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Case Law Database

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

Case No. ADJ7369877, ADJ7369872
Regular
Jan 20, 2016

SAMUEL DEBONE vs. CEMEX, INC., AMERICAN HOME ASSURANCE COMPANY, INC., GALLAGHER BASSETT SERVICES

The Workers' Compensation Appeals Board granted reconsideration to correct errors in a previous permanent disability rating. The WCJ incorrectly applied the Agreed Medical Examiner's (AME) WPI ratings, conflating cervical and lumbar spine impairments and miscalculating lower extremity to WPI conversions for the hips. The case is returned to the trial level for a new rating based on correct WPI values and to clarify the basis for any departure from AMA Guides ratings. The apportionment of disability was found to be correct.

Workers' Compensation Appeals BoardPetition for ReconsiderationPermanent DisabilityApportionmentAgreed Medical Examiner (AME)Cumulative TraumaCervical SpineLumbar SpineHipsDRE Method
References
1
Case No. ADJ4258585 (OXN 0130492) ADJ220258 (OXN 0130487)
Regular
Apr 17, 2018

ENRIQUE HERRERA vs. MAPLE LEAF FOODS, U.S. FIRE INSURANCE COMPANY, ALEA NORTH AMERICAN INSURANCE COMPANY

This notice informs parties that the Workers' Compensation Appeals Board (WCAB) intends to admit its rating instructions and a disability rater's recommended permanent disability rating into evidence. The WCAB previously granted reconsideration for further study. Parties have seven days to object to the rating instructions or the recommended rating, with specific procedures for addressing objections. If no timely objection is filed, the matters will be submitted for decision thirty days after service.

WORKERS' COMPENSATION APPEALS BOARDPermanent Disability RatingDisability Evaluation UnitRating InstructionsRecommended Permanent Disability RatingJoint RatingReconsiderationObjectionRater Cross-ExaminationRebuttal Evidence
References
0
Case No. ADJ7560161
Regular
Feb 16, 2017

Julie Cagle vs. Bank of America, ACE AMERICAN INSURANCE COMPANY

This case involves Julie Cagle's workers' compensation claim against Bank of America for admitted industrial injuries to her psyche and abdomen. The Appeals Board reconsidered a prior award, increasing the applicant's permanent disability rating. The key dispute centered on the proper rating for internal injuries under the AMA Guides, with the applicant arguing for a higher WPI rating based on a Class 3 classification. The Board ultimately determined the applicant's internal system impairment warranted a 25% WPI, leading to a total of 49% permanent disability. The award was also clarified to allow the defendant credit for permanent disability advances already paid.

Workers' Compensation Appeals BoardJulie CagleBank of AmericaAce American Insurance CompanyCorvelPetition for ReconsiderationFindings of Fact and AwardInternal Systems InjuryPsyche InjuryPermanent Disability
References
1
Case No. ADJ6820873
Regular
Oct 29, 2010

Thomas Wong vs. CITY OF LOS ANGELES/LAPD, TRISTAR 29106 GLENDALE

Here's a summary of the case in four sentences for a lawyer: The Workers' Compensation Appeals Board denied the City of Los Angeles' petition for reconsideration of an award for an injured police officer. The defendant contended the WCJ erred in adopting the PQME's whole person impairment (WPI) ratings for hypertension and cardiomyopathy, and in finding the defendant failed to rebut the diminished future earning capacity (DFEC) component. The Board affirmed the WCJ's reliance on Dr. Carlish's WPI ratings, finding them supported by the AMA Guides and substantial evidence. Furthermore, the Board found the defendant failed to meet its burden of proof to rebut the scheduled DFEC rating, as their arguments lacked sufficient evidentiary support.

Workers' Compensation Appeals BoardIndustrial InjuryHypertensionHypertensive Heart DiseaseCardiomyopathyWhole Person Impairment (WPI)AMA GuidesDisability Evaluation SpecialistDiminished Future Earning Capacity (DFEC)Ogilvie v. City and County of San Francisco
References
6
Case No. MISSING
Regular Panel Decision

People v. Young

An attorney representing an indigent defendant in Monroe County filed an application seeking reimbursement for legal services at a rate of $200 per hour, mirroring the rate charged by the Special Prosecutor, rather than the statutory rates under County Law § 722-b. The attorney argued that the significant disparity in hourly compensation violated the defendant's right to equal protection and that his qualifications justified the requested rate. The New York State Association of Criminal Defense Lawyers supported the application as amicus curiae, while Monroe County opposed it, arguing the request was untimely and lacked extraordinary circumstances. Presiding Judge Donald J. Mark, J., acknowledged the court's authority to grant compensation in excess of statutory limits under extraordinary circumstances but ultimately denied the application. The denial was based on the court's reasoning that an analogous argument was previously rejected, that linking assigned counsel rates to prosecutor rates would render County Law § 722-b ineffective, and that extraordinary circumstances could not be demonstrated prior to the conclusion of the criminal action. The court, however, reserved the right to reconsider an increased hourly fee upon the case's termination if such circumstances are then proven.

