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Case Law Database

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

Case No. ADJ9447222
Regular
Jun 23, 2015

Gloria Gutierrez vs. Moonlight Companies, Zenith Insurance Company

The Appeals Board denied the applicant's petition to disqualify the Administrative Law Judge (WCJ). The applicant alleged the WCJ formed an unqualified opinion on the merits of the case. While the WCJ initially dismissed the claim based on a misunderstanding of the law, he later rescinded the dismissal and scheduled further proceedings. The Board found no evidence the WCJ formed an unqualified opinion and believes he can render a fair hearing.

Petition for disqualificationWorkers' Compensation Appeals BoardWCJunqualified opinionmerits of actionLabor Code section 3600(a)(10)post-termination defensereporting of injuriesCode of Civil Procedure section 641(f)Order Rescinding Dismissal
References
0
Case No. 71 Civ. 2877
Regular Panel Decision

Equal Employment Opportunity Commission v. Local 638 ... Local 28 of the Sheet Metal Workers' International Ass'n

This opinion addresses backpay claims in an employment discrimination case spanning over two decades. The Equal Employment Opportunity Commission (EEOC) represents black and Hispanic workers against Local 28 of the Sheet Metal Workers’ International Association and its Joint Apprenticeship Committee, alleging discriminatory admission practices. The court denied defendants' motions to dismiss the backpay claims, rejecting arguments regarding settlement, prosecutorial delay, inadequate discovery, and notice-of-claim deadlines. It also found defendants failed to prove claimants were unqualified or failed to mitigate damages by joining the armed forces or attending school. Furthermore, the court clarified prejudgment interest rates to be applied and affirmed the administrator's decision regarding claimant Charles Moss, directing further proceedings on defendants' financial capacity and revised backpay calculations.

Employment DiscriminationBackpay ClaimsTitle VIICivil Rights ActLabor Union DiscriminationApprenticeship ProgramsRacial DiscriminationHispanic DiscriminationMitigation of DamagesPrejudgment Interest
References
32
Case No. ADJ7207861
Regular
May 06, 2011

STEVE TORDINI vs. JAMES DIEDRICH, PREFERRED EMPLOYERS INS. CO.

The Workers' Compensation Appeals Board granted reconsideration to address the defendant's contention that the WCJ erred in relying on the treating physician's opinion over the PQME's regarding permanent disability and apportionment. The Board found the treating physician's opinion unsubstantiated, as it included unqualified legal conclusions and improperly utilized AMA Guides criteria for apportionment. Consequently, the WCAB rescinded the prior award and returned the case for a new decision, directing the WCJ to base findings on the PQME's report. A dissenting opinion argued that both medical opinions were flawed and recommended further medical development.

PQMEWCJWPIapportionmentLabor Code sections 46634664Almaraz IIAMA GuidesDRE Lumbar Category IVdisc protrusion
References
4
Case No. ADJ3447287 (SBR 0263874) ADJ3565604 (ANA 0306676) ADJ3955433 (ANA 0306675)
Regular
Dec 09, 2016

PATSY HENDRY vs. KAISER FOUNDATION HOSPITAL, PERMISSIBLY SELF INSURED

The Workers' Compensation Appeals Board (WCAB) denied a petition to disqualify a workers' compensation administrative law judge (WCJ). The WCAB found that the alleged expressions of opinion by the WCJ did not demonstrate bias or an unqualified opinion as to the merits of the case, but rather reflected rulings based on evidence and law. The board also clarified that erroneous rulings do not constitute grounds for disqualification. Furthermore, the WCAB concluded that the petition, while not subject to strict timeliness rules due to the timing of the alleged events, was still ultimately denied on its merits.

Petition for DisqualificationWCJCode of Civil Procedure section 641formed or expressed an unqualified opinionexistence of a state of mindenmity against or bias towardTaylor v. Industrial Acc. Com.Lumbermen's Mut. Cas. Co. v. Industrial Acc. Com.Kreling v. Superior CourtMcEwen v. Occidental Life Ins. Co.
References
7
Case No. ADJ8737025 ADJ9415548
Regular
Jan 21, 2020

HERIBERTO GUILLEN vs. INFINITY STAFFING; AGGCAP INSURANCE, administered by SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

This case involves a defendant's petition to disqualify a Workers' Compensation Judge (WCJ) due to her testimony as a witness in a separate criminal proceeding concerning the applicant. The defendant argued the WCJ was a material witness, expressed an opinion on the merits, or had a doubtful capacity for impartiality. The Appeals Board denied the petition, finding her testimony, given under subpoena, did not demonstrate bias nor constituted an unqualified opinion on the case's merits, as she merely explained legal principles. One Commissioner dissented, believing the WCJ's testimony on the impact of the applicant's fraud conviction created an appearance of bias and prejudged the merits of a pending dismissal petition.

