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

Case No. ADJ7369071
Regular
Dec 10, 2015

JOHN MOCK (Deceased) vs. SECURITAS SECURITY SERVICES USA, INC.; Permissibly Self-Insured, Administered by SEDGWICK CLAIMS MANAGEMENT

In this workers' compensation case, the applicant's estate is represented. The lien claimant, California Psychiatric Evaluators, Inc., sought reconsideration of an administrative law judge's finding that their medical report was untimely under Labor Code section 139.2(j) and related regulations. Consequently, the defendant was excused from paying the lien claimant. The Workers' Compensation Appeals Board (WCAB) reviewed the petition and the WCJ's report. Adopting the WCJ's reasoning, the WCAB affirmed the original decision, upholding that the lien claimant's report was indeed untimely and the defendant is not liable for payment.

Workers' Compensation Appeals BoardLien ClaimantReconsiderationFindings and OrderLabor Code Section 139.2(j)California Code of Regulations Title 8 Section 38(a)TimelinessMedical ReportWCJAffirm
References
0
Case No. ADJ7643460
Regular
May 01, 2017

Tracy Lee vs. XCHANGING, GRANITE STATES INSURANCE COMPANY, SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

This case concerns Defendant's Petition for Removal seeking a new Qualified Medical Evaluator (QME) panel due to a QME's untimely supplemental report. The Appeals Board denied the petition, finding Defendant failed to demonstrate substantial prejudice or irreparable harm. While the QME's report was late, Labor Code Section 4062.5 and Rule 31.5(a)(12) do not mandate replacement for untimely supplemental reports, making the decision discretionary. The WCJ's decision not to order a replacement was reasonable given the QME's extensive involvement and the lack of a mandatory replacement provision.

Workers' Compensation Appeals BoardPetition for RemovalQualified Medical EvaluatorQME panelsupplemental reportuntimelysubstantial prejudiceirreparable harmLabor Code section 4062.5Rule 31.5(a)(12)
References
5
Case No. MISSING
Regular Panel Decision

Claim of Gabak v. New Venture Gear

The claimant sustained a left knee injury, and an independent medical examination (IME) in August 2003 concluded no ongoing work-related disability. Subsequently, a Workers’ Compensation Law Judge (WCLJ) suspended benefits and later precluded the IME report due to untimely filing. The WCLJ also granted the employer's request to cross-examine the treating physician and ordered continued payments. The Workers’ Compensation Board affirmed the WCLJ's decision, which the appellate court further affirmed. The appellate court found that the faxed IME report on August 11, 2003, did not substantially comply with filing requirements, and the official report with IME-4 form was received untimely on August 21, 2003. It also ruled that the doctrine of laches did not apply, upholding the order for continued payments.

Independent Medical ExaminationTimely FilingWorkers' Compensation BoardAppellate ReviewMedical Evidence PreclusionLaches DoctrineCausalityContinuing DisabilityWorkers' Compensation Law § 137NYCRR 300.2 Filing Requirements
References
2
Case No. ADJ1456820
Regular
Oct 30, 2008

JEFFREY TERRA vs. FRU-CON CONSTRUCTION, ZURICH SAN FRANCISCO

The Workers' Compensation Appeals Board denied Jeffrey Terra's petition for disqualification of the administrative law judge. The Board found the petition untimely filed and adopted the judge's report, which concluded that no bias or prejudice was demonstrated. The judge's actions, including ordering further testing for the applicant's claims, were consistent with her duties to prepare parties for trial.

Petition for DisqualificationWorkers' Compensation Appeals BoardWCJPeremptory ChallengeMandatory Settlement ConferenceExpedited HearingAgreed Medical EvaluatorTesticular InjuryPsychiatric InjuryLow Back Injury
References
0
Case No. 91-CV-689A
Regular Panel Decision
Sep 26, 1994

Frank v. New York State Electric & Gas

Plaintiff, while incarcerated, filed a pro se action alleging racial discrimination by New York State Electric and Gas Corporation (NYSEG) under Title VII and 42 U.S.C. § 1981, following his employment termination. He also claimed breach of duty of fair representation by his union, Local No. 966 of the International Brotherhood of Electrical Workers Systems Council U-7 (IBEW). Magistrate Judge Heckman recommended granting summary judgment to the defendants, finding the plaintiff failed to exhaust administrative remedies for the Title VII claim, and the § 1981 and fair representation claims were untimely or lacked evidentiary support for discrimination. District Judge Arcara adopted the Report and Recommendation, thereby granting the defendants' motions for summary judgment and dismissing the case in its entirety.

