardPetition for ReconsiderationOrder Terminating LiabilityTemporary Total Disability IndemnityLabor Code Section 4700Applicant's DeathPermanent and StationaryPetition to Terminate LiabilityCalifornia Code of RegulationsRule 10462
References
2
Case No. ADJ626438 (VNO 0450164) ADJ3665608 (VNO 0450166) ADJ3570389 (VNO 0521859) ADJ8592142
Regular
Jun 07, 2013

JOSEPH GIOIA vs. NEFTIN WESTLAKE CAR COMPANY, CALIFORNIA INDEMNITY INSURANCE COMPANY, GALLAGHER BASSETT SERVICES, INC., FREMONT INSURANCE COMPANY, CIGA

This Workers' Compensation Appeals Board decision denies the petition for reconsideration filed by California Indemnity Insurance Company (CIIC). Conversely, it grants the petition filed by the California Insurance Guarantee Association (CIGA). The original decision of March 18, 2013, is affirmed but amended to reflect specific findings regarding the applicant's employment periods, injuries, and temporary total disability payments. The amendment clarifies insurance responsibilities, with CIIC responsible for 92% of the temporary total disability and Mid-Century/Farmers for 8%.

Workers' Compensation Appeals BoardCIICCIGAPetition for ReconsiderationWCJ ReportInsurance CodeTemporary Total DisabilityLC § 4661.5Joint Findings of FactNeftin Westlake Car Company
References
0
Case No. ADJ9203286
Regular
Mar 23, 2018

Hugo Bucio vs. County of Merced

The Workers' Compensation Appeals Board granted reconsideration, reversing a prior decision that denied temporary total disability indemnity. The applicant, a deputy sheriff, underwent self-procured surgery for an admitted industrial back injury after the employer denied authorization. The Board held that an injured worker is entitled to temporary disability indemnity regardless of whether the treatment was employer-authorized or self-procured. The decision clarified that the utilization review process governs medical treatment disputes, not temporary disability indemnity claims arising from self-procured treatment.

BucioCounty of MercedDeputy Sheriff/Coronerbilateral sacroiliac joint fusiontemporary total disability indemnityself-procured medical treatmentutilization review (UR)denial of authorizationphysician depositionpermanent and stationary status
References
4
Case No. LAO 0840517
Regular
Aug 20, 2007

UZMA XINA KANG vs. ENTERTAINMENT PARTNERS, CNA CLAIMPLUS

The Workers' Compensation Appeals Board granted reconsideration and amended the original award. The Board found the applicant to be a "minimum earner" for both temporary and permanent disability indemnity purposes. Consequently, the temporary disability indemnity rate was reduced to \$126 per week and the total permanent disability indemnity was adjusted to \$11,576.25, reflecting a lower average weekly earnings calculation than initially awarded.

Uzma Xina KangEntertainment PartnersCNA ClaimplusPetition for ReconsiderationFindings and AwardWorkers' Compensation Appeals BoardIndustrial InjuryRight AnkleLow BackLungs
References
7
Case No. ADJ7188804; ADJ7196928
Regular
Feb 16, 2018

LURA SESSIONS vs. THE KROGER COMPANY, SEDGWICK ADMINISTRATORS

The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration. The Board affirmed the original findings and award but amended it to defer the issue of temporary total disability. This decision stems from a dispute over the period of temporary total disability indemnity awarded to the applicant, Lura Sessions, for knee and psyche injuries sustained while employed by The Kroger Company. The case is being returned to the WCJ for further proceedings regarding temporary disability.

Workers Compensation Appeals BoardPetition for ReconsiderationFindings and AwardTemporary Total Disability IndemnityKnee InjuryPsyche InjuryOrder PullerPallet Jack OperatorAgreed Medical EvaluatorPermanent and Stationary Status
References
10
Case No. 2021 NY Slip Op 07401
Regular Panel Decision
Dec 23, 2021

Matter of Carola B.-M. v. New York State Off. of Temporary & Disability Assistance

Petitioners Carola B.-M. and Tiara M. challenged the denial of their supplemental nutrition assistance program (SNAP) benefits by the New York State Office of Temporary and Disability Assistance and the Orleans County Department of Social Services. The benefits were denied because they were deemed ineligible college students. The Appellate Division, Fourth Department, reversed this determination, holding that participation in the Adult Career and Continuing Education Services, Vocational Rehabilitation program (ACCES-VR) qualifies as a Job Training Partnership Act (JTPA) program. This status exempts the students from certain SNAP eligibility requirements. The court found that the original determination was based on an unreasonable interpretation of relevant regulations, annulled the decision, granted the petition, and remitted the case for a calculation of retroactive benefits.

SNAP benefitscollege student eligibilityJob Training Partnership ActACCES-VRvocational rehabilitationCPLR article 78regulatory interpretationpublic assistancefood stampsAppellate Division
References
28
Case No. ADJ11816386
Regular
Nov 03, 2020

KRISTINA JONES vs. STATE OF CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION, legally uninsured, administered by STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration to amend a prior decision, affirming the award of temporary total disability. The amended decision clarifies that the temporary disability indemnity rate is to be adjusted by the parties based on a stipulated monthly earnings of approximately $7,855.65. Jurisdiction is reserved at the trial level to resolve any disputes regarding the indemnity rate. The original award of temporary disability for the period found remains affirmed.

Workers' Compensation Appeals BoardPetition for ReconsiderationWorkers' Compensation Administrative Law JudgeTemporary Disability Indemnity RateStipulation of EarningsJudicial EfficiencyIndemnity Rate AdjustmentJurisdiction ReservedLabor Code Section 4656(c)(2)Petition to Terminate
References
0
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