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

Case No. ADJ4016735 (BAK 0147536)
Regular
Jun 11, 2012

COLLEEN PARHAM vs. KERN RADIOLOGY MEDICAL GROUP, LEGION INSURANCE GROUP

This case involves an applicant seeking bilateral knee replacement surgery due to an admitted industrial back injury. The applicant argues the surgery is necessary to enable further treatment for her back, specifically a spinal cord stimulator. The defendants contested this, claiming the knee condition was independent and unrelated to the industrial injury. The Appeals Board granted reconsideration, finding the knee surgery reasonably required to relieve the industrial back injury, citing *Bolton* and *Rowan*, even if the knee condition itself was not industrial. The Board rescinded prior findings, awarding the knee surgery and deferring issues of permanent disability and temporary disability.

Workers' Compensation Appeals BoardReconsiderationFindings of FactBilateral Knee ReplacementIndustrial InjuryBack InjurySpinal Cord StimulatorTemporary Total DisabilityPermanent and StationaryQualified Medical Evaluator
References
8
Case No. 2021 NY Slip Op 00608 [191 AD3d 1078]
Regular Panel Decision
Feb 04, 2021

Matter of Peck v. The Donaldson Org.

Harry Peck, a carpenter, sustained a work-related back injury in 2013 and received workers' compensation benefits. After spinal fusion surgery, he was deemed medically unable to return to work. Following authorization for a spinal cord simulator trial in 2018, the employer's carrier alleged that Peck violated Workers' Compensation Law § 114-a, citing surveillance footage inconsistent with his claimed disability. Although a Workers' Compensation Law Judge initially found no misrepresentation, the Workers' Compensation Board reversed, finding a violation and imposing mandatory and discretionary penalties, including disqualification from future wage replacement benefits. The Appellate Division, Third Department, affirmed the Board's decision, concluding that substantial evidence supported the finding that Peck made willful misrepresentations regarding the extent of his disability to physicians.

Workers' Compensation FraudDisability MisrepresentationSurveillance EvidencePenalty ImpositionWage Replacement DisqualificationSpinal Cord InjuryBack PainClaimant CredibilityAppellate Review of Board DecisionMaterial False Statement
References
10
Case No. MISSING
Regular Panel Decision

Hawkins v. Center for Spinal Surgery

Demica Hawkins, a Black former Accounts Payable Coordinator, sued her employer, The Center for Spinal Surgery (CSS), alleging race discrimination, retaliation, and FMLA interference. The lawsuit stemmed from denied pay raises, disciplinary actions, and ultimately her termination while on pregnancy leave, which Hawkins claims was discriminatory and retaliatory. CSS filed a renewed motion for summary judgment, and Hawkins filed a partial motion for summary judgment. The court granted in part and denied in part CSS's motion, dismissing Hawkins' pregnancy discrimination and certain retaliation claims. However, Hawkins' retaliatory discharge and FMLA interference claims related to her 2013 termination will proceed to trial due to genuine disputes of material fact regarding CSS's motivations.

Race DiscriminationRetaliationFMLA InterferenceSummary JudgmentEmployment LawTitle VIIPregnancy Discrimination ActMcDonnell Douglas FrameworkHonest Belief RulePretext
References
64
Case No. 09-19-00101-CV
Regular Panel Decision
Dec 12, 2019

Brian W. Justice v. Wells Fargo Bank, National Association, on Behalf of the Registered Holders of Bear Stearns Asset Backed Securities I Trust 2007-AC2, Asset-Backed Certificates, Series 2007-AV2

Brian W. Justice appealed the trial court's summary judgment in favor of Wells Fargo Bank, National Association, regarding a breach of contract and judicial foreclosure claim. Justice had defaulted on a promissory note, leading Wells Fargo to seek foreclosure on his property. Following a summary judgment for Wells Fargo, Justice, through an attorney, moved to set aside the judgment and for a new trial, arguing he lacked notice due to being out of state. The appellate court affirmed the trial court's decision, concluding that Justice failed to prove his failure to respond was not due to conscious indifference and that Wells Fargo had adequately demonstrated its status as the note holder. Additionally, the court ruled that Justice waived his objection to attorney's fees by not raising it at the trial level.

Summary Judgment AppealBreach of ContractJudicial ForeclosurePromissory Note DefaultHome EquityDefault JudgmentMotion for New TrialCraddock TestConscious IndifferenceHolder of Note
References
46
Case No. MISSING
Regular Panel Decision

United Spinal Ass'n v. Board of Elections in the City of New York

Plaintiffs United Spinal Association and Disabled in Action brought an action against the Board of Elections in the City of New York (BOE) under Title II of the Americans with Disabilities Act and Section 504 of the Rehabilitation Act, alleging pervasive access barriers at poll sites. The Court previously denied a preliminary injunction. Both parties subsequently moved for summary judgment. The Court found no genuine dispute of material fact regarding the existence of pervasive and recurring accessibility barriers and deemed the BOE's accommodation methods insufficient. Consequently, the Court granted the plaintiffs' motion for summary judgment on liability and denied the defendants' cross-motion. The case is now referred to a Magistrate Judge for the determination of the appropriate remedy.