Employment DiscriminationSummary JudgmentTitle VII42 U.S.C. § 1981Duty of Fair RepresentationStatute of LimitationsAdministrative ExhaustionPro Se LitigantRacial DiscriminationWorkers' Rights
References
45
Case No. MISSING
Regular Panel Decision
Jan 27, 1965

Rivera v. Hellman

This case involves a motion to confirm a Special Referee's report concerning the amounts and priorities of various liens. The Special Referee conducted a hearing and reported on claims from an attorney for the plaintiff ($793.50), Roosevelt Hospital ($846.53), and the Millinery Health Fund ($641.00, later adjusted to $528). The report established the amounts of each lien and recommended priorities, placing the attorney's lien first, followed by the hospital lien (except for a $12 outpatient service), and then the compensation lien. The court concurred with the Special Referee's report and recommendations, granting the motion to confirm.

Lien PriorityAttorney's LienHospital LienDisability BenefitsWorkmen's Compensation LawSpecial Referee ReportMotion GrantedNew York Supreme CourtLien LawMotion Practice
References
2
Case No. MISSING
Regular Panel Decision

Colindres v. Carpenito

Plaintiff Rochelle Colindres sought a protective order to deny defendants' demand for a medical report from her former treating psychologist, Diane Henry, or alternatively, relief from compliance with Uniform Rules for Trial Courts § 202.17(b)(1). Colindres argued that the defendants waived their right to the report as the independent medical examination (IME) already occurred, and that obtaining the report would be an undue hardship since Henry ceased treatment due to Colindres' attendance issues. Defendants Mario Carpenito, Jr., City of White Plains, and White Plains Parking Department opposed, asserting that the report was necessary to clarify alleged injuries, prepare for cross-examination, and facilitate settlement, highlighting Colindres' complex medical history predating the incident. The court denied both branches of Colindres' motion, finding that the rule applies broadly to personal injury actions, defendants did not waive their entitlement, and Colindres failed to prove it was impossible to obtain the report. The court ordered Colindres to exchange a compliant medical report from Diane Henry by March 27, 2017.

protective ordermedical report disclosurediscovery disputepsychological treatmentindependent medical examinationCPLR 310322 NYCRR 202.17waiver of discoveryundue hardshippersonal injury damages
References
12
Case No. ADJ8162481
Regular
Aug 29, 2014

JERRY CRADDUCK vs. LOS ANGELES COUNTY OFFICE OF EDUCATION

This case involves the denial of a defendant's Petition for Removal regarding a workers' compensation matter. The defendant sought to have a Qualified Medical Evaluator (QME) report admitted, arguing the applicant's objection was untimely. However, the Board found the QME's report was indeed untimely and the applicant's objection was valid. Removal was denied because the defendant failed to demonstrate substantial prejudice and the WCAB Rules were also violated by the defendant.

Petition for RemovalQualified Medical Evaluator (QME)Untimely ReportOff CalendarStatus ConferenceMedical UnitReplacement PanelTimeliness ObjectionComprehensive Medical-Legal EvaluationMedical Director
References
2
Case No. MISSING
Regular Panel Decision

Chaplin v. Pathmark Supermarkets

This case addresses a motion by defendants, including Supermarkets General Corp., for a protective order to vacate the plaintiff Mimi Chaplin's notice for discovery and inspection of accident reports. Mimi Chaplin sought these reports after sustaining personal injuries from a fall at the defendant's premises. The court, presided over by Justice James F. Niehoff, analyzed the newly enacted CPLR 3101 (g), which mandates full disclosure of accident reports prepared in the regular course of business. The court found that the accident report in question was prepared in Supermarkets General Corp.'s regular course of business, rendering it discoverable regardless of its potential use in litigation, thus denying the defendants' motion.

DiscoveryProtective OrderAccident ReportsCPLR 3101(g)Litigation PreparationRegular Course of BusinessPersonal InjuryNegligenceDisclosureEvidence
References
10
Case No. ADJ135793 (RIV 0002626)
Regular
Mar 04, 2009

STEPHANIE KAUPP-COUTTS, STEPHANIE RICE vs. VALLEY HEALTH SYSTEM, TRISTAR RISK MANAGEMENT

This case involves a defendant's untimely petition for reconsideration of an order awarding attorney fees. The defendant argued that a later dental report indicated the applicant was not temporarily disabled for the entire period. However, the petition was filed 56 days after service, exceeding the 25-day limit for reconsideration. The Appeals Board dismissed the petition as untimely, finding no basis to act on its own motion. The Board also noted the defendant's request to rescind was not compelling given the timing of the supplemental report.

Workers Compensation Appeals BoardPetition for ReconsiderationOrder to Pay Attorney FeesTemporary Disability BenefitsJerome Peterson D.D.S.Labor Code section 5900(b)Untimely PetitionJurisdictional Time LimitMandatory Settlement ConferenceOverpayment Issue
References
2
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