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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
Dec 21, 1995

In re Jordan Rehabilitation Service, Inc.

Jordan Rehabilitation Service, Inc., providing medical and vocational rehabilitative services, appealed a decision by the Unemployment Insurance Appeal Board. The Board assessed additional unemployment insurance contributions, finding that specialists hired by Jordan were employees, not independent contractors, between 1989 and 1991. The court reviewed whether there was substantial evidence to support the Board's conclusion of an employer-employee relationship. Key factors included Jordan's control over recruitment, screening, compensation, billing, and contractual restrictions on specialists. Ultimately, the court affirmed the Board's decision, determining that Jordan exercised sufficient overall control to establish an employer-employee relationship and thus was liable for the contributions.

Unemployment InsuranceEmployer-Employee RelationshipIndependent ContractorRehabilitation ServicesLabor LawSubstantial EvidenceControl TestJudicial ReviewAdministrative Law JudgeDepartment of Labor
References
8
Case No. OAK 0284985
Regular
Oct 10, 2007

RICHARD DENNY vs. PINKERTON, ACE USA/ESIS

The Workers' Compensation Appeals Board denied reconsideration of a decision that found Richard Denny's employer, Pinkerton, liable for Vocational Rehabilitation Maintenance Allowance (VRMA) at the medical temporary disability rate outside the vocational rehabilitation cap. This liability arose from Pinkerton's violation of Labor Code §4642 and related regulations by failing to timely refer the applicant for vocational rehabilitation services after determining him to be a Qualified Injured Worker. The Board affirmed that this VRMA award is not considered a penalty and rejected Pinkerton's claim for restitution.

Workers' Compensation Appeals BoardPinkertonACE USA/ESISPetition for ReconsiderationVRMAMedical TD RateVocational Rehabilitation CapLabor Code §4642Cal.CodeRegs.tit. 8
References
4
Case No. 2017 NY Slip Op 08460 [156 AD3d 404]
Regular Panel Decision
Dec 05, 2017

Clavin v. CAP Equipment Leasing Corp.

The Appellate Division, First Department, reversed a Supreme Court order, dismissing third-party claims for common law indemnification, contribution, and contractual indemnification. The court found that the plaintiff did not sustain a 'grave injury' as defined in Workers' Compensation Law § 11, making common law indemnification and contribution claims unsustainable against the employer. The claim for contractual indemnification was deemed unenforceable under General Obligations Law § 5-322.1, as it would indemnify CAP Rents for its own potential negligence. Additionally, the claim for failure to procure insurance was dismissed because the reservation contract did not expressly and specifically require Schiavone to name CAP Rents as an additional insured. CAP Equipment Leasing Corporation was also found to lack standing to enforce the contract.

indemnificationcontributiongrave injuryWorkers' CompensationGeneral Obligations Lawcontractual indemnificationinsurance procurementadditional insuredsummary judgmentnegligence
References
7
Case No. ADJ8772254
Regular
Jul 20, 2017

Lorenzo Hernandez vs. STATE OF CALIFORNIA, DEPARTMENT OF CORRECTIONS AND REHABILITATION, NORTH KERN STATE PRISON, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied Lorenzo Hernandez's petition for reconsideration, upholding the original award of 24% permanent disability for a right shoulder injury. The applicant argued that a vocational expert's report should have rebutted the scheduled disability rating, but the Board found this report insufficient. Relying on *Ogilvie* and *Dahl*, the Board determined that an applicant's amenability to vocational rehabilitation precludes using vocational expert testimony to challenge a scheduled rating based on lost earning capacity. Therefore, the vocational expert's opinion was deemed not substantial evidence to overcome the QME's scheduled rating.

Workers' Compensation Appeals BoardPermanent DisabilityVocational ExpertQualified Medical EvaluatorScheduled RatingReconsiderationLabor Code §4660.1AMA Guides 5th EditionAmenability to Vocational RehabilitationDiminished Future Earning Capacity
References
3
Case No. ADJ9025732
Regular
Apr 07, 2023

ALBERT MATA vs. STATE OF CALIFORNIA - DEPARTMENT OF CORRECTIONS & REHABILITATION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the finding of 100% permanent total disability for the applicant, Albert Mata. The defendant argued that the applicant's vocational counselor's reports and medical reports did not constitute substantial evidence for total disability. However, the Board affirmed the Administrative Law Judge's decision, finding the vocational expert's opinions were substantial evidence, not based on speculation, and correctly applied California's 2005 Permanent Disability Rating Schedule for psychiatric impairments. Therefore, the Board concluded the applicant was precluded from vocational rehabilitation and participating in the labor force.

