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Case Law Database

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

Case No. 2016-07-0351
Regular Panel Decision
Nov 08, 2016

Crumble, Mae v. Express Services

This expedited hearing order addresses a workers' compensation claim filed by Mae Crumble against Express Services and New Hampshire Ins. Co. for a right shoulder injury sustained on November 14, 2015. The case was remanded by the Tennessee Workers’ Compensation Appeals Board to determine if Dr. Sioson was an authorized treating physician whose causation opinion was entitled to a presumption of correctness. The Court found that Express Services failed to provide Ms. Crumble with a valid panel of physicians, noting issues with the selection process and Ms. Crumble's intellectual limitations. Consequently, Dr. Sioson's opinion was not afforded a presumption of correctness, and the Court determined it did not meet the legal standard for causation. The Court ordered Express Services to provide Ms. Crumble with a new, valid panel of physicians to evaluate and treat her injury.

Medical BenefitsExpedited HearingRemandAuthorized Treating PhysicianCausation OpinionPanel of PhysiciansRight Shoulder InjuryMedical ExaminationEmployer's DutyEmployee Selection
References
4
Case No. ADJ9343248
Regular
Dec 07, 2017

LONNY BUBAK vs. SOLANO COUNTY SHERIFFS DEPARTMENT

This case, concerning a workers' compensation claim by Lonny Bubak against Solano County Sheriff's Department, involves the application of Labor Code section 4062.9, which presumes the correctness of a treating physician's opinion. The Appeals Board denied the defendant's petition for reconsideration, affirming the administrative law judge's finding that the defendant failed to rebut this presumption. This means the defendant did not provide sufficient evidence to disprove the industrial nature of the injury as determined by the treating physician. Therefore, the Appeals Board was bound to accept the treating physician's opinion as correct.

Workers' Compensation Appeals BoardPetition for ReconsiderationAdministrative Law JudgePresumptionLabor Code Section 4062.9Treating PhysicianBurden of ProofRebuttalIndustrial RelationshipSolano County Sheriffs Department
References
2
Case No. 2015-01-0281
Regular Panel Decision
Mar 19, 2018

Tucker, David E. v. Star Transportation

David Tucker, an employee of Star Transportation, sought to change his treating physician for a shoulder injury sustained on July 1, 2015. He expressed a loss of confidence in Dr. Mejia due to perceived ineffectual treatment, improper impairment assessment methodology, and the physician's refusal to complete a Physician Certification Form. The Court, citing precedents like Scott v. Integrity Staffing Solutions and Baker v. Electrolux, found no legal basis to compel the employer to provide a new panel of physicians. The Court ruled that Mr. Tucker's subjective dissatisfaction and the alleged inadequacies of Dr. Mejia did not warrant a change in treating physician.

Workers' CompensationShoulder InjuryTreating PhysicianMedical TreatmentImpairment RatingAMA GuidesTennessee LawRight to Control Medical TreatmentPhysician Certification FormMMI (Maximum Medical Improvement)
References
3
Case No. MISSING
Regular Panel Decision

New York State Correctional Officer & Police Benevolent Ass'n v. New York State Department of Correctional Services

Elsie Pierre, a correction officer, sustained a work-related injury in May 2004, leading to workers’ compensation leave. Respondent Department of Correctional Services initiated termination proceedings, but a medical evaluation by respondent's designated physician on September 15, 2005, found her unfit for duty. Pierre's physician, Sanford Wert, later cleared her for work on June 12, 2006, a finding supported by a Hearing Officer who recommended reinstatement with retroactive pay. Respondent, however, rejected the full retroactive award, granting pay only from October 12, 2007, arguing that Pierre had not properly exhausted administrative remedies for the earlier date and that an independent evaluation was lacking. Petitioners challenged this limited retroactive pay, but the Court confirmed the respondent's determination, dismissing the petition and upholding the October 12, 2007, start date for back pay.

Workers' Compensation LeaveRetroactive Back PayCivil Service LawAdministrative ReviewFitness for DutyMedical Evaluation DisputeCorrection Officer EmploymentCPLR Article 78 ProceedingJudicial DiscretionAppellate Court Decision
References
1
Case No. MISSING
Regular Panel Decision
Aug 21, 1998

Westchester County Correction Officers Benevolent Ass'n v. County of Westchester

The County of Westchester appealed orders from the Supreme Court, Westchester County. The Supreme Court had granted the Westchester County Correction Officers Benevolent Association, Inc.'s petition to quash administrative subpoenas (Matter No. 1) and denied the County's motion to enjoin the Association from challenging the subpoenas (Matter No. 2). The appellate court affirmed both orders, finding that the County failed to adhere to Workers’ Compensation Law § 300.10 (c). This statute mandates that subpoenas to a claimant's treating physician can only be issued upon the physician's non-appearance at the first adjournment, not as a routine practice prior to attempts at voluntary appearance. The court emphasized that the County's prior practice violated the statute and impeded the remedial goals of the Workers' Compensation Law.

