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Case Law Database

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

Case No. MISSING
Regular Panel Decision
Aug 18, 1971

Claim of Bernsley v. Telemarine Communications Co.

Appeal from a decision of the Workmen’s Compensation Board which allowed a claim for death benefits. The decedent, a principal in the appellant corporation, died from cardiac failure during an emotional discussion about a vault tax assessed against a related corporation and paid by the appellant. The board found that the tax problems arose from decedent's employment with the appellant and that the emotional strain caused his death. The court affirmed the board’s finding that the problems over the vault tax arose out of and during the course of decedent’s employment and that the emotional strain and anxiety from dealing with the tax problems caused decedent’s death.

Death benefitsCardiac failureEmotional strainEmployment-related deathVault taxWorkmen's Compensation Board appealCausationSubstantial evidenceEmployer liability
References
2
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. MISSING
Regular Panel Decision

Adamski v. Barnhart

Plaintiff Richard M. Adamski sued the Commissioner of Social Security under 42 U.S.C. §§ 405(g) and 1383(c) to review the denial of Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) benefits. Adamski, born in 1952 with a history of back problems and surgeries, alleged disability since 1998 due to recurrent back problems. An Administrative Law Judge (ALJ) found him not disabled, a decision affirmed by the Appeals Council. The court reviewed the ALJ's five-step disability evaluation, concluding that the ALJ correctly applied legal standards and that her decision is supported by substantial evidence regarding Adamski's residual functional capacity for light work, his treating physician's opinions, and his pain complaints. Consequently, the Commissioner's motion for judgment on the pleadings was granted, and Adamski's motion was denied, leading to the dismissal of the action with prejudice.

Disability BenefitsSocial Security ActALJ Decision ReviewResidual Functional CapacityTreating Physician RuleVocational Expert TestimonyCredibility AssessmentBack DisorderKnee DisorderLight Work
References
38
Case No. MISSING
Regular Panel Decision

Romanelli v. Long Island Railroad

Frank Romanelli sued his employer, the Long Island Railroad Company (LIRR), under the Federal Employers Liability Act (FELA), alleging that his work as a track worker exposed him to hazardous environmental contaminants, causing pulmonary and cardiac problems. LIRR filed three motions in limine to preclude Romanelli's medical experts from testifying on causation, Romanelli from testifying about exposure to toxins at unsafe levels, and Romanelli from testifying that LIRR had a duty to provide a respirator. The court granted the motions in part and denied in part. It allowed treating physicians to testify on the causation of respiratory issues by workplace exposures due to common knowledge, but not on the link between pulmonary and cardiac problems without demonstrated methodology. Romanelli was permitted to testify about his first-hand exposure to dust, fumes, and chemicals but not to label them as 'hazardous contaminants' or at 'unsafe' levels. Lastly, Romanelli could not testify about LIRR's legal duty to provide a respirator, but could testify about not being provided one despite requests and that its absence caused him to ingest more harmful substances.

FELAMotions in LimineExpert Witness TestimonyLay Witness TestimonyCausationEvidentiary StandardsWorkplace ExposurePulmonary ConditionsCardiac ConditionsRespirator Requirements
References
18
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. GRO 0020213
Regular
May 28, 2008

Sandra K. Carnahan vs. Albertsons Stores, Inc., Specialty Risk Services

The Workers' Compensation Appeals Board dismissed the applicant's petition for reconsideration as it was not a final order, but granted removal. The Board found substantial evidence, including the primary treating physician's report and a utilization review certification, supported the applicant's need for a urological consultation due to urinary problems secondary to her industrial back injury. Therefore, the Board rescinded the WCJ's decision and ordered the defendant to provide the applicant with a urological consultation.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalWCJFindings of FactUrological consultationLumbar injuryNeural innervationUrinary tract infectionsUtilization review
References
10
Case No. VNO 0492098
Regular
Feb 07, 2008

LAILA BOUCHER vs. 21ST CENTURY INSURANCE COMPANY, NATIONAL UNION FIRE INSURANCE COMPANY, AIG Claim Services, Inc.

The Appeals Board granted reconsideration on its own motion due to a lack of substantial evidence supporting the Workers' Compensation Judge's (WCJ) findings on permanent disability and apportionment. The WCJ declared the medical reports regarding the applicant's back problems not credible, yet issued rating instructions not based on medical evidence. The case is returned to the trial level for further proceedings, including the potential appointment of an Agreed Medical Evaluator to supplement the record.

Workers' Compensation Appeals BoardReconsiderationApportionmentPermanent DisabilitySubstantial EvidenceMedical TreatmentQualified Medical EvaluatorPrimary Treating PhysicianWCJAgreed Medical Evaluator
References
3
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