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

Case No. ADJ9171432
Regular
Apr 25, 2016

Kenneth Evanoff vs. CITY OF LOS ANGELES, SUBSEQUENT INJURIES BENEFITS TRUST FUND

This case involves an applicant seeking reconsideration of a workers' compensation award. The applicant, previously awarded 96% permanent disability for a 2007 injury, suffered a subsequent injury in 2012 resulting in prostate cancer. The initial award used the Combined Values Chart to calculate the combined disability at 98%, entitling him to benefits from the Subsequent Injuries Benefits Trust Fund (SIBTF). The applicant argues the trial judge erred by using the Combined Values Chart and seeks to simply add the disability percentages, leading to a 100% combined disability. The Board granted reconsideration, finding that in the absence of overlapping disabilities, the disabilities should be added, entitling the applicant to a 100% permanent disability rating and remanding for a new award.

Subsequent Injuries Benefits Trust FundSIBTFCumulative Trauma InjuryPermanent DisabilityCombined Values ChartLabor Code section 4664(c)(1)(G)Whole Person ImpairmentWPIDate of InjuryDate of Knowledge
References
1
Case No. MISSING
Regular Panel Decision
Nov 30, 2015

Claim of Gramza v. Buffalo Board of Education

Claimant, a teacher, sustained a work-related injury to his left shoulder and neck in 2005 and was subsequently classified with a permanent partial disability. The employer sought reimbursement from the Special Disability Fund, citing the claimant's preexisting medical conditions, including rheumatoid arthritis and hypertension. The Workers' Compensation Board granted this application, prompting an appeal from the Fund. The court affirmed the Board's decision, finding substantial evidence that the claimant's rheumatoid arthritis was a permanent condition restricting hand use and hindering general employability. An independent medical reviewer's opinion further supported that the claimant's overall disability was significantly greater due to the combined effect of both conditions.

Workers' CompensationSpecial Disability FundReimbursementPreexisting ImpairmentRheumatoid ArthritisPermanent Partial DisabilityMaterially and Substantially Greater DisabilityGeneral EmployabilityIndependent Medical ReviewerAppellate Division
References
6
Case No. ADJ9443336 ADJ9779744
Regular
Nov 25, 2019

JAMES KWASIGROCH vs. SUBSEQUENT INJURIES BENEFIT TRUST FUND OF CALIFORNIA

This case concerns the calculation of combined permanent disability for Subsequent Injuries Benefit Trust Fund (SIBTF) benefits. The applicant, James Kwasigroch, received awards for a prior disability of 63% and a subsequent disability of 74%. The central dispute was whether to add these percentages directly or use a Combined Values Chart (CVC) as the trial judge did. The Appeals Board reversed the trial judge's decision, holding that non-overlapping prior and subsequent disabilities should be added based on the precedent set in *Bookout v. Workers' Comp. Appeals Bd.* This resulted in a finding of 100% combined permanent disability and an adjustment to attorney's fees.

Subsequent Injuries Benefit Trust FundCombined Values ChartBookout v. Workers' Comp. Appeals Bd.Permanent Disability RatingApportionmentMultiple Disabilities TablesPyramidingOverlapNon-overlapping disabilitiesLabor Code section 4751
References
9
Case No. MISSING
Regular Panel Decision

Smith v. New York State & Local Retirement Systems

Petitioner, a taxpayer services representative, sustained a back injury in March 1981 while lifting forms, leading to a decline in attendance and eventual termination in November 1989. She applied for accidental and ordinary disability retirement benefits, both of which were denied by the Comptroller. The accidental disability claim was denied because the incident was not deemed an 'accident' under Retirement and Security Law § 63. The ordinary disability claim was denied as untimely, having been filed approximately six months after her termination, exceeding the 90-day limit stipulated by Retirement and Social Security Law § 62. The Supreme Court dismissed the challenge to the ordinary disability denial due to untimeliness and transferred the accidental disability challenge to this Court. This Court confirmed the Comptroller's determination on both counts, rejecting the petitioner's estoppel argument regarding the untimely ordinary disability application and finding substantial evidence to support the finding that the injury did not constitute an 'accident' within the meaning of the relevant law, as it resulted from ordinary employment duties without an unexpected event.

Disability Retirement BenefitsAccidental DisabilityOrdinary DisabilityUntimely ApplicationEstoppel Against GovernmentWork-Related InjuryBack InjuryDefinition of AccidentOrdinary Employment DutiesSubstantial Evidence Review
References
16
Case No. MISSING
Regular Panel Decision
May 15, 2012

Hamzik v. Office for People with Developmental Disabilities

Plaintiff John J. Hamzik sued the Office for People with Developmental Disabilities (OPWDD) and several individual employees, alleging discrimination based on sex, age, and disability, as well as equal protection, due process, and retaliation claims under federal and state laws, including Title VII, ADEA, and ADA. Defendants moved to dismiss the amended complaint, and plaintiff cross-moved to file a second amended complaint. The District Court, finding that many claims were barred by Eleventh Amendment immunity or failure to exhaust administrative remedies, and that the remaining claims failed to state a plausible cause of action, granted the defendants' motion to dismiss. All federal claims were dismissed with prejudice, the cross-motion was denied as futile, and the remaining state law claims were dismissed without prejudice.

