CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

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

Case No. MISSING
Regular Panel Decision

Main Evaluations, Inc. v. State

The claimant, Main Medical Evaluations, entered into contracts with the New York State Office of Temporary and Disability Assistance (OTDA) to perform consultative medical evaluations. OTDA terminated these contracts, alleging the claimant failed to disclose professional disciplinary proceedings against its chief medical officer, Arvinder Sachdev, and submitted false information during the bidding process. Following the dismissal of its claim in the Court of Claims, the claimant appealed. The appellate court affirmed the lower court's judgment, concluding that OTDA had legitimate grounds for termination due to the claimant's misrepresentations and failure to report substantial contract-related issues concerning Sachdev's integral role. Additionally, the court rejected the claimant's equal protection argument, finding no evidence of selective enforcement based on impermissible considerations.

Contract TerminationProfessional MisconductFalse RepresentationEqual ProtectionGovernment ContractsAppellate ReviewBreach of ContractMedical LicensingAdministrative ProceedingsDue Diligence
References
5
Case No. MISSING
Regular Panel Decision

Davis v. Medical Evaluation Specialists, Inc.

Justice Wilson dissents from the majority's decision on a motion for rehearing, arguing that the majority improperly considered non-evidence and engaged in speculation. The dissent contends that Lennie Davis's controverting affidavit by Dr. Bergeron, which stated a 17% impairment rating compared to the defendants' 0%, was conclusory and insufficient to establish bad faith by Medical Evaluation Specialists, Inc., Dr. DeFrancesco, and Dr. Dozier. Justice Wilson believes that the affidavit failed to meet the objective 'no reasonable doctor' standard for controverting good faith, and therefore, the trial court's summary judgment in favor of the defendants should have been affirmed based on official immunity.

Summary JudgmentOfficial ImmunityGood FaithImpairment RatingMedical AffidavitConclusory StatementsTexas Workers' Compensation ActAppellate ReviewDissenting OpinionPermanent Disability
References
7
Case No. 2016-198 Q C
Regular Panel Decision
Jun 01, 2018

Comprehensive Care Physical Therapy, P.C. v. Allstate Ins. Co.

This case concerns a provider, Comprehensive Care Physical Therapy, P.C., seeking no-fault benefits from Allstate Insurance Company. The Civil Court initially denied the plaintiff's summary judgment motion and granted the defendant's cross-motion, dismissing the complaint based on the assignor's failure to appear for independent medical examinations (IMEs) and claims exceeding the fee schedule. On appeal, the Appellate Term modified this order, finding that Allstate failed to provide sufficient proof of timely denial form mailing, thereby precluding its defenses regarding IMEs and the fee schedule. Consequently, Allstate's cross-motion for summary judgment was denied, reversing that part of the lower court's decision. However, the Appellate Term affirmed the denial of the plaintiff's summary judgment motion, as the plaintiff also failed to establish their claims.

no-fault insurancesummary judgmentindependent medical examinationstimely denialinsurance defenseappellate reviewmedical billingassignee rightsprocedural requirementsfee schedule
References
5
Case No. 2025 NY Slip Op 02445 [237 AD3d 1500]
Regular Panel Decision
Apr 25, 2025

Matter of Cooper (Roswell Park Comprehensive Cancer Ctr.)

This case involves an appeal from an order that vacated an arbitration award concerning the termination of a registered nurse, Wendy Cooper, from Roswell Park Comprehensive Cancer Center. Cooper was terminated for failing to comply with a COVID-19 vaccine mandate, which was later declared null and void in an unrelated case. The arbitrator, however, upheld Cooper's termination based on the collective bargaining agreement. The Supreme Court vacated the arbitration award, reinstating Cooper, finding it irrational and against public policy. The Appellate Division reversed the Supreme Court's order, confirming the arbitration award. It held that the Supreme Court erred in vacating the award, as petitioners failed to prove it violated a strong public policy or was irrational under CPLR 7511 (b), reaffirming the limited scope of judicial review for arbitration awards.

Arbitration AwardVacaturPublic PolicyIrrationalityCOVID-19 Vaccine MandateEmployment TerminationCollective Bargaining AgreementCPLR Article 75Appellate ReviewJudicial Review Limitation
References
9
Case No. MISSING
Regular Panel Decision

55th Management Corp. v. Goldman

This case addresses whether an out-of-court statement made to a court evaluator in an Article 81 guardianship proceeding is protected by absolute privilege, thereby defeating a defamation claim. The defendant, a tenant, made allegedly defamatory remarks about a landlord to a court evaluator during the evaluator's investigation for a guardianship proceeding. The court considered if the remarks were pertinent, if a statement to a court evaluator is considered part of a judicial proceeding, and if the speaker had standing. The court found the remarks pertinent, extended the absolute privilege to statements made to court evaluators given their role as court agents, and affirmed the defendant's standing as a potential witness. Consequently, the defendant's motion to dismiss the defamation complaint was granted.

