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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

Gross v. New Balance Athletic Shoe, Inc.

Plaintiffs Ellen M. Sullivan and Mark Gross filed an antitrust class action lawsuit against New Balance Athletic Shoe, Inc., alleging a vertical resale price maintenance scheme that violated antitrust laws and New York’s Consumer Protection Act. They claimed to have suffered economic injury due to inflated shoe prices. Defendant New Balance moved to dismiss the complaint. District Judge Sweet granted the motion to dismiss, ruling that the plaintiffs lacked standing because they could not demonstrate direct injury from purchasing from conspiring retailers. The court also dismissed the pendent state law claims without prejudice, granting plaintiffs leave to refile the complaint within 30 days, provided they limit the class to those who purchased from conspiring retailers.

AntitrustClass Action LawsuitResale Price MaintenanceSherman Act Section 1Clayton Act Section 4Consumer StandingMotion to DismissEconomic InjuryPrice Fixing SchemeIndirect Purchaser Standing
References
38
Case No. MISSING
Regular Panel Decision

In Re J.P. Morgan Chase Cash Balance Litigation

Plaintiffs alleged that the JPMorgan Chase Retirement Plan implemented by JPMorgan Chase violated ERISA by being age discriminatory and by failing to provide adequate notice of reduced benefit accruals after converting to a cash balance plan. Defendants moved to dismiss all remaining counts. The court denied the motion to dismiss for the age discrimination claim (Count I) and the notice claims (Counts IV-VI), interpreting ERISA's "rate of benefit accrual" to refer to the employee's retirement benefit, which is detrimentally affected for older workers in cash balance plans. The court found that the plan conversion could lead to a significant reduction in benefit accrual, requiring notice. Counts II and III, related to back-loading and forfeiture claims, were dismissed as they had been withdrawn by the plaintiffs.

ERISAAge DiscriminationCash Balance PlansDefined Benefit PlansDefined Contribution PlansBenefit AccrualStatute of LimitationsMotion to DismissNotice RequirementsSummary Plan Description
References
23
Case No. ADJ8751227
Regular
Nov 16, 2015

GLORIA ACOSTA vs. BALANCE STAFFING SERVICES, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, ULLICO CASUALTY COMPANY

The Workers' Compensation Appeals Board (WCAB) has dismissed a Petition for Reconsideration filed by Balance Staffing Services. The petitioner voluntarily withdrew their petition. The WCAB noted that even if not withdrawn, the petition would have been dismissed as untimely and lacking in substance. Furthermore, the WCAB would have denied the petition on its merits based on the Workers' Compensation Judge's report.

Workers' Compensation Appeals BoardPetition for ReconsiderationDismissedUntimelySkeletalWCJ's ReportBalance Staffing ServicesCalifornia Insurance Guarantee AssociationPatriot Risk ServicesULLICO Casualty Company
References
0
Case No. ADJ7217859, ADJ7544106
Regular
Oct 21, 2014

YOLANDA MARTINEZ vs. MASS PRECISION, COMPWEST INSURANCE COMPANY, SCI @ BALANCE STAFFING SERVICE, ZURICH NORTH AMERICA

This case involves applicant Yolanda Martinez claiming industrial injuries (lumbar spine, right shoulder, psyche) from her employment at Mass Precision. Defendant Zurich North America, insurer for SCI @ Balance Staffing Service, contested liability for the psyche injury, arguing applicant's employment by SCI was less than the six-month statutory minimum. The Appeals Board affirmed the WCJ's finding of joint and several liability, holding that prior employment at the same worksite with dual employers counts towards the six-month requirement for psyche injury claims. This decision was based on the principle that the six-month rule aims to prevent claims from routine stress in new employment, a purpose not served when an employee has a longer-term relationship with the worksite.

Workers' Compensation Appeals BoardSpecific InjuryCumulative Trauma InjuryApportionmentPsychiatric InjuryLabor Code Section 3208.3(d)Six Month Employment RequirementDual EmploymentGeneral EmployerSpecial Employer
References
3
Case No. ADJ4571933
Regular
Aug 30, 2013

RAUL ALVARADO vs. DPR CONSTRUCTION, INC., NATIONAL UNION FIRE INSURANCE CO.

The Appeals Board granted the Lien Claimant's Petition for Reconsideration and issued a notice of intention to impose sanctions. The Lien Claimant sought reconsideration of the dismissal of its lien for failure to pay an activation fee. The Board found the Lien Claimant's petition to be frivolous and without merit because the lien had a zero balance at the time of dismissal, meaning it was already resolved and should have been withdrawn. Consequently, the Board intends to sanction the Lien Claimant under Labor Code section 5813 for bad-faith actions.