Administrative LawWorkers' CompensationSubpoena ComplianceAppellate CourtLabor RelationsStatutory InterpretationDue ProcessCollective BargainingJudicial ReviewPublic Sector Employment
References
3
Case No. 2018-03-1494
Regular Panel Decision
May 24, 2019

Stephens, Tonya Lynn v. Quality Private Care d/b/a Volunteer Staffing, Inc.

Ms. Tonya Lynn Stephens, a Licensed Practical Nurse, sustained work-related injuries including a left shoulder injury, leading to a diagnosis of Complex Regional Pain Syndrome (CRPS). Her authorized treating physician, Dr. David Newman, prescribed compounded creams as part of her pain management treatment. This prescription was initially denied by a Utilization Review physician, but the Court of Workers’ Compensation Claims at Knoxville reviewed the case based on an expedited hearing request. The court, presided over by Judge Lisa A. Lowe, found Dr. Newman's recommendations to be medically necessary and upheld the presumption of correctness for the authorized treating physician's orders. Consequently, the court ordered the employer, Quality Private Care, and its carrier, Bridgefield Casualty Insurance Company, to provide the recommended compounded creams to Ms. Stephens.

Workers' CompensationCRPSCompounded CreamsMedical TreatmentUtilization ReviewPain ManagementShoulder InjuryLumbar Facet SyndromeExpedited HearingMedical Necessity
References
4
Case No. 2018-01-0388
Regular Panel Decision
Jan 08, 2019

Vanveldhuizen, John v. Crown Automotive Group, Inc.

John Vanveldhuizen, an employee, requested an expedited hearing against Crown Automotive Group, Inc. and FFVA Mutual Ins. Co. concerning the authorization of a third lumbar surgery recommended by his treating physician, Dr. Jay Jolley. Crown denied the surgery based on a utilization review physician's opinion, Dr. Richard Lutz, who deemed it not medically necessary. The Court, however, sided with the treating physician, Dr. Jolley, affording his opinion a presumption of medical necessity due to his long history of treating the employee and the lack of compelling evidence from Crown to rebut this presumption. Ultimately, the Court ordered Crown to authorize the recommended surgery.

Lumbar surgeryMicrodiskectomyFusion surgeryRadiculopathyDisk herniationUtilization reviewMedical necessityTreating physicianExpedited hearingWorkers' Compensation Appeals Board
References
5
Case No. 2015-01-0339
Regular Panel Decision
Jan 17, 2017

Darraj, Jamal v. McKee Foods Corporation

The employee, Jamal Darraj, sought workers’ compensation benefits for a gradual, repetitive injury to his hands and arms. The authorized treating physician opined that the condition was not primarily work-related, while the employee presented expert opinions suggesting a work-related cause. Following a trial, the court denied the employee’s claim, concluding that the medical evidence offered by the employee did not overcome the presumption of correctness accorded the authorized treating physician’s opinion, partly due to incomplete medical reports. The Workers’ Compensation Appeals Board affirmed the trial court’s determination, dismissed the employee’s claim, and certified the compensation order as final.

Workers' Compensation BenefitsRepetitive Strain InjuryUpper Extremity ArthritisMedical CausationPresumption of CorrectnessExpert Medical OpinionPro Se LitigantAppellate ReviewAbuse of DiscretionIncomplete Medical Reports
References
10
Case No. 2017-08-0772
Regular Panel Decision
Jun 20, 2018

Wallis,Jeffrey v. Baptist Memorial Hospital

The employee, Jeffrey D. Wallis, a patient care assistant, alleged a low back injury while assisting a patient. Initially, the employer, Baptist Memorial Hospital, accepted the claim, but later denied it based on the authorized treating physician's opinion that the condition was not work-related. Following an expedited hearing, the trial court found sufficient evidence to rebut the statutory presumption of correctness of the treating physician's causation opinion and ordered ongoing medical and temporary disability benefits. The employer appealed this decision. The Appeals Board affirmed the trial court's decision, concluding that the employee successfully rebutted the causation opinion and was likely to prevail at trial, and remanded the case.

Worker's CompensationBack InjuryCausation OpinionStatutory PresumptionRebuttal of PresumptionMedical BenefitsTemporary Disability BenefitsAppellate ReviewTrial Court DecisionTreating Physician
References
9
Case No. 2016-05-0536
Regular Panel Decision
Jan 13, 2017

Henderson, Deonya v. Staff Management/SMX

Deonya Henderson sought expedited medical and temporary disability benefits for a neck injury allegedly sustained at work on February 27, 2016. The Workers' Compensation Judge, Dale Tipps, reviewed the evidence, including conflicting medical opinions regarding causation. The authorized treating physician, Dr. William Ledbetter, stated the work injury did not contribute more than 50% to her condition, an opinion presumed correct under Tennessee law. While another physician, Dr. Juris Shibayama, attributed causation to the work incident, his opinion's foundation was deemed uncertain due to potentially inaccurate patient history. Consequently, the Court found Ms. Henderson failed to rebut the presumption of correctness and denied her request for benefits, setting a scheduling hearing for further proceedings.

Workers' CompensationExpedited HearingCausationMedical BenefitsTemporary DisabilityNeck InjuryPre-existing ConditionAuthorized Physician PresumptionBurden of ProofMedical Opinion
References
1
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