DefamationAbsolute PrivilegeJudicial ProceedingsCourt EvaluatorGuardianshipMental Hygiene Law Article 81Tenant-Landlord DisputeMotion to DismissCPLR 3211 (a) (7)Scope of Privilege
References
44
Case No. 2017-2088 K C
Regular Panel Decision
Oct 25, 2019

Quality Comprehensive Med. Care, P.C. v. New York Cent. Mut. Fire Ins. Co.

The Appellate Term, Second Department, reviewed an appeal concerning assigned first-party no-fault benefits. The plaintiff, Quality Comprehensive Medical Care, P.C., appealed a Civil Court order that granted summary judgment to the defendant, New York Central Mutual Fire Insurance Company, dismissing the complaint. The defendant had denied claims asserting a lack of medical necessity and excessive fees. The appellate court determined that the defendant did not establish a lack of medical necessity. However, it agreed that fees exceeding $425.88 per claim surpassed the allowed amount under the workers' compensation fee schedule. Therefore, the Civil Court's order was modified to dismiss only the portion of the complaint seeking recovery in excess of $425.88 per claim, and the order was affirmed as modified.

No-fault benefitsMedical necessityWorkers' compensation fee scheduleSummary judgmentAppellate reviewInsurance claimsFee disputeAssigned benefitsCivil CourtKings County
References
4
Case No. 2016-03-0413
Regular Panel Decision
Oct 05, 2017

Dodson, Deborah v. LHC Group

Deborah Dodson, an employee of LHC Group, injured her left ankle and right knee in May 2015. She underwent knee surgery and was placed at maximum medical improvement by Dr. Johnson. She later developed small fiber neuropathy, and despite a referral, faced difficulties obtaining a neurologic impairment evaluation. The Court granted Ms. Dodson's request for a neurologic impairment evaluation, either by Dr. Butler or another neurologist, referring Dr. Butler to the Penalty Program for failure to provide an impairment opinion. However, the Court denied her claim for additional temporary total disability benefits, finding she reached MMI on March 23, 2017, when Dr. Butler ceased active treatment.

Workers' CompensationNeurologic Impairment EvaluationTemporary Total Disability BenefitsMaximum Medical ImprovementSmall Fiber NeuropathyPain ManagementExpedited HearingMedical TreatmentImpairment RatingPenalty Program
References
3
Case No. ADJ9066751, ADJ9886621, ADJ10024303
Regular
Oct 05, 2016

CONSTANZA MEDINA VARGAS vs. BARRETT BUSINESS SERVICES, INC.

Here's a concise summary for a lawyer: The Workers' Compensation Appeals Board denied the applicant's petition for removal of an order taking the case off calendar. The Board found no irreparable harm or extraordinary circumstances justifying removal, as the applicant can refile a declaration of readiness. The Board also suggested the parties attempt to resolve disputes regarding additional medical evaluations before seeking Board intervention. They clarified that medical-legal expenses incurred during comprehensive evaluations are not subject to utilization review.

Petition for RemovalOrder Taking Case Off CalendarIrreparable HarmQualified Medical EvaluationsPrimary Treating PhysicianUtilization ReviewMedical-Legal ExpensesDiagnostic TestsDisputed Medical FactAdjudication of Claim
References
2
Case No. ADJ10077078
Regular
Oct 06, 2016

Francisco Meza Diaz vs. Silvestri Studio, Inc., Travelers Property Casualty Company of America

The Workers' Compensation Appeals Board granted the employer's petition for reconsideration, rescinding the previous order. The Board found that the Qualified Medical Evaluator (QME) should address all contested medical issues, not just compensability and causation, as initially ordered. This aligns with statutory requirements for comprehensive medical evaluations under Labor Code sections 4060, 4062.2, 4062.3, and 4064. Additionally, the Board found no basis for the prior order's findings on earnings, impairment, or further medical treatment, as these were not the stipulated issues for trial.

QMEpanel QMEDr. Hymancompensabilitycausationcumulative traumaLabor Code section 4060Labor Code section 4062comprehensive medical evaluationcontested medical issues
References
0
Case No. ADJ8814212
Regular
Sep 08, 2017

VICTORIA LEWIS vs. LOS ANGELES UNIFIED SCHOOL DISTRICT

The Workers' Compensation Appeals Board granted the defendant's petition for removal, rescinding the administrative law judge's order for a replacement Qualified Medical Evaluator (QME). The Board found the judge did not properly consider if good cause existed for replacement, particularly regarding an untimely supplemental report. The Board remanded the case to the trial level for further proceedings, requiring evaluation of factors like prejudice and efforts to remedy delays before a replacement QME is ordered. The ultimate decision will hinge on a comprehensive analysis of these factors, not solely the untimeliness of the report.

Petition for RemovalQualified Medical EvaluatorQME panelFindings of Fact and Orderreplacement QMEuntimely reportgood causesupplemental reportMedical UnitAdministrative Director Rule 31.5
References
8
Showing 1-10 of 2,405 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational