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Case Law Database

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

Case No. ADJ1220987 (SJO 0262634)
Regular
Nov 17, 2010

RICHARD GILLISPIE vs. PLASTECH, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Subsequent Injuries Benefits Trust Fund (SIBTF) appealed an award of benefits to an applicant with a pre-existing disability, arguing a subsequent industrial back injury did not cause pathology in the opposite leg as required by statute. The Appeals Board affirmed the award, finding that Labor Code section 4751 only requires the subsequent injury to "affect" the opposite member, not necessarily cause direct pathology. Evidence showed the applicant's low back injury caused verified radiculopathy and impaired leg function, meeting the statutory requirement. The Board found SIBTF's legal arguments unpersuasive and the WCJ's findings supported by substantial evidence.

Subsequent Injuries Benefits Trust FundLabor Code section 4751industrial injurylow backradiculopathypermanent disabilityopposite and corresponding memberpathologyAMA GuidesDRE category III
References
2
Case No. ADJ10511809, ADJ10227114
Regular
Oct 09, 2017

MARIA GARCIA vs. TRIPLE A EXPRESS, INC., STATE COMPENSATION INSURANCE FUND

This case concerns a workers' compensation claim for injuries to the applicant's back and legs. The applicant appealed a decision that denied her claim, arguing the Qualified Medical Evaluator's (QME) report was insufficient due to improper apportionment. The Appeals Board affirmed the original decision, finding the QME's report constituted substantial evidence. However, the Board amended the award to specify that the applicant did sustain an injury to her low back and right upper leg, but that this injury did not cause permanent disability or require further medical treatment.

AOE/COEApportionmentQualified Medical EvaluatorPermanent DisabilitySubstantial EvidenceWorkers' Compensation Appeals BoardFindings and AwardReconsiderationPre-existing conditionMedical treatment
References
1
Case No. 529417
Regular Panel Decision
Feb 06, 2020

Matter of Johnson v. City of New York

Thomas Johnson, a patient care technician, sustained work-related knee injuries in a February 2006 fall. He subsequently sustained additional work-related injuries in November 2009 to his neck, back, shoulder, and hips, for which he received schedule loss of use (SLU) awards for his right arm, left leg, and right leg. The Workers' Compensation Board later ruled on the permanency of his 2006 injuries, finding an 80% SLU for his left leg and a 40% SLU for his right leg. However, the Board reduced these new awards by his previously received SLU awards for the 2009 injuries, resulting in a final 30% SLU for his left leg and a 0% SLU for his right leg. The Appellate Division affirmed the Board's decision, confirming that SLU awards for the knee and hip are encompassed within leg awards, and prior leg SLU awards must be deducted from subsequent leg SLU awards.

Schedule Loss of UseKnee InjuriesHip InjuriesLeg ImpairmentPrior SLU Award DeductionAppellate Division ReviewIndependent Medical ExaminationTreating Physician ReportPermanent Impairment GuidelinesWork-related Accident
References
9
Case No. ADJ2562434 (OAK 0287611) ADJ1551889 (OAK 0306392)
Regular
Dec 10, 2012

JOHN HENDERSON vs. AIRE SHEET METAL, SUBSEQUENT INJURIES BENEFITS TRUST FUND

This case concerns an applicant seeking benefits from the Subsequent Injuries Benefits Trust Fund (SIF) after sustaining two upper extremity injuries. The Workers' Compensation Appeals Board (WCAB) reconsidered the original award, finding that the applicant was not "permanently partially disabled" by the first injury prior to the second injury. Therefore, the WCAB determined that the SIF was not liable for benefits, as the applicant did not meet the threshold requirement for SIF eligibility under Labor Code section 4751 and relevant case law. The WCAB also amended the applicant's permanent disability to 89%, aligning with a prior stipulation.

Subsequent Injuries Benefits Trust Fundpermanent total disabilitypermanent partial disabilitylabor disablinghealing periodpermanent and stationarycumulative traumacontralateral upper extremitiesFerguson v. Industrial Accidents Commissionlabor market
References
4
Case No. MISSING
Regular Panel Decision

Bennett v. Roman Catholic Diocese of Rockville Centre

In this workers' compensation case, the claimant appealed a decision from the Workers’ Compensation Board. The Board ruled that the claimant's cervical spine injury claim was barred by Workers’ Compensation Law § 28 because it was filed more than two years after the 2010 work-related accident, which initially caused back and leg injuries. Although the claimant argued that a carrier's payment for a 2010 CT scan constituted an advance payment of compensation, the court disagreed, noting the CT scan did not reveal neck abnormalities at the time and subsequent treatment focused on other injuries. The Appellate Division affirmed the Board's decision, concluding that substantial evidence supported the finding that the neck injury claim was untimely.