Petition for disqualificationWCJ testimonyInsurance Code section 1871.4Penal Code section 118Code of Civil Procedure section 641Rule 9721.12material witnessunqualified opinionappearance of biasnolo contendere
References
8
Case No. MISSING
Regular Panel Decision
May 17, 2016

United States v. Nesbeth

Chevelle Nesbeth was convicted by a jury for importation of cocaine and possession with intent to distribute. Senior District Judge Block rendered a non-incarceratory sentence of one-year probation, with special conditions including six months' home confinement and 100 hours of community service. The judge wrote this opinion to emphasize the importance of considering the numerous statutory and regulatory collateral consequences facing Nesbeth as a convicted felon, such as restrictions on employment, housing, and voting. These consequences were extensively balanced against 18 U.S.C. § 3553(a) factors to determine a just punishment. The opinion advocates for legal counsel and the Probation Department to proactively address collateral consequences in all future pre-sentence reports and sentencing proceedings.

Collateral ConsequencesSentencing ReformCriminal JusticeProbationary SentenceDrug Trafficking OffensesFelony ConvictionJudicial DiscretionFederal Sentencing GuidelinesRehabilitationRecidivism
References
55
Case No. MISSING
Regular Panel Decision

Pizzo v. Barnhart

Plaintiff Kathleen Pizzo appealed the Commissioner of the Social Security Administration's final determination denying her disability insurance benefits. The District Court reviewed the ALJ's decision, which had assigned no weight to the treating physician's opinion and significant weight to a consulting physician's report. The court found that the ALJ erred by failing to give appropriate weight to the treating physician's opinion, not adequately developing the administrative record to obtain missing medical notes, and giving undue weight to the consulting physician's report which did not explicitly support the capacity for sedentary work. Consequently, the Commissioner's determination was remanded for further administrative proceedings consistent with the District Court's decision, granting the plaintiff's motion for judgment on the pleadings to the extent of the remand and denying the Commissioner's cross-motion.

Social Security ActDisability Insurance BenefitsAdministrative Law JudgeTreating Physician RuleResidual Functional CapacitySedentary WorkMedical EvidenceRemandSubstantial EvidenceRecord Development
References
23
Case No. MISSING
Regular Panel Decision

Formal Opinion No.

This opinion from the Chairman of the New York Workers' Compensation Board addresses the priority of income execution and income deduction orders, established by the 1985 Support Enforcement Act (CPLR §§ 5241, 5242), against other statutory deductions from workers' compensation awards. Historically, WCL § 33 provided broad exemptions for workers' compensation benefits. However, WCL §§ 206(2) and 25(4)(a) allow for reimbursement of disability insurers and employers for advance payments, respectively, and WCL § 24 establishes liens for attorneys' fees, traditionally enjoying highest priority. The 1985 Act amended WCL § 33 to make benefits subject to support enforcement and also stipulated that income executions and deduction orders take priority over other assignments, levies, or processes. The Board concluded that claims for attorneys' fees and reimbursements by disability insurance carriers and employers are to be deducted first from the workers' compensation award. The support enforcement remedies under CPLR §§ 5241 and 5242 then apply to the balance of the workers' compensation benefits paid to the employee. This approach ensures prompt payment to injured workers and prevents double payment issues.

Workers' CompensationSupport Enforcement ActIncome ExecutionIncome DeductionLien PriorityStatutory InterpretationDisability Benefits ReimbursementEmployer ReimbursementAttorneys' Fees PriorityCPLR 5241
References
9
Case No. ADJ8132311
Regular
Aug 12, 2019

Celia Kalbaugh vs. County of Kern

This case involves a claim by Celia Kalbaugh for 100% permanent disability due to a psyche injury sustained as a Deputy Detentions Officer. The defendant, County of Kern, contested the findings, arguing the Agreed Medical Examiner was unqualified to assess employability and that the applicant was capable of vocational rehabilitation. The Workers' Compensation Appeals Board affirmed the original award, adopting the WCJ's reasoning that the Agreed Medical Examiner's findings of profound cognitive deficits preventing work were persuasive. The Board also found the applicant's vocational consultant's opinion, supporting unsuitability for rehabilitation and the open labor market, credible.

Workers' Compensation Appeals BoardCelia KalbaughCounty of KernPetition for ReconsiderationFindings Orders and Awardpermanent disabilityDeputy Detentions Officerpsyche injuryAgreed Medical Examinervocational rehabilitation
References
1
Case No. MISSING
Regular Panel Decision

Trumps v. Toastmaster, Inc.

Christel Trumps, a kitchen helper, sued Toastmaster, Inc. after receiving an electric shock from a griddle. She alleged negligence, breach of implied warranty, and strict liability due to a defective design. Toastmaster moved to exclude the plaintiff's expert witness, Michael Kaufmann, arguing his opinions were inadmissible under Daubert. The court, presided over by Senior District Judge Haight, found Kaufmann unqualified as a mechanical engineer to testify on electrical engineering issues and deemed his methodology inadequate as he did not test his hypothesis. Consequently, the court granted Toastmaster's motions to exclude expert testimony and for summary judgment, dismissing Trumps' complaint with prejudice due to a lack of evidence on design defect and causation.

Daubert ChallengeExpert Witness AdmissibilityElectrical Shock InjuryProduct DefectGriddle MalfunctionMechanical Engineering ExpertElectrical Engineering ExpertSummary Judgment GrantedFederal Rules of EvidenceFederal Rules of Civil Procedure
References
13
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