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Case Law Database

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

Case No. ADJ900432 (SAC 0323091)
Regular
Dec 30, 2011

MARLENE COPUS vs. NORTH SACRAMENTO ELEMENTARY SCHOOL DISTRICT

This case involves a dispute over the necessity of spinal surgery for an applicant who sustained a cumulative trauma injury to her neck and back. While the applicant's treating physician recommended surgery, a second opinion physician disagreed, citing a lack of nerve root compression. The Appeals Board found that the medical evidence was insufficient to determine the necessity of surgery, particularly in light of ACOEM Practice Guidelines which generally recommend against surgery without nerve root compression. Therefore, the Board rescinded the prior award and remanded the case to appoint an independent physician to evaluate the applicant and determine the reasonableness and necessity of the proposed surgery.

Workers' Compensation Appeals BoardMarlene CopusNorth Sacramento Elementary School Districtcumulative traumaspinal surgerynerve root impingementcervical stenosisDr. OrisekDr. GregoriusACOEM Practice Guidelines
References
4
Case No. MISSING
Regular Panel Decision

Claim of Carr v. Cairo Fire District

Claimant, a volunteer firefighter, sustained a right hand fracture and subsequently developed bilateral carpal tunnel syndrome and ulnar nerve compression, which his treating physician and a first independent medical examination (IME) linked to his work injury. The employer's workers' compensation carrier disputed the claim after a second IME found no carpal tunnel syndrome. During a Workers' Compensation Law Judge (WCLJ) proceeding, the WCLJ amended the claim to include consequential injuries without taking sworn testimony or allowing the carrier to cross-examine the claimant or his treating physician. The Workers’ Compensation Board affirmed this decision. On appeal, the court reversed, holding that the carrier was improperly denied its right to present testimony and cross-examine the treating physician, thereby prejudicing the employer. The matter was remitted for further proceedings.

Workers' CompensationVolunteer FirefighterCarpal Tunnel SyndromeUlnar Nerve CompressionIndependent Medical ExaminationRight to TestimonyCross-ExaminationProcedural Due ProcessEvidentiary HearingAppellate Review
References
3
Case No. RIV 0079075
Regular
Apr 14, 2008

JOSEPH VIGARI vs. ARNOLD PALMER'S RESTAURANT, EMPLOYER'S COMPENSATION INSURANCE COMPANY

The Workers' Compensation Appeals Board overturned a prior finding, ruling that the applicant's nerve compression injury resulting from back surgery was a compensable consequence of the original admitted industrial injury, not a new and independent injury. Therefore, the applicant is not entitled to further temporary disability indemnity beyond the 104-week limit established by Labor Code section 4656(c)(1) for the original injury. The Board clarified that the "compensable consequences" doctrine applies, and certain cited cases regarding vocational rehabilitation do not alter this principle for temporary disability claims.

Compensable Consequences DoctrineLabor Code section 4656(c)(1)Temporary Disability IndemnityNew and Independent InjuryBack SurgeryNerve CompressionLateral Femoral Cutaneous NerveVocational RehabilitationStatute of LimitationsPetition for Reconsideration
References
9
Case No. MISSING
Regular Panel Decision
Sep 22, 1999

Umansky v. Masterpiece International Ltd.

The plaintiff, a receptionist and clerical worker, was terminated by the defendants after being diagnosed with bilateral ulnar nerve entrapment, a condition similar to carpal tunnel syndrome. The plaintiff alleged discrimination based on disability, violating Executive Law § 296 and Administrative Code § 8-107. The defendants contended the termination was due to poor job performance. The Supreme Court denied the defendants' motion for summary judgment, citing a material question of fact regarding whether the disability prevented the plaintiff from performing her job or if there was a legitimate non-discriminatory reason for termination. The appellate court affirmed the Supreme Court's order, upholding the denial of summary judgment.

discriminationdisabilitywrongful terminationsummary judgmenthuman rights lawulnar nerve entrapmentemployment lawappellate reviewmaterial question of factKings County
References
3
Case No. ADJ6552734
Regular
Apr 02, 2015

Diane Garibay-Jimenez vs. Santa Barbara Medical Foundation Clinic, Zurich American Insurance

This case concerns a denied request for left ulnar nerve decompression surgery. The Administrative Law Judge (WCJ) upheld the denial, finding the applicant failed to provide necessary Agreed Medical Examiner (AME) reports to the Independent Medical Review (IMR), making a further review unreasonable. However, the Workers' Compensation Appeals Board (WCAB) granted reconsideration, rescinding the WCJ's order. The WCAB found the defendant failed to comply with Labor Code section 4610.5(l) by not providing all relevant medical records to IMR, thus invalidating the prior IMR determination. The matter was returned for a new IMR application, holding the defendant responsible for submitting complete records.

