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

Case No. MISSING
Regular Panel Decision

Claim of Zygler v. Tenzer Coat Co.

An employer and carrier appealed a disability award granted to a claimant who suffered a cerebral vascular episode after an oral quarrel with his foreman over work distribution. The Workers' Compensation Board had previously determined this constituted an accident, reversing a Referee's finding of no accident. The court, however, found that an argument without physical violence, even if it leads to a vascular incident, does not constitute an accident within the meaning of the Workmen’s Compensation Law, especially when such arguments are common in piece work environments. Citing relevant precedents involving similar emotional strain without physical exertion leading to heart attacks or vascular incidents, the court concluded that a finding of accident could not be sustained. Consequently, the award was reversed, and the claim was dismissed, with costs awarded to the appellants against the Workmen’s Compensation Board.

Workers' CompensationAccident DefinitionCerebral Vascular EpisodeEmotional StrainOral QuarrelDisability AwardEmployer LiabilityCarrier LiabilityPiece WorkPre-existing Condition
References
3
Case No. SJO 238655 SJO 238656 SJO 238657
Regular
Apr 02, 2008

JAMES BEENE vs. ANDERSON CHEVROLET/AUTONATION, INC., ACE-USA, UNIVERSAL UNDERWRITERS GROUP

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior award because the Agreed Medical Examiner's opinion was based on an incorrect legal theory regarding industrial causation. The Board found that the AME's opinion that the applicant's vascular condition was not industrially caused or aggravated was not substantial evidence, requiring further development of the record. Therefore, the case was returned to the trial level for the AME to provide a supplemental opinion on whether the vascular condition was industrially caused or a consequence of the admitted injury.

workers compensationindustrial injuryvascular systemagreed medical evaluatorAMEreconsiderationtemporary disability indemnityTDIlien claimsubrogation
References
15
Case No. 2019 NY Slip Op 02568
Regular Panel Decision
Apr 03, 2019

Peterson v. Estate of John Rozansky

Elaine M. Peterson and David Peterson (later his estate) sued the Estate of John Rozansky for personal injuries after David Peterson was struck by Rozansky's vehicle. Rozansky had previously declined deposition citing dementia and subsequently died from Alzheimer's. Plaintiffs sought Rozansky's medical records, but the Supreme Court granted a protective order and denied plaintiffs' motion to strike the defendant's answer, a decision upheld upon reargument. The Appellate Division, Second Department, affirmed, ruling that plaintiffs failed to show Rozansky's condition was 'in controversy' for CPLR 3121 (a) purposes, and neither Rozansky nor his estate waived physician-patient privilege. A dissenting opinion argued that Rozansky's refusal to be deposed due to dementia did place his condition in controversy, warranting medical record disclosure.

Personal InjuryMedical Records DiscoveryPhysician-Patient PrivilegeWaiver of PrivilegeProtective OrderDiscovery SanctionsStriking AnswerDementiaAlzheimer's DiseaseAppellate Review
References
22
Case No. SDO 355322
Regular
Feb 06, 2008

Jocelyn Dubbs vs. Abbott Vascular, ACE USA c/o MATRIX ABSENCE MANAGEMENT, INC.

The Workers' Compensation Appeals Board denied reconsideration of a Finding and Award that determined applicant sustained an industrial injury to her right upper extremity. The Board clarified that the temporary disability rate in the award should be corrected to $626.35 per week to align with the Findings of Fact, despite the defendant's arguments regarding concurrent employment and average weekly earnings. The defendant's petition for reconsideration was denied as the Board adopted the Workers' Compensation Judge's report and recommendation.

Workers' Compensation Appeals BoardJocelyn DubbsAbbott VascularACE USASDO 355322Reconsideration DeniedClerical Error CorrectionIndustrial InjuryRight Upper ExtremityAverage Weekly Earnings
References
0
Case No. ADJ8128004
Regular
Nov 28, 2017

GLADYS PATINO vs. ABBOTT LABORATORIES, INC./ABBOTT VASCULAR, INC., TRAVELERS PROPERTY CASUALTY COMPANY of AMERICA

The Workers' Compensation Appeals Board granted reconsideration and rescinded the original findings regarding the applicant's requirement to seek treatment within the employer's Medical Provider Network (MPN). The Board found that the employer's MPN notice may not have complied with the bilingual notice requirement under California regulations. Therefore, the issue of treatment outside the MPN was deferred, and the case was returned to the WCJ for further proceedings to develop the record on this issue.