AccessibilityVoting RightsAmericans with Disabilities ActRehabilitation ActPoll SitesSummary JudgmentDisability DiscriminationBoard of ElectionsMeaningful AccessReasonable Accommodation
References
26
Case No. ADJ3715225
Regular
Mar 16, 2009

MICHAEL COYER vs. COUNTY OF SAN BERNARDINO

The Workers' Compensation Appeals Board denied reconsideration of its prior decision. The Board found that the applicant's back and spinal cord injury did not arise out of his employment as a firefighter. This was because the injury occurred while the applicant was on paid administrative leave and performing a personal task of protecting his own roof, without departmental authorization or assistance. The Board determined the applicant was not performing his firefighter responsibilities at the time of the injury.

Industrial injuryBack injurySpinal cord injuryFirefighterPaid administrative leavePersonal undertakingDepartmental authorizationLabor Code section 3600.4Petition for reconsiderationOpinion and Decision After Reconsideration
References
0
Case No. Docket No. 2020-05-0361 / State File No. 25334-2020
Regular Panel Decision
Nov 18, 2020

Elmore, Stacey v. Federal Express Ground

Ms. Elmore, an employee of FedEx, sustained a left foot injury on November 27, 2018. She developed complex regional pain syndrome in her foot and leg, leading her authorized pain specialist, Dr. Matthew Rupert, to recommend a spinal cord stimulator trial in February 2020. The recommendation was denied by utilization review due to missing lab work, a denial upheld on appeal. Ms. Elmore sought a court order for the trial, but FedEx argued that prerequisite lab work was missing for UR approval. The Court ruled that FedEx failed to rebut the presumption of medical necessity for Dr. Rupert's recommendation, as it did not provide evidence related to ODG guidelines or generally accepted medical practice standards. Consequently, the Court granted Ms. Elmore's request, ordering FedEx to provide the recommended spinal cord stimulator trial.

spinal cord stimulatorcomplex regional pain syndromemedical necessityutilization reviewODG guidelinesauthorized treating physicianexpedited hearingworker's compensationTennesseemedical treatment dispute
References
2
Case No. 2018 NY Slip Op 02693 [160 AD3d 1238]
Regular Panel Decision
Apr 19, 2018

Matter of Nock v. New York City Dept. of Educ.

Claimant Tykeisha D. Nock, a school lunch helper, filed for workers' compensation benefits due to spinal cord, lower back, leg, foot, and thigh injuries. The Workers' Compensation Law Judge initially established the claim due to the employer's untimely notice of controversy. However, the Workers' Compensation Board reversed this decision, finding that the claimant failed to provide sufficient proof of a causally-related injury. The Appellate Division affirmed the Board's decision, emphasizing the claimant's burden to demonstrate a causal connection between her injuries and employment through competent medical evidence. The court clarified that the Board's decision did not prevent the claimant from submitting further medical evidence in the future to establish this causal link.

Workers' CompensationSpinal InjuryCausal RelationshipMedical EvidenceUntimely NoticeAppellate ReviewClaim DisallowanceSchool Lunch HelperEmployer LiabilityBoard Decision
References
8
Case No. 2017-01-0401
Regular Panel Decision
Mar 12, 2018

Owens, Sheila vs. Sitters, Etc.

Sheila Owens, a nursing assistant, sustained a work-related injury to her left shoulder and back on June 9, 2015. She later developed cervical issues, with Dr. Richard Pearce recommending surgery for a C3-4 spinal cord compression, attributing it to an aggravation of a pre-existing condition by the 2015 injury. Despite initial employer resistance, the authorized treating physician, Dr. Mastey, and an IME physician, Dr. Jolley, both agreed with or deferred to Dr. Pearce's causation opinion. The Court, presided over by Judge Audrey Headrick, found Ms. Owens likely to prevail on the merits. Consequently, the Court granted her request for expedited hearing, ordering Sitters, Etc. or its carrier, Bridgefield Casualty Ins. Co., to authorize medical treatment and provide a panel of orthopedic surgeons for her cervical condition.

workers' compensationoccupational injurycervical spinespinal fusiondiscectomymedical causationpre-existing condition aggravationexpedited hearingTennessee laworthopedic surgery
References
3
Case No. MISSING
Regular Panel Decision
Aug 07, 1984

Murtaugh v. Bankers Trust Co.

In November 1978, claimant Murtaugh filed a discrimination claim against Bankers Trust Company of Albany, N. A. following her 1977 dismissal, citing Workers’ Compensation Law § 241. The Workers’ Compensation Board affirmed a discrimination finding, which was subsequently upheld by the Appellate Division. An administrative law judge directed Murtaugh's reinstatement and awarded back wages from January 1, 1978, to October 19, 1982, with an offset for unemployment benefits. The Bank appealed this decision, contending the back pay award was unauthorized under Workers’ Compensation Law § 120, arguing Murtaugh failed to accept reemployment or mitigate damages. The court found substantial evidence that no bona fide reemployment offer was made and that the issue of mitigation of damages was not properly raised. Consequently, the court affirmed the Board's decision, upholding Murtaugh's entitlement to back pay.

Workers' Compensation LawDiscriminationBack Pay AwardReinstatementMitigation of DamagesUnemployment BenefitsOffer of ReemploymentAppellate DivisionNew York LawEmployer Liability
References
4
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