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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 Keselman v. New York City Transit Authority

Claimant, injured in 1986, initially established a right shoulder injury. The Workers’ Compensation Board affirmed this but denied a causally related neck injury in 1996. After another application in 1998 alleging a worsened neck condition, the Workers’ Compensation Law Judge found a causally related neck injury and permanent partial disability, awarding benefits from February 5, 1998, which the Board affirmed. Separately, the Board also ruled the employer was entitled to credit schedule payments against disability payments made after February 5, 1998. The court affirmed both decisions, finding substantial evidence supported the deterioration of the neck injury post-1996 and that schedule awards are independent of actual disability periods, thus allowing the employer's credit.

Workers' CompensationPermanent Partial DisabilitySchedule AwardDisability PaymentsNeck InjuryRight Shoulder InjuryCausally Related InjuryReopening CaseMedical EvidenceMRI
References
7
Case No. ADJ4334434 (RIV 0047774) ADJ1332571 (VNO 0485919)
Regular
Sep 02, 2010

TARIK JUSUFBEGOVIC vs. FIESTA FORD LINCOLN MERCURY, STATE COMP. INS. FUND

This case concerns retroactive temporary disability payments for an admitted industrial injury. The applicant argued for higher retroactive payments based on an increased average weekly earnings determination and Labor Code section 4661.5, which mandates payment rates in effect at the time of payment if made more than two years after the injury. The Board reversed the WCJ, ruling that section 4661.5 applies even if some prior payments were made, as long as the payments are for temporary disability and occur more than two years post-injury. Therefore, the award was amended to reflect the higher indemnity rate in effect at the time of the Board's decision. A dissenting opinion argued against this interpretation, favoring the WCJ's narrower application of the statute.

Workers' Compensation Appeals BoardReconsiderationTemporary Total DisabilityAverage Weekly EarningsLabor Code Section 4661.5Hofmeister v. Workers' Comp. AppealsBd.Permanent DisabilityRetroactive Temporary DisabilityMaximum Rate
References
6
Case No. MISSING
Regular Panel Decision

Claim of Guarascio v. Spargo Wire Co.

The claimant, a truck driver, suffered work-related back and shoulder injuries in October 1995. The employer’s workers’ compensation carrier paid benefits. In 2000, the carrier sought reimbursement from the Special Disability Fund under Workers’ Compensation Law § 15 (8) (d) for these payments. A Workers’ Compensation Law Judge (WCLJ) established the claim in 2002 and later found the claimant permanently partially disabled, ruling on apportionment but deferring the reimbursement issue. The WCLJ subsequently found the carrier’s request for reimbursement timely. The Workers’ Compensation Board affirmed this decision. This appeal concerns the Board’s ruling that the carrier’s C-250 claim for reimbursement was timely filed within the statutory 52-week period, despite the underlying claim documents being posted by the Board in 2000.

ReimbursementSpecial Disability FundTimeliness of ClaimPermanent Partial DisabilityWorkers' Compensation LawPreexisting ImpairmentWork-related InjuryC-250 ClaimStatute of LimitationsAppellate Review
References
3
Case No. MISSING
Regular Panel Decision

Claim of Schwartz v. State Insurance Fund

Claimant appealed two Workers' Compensation Board decisions. The first decision, filed April 25, 2012, ruled that her alleged cardiac conditions were not causally related to her established work-related stress claim. The second decision, filed May 2, 2012, denied her payment for intermittent lost time. The court affirmed both decisions, finding that the employer's independent medical examiner complied with Workers' Compensation Law § 137, and the Board's resolution of conflicting medical opinions regarding cardiac conditions was supported by substantial evidence. Additionally, the Board's determination that the claimant's Friday absences were for convenience, not disability, was also upheld by substantial evidence.

Workers' Compensation Board AppealsCausally Related DisabilityCardiac ConditionsHypertensionMitral Valve InsufficiencyTricuspid Valve InsufficiencyEnlarged Left AtriumWork-Related StressAdjustment DisorderIntermittent Lost Time Benefits
References
4
Case No. SJO 0196764, SJO 0196841
Regular
Nov 16, 2007

CONSTANCE KELLOGG vs. CITY OF SANTA CLARA

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration regarding industrial injury findings and permanent disability percentages. However, the Board granted the applicant's petition, amending the original award to reflect the correct temporary disability indemnity rate calculation under Labor Code § 4661.5, adjusting the weekly payments based on different time periods post-injury. This amendment ensures the applicant receives appropriate temporary disability payments based on the statutory wage adjustments over time.