Workers' Compensation Appeals BoardDiane Garibay-JimenezSanta Barbara Medical Foundation ClinicZurich American InsuranceADJ6552734Opinion and Order Granting Petition for ReconsiderationExpedited Findings of Fact and OrderAdministrative Law JudgeIndependent Medical ReviewUtilization Review
References
0
Case No. MISSING
Regular Panel Decision

Meyers v. Astrue

Plaintiff Linda Meyers sought judicial review of a denial of Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) benefits. Magistrate Judge Leslie G. Foschio recommended granting the plaintiff's motion for judgment on the pleadings and denying the defendant's, remanding the case for benefits calculation. District Judge Richard J. Arcara adopted this recommendation after a de novo review. The court found that the Administrative Law Judge (ALJ) erred by concluding the plaintiff was not disabled from March 2004 through March 2006, specifically by failing to properly apply the treating physician rule to Dr. Lewis's opinion, which consistently described the plaintiff as totally disabled due to cervical disc disease and nerve root compression.

Social Security DisabilitySupplemental Security IncomeDisability Benefits ReviewTreating Physician RuleAdministrative Law Judge ErrorResidual Functional CapacityCervical Spine DisorderNerve Root CompressionVocational ExpertSedentary Work Limitations
References
27
Case No. 2018 NY Slip Op 07810
Regular Panel Decision
Nov 15, 2018

Matter of Maunder v. B & B Lbr. Co.

Claimant, Elizabeth A. Maunder, appealed a decision by the Workers' Compensation Board that denied her a schedule loss of use (SLU) award for her arms, related to occupational disease and cubital tunnel syndrome. Her treating orthopedic surgeon, Nathan Everding, opined a 25% SLU for each elbow after revision surgery, despite previous awards for her hands. The Board found Everding's testimony and reports insufficient and inconsistent with the New York State Guidelines for Determining Permanent Impairment, noting his inability to explain the percentage or identify required 'elbow defects' for ulnar nerve entrapment. The Appellate Division affirmed the Board's decision, emphasizing the Board's prerogative to accept or reject medical evidence and the claimant's burden to prove facts supporting her claim, which was not met under the guidelines.

Schedule Loss of UseSLU AwardCubital Tunnel SyndromeBilateral WristsOccupational DiseaseWorkers' Compensation Board DecisionMedical Evidence InsufficiencyPermanent Impairment GuidelinesUlnar Nerve EntrapmentElbow Defects
References
11
Case No. MISSING
Regular Panel Decision
Apr 15, 2003

Claim of Paradise v. Goulds Pump

In March 1993, the claimant suffered a cervical and thoracic spine strain/sprain while lifting a heavy carton at work. Although he initially recovered, he later developed recurring neck pain and numbness in his left hand. Neurosurgeon Webster Pilcher diagnosed nerve root compression at C5 and C6, attributing it to the 1993 work-related injury and recommending surgery. The employer's workers’ compensation carrier declined coverage. The Workers’ Compensation Board subsequently found a causal relationship between the injury and the claimant's current condition, authorizing the surgery. The employer and carrier appealed, contending that the Board's finding was based on speculative medical opinion. The court affirmed the Board's decision, finding that Pilcher's opinion had a rational basis and was supported by substantial evidence.

Workers' CompensationNerve Root CompressionCervical SpineThoracic SpineCausationMedical OpinionSubstantial EvidenceNeurosurgeonSpinal InjuryAppeal
References
2
Case No. ADJ3744023
Regular
May 15, 2009

JOSEPH CRABTREE vs. MITCHELL BERMAN CABINET MAKER, STATE COMPENSATION INSURANCE FUND

In this workers' compensation case, the defendant sought reconsideration of an award finding an industrial injury to the applicant's abdomen/groin (hernia) and a resulting peripheral nerve injury causing 24% permanent disability. The defendant argued the peripheral nerve injury was not supported and the disability rating was incorrect due to misapplication of the AMA Guides. The Board denied reconsideration, adopting the judge's report and finding that the medical evidence supported the peripheral nerve injury and the AMA Guides were correctly applied. The Board found the agreed medical evaluator's conclusions were well-reasoned and supported by the evidence.

Workers Compensation Appeals BoardIndustrial InjuryHerniaPeripheral Nerve InjuryPermanent DisabilityAgreed Medical Evaluator (AME)AMA GuidesPetition for ReconsiderationMedical EvidenceWCJ
References
4
Case No. 524328
Regular Panel Decision
Jan 11, 2018

Matter of Murrah v. Jain Irrigation, Inc.

Claimant Steven Murrah sustained a work-related injury to his right shoulder in 2010 while working for Jain Irrigation, Inc., leading to workers' compensation benefits. In 2014, while working for a different employer, he jarred his right shoulder again. A Workers' Compensation Law Judge initially found ulnar neuritis and cubital tunnel syndrome causally related to the 2010 incident. The Workers' Compensation Board modified this, finding no causal relation for ulnar neuritis but affirming and amending the 2010 claim to include right cubital tunnel syndrome. Jain Irrigation and its carrier appealed, arguing that ulnar neuritis and cubital tunnel syndrome are the same condition and that the issue was not properly preserved. The Appellate Division, Third Department, affirmed the Board's decision, declining to take judicial notice of the conditions' synonymity due to conflicting record evidence and deferring to the Board's resolution of medical evidence.

Workers' CompensationRight Shoulder InjuryRotator CuffUlnar NeuritisCubital Tunnel SyndromeCausationMedical EvidenceAppellate ReviewJudicial NoticeWork-Related Injury
References
8
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