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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

Claim of Pugliese v. Remington Arms, Inc.

The claimant, employed by Remington Arms, Inc. for over three decades, sought workers' compensation benefits, citing severe depression and anxiety stemming from alleged harassment and falsification of attendance records by a supervisor. Initially, a Workers' Compensation Law Judge denied further adjournments for an independent medical examination (IME) report and cross-examination of the treating psychologist, determining the depression to be an occupational disease. The Workers' Compensation Board subsequently modified this, reclassifying it as a compensable accidental injury. The employer and its carrier appealed, challenging the use of hearsay evidence, the preclusion of their IME report, and the denial of their right to cross-examine the claimant's treating psychologist. The appellate court found sufficient corroboration for the hearsay evidence and upheld the IME report's preclusion due to the carrier's delays. However, the court reversed the denial of cross-examination, stating that the absence of the IME report did not negate the carrier's right, especially given their dispute on causal relationship. Consequently, the case was reversed and remitted to the Workers' Compensation Board for further proceedings.

DepressionAnxietyWorkplace HarassmentAttendance Records FalsificationIndependent Medical ExaminationIME Report PreclusionRight to Cross-ExaminationHearsay EvidenceCorroborating EvidenceOccupational Disease
References
11
Case No. ADJ3103905
Regular
Oct 28, 2011

JOSE PENALOZA VALDEZ vs. MANUEL AVILA, TRANSGUARD INSURANCE, Administered By FRYE CLAIMS CONSULTATION

This case concerns an applicant awarded 68% permanent disability, including a significant portion for psyche injury, based on a psychologist's report. The defendant appeals, arguing the psychologist's report was improperly admitted and they were denied the opportunity for rebuttal. The Appeals Board rescinded the award, finding that while the report was admissible, the defendant should have been allowed to obtain a rebuttal report, especially since the psychologist was not the primary treating physician. The case is returned for further proceedings to develop the record regarding the psyche injury and disability claims.

Workers' Compensation Appeals BoardPetition for ReconsiderationIndustrial InjuryPsyche InjuryPermanent DisabilityMedical Report AdmissibilityQualified Medical EvaluatorAgreed Medical EvaluatorDeclaration of Readiness to ProceedMandatory Settlement Conference
References
0
Case No. ADJ9549773
Regular
Nov 13, 2015

EDWARD BAUTISTA vs. ARLON GRAPHICS, TRAVELERS

The Appeals Board dismissed the applicant's petition for reconsideration or removal, finding the WCJ's order was not a final determination. The WCJ correctly ordered the applicant to first discuss his anxiety symptoms and need for psychological referral with his primary treating orthopedist. Applicant is not entitled to a second opinion from a psychologist until the primary treating physician has diagnosed the anxiety or determined a referral is unnecessary. Commissioner Sweeney dissented, believing the applicant had an absolute right to an MPN second opinion for his psychiatric condition without first obtaining a referral from his orthopedist.

ADJ9549773Arlon GraphicsTravelersPetition for ReconsiderationPetition for RemovalWorkers' Compensation Appeals BoardWCJLabor Code Section 4616.3Labor Code Section 4616.4Administrative Director Rules
References
4
Case No. MISSING
Regular Panel Decision

Harris v. Colvin

Maleesha Harris challenged the Acting Commissioner of Social Security's denial of her Supplemental Security Income (SSI) application. The District Court found that the Administrative Law Judge (ALJ) made several errors in evaluating Harris's disability claim, specifically regarding the weight given to treating physician opinions. The ALJ improperly discounted the opinions of Harris's treating psychiatrist, Dr. Spurling, and consultative psychologist, Dr. Lin. The court concluded that when proper deference is given to the medical opinions, a finding of disability is compelled, reversing the Commissioner's decision and remanding for calculation and payment of benefits.

Social Security ActSupplemental Security IncomeDisability BenefitsAdministrative Law Judge ErrorTreating Physician RuleMental ImpairmentBipolar DisorderAnxiety DisorderResidual Functional CapacityCredibility Assessment
References
34
Case No. MISSING
Regular Panel Decision

In re K.M.

The New York County District Attorney's Office (DA) filed an ex parte application for a subpoena duces tecum seeking K.M.'s psychiatric records and access to treating hospital staff. K.M. was committed to the Commissioner of Mental Health after pleading not responsible by reason of mental disease or defect. The court granted the DA's request for K.M.'s psychiatric records but denied the request to interview treating psychiatrists and psychologists, citing psychotherapist-patient privilege. The court found that the interests of justice did not significantly outweigh K.M.'s right to confidentiality, suggesting that the DA could interview a member of Kirby's Psychiatric Committee instead.

