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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

What Happened in Felix vs. Weber Metals Reconsideration?

Claimant applied for workers' compensation benefits after a March 2010 work fall, establishing injuries to his back, left knee, and left hip. After thoracic spine surgery in 2011, the employer and its workers' compensation carrier objected to coverage, arguing it was not causally connected to the initial claim. The Workers’ Compensation Board agreed, a decision which the appellate court affirmed. The court credited an independent medical examiner's opinion that the thoracic condition and subsequent falls were unrelated to the compensable accident, despite the claimant's orthopedic surgeon's testimony suggesting otherwise.

Workers' Compensation BenefitsCausal RelationThoracic Spine InjuryDegenerative ConditionIndependent Medical ExaminationSubsequent FallsBoard DecisionAppellate ReviewCredibility AssessmentSubstantial Evidence
References
3
Case No. 02-23-00220-CV
Regular Panel Decision
Apr 17, 2025

How Did the WCAB Rule in Hardgrove vs. Intercon Security?

This case concerns a medical malpractice claim brought by Larry and Shelley Jones against Bianco Brain and Spine, PLLC and Dr. Nikhil Kanti Patel. Mr. Jones suffered a cauda equina injury during spine surgery performed by Dr. Patel. The jury found Dr. Patel negligent, and his negligence proximately caused Mr. Jones's injury. On appeal, Dr. Patel challenged the legal and factual sufficiency of the evidence. The Court affirmed the judgment against Dr. Patel, finding sufficient evidence to support the jury's finding that Dr. Patel's intraoperative surgical technique (removing existing hardware before stabilizing the L3-L4 junction) breached the standard of care and caused the injury. Bianco Brain and Spine, PLLC was sued under a theory of respondeat superior. The Court reversed the judgment imposing liability on Bianco, holding that the Joneses waived their independent ground of recovery for respondeat superior by failing to submit a jury question on this claim, and the evidence of Dr. Patel's employment status was not conclusive.

Medical MalpracticeMedical NegligenceSpine SurgeryCauda Equina InjuryRespondeat SuperiorVicarious LiabilityLegal SufficiencyFactual SufficiencyExpert TestimonyProximate Cause
References
87
Case No. 2024 NY Slip Op 00599 [224 AD3d 428]
Regular Panel Decision
Feb 06, 2024

What Did the WCAB Decide in Cuadra vs. Community Home Care?

This case involves two appeals by New Millennium Pain & Spine Medicine, P.C. against Garrison Property & Casualty Insurance Company and GEICO Casualty Company. New Millennium sought to vacate master arbitration awards that denied its claims for no-fault benefits for medical services. The Supreme Court denied these applications. The Appellate Division, First Department, affirmed the Supreme Court's decisions, stating that an arbitrator's award will not be set aside unless it is irrational. The court also addressed the argument regarding a 20% wage offset in no-fault benefits, finding it unavailing under Insurance Law § 5102 (b). Ultimately, New Millennium was not entitled to attorneys' fees as it was not the prevailing party.

No-fault benefitsarbitration awardvacaturinsurance lawwage offsetappellate reviewmedical servicesno-fault policy exhaustionattorneys' feesCPLR Article 75
References
8
Case No. ADJ6626529
Regular
Nov 05, 2015

How Were Death Benefits Handled in Bocanegra vs. Sun-Gro Commodities?

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to further study the issues in this case. The WCAB rescinded the prior Findings of Fact & Award, denied the defendant's motion to be relieved of stipulation regarding the thoracic spine, and found that the applicant sustained industrial injury to his cervical spine, shoulders, and thoracic spine. The WCAB deferred issues of permanent disability, apportionment, and attorney's fees, returning the matter to the WCJ for further record development.

Workers' Compensation Appeals BoardNicolas WalkerLos Angeles Unified School DistrictSedgewick Claims Management ServicesInc.ADJ6626529Opinion and Decision After ReconsiderationFindings of Fact & AwardWCJcervical spine
References
5
Case No. 2019-03-0262
Regular Panel Decision
Mar 11, 2021

Can a WCJ Be Disqualified for Appearance of Bias?

April Mays, an employee, fell at work and initially received treatment for her neck and cervical spine. She sought additional treatment for her lumbar and thoracic spine, which Fast Pace Medical Clinic, PLLC, denied. The Court reviewed conflicting medical opinions from Dr. Paul Johnson, the panel-selected physician, and Dr. C.M. Salekin, an independent medical examiner. Dr. Salekin diagnosed lumbosacral radiculopathy and probable rod displacement related to the fall, recommending further evaluation. The Court found Ms. Mays presented sufficient proof to rebut Dr. Johnson's causation opinion, which stated the lumbar and thoracic pain was unrelated to the work injury without detailed explanation. Therefore, the Court granted Ms. Mays's claim for the requested lumbar and thoracic MRIs and an orthopedic evaluation.