Workers' CompensationStatute of LimitationsTimeliness of ClaimNeck InjuryBack InjuryAdvance Payment of CompensationIndependent Medical ExaminationAppellate DivisionNew YorkWorkers' Compensation Board Appeal
References
5
Case No. MISSING
Regular Panel Decision

In re the Claim of Trickel

In this case, the claimant appealed a decision by the Workers’ Compensation Board regarding a consequential injury claim. The claimant sustained a fractured right tibia and fibula in 1988 during employment, for which workers’ compensation benefits were granted. In 1991, the claimant suffered a lower back injury and contended it was a consequence of the 1988 leg injury and subsequent leg shortening. The Workers’ Compensation Board denied this claim, ruling the 1991 accident was new and unrelated, and apportioned disability with 50% attributed to the noncompensable 1991 incident, 25% to the 1988 leg injury, and 25% to a prior noncompensable leg injury. The court affirmed the Board's decision, stating that whether a disability is consequentially related is a factual question for the Board and that the Board was free to credit the carrier’s expert testimony which found no causal relationship.

Workers' CompensationAppealCausally Related InjuryBack InjuryLeg FracturePermanent DisabilityApportionmentMedical Expert TestimonySubstantial EvidenceNew Accident
References
3
Case No. ADJ3321235 (SFO 0492639)
Regular
Apr 29, 2011

Nick Calvan vs. Pacific Gas & Electric, Subsequent Injuries Benefits Trust Fund

This Workers' Compensation Appeals Board decision grants reconsideration of a prior award and rescinds the original findings. The Board finds that the applicant sustained industrial injury to his low back, legs, shoulders, and psyche. However, the case is returned to the trial level for further proceedings because the original decision lacked necessary findings on permanent disability, apportionment, and the liability of the Subsequent Injuries Benefits Trust Fund, specifically regarding Labor Code section 4751. The Board did affirm the finding of psychiatric injury arising out of and occurring in the course of employment.

Workers Compensation Appeals BoardSubsequent Injuries Benefits Trust Fundpermanent disabilitypsychiatric injuryapportionmentLabor Code 4751Labor Code 4659Labor Code 4662vocational assessmentcausation
References
0
Case No. MISSING
Regular Panel Decision

Claim of Cortese v. Rochester Products Division, G.M.C.

This case concerns an appeal from decisions of the Workers’ Compensation Board regarding a claimant who developed leg and back pain, culminating in a herniated disc, after a new work assignment involving lifting heavy carburetors. The self-insured employer appealed the Board's findings that the claimant sustained a compensable injury and that her failure to give timely statutory notice was excused. The court affirmed the Board's decisions, asserting that a compensable accident can arise from repetitive trauma leading to a sudden collapse, and the specific onset of severe pain satisfies the suddenness test. Furthermore, the Board properly excused the delayed notice as it neither aggravated the injury nor hindered the defense. Substantial medical evidence supported the causal relationship between the work activities and the injury.

Repetitive TraumaHerniated DiscLaminectomyDelayed Notice ExcusedCausal ConnectionSuddenness TestWorkers' Compensation Board AppealSubstantial EvidenceWork-related InjuryEmployer Liability
References
10
Case No. ADJ11266442
Regular
Apr 26, 2019

DONALD SEARLES vs. ROUNDTABLE PIZZA, EMPLOYERS COMPENSATION INSURANCE CO.

The WCAB granted reconsideration to address the defendant's due process claims regarding an expedited trial and the sufficiency of medical evidence for the applicant's cervical spine, right wrist, and right upper extremity injuries. The Board affirmed the WCJ's findings of injury to these body parts, finding substantial medical evidence supported them and that the defendant was aware of these claims timely. However, the Board struck the WCJ's deferral of the "nature and extent" issue, remanding for further proceedings on undeveloped claims of injury to the lumbar spine and left leg.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardExpedited TrialQualified Medical EvaluatorDue ProcessSubstantial Medical EvidenceCervical Spine InjuryRight Upper Extremity InjuryCarpal Tunnel Syndrome
References
5
Case No. ADJ9391561 ADJ8266496
Regular
Apr 12, 2019

HENDRIKUS ANTONIUS BENNINK vs. CITY OF FRESNO

This case involves a police officer claiming industrial injuries to multiple body parts, including orthopedic and digestive systems, in addition to previously resolved cardiovascular and hearing claims. The Workers' Compensation Appeals Board (WCAB) affirmed the trial judge's decision, finding that the applicant did not sustain industrial injuries to his neck, upper extremities, back, legs, or digestive system. This decision was based on substantial evidence from Qualified Medical Examiners (QMEs) who concluded these conditions were degenerative and non-industrial. The WCAB found no error in the QMEs' reasoning or the applicant's failure to prove industrial causation for these specific injuries.

ADJ9391561ADJ8266496Industrial injuryCardiovascular systemHearing lossOrthopedic injuryDigestive systemQMESubstantial evidenceCausation
References
0
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