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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 Dusharm v. Green Island Contracting, LLC

Claimant, a labor supervisor, allegedly sustained a work-related back injury in April 2006 but significantly delayed seeking medical treatment and applying for workers' compensation benefits. A Workers' Compensation Law Judge initially awarded benefits, but the Workers' Compensation Board reversed the decision, citing the claimant's failure to provide timely written notice to his employer as mandated by Workers' Compensation Law § 18. The Board, exercising its discretion, refused to excuse this lack of written notice, concluding that the employer was prejudiced by the delay due to inconsistencies in the claimant's statements and his extensive medical history. The Board considered factors like the delay in treatment, failure to initially mention the work injury to medical providers, a previous 20-year history of back pain, and failure to miss work for over a year. The appellate court affirmed the Board's determination, finding its exercise of discretion to be based on substantial evidence.

Workers' CompensationTimely NoticeEmployer PrejudiceBoard DiscretionOral NoticeBack InjuryAppellate ReviewSubstantial EvidenceClaimant DelayMedical Treatment
References
4
Case No. MISSING
Regular Panel Decision
Jan 22, 2004

Mete v. New York State Office of Mental Retardation

This class action alleged age discrimination in employment against the New York State Office of Mental Retardation and Development Disabilities (OMRDD). Plaintiffs, former Chiefs of Developmental Center Treatment Services, claimed disparate treatment and disparate impact arising from a 1989 reduction in force (RIF) that eliminated their positions. All 46 Chiefs, who were over 40, were either demoted or retired, and statistical evidence showed a disproportionate impact on employees over 40. The Supreme Court granted defendants’ motion for summary judgment, dismissing all causes of action. The appellate court affirmed, finding that while plaintiffs established a prima facie case, OMRDD provided a legitimate, nondiscriminatory reason for the RIF (economic conditions and long-standing concerns about the position's utility), which plaintiffs failed to adequately prove was a pretext for discrimination.

Age DiscriminationClass ActionSummary JudgmentDisparate TreatmentDisparate ImpactReduction in ForceEmployment LawPretextPrima Facie CaseStatistical Evidence
References
11
Case No. MISSING
Regular Panel Decision

Claim of Evevsky v. Liberty Mutual Group

This case involves an appeal from a Workers’ Compensation Board decision regarding a claimant's unauthorized medical treatment. The claimant, who sustained neck and shoulder injuries in 1993, had her case reopened in 2001 after the employer's carrier objected to her request for authorized massage therapy. Both the Workers’ Compensation Law Judge and the Board determined that the treatment was not authorized under Workers’ Compensation Law § 13-b, as the massage therapist was not Board-authorized nor supervised by an authorized physician. The appellate court reviewed the Board's decision, affirming that there was no legal basis to overturn the finding. The court also considered and dismissed the claimant's constitutional arguments as being without merit.

Workers' CompensationMedical TreatmentMassage TherapyAuthorizationBoard DecisionAppellate ReviewStatutory InterpretationPhysician SupervisionConstitutionalityPermanent Partial Disability
References
3
Case No. ADJ2596798
Regular
Jul 11, 1941

MINERVA BUTLER vs. COUNTY OF RIVERSIDE

This case involves a lien claimant, Universal Psychiatric, seeking reconsideration after their claim for medical treatment costs was denied. The claimant asserted industrial injury to Minerva Butler's psyche and internals, but the Administrative Law Judge found the lien claimant failed to meet its burden of proof. Medical evaluations, including those by Dr. Reichwald and Dr. Soltz, presented conflicting histories and failed to establish an industrial causation for the psychiatric treatment, with significant non-industrial factors and pre-existing conditions noted. The Workers' Compensation Appeals Board adopted the judge's report and denied the petition for reconsideration.

WCABReconsiderationLien ClaimACOEM GuidelinesAOE/COECompromise and ReleaseMedical-Legal EvaluationPrimary Treating PhysicianMedical Provider NetworkAgreed Medical Examiner
References
0
Case No. ADJ8424952
Regular
Sep 10, 2014

ALFONSO CRUZ vs. SIERRA CIRCUITS, INC.; THE HARTFORD

This case involves an applicant's petition for removal regarding deposition questions about medical history and insurance coverage. The Workers' Compensation Appeals Board (WCAB) granted the petition in part, allowing questions about medical insurance and personal doctors, as these are discoverable under CCP § 2017.010. However, the WCAB found questions about past medical treatment paid by others and prior hospitalizations to be overbroad, as they could infringe on the physician-patient privilege regarding unrelated conditions. The Board ordered the applicant to answer specific questions but requires defendants to reframe broader questions concerning medical history to avoid privileged information.