Workers' CompensationExpedited HearingMedical Treatment DenialCausation DisputeIndependent Medical Examination (IME)Pre-existing Condition AggravationLumbar Spine InjuryThoracic Spine InjuryCervical RadiculopathyOrthopedic Evaluation
References
1
Case No. 14-07-00887-CV
Regular Panel Decision
Jun 02, 2009

What Were the Key Rulings in Torrez vs. SuperShuttle?

Tanya E. Dowell appealed the trial court's grant of summary judgment in favor of Theken Spine, LLC, arguing lack of proper notice for the summary judgment motion and hearing. Dowell's motion for summary judgment was granted after her certified mail for the notice was returned "unclaimed." The appellate court affirmed the trial court's judgment, finding that Dowell failed to provide verified proof at the time of the summary judgment ruling to rebut the presumption of actual notice. The court also upheld the denial of Dowell's motion for new trial, stating that a complete record of the hearing on the motion was not presented by the appellant, thus precluding a finding of abuse of discretion by the trial court.

Summary JudgmentNoticeDue ProcessCertified MailUnclaimed MailPresumption of ReceiptMotion for New TrialAbuse of DiscretionAppellate ProcedureTexas Rules of Civil Procedure
References
21
Case No. ADJ203727 (SRO 0140512)
Regular
Jan 29, 2013

Why Was Removal Denied in Rush vs. California Correctional Institution?

In this workers' compensation case, the applicant sustained an industrial injury resulting in multiple impairments. Initially awarded 60% permanent disability, the applicant sought reconsideration, arguing the rating omitted the thoracic spine and advocating for total disability based on vocational expert testimony. The WCJ amended the rating to 63% after including the thoracic spine, finding no substantial evidence for total disability. The Appeals Board adopted the WCJ's recommendation, affirming the amended 63% permanent disability award and adjusting the attorney's fee.

Petition for ReconsiderationDecision After Reconsiderationindustrial injurycognitive impairmentpsycheconsciousness disorderpermanent disabilityapportionmentvocational expertamended rating
References
0
Case No. ADJ9709726
Regular
Jun 25, 2015

What Did the WCAB Clarify in Ontiveros vs. Savers Stores?

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The defendant challenged the finding of industrial injury AOE/COE for thoracic outlet syndrome, arguing it wasn't an issue for trial and the medical evidence was insufficient. The Board found that thoracic spine injury was an issue and that Dr. Avery's opinion provided substantial medical evidence to support the thoracic outlet syndrome finding. Any potential defects in the original WCJ opinion were cured by the WCJ's subsequent report.

Thoracic outlet syndromeAOE/COEPetition for Reconsiderationsubstantial medical evidenceG. James Avery M.D.Steven Bratman M.D.industrial injuryapportionmentWCJlabor code 5313
References
1
Case No. ADJ9841969
Regular
Jul 23, 2019

Why Was Reconsideration Denied in Gomez vs. Dorothy Stevens?

This case involves a workers' compensation applicant who sustained injuries to her left elbow, left upper extremity, lumbar spine, and right knee. The WCAB granted reconsideration of an administrative law judge's decision to re-evaluate specific injuries and permanent disability. The Board found that further development of the medical record was necessary concerning alleged injuries to the right wrist, thoracic spine, and cervical spine. Consequently, the decision defers these issues and the determination of permanent disability pending further medical evidence.

WCABReconsiderationPanel Qualified Medical EvaluatorAdministrative Law JudgePermanent DisabilityIndustrial InjuryCervical SpineThoracic SpineRight WristMedical Opinion
References
3
Case No. ADJ790852
Regular
Apr 05, 2016

Why Was Reconsideration Dismissed in Sabino vs. Johnson Pump Company?

The Workers' Compensation Appeals Board granted the applicant's petition for reconsideration, amending the award to include attorney fees on accrued unpaid permanent disability benefits and correcting clerical errors. The Board denied the defendant's petition for reconsideration, upholding the finding of 100% permanent disability and injury to the lumbar spine. The defendant was also admonished for filing a document exceeding the page limit without prior permission. The applicant, a nurse, sustained industrial injuries to her thoracic spine, lumbar spine, and psyche.

Workers' Compensation Appeals BoardLaura BreitiganCounty of RiversideFindings and Awardindustrial injurythoracic spinelumbar spinepsychepermanent disabilityapportionment
References
0
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