WCABPetition for ReconsiderationFindings and AwardTemporary Total DisabilityPermanent DisabilityApportionmentLabor Code § 4453Labor Code § 4661.5Average Weekly WageIndustrial Injury
References
0
Case No. ADJ6467603
Regular
Apr 05, 2011

TOODY CLITES-PORTER vs. COUNTY OF KERN, SHERIFF'S DEPARTMENT

In this Workers' Compensation Appeals Board decision, the applicant sustained industrial injury to her cardiovascular system. The defendant employer's offer of regular work was found tardy by the WCJ, resulting in a 15% increase in permanent disability payments. However, on reconsideration, the Board amended the decision, finding the employer entitled to a 15% **decrease** in permanent disability payments. This was based on the employer making a timely offer of regular work within a reasonable time after receiving the permanent and stationary report, aligning with the statute's purpose of returning injured employees to work. The matter was returned to the trial level for recalculation of permanent disability indemnity and attorney's fees.

Permanent and stationary dateLabor Code section 4658(d)tardy offer of regular work15 percent decreasepermanent disability paymentsAdministrative Director Rule 10117(b)Ornelaz v. Albertson'sInc.Audiss v. City of Rohnert ParkAgreed Medical Evaluator (AME)
References
2
Case No. MISSING
Regular Panel Decision
Apr 04, 2011

Claim of Stevens v. Hotels

The case concerns an appeal from a Workers' Compensation Board decision that found a workers' compensation carrier's application for reimbursement from the Special Disability Fund to be timely. In 2005, the claimant sustained work-related injuries. The carrier filed a claim for reimbursement in September 2009, based on a medical expert's report acknowledging serious preexisting conditions that significantly increased the claimant's disability. The Special Disability Fund contested the claim's timeliness. The Board ruled the claim was timely, determining that the case was "truly closed" in July 2008, and the C-250 form was filed after reopening and prior to a finding of permanency. The Appellate Division affirmed the Board's decision, concluding that substantial evidence supported the finding that the case was closed in July 2008, thus making the subsequent reimbursement claim timely.

TimelinessReimbursementSpecial Disability FundPreexisting ConditionPermanent Partial DisabilityMaximum Medical ImprovementVocational RehabilitationWorkers' Compensation BenefitsRFA-2 FormC-250 Form
References
4
Case No. MISSING
Regular Panel Decision
Apr 15, 1980

Brock v. Great A & P Tea Co.

The Workers' Compensation Board affirmed a referee's decision to discharge the Special Disability Fund from liability under Workers' Compensation Law section 25-a, concerning a claimant's 1967 back injury that was reopened in 1978. The employer conceded making lost-time payments within three years of reopening, aware of the connection to the 1967 injury, but argued these payments were made under a company sick-leave plan covering disability irrespective of cause. The appellate court reversed this decision, holding that payments made solely due to disability, without regard to its cause, do not constitute "advance payments of compensation" as defined under subdivision 1 of section 25-a of the Workers' Compensation Law, thus impacting the Special Fund's liability. The matter was remitted to the Board for further proceedings consistent with this ruling.

Workers' Compensation LawSpecial Disability FundSection 25-aAdvance Payments of CompensationSick Leave PlanEmployer LiabilityDisability BenefitsCase ReopeningLost Time PaymentAppellate Division
References
5
Case No. MISSING
Regular Panel Decision

Soper v. Gouverneur Talc Co.

This case involves a claimant who suffered from occupational lung disease and hearing loss while employed by the same employer. The Workers' Compensation Board initially awarded benefits for both disabilities, including a schedule award for hearing loss and benefits for total disability due to lung problems. An issue of overpayment arose because concurrent payments for a schedule award and total disability are not legally permissible. The employer's insurance carrier sought to recoup overpayments. The Workers' Compensation Law Judge and subsequently the Workers' Compensation Board affirmed the carrier's right to a credit for the overpaid amounts. This appellate court upheld the carrier's entitlement to a credit for payments made on the schedule award after the date of total disablement, but reversed the Board's decision regarding the payment timing of the remaining schedule award and remitted the matter for determination of the recoupment method.

Workers' CompensationOccupational DiseaseHearing LossLung DiseaseConcurrent PaymentsSchedule AwardTotal DisabilityOverpaymentRecoupmentAppellate Review
References
10
Case No. ADJ6413657
Regular
Feb 26, 2009

LUIS PENA vs. CITY OF SANTA ROSA

The City of Santa Rosa sought reconsideration of a Stipulated Award that adjusted permanent disability payments under Labor Code section 4658(d) starting March 25, 2008. The Board denied the petition, finding the employer's argument that the 15% reduction applied retroactively to all payments was erroneous. The employer failed to comply with statutory requirements for providing notice of permanent disability status and commencing timely payments after temporary disability ended. Consequently, the employer is not entitled to the benefit of the Labor Code section 4658(d) reduction due to its own statutory non-compliance.

Workers' Compensation Appeals BoardStipulated AwardPermanent Disability IndemnityLabor Code section 4658(d)Police OfficerIndustrial InjuryLow BackPermanent and StationaryOffer of Regular WorkLabor Code section 4061
References
1
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