DiscriminationRetaliationDue ProcessEqual ProtectionTitle VIIADEAADAEleventh Amendment ImmunityAdministrative ExhaustionMotion to Dismiss
References
50
Case No. 2020 NY Slip Op 02301 [182 AD3d 821]
Regular Panel Decision
Apr 16, 2020

Matter of Community, Work, & Independence, Inc. v. New York State Off. for People with Dev. Disabilities

This case involves a CPLR article 78 proceeding initiated by Community, Work, and Independence, Inc. (petitioner) to challenge a determination affirming the objection to its proposed discharge of M.D., an individual with developmental disabilities, from day habilitation services. M.D.'s parents objected to the discharge, and an administrative hearing sustained their objection, a decision later affirmed by the Commissioner of the Office for People with Developmental Disabilities. The Appellate Division, Third Department, confirmed the Commissioner's determination, finding that the burden of proof was appropriately placed on the service provider. The court concluded that substantial evidence supported the finding that discharging M.D. was not reasonable, considering his needs, the lack of suitable alternative programs, and despite the petitioner's financial concerns. The court suggested that financial issues for service providers should be addressed by seeking increased funding rather than by discharging individuals.

Developmental DisabilityHCBS WaiverDischarge ServicesAdministrative HearingBurden of ProofSubstantial EvidenceFinancial ConcernsService ProviderMedicaid FundingAutism Spectrum
References
7
Case No. ADJ12660754
Regular
Apr 04, 2025

NANCY ARNOLD vs. SUBEQUENT INJURIES BENEFITS TRUST FUND, et. al.

The Subsequent Injuries Benefits Trust Fund (SIBTF) sought reconsideration of a WCJ's F&A finding the applicant entitled to SIBTF benefits for 100% permanent total disability. SIBTF contended errors regarding findings on prior/subsequent disabilities, psychiatric disability compensability, and the method of combining disabilities. The Appeals Board granted reconsideration, rescinded the F&A, and remanded the case for further proceedings. The trial level must now address the compensability of psyche injury and permanent disability, and the correct application of the Combined Values Chart.

Subsequent Injuries Benefits Trust FundSIBTFpermanent total disabilityprior disabilitysubsequent industrial disabilitypsychiatric disabilitycompensabilityLabor Code section 4660.1Combined Values ChartCVC
References
25
Case No. MISSING
Regular Panel Decision
Mar 31, 1998

Claim of Chadwick v. Mallinkrodt Anesthesia Products

This case involves an appeal by an employer and its insurance carrier from a Workers’ Compensation Board decision, filed March 31, 1998, which discharged the Special Disability Fund from liability under Workers’ Compensation Law § 15 (8). The employer and carrier sought reimbursement, arguing that the claimant's preexisting medical conditions, combined with a work-related injury, resulted in a greater disability. However, the Board found insufficient evidence that these prior conditions hindered the claimant's job potential before the work injury. The Appellate Division, Third Department, affirmed the Board's decision, reiterating that proof of a preexisting permanent impairment hindering job potential is crucial for employer reimbursement under WCL § 15 (8).

Workers' CompensationSpecial Disability FundReimbursementPermanent ImpairmentPreexisting ConditionJob PotentialWorkers' Compensation Law § 15 (8)AppealAffirmed DecisionLiability Discharge
References
3
Case No. ADJ744235
Regular
Aug 11, 2009

ROBERT RATTO vs. CURTIN AIR FREIGHT, INC., STATE COMPENSATIN INSURANCE FUND

This case concerns a worker seeking reconsideration of a prior permanent disability award. The applicant argued their back and psychiatric conditions combined to increase their overall permanent disability to 73%. The Appeals Board granted reconsideration, finding that a prior award for the back injury could not be reopened due to pre-SB 899 apportionment issues. However, the Board allowed for a combined rating of 70% by including the psychiatric disability with the previously awarded orthopedic disability, thus increasing the total permanent disability. The applicant's attorney was awarded a fee based on this increase.

ReconsiderationNew and further disabilityIndustrial injuryPsyche injuryPermanent disabilityApportionmentSB 899Agreed Medical EvaluatorStipulated AwardPetition to reopen
References
1
Case No. ADJ1970560 (OAK 0344240)
Regular
Mar 09, 2016

VAZGEN MANAS vs. THE DIRECTOR OF THE DEPARTMENT OF INDUSTRIAL RELATIONS, as administrator of the SUBSEQUENT INJURIES BENEFITS TRUST FUND

This case concerns a credit sought by the Subsequent Injuries Benefits Trust Fund (SIBTF) for permanent disability advances paid to the applicant. The SIBTF argued that its liability for combined permanent disability should be calculated under Labor Code section 4751, which limits liability to the difference between the combined disability and the disability from the subsequent injury alone. The Workers' Compensation Appeals Board agreed, reversing the prior finding that allowed a credit under section 4753 for the employer's payments. The Board clarified that section 4753 applies to payments for preexisting disability, not the subsequent industrial injury, and thus SIBTF's credit is limited by section 4751.

Subsequent Injuries Benefits Trust FundLabor Code section 4751Labor Code section 4753permanent disability advancespreexisting permanent disabilitysubsequent industrial injurycombined permanent disabilitycreditWCJFindings of Fact
References
6
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