Permanent total disabilityPsychiatric injuryVocational Rehabilitation CounselorAmerican Medical Association GuidesGlobal Assessment of FunctioningPermanent Disability Rating ScheduleSubstantial evidencePetition for ReconsiderationAdministrative Law JudgeAgreed Medical Examiner
References
7
Case No. MISSING
Regular Panel Decision
May 14, 2014

Forest Rehabilitation Medicine PC v. Allstate Insurance

Plaintiff Forest Rehabilitation Medicine PC sued defendant Allstate to recover $3,490 for no-fault medical benefits provided to assignor Tracy Fertitta. The core issue was the medical necessity of "Calmare pain therapy" (scrambler therapy), a novel treatment. The court conducted a bench trial, hearing expert testimony from both sides. Dr. Ayman Hadhoud, for the defense, argued the treatment was not medically necessary, not cost-effective, and essentially a form of physical therapy. Dr. Jack D’Angelo, for the plaintiff, countered that the therapy, though new, had FDA approval, was used by the military, and reduced the assignor's pain levels. Applying the Frye standard, the court found the evidence regarding Calmare scrambler therapy reliable and ruled it was medically necessary for Ms. Fertitta's pain management. Consequently, judgment was awarded to the plaintiff, Forest Rehabilitation Medicine PC, for $3,490 plus attorney's fees and interest.

No-Fault InsuranceMedical NecessityCalmare Pain TherapyScrambler TherapyNovel TreatmentFrye StandardExpert TestimonyPain ManagementFDA ApprovalCervical Radiculopathy
References
14
Case No. 2024 NYSlipOp 01444 [225 AD3d 1189]
Regular Panel Decision
Mar 15, 2024

Jesmain v. Time Cap Dev. Corp.

Plaintiff Connor B. Jesmain was injured at a construction site on property owned by 980 James Street, LLC, while moving a stack of drywall panels that fell on his ankle. He commenced a Labor Law and common-law negligence action against Time Cap Development Corp. and 980 James Street, LLC (980 James defendants), and Interior Builders Framing and Drywall LLC. The 980 James defendants also sought contractual indemnification against third-party defendant Syracuse Energy Systems, Inc. The Appellate Division modified the Supreme Court's order, reinstating Labor Law §§ 240 (1) and 241 (6) causes of action due to issues of fact regarding safe storage and a dangerous material pile. The court also granted summary judgment dismissing Labor Law § 200 and common-law negligence claims against 980 James, denied contractual indemnification for 980 James defendants against Syracuse Energy, and granted summary judgment dismissing 980 James defendants' cross-claim for contractual indemnification against Interior Builders. The decision affirmed the denial of Interior Builders' motion to dismiss the amended complaint and other cross-claims.

Construction Site InjuryDrywall AccidentLabor Law § 240(1)Labor Law § 241(6)Labor Law § 200Common-Law NegligenceSummary JudgmentContractual IndemnificationThird-Party ActionAppellate Review
References
14
Case No. ADJ2860436
Regular
Dec 02, 2011

HAROLD DAVID WATSON vs. VANCE INTERNATIONAL, NATIONAL FIRE CO. OF PITTSBURGH PENNSYLVANIA

The applicant seeks reconsideration of a prior decision finding the employer's appeal of a vocational rehabilitation benefits determination was timely filed. The Appeals Board upheld its prior finding, determining that the employer filed its appeal on December 11, 2008, which was before the January 1, 2009 repeal of the vocational rehabilitation statute. Because the appeal was timely and the right to benefits was not vested prior to the repeal, the applicant is not entitled to vocational rehabilitation benefits.

Rehabilitation UnitVocational rehabilitation benefitsLabor Code section 139.5Appeal PetitionDeclaration of Readiness to ProceedPersonal serviceService by mailDocument Cover SheetWCAB District OfficeProof of service
References
50
Case No. ADJ2862114
Regular
Oct 30, 2008

PATRICIA TRUJILLO vs. EARTHLINK, INC., CHUBB INSURANCE SERVICES

The Workers' Compensation Appeals Board affirmed a prior ruling that the defendant, Earthlink, Inc., owes vocational rehabilitation benefits to the applicant, Patricia Trujillo. The court found that the defendant failed to provide legally required notices when the applicant deferred vocational rehabilitation services. This failure meant the deferral was invalid, making the defendant liable for vocational rehabilitation maintenance allowance (VRMA) from the date of the notice breach.

Vocational rehabilitationAD Rule 9813(a)(4)VRMAdeferral of servicesnotice requirementsclaims administratorinterrupted servicesreinstatement of servicesstatute of limitationsemployer's duty
References
6
Case No. ADJ2065496 (LAO 0777249)
Regular
Mar 06, 2013

MIGUEL RODRIGUEZ vs. RALPHS GROCERY COMPANY/FOOD 4 LESS, Permissibly Self-Insured, Administered by SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves a defendant's effective appeal of a vocational rehabilitation award, despite the absence of a Declaration of Readiness to Proceed. The Court of Appeal directed the Board to vacate the original vocational rehabilitation allowance and annul a prior Board decision that had invalidated the defendant's appeal. Consequently, the Board rescinded its prior finding and ordered that the applicant take nothing for vocational rehabilitation benefits, as the award was not final before the repeal of the relevant Labor Code section.

Workers' Compensation Appeals BoardRemittiturVocational RehabilitationDeclaration of Readiness to ProceedRehabilitation UnitLabor Code Section 139.5Findings of FactRescindedVacatedAward
References
5
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