Mental HealthPsychiatric RecordsSubpoena Duces TecumPsychotherapist-Patient PrivilegeConfidentialityCPL 330.20Dangerous Mental ConditionWaiver of PrivilegeNew York LawCriminal Procedure Law
References
4
Case No. ADJ7099916
Regular
Jun 20, 2014

ANGELICA SANCHEZ vs. TORRES FARM LABOR, SEABRIGHT INSURANCE COMPANY

The defendant sought reconsideration of an award finding industrial injury to the applicant's cervical spine and psyche, in addition to admitted injuries, and awarding temporary disability. The defendant argued the temporary disability award was improper as the psychologist relied upon by the judge did not review orthopedic records, and that EDD benefits should be credited. The WCJ conceded the temporary disability finding lacked substantial evidence, agreeing the psychologist's opinion was insufficient due to lack of review of the orthopedic records. The Appeals Board granted reconsideration, adopting the WCJ's recommendation to limit temporary disability to the period found by the orthopedic QME. A dissenting opinion argued that substantial evidence, including the primary treating physician's reports, supported the initial temporary disability award.

Workers' Compensation Appeals BoardPetition for ReconsiderationDecision After ReconsiderationTemporary Disability IndemnityPsychiatric InjuryOrthopedic InjurySubstantial Medical EvidenceQualified Medical EvaluatorApportionmentPermanent Disability
References
0
Case No. MISSING
Regular Panel Decision

In re Evelyn B.

The petitioner initiated proceedings to terminate the parental rights of the respondent, mother of Evelyn B., alleging mental illness or retardation after Evelyn B. was adjudicated neglected. The Family Court, Clinton County, terminated parental rights, relying on testimony from a court-appointed clinical psychologist who diagnosed the respondent with an untreatable learning disorder and mixed personality disorder, rendering her unable to provide proper care. The respondent appealed, presenting testimony from her treating therapist suggesting potential improvement. The appellate court affirmed the Family Court's decision, finding clear and convincing evidence supporting the termination due to the respondent's mental illness and upholding the Family Court's discretion in crediting the court-appointed psychologist over the respondent's therapist, whose expert qualification was also appropriately denied.

Parental Rights TerminationMental IllnessChild NeglectFamily LawAppellate ReviewClinical PsychologyForensic EvaluationPersonality DisorderLearning DisorderExpert Witness Credibility
References
6
Case No. VNO 0462079
Regular
Jul 11, 2007

JONAS MORENO vs. FILTERCOR, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's untimely petition for reconsideration of an approved compromise and release settlement. Despite the untimeliness, the WCAB remanded the matter to the administrative law judge to treat the petition as a request to reopen the case. This allows for further proceedings on the merits of the lien claimant's claim.

Petition for ReconsiderationPetition to ReopenUntimely FilingService by MailDefective ServiceLabor Code Sections 5803Labor Code Sections 5804Compromise and ReleaseLien ClaimantWorkers' Compensation Appeals Board
References
1
Case No. ADJ1377755 (FRE 0242857) ADJ1891281 (FRE 0242858)
Regular
Oct 11, 2010

RUDOLPH GUTIERREZ vs. DERREL'S MINI STORAGE, BERKSHIRE HATHAWAY HOMESTATE, CO.

The Workers' Compensation Appeals Board dismissed Applicant Gutierrez's petition for reconsideration of a January 19, 2010 stipulation and order. Applicant contended the settlement was not secured with his consent. The Board treated his petition as a motion to set aside the award. The case is returned to the trial level for the judge to consider the set-aside petition and conduct further proceedings.

Workers' Compensation Appeals BoardReconsiderationPetition to Set AsideStipulation and OrderPro SeAdministrative Law JudgeDismissedReturned to Trial LevelAwardConsent
References
0
Case No. ADJ9834159 (MF) ADJ9834161
Regular
Jul 30, 2018

ESAU HERNANDEZ vs. D.L. BONE AND SONS PAINTING, ICW GROUP/EXPLORER INSURANCE COMPANY, STATE COMPENSATION INSURANCE FUND

This case concerns a defendant's attempt to obtain a replacement Qualified Medical Evaluator (QME) panel after the applicant initially objected to the timeliness of the original QME's report. The Appeals Board treated the defendant's petition as one for removal and denied it. The Board found that the defendant, having failed to timely object to the QME's report itself, could not rely on the applicant's subsequent objection to request a new panel. The Board concluded that the defendant's failure to act promptly meant they were not entitled to a replacement QME panel, and no substantial prejudice or irreparable harm warranting removal was demonstrated.

Workers' Compensation Appeals BoardReconsiderationRemovalQualified Medical EvaluatorQME panelAdministrative Director RuleTimeliness objectionReplacement QME panelLabor CodeFindings of Fact
References
1
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