Workers' Compensation Appeals BoardMedical Provider NetworkMPN NoticeContinuity of CarePetition for ReconsiderationFindings of FactWCJNotice of DenialPrimary Treating PhysicianDue Process
References
5
Case No. SRO 112972
Regular
Jun 12, 2008

STELLA JUAREZ vs. ARTERIAL VASCULAR ENGINEERING, NELSON STAFFING, CENTRE INSURANCE COMPANY by REM, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION by BROADSPIRE for CALIFORNIA COMPENSATION INSURANCE COMPANY, in liquidation

The California Insurance Guarantee Association (CIGA) has the right to seek contribution from Centre Insurance Company for workers' compensation benefits paid to an applicant with a cumulative trauma injury. CIGA's claim is not barred by the one-year limitation period for employer contribution claims under Labor Code section 5500.5(e), as CIGA is not an employer and Centre is considered "other insurance" under Insurance Code section 1063.1(c)(9). Therefore, the Appeals Board granted CIGA's petition for reconsideration and reversed the arbitrator's decision, awarding CIGA contribution from Centre.

CIGAContributionReconsiderationFindings Award and OrderLabor Code section 5500.5Insurance Code section 1063.1(c)(9)Cumulative TraumaGeneral EmployerSpecial EmployerOther Insurance
References
8
Case No. LAO 733786
Regular
Jul 25, 2007

David Coe vs. PROFESSIONAL ASSOCIATION OF DIVING INSTRUCTORS, MISSION INSURANCE COMPANY, CIGA

The Appeals Board granted reconsideration of the trial judge's decision that barred the applicant's claim due to the statute of limitations. The Board found that the applicant's severe head injury and resulting dementia raised serious questions about his competency to file a timely claim. Therefore, the case was returned to the trial level for further proceedings to determine if the statute of limitations should be tolled due to the applicant's mental incapacity.

Statute of LimitationsIncompetencyGuardian Ad LitemTollingWorkers' Compensation Appeals BoardMission InsuranceCIGAScuba Diving InstructorCatastrophic InjuryHypoxic Encephalopathy
References
1
Case No. MISSING
Regular Panel Decision
Nov 02, 1995

Claim of Connelly v. Connelly

The claimant appealed a Workers’ Compensation Board decision from November 2, 1995, which found no causal relationship between the decedent's death and his employment as a workers' compensation attorney. The 55-year-old decedent, who had a history of hypertension and obesity, died from an acute vascular event or stroke. Medical experts presented conflicting testimony regarding the cause of death, with claimant's experts attributing it to work-related stress and the carrier's expert to untreated health conditions. The court affirmed the Board's decision, ruling that the Board's resolution of conflicting medical evidence was supported by substantial evidence.

Workers' CompensationCausal RelationshipEmployment-related DeathStrokeHypertensionObesityMedical Expert TestimonySubstantial EvidenceAppellate ReviewBoard Decision
References
1
Case No. ADJ1443846 (AHM 0145673)
Regular
May 26, 2009

Barry Rawlins vs. Acker-Stone Industries, STATE COMPENSATION INSURANCE FUND, BERKSHIRE HATHAWAY

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the finding that Barry Rawlins sustained an industrial cumulative trauma injury to his cerebral vascular system and brain. The Board found that the defendant, State Compensation Insurance Fund, failed to diligently pursue its discovery rights and timely utilize the medical dispute resolution process. Dr. Araneta's opinion, establishing a causal link between Rawlins' employment stress and his stroke, was deemed substantial medical evidence supporting the injury finding. Therefore, the Board affirmed the WCJ's decision and denied the defendant's petition.

Cumulative traumaCerebral vascular system injuryIndustrial injurySale representativePetition for reconsiderationDue processDeposition transcriptMedical recordsSubstantial medical evidenceLabor Code section 4062.2
References
2
Case No. ADJ302560 (LAO 0733786)
Regular
Aug 11, 2009

DAVID COE vs. PROFESSIONAL ASSOCIATION OF DIVING INSTRUCTORS, MISSION INSURANCE COMPANY

The applicant, injured in 1984, filed a workers' compensation claim in 1996, outside the typical statute of limitations. The Administrative Law Judge found the claim barred due to the applicant's failure to prove incompetence during the intervening period. The Appeals Board, while granting reconsideration to address a separate fee issue, affirmed the statute of limitations bar, finding insufficient evidence that the applicant was legally incompetent to file his claim between 1984 and 1996. The Board concluded that the medical expert, while diagnosing dementia, could not definitively state the applicant was incompetent for the entire relevant period, thus applicant failed to meet his burden of proof.

Statute of LimitationsIncompetencyTollingDementiaExecutive FunctioningAgreed Medical EvaluatorEquitable EstoppelLabor Code Section 5710Petition for ReconsiderationWCJ
References
4
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