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Case Law Database

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

Case No. MISSING
Regular Panel Decision

Brennan v. Bally Total Fitness

Kathryn Brennan filed a civil rights action against her former employer, Bally Total Fitness Corp., alleging sexual harassment under Title VII and disability discrimination under the ADA. Bally moved to dismiss the complaint as untimely and to compel arbitration based on its Employee Dispute Resolution Procedure (EDRP). The court denied Bally's motion to dismiss the Title VII claim, applying the 'continuing-violation exception' due to Brennan's allegations of ongoing harassment. The court also denied Bally's motion to compel arbitration, finding Bally's unilateral modifications to the EDRP invalid and raising questions of unconscionability regarding the original EDRP. The case is remanded for jurisdictional discovery and a possible hearing to determine the validity of the arbitration agreement.

Civil RightsSexual HarassmentDisability DiscriminationTitle VIIAmericans with Disabilities Act (ADA)Arbitration AgreementFederal Arbitration Act (FAA)Motion to DismissMotion to Compel ArbitrationContinuing Violation Exception
References
27
Case No. ADJ8134312
Regular
Sep 15, 2016

ERNIE GALLEGOS vs. GROTH BROTHERS CHEVROLET, AUTO DEALERS COMPENSATION OF CALIFORNIA, CORVEL

The applicant sustained a right knee injury, leading to a total knee replacement. The original award granted permanent disability without apportionment, which the defendant appealed. The Appeals Board granted reconsideration, finding that apportionment to pre-existing knee conditions was legally permissible even after total knee replacement. The case is remanded for a new award based on the Qualified Medical Evaluator's 50% apportionment to pre-existing pathology. A dissenting opinion argues the medical evidence lacked sufficient reasoning to support apportionment.

WORKERS' COMPENSATION APPEALS BOARDERNE GALLEGOSGROTH BROTHERS CHEVROLETAUTO DEALERS COMPENSATION OF CALIFORNIACORVELADJ8134312PETITION FOR RECONSIDERATIONFINDINGS AND AWARDPERMANENT DISABILITYAPPORTIONMENT
References
5
Case No. FRE 191206
Regular
Nov 20, 2007

MARY SEPEDA vs. SEPEDA BROTHERS DAIRY, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION on behalf of FREMONT INDEMNITY, in liquidation, REPUBLIC INDEMNITY

This case involves an applicant seeking reconsideration of a workers' compensation award concerning a low back injury sustained through July 13, 1995. The applicant, supported by her treating physician, argued for additional disc replacement surgery at the L4-5 level beyond the previously awarded L5-S1 spinal fusion. The Workers' Compensation Appeals Board granted reconsideration and amended the award to include the L4-5 disc replacement surgery, finding it reasonably required to cure or relieve the applicant's injury based on the treating physician's opinion.

CIGAFremont IndemnityRepublic Indemnitylow back injurypermanent disabilityfurther medical treatmentspinal surgeryL5-S1 fusionL4-5 disc replacementtreating physician
References
2
Case No. MISSING
Regular Panel Decision

Claim of Harrington v. L.C. Whitford Co.

The claimant, a construction worker, experienced a severe exacerbation of pre-existing asthma after exposure to burning lead paint fumes in June 1996. A certified pulmonologist, Richard Evans, determined the exposure caused a permanent and total disability. A Workers' Compensation Law Judge (WCLJ) found an accidental injury causing permanent and total disability, which the Workers' Compensation Board affirmed in August 2001. The employer and carrier appealed, arguing the condition was pre-existing and only temporarily aggravated. The appellate court affirmed the Board's decision, finding substantial evidence to support that the work-site exposure significantly exacerbated the claimant's stabilized asthma, leading to a permanent and total disability.

Workers' CompensationPermanent Total DisabilityAsthma ExacerbationOccupational ExposureLead Paint FumesPre-existing ConditionMedical Expert TestimonySubstantial EvidenceAppellate ReviewIndustrial Accident
References
14
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. MISSING
Regular Panel Decision

Claim of Kowalchyk v. Wade Lupe Construction Co.