Assigned CounselLegal Aid CompensationCounty Law Section 722-bHourly Rate DisputeSpecial Prosecutor FeesIndigent RightsJudicial DiscretionExtraordinary CircumstancesMonroe County LawEqual Protection Challenge
References
16
Case No. MISSING
Regular Panel Decision

Claim of Perrin v. Builders Resource, Inc.

The case concerns an appeal from a Workers' Compensation Board decision regarding the reimbursement rate for home health aide services provided to a claimant by their sister. Initially, the carrier denied payment but was later directed to pay. The Workers’ Compensation Law Judge set the reimbursement rate at $12 per hour for services starting in 2011, which the Board affirmed. The claimant appealed, solely challenging this rate. The court dismissed the appeal, ruling that the claimant was not an aggrieved party concerning the reimbursement rate, as the dispute was between the care provider (the sister) and the carrier. The court affirmed that the claimant received the care sought and could not raise issues on behalf of the care provider.

Workers' CompensationHome Health Aide ServicesReimbursement RateAppeal DismissalAggrieved PartyCare ProviderWorkers' Compensation BoardAppellate ProcedureNew York LawCarrier Liability
References
4
Case No. MISSING
Regular Panel Decision

Anthony L. Jordan Health Corp. v. Axelrod

The Anthony L. Jordan Health Center, a not-for-profit corporation, challenged the New York State Department of Health's recalculation of its Medicaid reimbursement rates for the 1983-1984 and 1984-1985 periods. Following an appeal, the parties entered into a stipulation agreement. However, the Department, while recalculating the rates in accordance with the stipulation, unilaterally changed the group composition, resulting in a significant negative adjustment and recoupment from Jordan. The court determined that this regrouping constituted an 'error of judgment,' not a permissible correction for mathematical error or an audit finding. Consequently, the court found that the Department did not have the right to retroactively adjust the rates based on this discretionary change. The petition was granted.

Medicaid ReimbursementRate RecalculationAdministrative ReviewStipulation AgreementError of JudgmentGroup CompositionRetroactive AdjustmentHealth Care LawJudicial ReviewDepartment of Health
References
5
Case No. MISSING
Regular Panel Decision

In re Striley

This case addresses an employer's constitutional challenge to the New York State Unemployment Insurance Law concerning payments to striking workers and the application of the 'experience rating' method (Labor Law, § 581). The employer questioned the constitutionality under both Federal and State Constitutions. The court referenced W. H. H. Chamberlin, Inc., v. Andrews, which previously affirmed the constitutionality of taking money from employers for a general fund to pay strikers, and extended this principle to the 'experience rating' method. The decision emphasized that the method of assessment is a legislative matter and found no unreasonable or arbitrary act or constitutional violation in the change from a percentage ratio to 'experience rating'. The court affirmed the decision of the Unemployment Insurance Board.

Unemployment Insurance LawConstitutionalityExperience RatingStriking WorkersLabor LawLegislative IntentJudicial ReviewStatutory InterpretationEmployer ContributionsBenefit Payments
References
3
Case No. MISSING
Regular Panel Decision
Mar 19, 2015

Matter of Suit-Kote Corporation v. Rivera

Petitioner, a highway construction contractor, challenged the prevailing wage rates set by the respondent for operating engineers, laborers, and teamsters for public work projects. Petitioner alleged that respondent failed to ensure that the collective bargaining agreements (CBAs) used to determine these rates covered at least 30% of the workers, as required by Labor Law § 220. The Supreme Court dismissed the petition and denied petitioner's request for disclosure. On appeal, the judgment was affirmed, with the court holding that the burden of proving that less than 30% of workers were covered rests with the employer. The appellate court also found the respondent's method for determining wage rates was not arbitrary or capricious and that the request for disclosure was overly broad, thus upholding the denial.

Prevailing WagePublic Work ProjectsCollective Bargaining AgreementsLabor Law ComplianceBurden of ProofDisclosureCPLR Article 78 ProceedingAdministrative ReviewWage Rate DeterminationHighway Construction
References
12
Case No. MISSING
Regular Panel Decision
Feb 05, 1980

Hospital Service Plan v. Warehouse Production & Sales Employees Union

The appellants, who are successors in interest to the original defendants, appealed an order from the Supreme Court, Queens County. The order denied their motion to compel the plaintiffs to execute a 'satisfaction piece' after the appellants paid the judgment with interest calculated at the New York rate. The appellate court affirmed the denial, holding that according to the principles of full faith and credit, the judgment from New Jersey required interest to be paid at the 8% New Jersey rate, not the 6% New York rate. Additionally, the appellants were deemed responsible for the Sheriff's levy costs because they failed to properly serve the Sheriff with a stay of execution, thereby necessitating the levy.

Judgment EnforcementFull Faith and CreditInterest RatesSheriff's LevySatisfaction PieceNew Jersey JudgmentNew York LawCivil ProcedureAppellate ReviewCourt Costs
References
2
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