Lien Activation FeePetition for ReconsiderationOrder Dismissing LienZero BalanceLabor Code Section 5813SanctionsAppeals Board Rule 10561Bad Faith TacticsFrivolousWithout Merit
References
3
Case No. MISSING
Regular Panel Decision

Stena Line (U.K.) Ltd. v. Sea Containers Ltd.

This action involves a dispute between Stena Line (U.K.) Limited (Stena) and Sea Containers Ltd. along with its subsidiary Ferry and Port Holdings Limited (Holdings) concerning a post-closing adjustment to the purchase price of a ferry business. Stena seeks to compel arbitration over a balance sheet dated March 31, 1990, which is crucial for calculating the adjustment. Holdings does not oppose arbitration but seeks to limit its scope, arguing that Stena waived its right to challenge an earlier balance sheet from December 31, 1989. The court grants Stena's petition to compel arbitration regarding the March 31 balance sheet, allowing the arbitrator to examine the procedures of the December balance sheet but restricting any alteration of its findings without the parties' consent. The arbitrator is tasked with determining whether the March balance sheet aligns with the agreement, considering UK GAAP standards, consistency, and a true and fair view of the business.

ArbitrationStock Purchase AgreementBalance Sheet DisputePost-Closing AdjustmentUK GAAPContract InterpretationWaiverScope of ArbitrationFederal Arbitration ActBusiness Sale
References
13
Case No. ADJ6978832
Regular

Mona Dill vs. CITY OF RANCHO PALOS VERDES, PSI, by CJPIA through their TPA, YORK INSURANCE SERVICES GROUP

The Appeals Board granted the defendant's petition for removal, reversing the WCJ's order for a QME evaluation. The Board found the applicant's stipulated zero percent permanent disability and need for further medical treatment to be adequate, given the treating physician's report of no ratable impairment and the applicant's expressed desire to settle. Therefore, the Stipulations with Request for Award were approved, granting the applicant ongoing medical care and zero percent permanent disability.

Petition for RemovalStipulations with Request for AwardPanel Qualified Medical Evaluator (QME)ApportionmentPermanent DisabilityMedical TreatmentIndustrial InjuryRecreation SupervisorPro PerInformation and Assistance Officer (I & A)
References
0
Case No. ADJ2904305 (GOL 0095697) ADJ1827151 (GOL 0095698)
Regular
Aug 02, 2010

GUADALUPE CARRILLO vs. SAN ANTONIO VILLAGE HOA, STATE FARM INSURANCE COMPANIES

The Workers' Compensation Appeals Board denied a lien claimant's petition for reconsideration regarding a disallowed lien balance of $9,349.46. The claimant, a doctor, failed to obtain required written authorization for work hardening services billed under CPT Code 97545. Despite a claim of verbal authorization and a general request for multiple modalities, the Board found the lack of specific written authorization for the disputed services to be determinative. Therefore, the administrative law judge's disallowance of the lien balance was upheld.

Workers' Compensation Appeals BoardLien claimantPetition for ReconsiderationCompromise and ReleaseWork hardeningWork conditioningCPT Code 97545Prior authorizationVerbal authorizationWritten authorization
References
0
Case No. ADJ353130 (VNO 0378284)
Regular
Jun 04, 2015

JAMES KIRKLAND vs. COUNTY OF LOS ANGELES

This case involves a lien claim by Monrovia Memorial Hospital (MMH) for $303,711.89 in spinal surgery services provided to an injured deputy sheriff. The original judge disallowed the outstanding balance, deeming it unreasonable. The Appeals Board granted reconsideration, finding that MMH, as a long-term acute care hospital, is exempt from fee schedules and paid on a reasonable cost basis. Based on the unrefuted testimony of MMH's bill review expert, the Board determined a reasonable reimbursement of $156,938.00 and ordered the defendant to pay the remaining balance of $80,376.08.

Lien claimReconsiderationFindings and OrderBill reviewReasonable cost basisLong term acute care hospitalInpatient fee scheduleStipulation with Request for AwardMedical treatmentSpinal surgery
References
2
Case No. MISSING
Regular Panel Decision
Oct 24, 2011

Curry v. Hudson Valley Hospital Center

The plaintiff appealed from an order denying her motion to set aside a jury verdict and from a subsequent judgment dismissing her complaint in a medical malpractice action. The jury had found both the decedent and the defendants 50% at fault, but awarded zero damages for conscious pain and suffering. The appeal from the intermediate order was dismissed, but the issues were reviewed on appeal from the judgment. The appellate court affirmed the judgment, finding that the jury verdict of zero damages for conscious pain and suffering was based on a fair interpretation of the evidence. The court emphasized that a claim for conscious pain and suffering requires proof of cognitive awareness and that a jury is not bound to accept expert opinion.

Medical MalpracticeConscious Pain and SufferingJury VerdictDamagesWeight of EvidenceAppellate ReviewCPLRExpert TestimonyCausationAsphyxiation
References
18
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