The claimant, a carpenter over 60 with an 11th-grade education, fractured his back and wrist in August 1985 while on a construction jobsite. Initially, his physician, Dr. James Slavin, considered him totally disabled, and he received total disability benefits from his employer's carrier. However, in December 1985, the employer reduced benefits to a partial disability rate, relying on a report from their consultant, Dr. Edward Pasquarella. The claimant subsequently filed for compensation, leading to a determination by the Workers’ Compensation Law Judge and ultimately the Workers’ Compensation Board that he had a total industrial disability. The employer appealed this decision, arguing it lacked substantial evidence. The court affirmed the Board's decision, considering the claimant’s physical limitations, age, work experience, and limited education, concluding he had no marketable skills outside carpentry.

Workers' CompensationTotal Industrial DisabilityPartial DisabilityMedical Testimony ConflictEarning Capacity AssessmentAppellate ReviewVocational RehabilitationAge & Education FactorsCarpenter InjuryScaffold Accident
References
3
Case No. MISSING
Regular Panel Decision

Matter of Williams v. Preferred Meal Systems

Claimant, a driver, suffered injuries to his right knee and back in 2009 while making a delivery, leading to an established workers' compensation claim. The claim was later amended to include consequential adjustment disorder, and the Workers' Compensation Board ultimately found that claimant had sustained a permanent total disability from May 2012 onward. The employer, workers’ compensation carrier, and policy administrator appealed this decision, arguing that further proof was needed regarding claimant's vocational and functional capacity. The court affirmed the Board's decision, holding that extensive evidence of vocational and functional capacity is not required when medical proof demonstrates a permanent total disability and inability to engage in any gainful employment, as benefits continue for life in such cases. The court found substantial evidence in the opinions of treating and independent medical examination orthopedists to support the finding of permanent total disability.

Workers' CompensationPermanent Total DisabilityWage-Earning CapacityMedical ProofVocational CapacityFunctional CapacityAppellate ReviewNew York LawDisability BenefitsClaimant Rights
References
4
Case No. MISSING
Regular Panel Decision

Matter of Paez v. Lackman Culinary Services

Claimant, an immigrant, injured his lower back while working as a food service worker in 2010. His workers' compensation claim was established, leading to surgery in 2012 for a herniated disc. Despite surgery, he continued to experience pain and was unable to return to his job. A WCLJ determined he had a permanent partial disability and an 80% loss of wage-earning capacity, which was affirmed by the Workers' Compensation Board. Claimant appealed, arguing the Board failed to consider total industrial disability, an issue he had raised before the WCLJ. The appellate court found that the Board did err by not addressing the total industrial disability claim and remitted the matter for further proceedings, as total industrial disability can have a more favorable outcome than loss of wage-earning capacity.

Permanent Partial DisabilityWage-Earning CapacityTotal Industrial DisabilityLumbar DiscectomyLaminectomyMedical ExaminationRemittalAppellate ReviewBack InjuryFood Service Worker
References
4
Case No. MISSING
Regular Panel Decision

Singletary v. Apfel

Plaintiff Sylvester M. Singletary appealed the Commissioner of Social Security's denial of disability insurance benefits, leading to this action under 42 U.S.C. § 405(g). The Court reviewed the final determination, including an Administrative Law Judge's decision, which the Appeals Council upheld. The central issue revolved around the ALJ's rejection of Singletary's treating physician's opinion of total disability, which the ALJ deemed unsupported by objective evidence, specifically the absence of disc herniation. The Court found that the ALJ arbitrarily substituted his lay opinion for competent medical evidence and ignored other objective findings like degenerative disc disease and disc bulging. Consequently, the Commissioner’s decision was not supported by substantial evidence, and the case was remanded solely for the calculation of benefits, with the plaintiff's motion for judgment on the pleadings granted.

Disability BenefitsSocial Security ActTreating Physician RuleSubstantial Evidence ReviewDegenerative Disc DiseaseChronic PainSpinal ImpairmentALJ ErrorRemandFederal Court Review
References
13
Case No. MISSING
Regular Panel Decision

Claim of Filipowicz v. De Laval Separator Co.

This case concerns an appeal by an employer and carrier challenging an award for total disability due to silicosis. It was conceded that the claimant suffered from silicosis and was permanently and totally disabled. Appellants argued that there was no proof of injurious exposure during the claimant's last employment with the employer. However, evidence showed the claimant worked as a trucker in the employer's rubber plant, where he was exposed to talc containing silica. The board found sufficient evidence of a causal relationship between this exposure and the claimant's disability, thus affirming the award.

SilicosisOccupational DiseaseTotal DisabilityInjurious ExposureTalc ExposureFoundry WorkerRubber PlantWorkers' Compensation BoardCausal Relation
References
2
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