Petition for RemovalFifth AmendmentFirst Amendmentphysician-patient privilegeconfidential communicationindustrial injurymedical historydeposition questionsCode of Civil Procedure section 2017.010Evidence Code sections 990
References
3
Case No. ADJ532181 (SFO 0438716) ADJ250509 (SFO 0242560) ADJ6545137
Regular
Nov 14, 2014

MICHAEL THOMAS, vs. SAFEWAY STORES, INC. Permissibly Self-Insured,

This case involved an applicant seeking treatment from a highly specialized surgeon, Dr. Matsen, located in Seattle, for a complex shoulder revision. The original decision denied authorization for Dr. Matsen, deeming Seattle outside a reasonable geographic area, and excluded a crucial report from the applicant's treating physician, Dr. Osborn. The Appeals Board granted reconsideration, admitting Dr. Osborn's report, which strongly supported Dr. Matsen's expertise and the inadequacy of local Bay Area surgeons for this complex case. Based on the applicant's medical history and the availability of specialized treatment, the Board reversed the original decision, finding Dr. Matsen to be within a reasonable geographic area.

Workers' Compensation Appeals BoardReasonable geographic areaTreating surgeonAdministrative Director Rule 9780Labor Code section 4600Orthopedic surgeonTotal shoulder replacementRevision surgeryMedical historyPhysician competency
References
1
Case No. 2019 NY Slip Op 09336 [178 AD3d 1312]
Regular Panel Decision
Dec 26, 2019

Matter of Trusewicz v. Delta Envtl.

Claimant Roman Trusewicz filed for workers' compensation benefits alleging injuries from prolonged asbestos handling, having previously received treatment for the same body parts. At a hearing, the Workers' Compensation Law Judge (WCLJ) directed him to provide an open-ended HIPAA medical release for all treatment records, despite his request to limit it to only the claimed sites of injury. The Workers' Compensation Board upheld the WCLJ's decision. On appeal, the Appellate Division, Third Department, reversed, holding that the Board erred by requiring an unlimited medical release, as regulations specify that only a limited release for relevant medical records regarding the prior medical history of the body part or illness at issue is required.

Workers' compensationmedical recordsHIPAA releaseprior injurylimited releaseunlimited releaseemployer's rightsclaimant's rightsmedical treatmentBoard decision
References
2
Case No. 2022 NY Slip Op 06524
Regular Panel Decision
Nov 17, 2022

Matter of Yearwood v. Long Is. Univ.

Claimant Trina Yearwood sought workers' compensation benefits for bilateral wrist, hand, and thumb pain, diagnosed as an occupational disease from repetitive stress. A Workers' Compensation Law Judge (WCLJ) initially established the claim. However, the Workers' Compensation Board reversed this decision and disallowed the claim because Yearwood failed to disclose a prior 2014 treatment history for hand problems to her treating physician, the IME physician, or the Board. The Appellate Division, Third Department, affirmed the Board's decision, finding that the Board rationally concluded the medical providers lacked sufficient understanding of claimant's complete medical history to proffer a credible opinion on causation, and thus her medical proof was insufficient.

Workers' Compensation BenefitsOccupational DiseaseRepetitive Stress InjuryCarpal Tunnel SyndromeMedical Evidence CredibilityTreatment History NondisclosureCausal ConnectionIndependent Medical ExaminationAppellate ReviewBoard Discretion
References
11
Case No. MISSING
Regular Panel Decision

Claim of Siddon v. Advance Energy Technologies

The case involves an appeal by a claimant from an amended decision of the Workers’ Compensation Board, which found she violated Workers’ Compensation Law § 114-a and disqualified her from future wage replacement benefits. The claimant had misrepresented her prior medical history regarding back injuries, initially denying any previous treatment or missed work due to back pain before her 2006 injury. However, medical records contradicted her testimony, showing multiple instances of back pain and treatment between 1993 and 2006. The Board concluded these omissions constituted a material misrepresentation, leading to the forfeiture of benefits and disqualification. The appellate court affirmed the Board's decision, citing substantial evidence to support the finding of a material misrepresentation and the appropriateness of the penalty.

Workers' CompensationFraudMisrepresentationPrior InjuryBack PainForfeiture of BenefitsDisqualificationCredibility IssueSubstantial EvidenceAppellate Review
References
4
Case No. MISSING
Regular Panel Decision

In Re McKenzie

The case concerns the confirmation of a Chapter 13 plan proposed by John A. McKenzie, the debtor. The plan included a controversial provision for special treatment, payment in full, for one unsecured claim from the Spencer Workers Federal Credit Union, due to the presence of a co-debtor. The standing trustee objected, arguing that this classification unfairly discriminated against other unsecured creditors, violating provisions of the Bankruptcy Code, specifically § 1322(a)(3) and § 1322(b)(1). The Court, referencing legislative history and established case law regarding claim classification in bankruptcy, determined that the co-debtor status did not fundamentally alter the nature of the claim against the estate to justify preferential treatment. Consequently, the Court denied confirmation of the plan, allowing the debtor to modify it.

BankruptcyChapter 13Claim ClassificationUnsecured ClaimsCodebtor LiabilityPlan ConfirmationFair DiscriminationBankruptcy CodeTrustee ObjectionDebtor Plan
References
10
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