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

Case No. ADJ10813026
Regular
May 27, 2025

Noureddine Manser vs. Return-to-Work Supplement Program

Applicant Noureddine Manser sought reconsideration of a November 9, 2023 finding that he was not entitled to a second Return-to-Work Supplement Program (RTWSP) benefit under Rule 17302(b), which prohibits a second benefit unless for a subsequent injury. Applicant contended the word "injury" should include a continuing injury. The Appeals Board affirmed the November 9, 2023 Findings of Fact, declining to interpret "injury" as a continuing injury and noting that the validity of Rule 17302(b) is subject to judicial review in the Superior Court, not the Appeals Board. The Board also asserted its jurisdiction to review the WCJ's denial despite arguments to the contrary.

Return-to-Work Supplement ProgramRTWSPRule 17302(b)vocational rehabilitationsubsequent injurySJDBVQMEtemporary total disabilityWCABLabor Code section 139.48
References
8
Case No. MISSING
Regular Panel Decision
Dec 03, 2004

Claim of Scally v. Ravena Coeymans Selkirk Central School District

In this case, a claimant appealed a Workers’ Compensation Board decision regarding apportionment of her workers' compensation award. The claimant, who suffered a work-related left knee injury in 2002, had a pre-existing non-work-related injury to the same knee from 1986. While a WCLJ initially denied apportionment, the Board reversed, directing a 50/50 apportionment based on the premise that the prior injury would have resulted in a schedule loss of use award had it been work-related. The appellate court upheld the Board's determination, deferring to its interpretation that a non-work-related injury leading to a schedule loss of use constitutes a "disability in a compensation sense" for apportionment purposes. This decision was supported by medical expert testimony indicating a schedule loss of use from the prior surgery.

Workers' CompensationApportionmentKnee InjuryNon-work-related InjurySchedule Loss of UsePreexisting ConditionMedical Expert TestimonyBoard InterpretationJudicial ReviewAppellate Decision
References
13
Case No. MISSING
Regular Panel Decision
Dec 03, 2003

Beesmer v. Village of DeRuyter Fire Department

In 1975, the decedent, a volunteer firefighter, suffered a heart attack and continuously received workers' compensation benefits until his death in 2002. His claimant applied for death benefits, alleging a causal link between the 1975 injury and his death. A Workers’ Compensation Law Judge (WCLJ) awarded benefits after denying the employer's request for a second adjournment to depose treating physicians, a decision affirmed by the Workers' Compensation Board. The court found substantial evidence supporting the causal relationship between the heart attack and death, noting that a work-related injury need not be the sole cause of death. Additionally, the court upheld the WCLJ's denial of the adjournment, as the employer failed to provide a sufficient excuse for not scheduling depositions or serving subpoenas during the initial adjournment period.

Workers' Compensation Death BenefitsCausal RelationshipHeart AttackCongestive Heart FailureAdjournment DenialTreating Physician DepositionSubstantial EvidenceAppellate ReviewMedical OpinionVolunteer Firefighter
References
5
Case No. MISSING
Regular Panel Decision

Claim of Grant v. Niagara Mohawk Power Co.

The claimant, a 60-year-old lineman, suffered a left leg and back injury in December 2000 while working for Niagara Mohawk Power Company, receiving initial benefits. He later underwent surgery for an unrelated right foot injury and subsequently retired in June 2002, receiving disability retirement benefits. The Workers’ Compensation Board reversed a WCLJ decision, finding that the claimant voluntarily withdrew from the labor market because he lacked a finding of permanency and failed to provide sufficient medical documentation to prove a continuing disability causally related to his initial work injury. The appellate court affirmed the Board's determination, concluding that substantial evidence supported the finding that his retirement was due to the unrelated right foot injury and not the work-related back and leg injury, and that he failed to meet the burden of demonstrating a continuing disability for permanency classification.

Workers' CompensationLabor Market AttachmentVoluntary WithdrawalPermanent Partial DisabilityMedical EvidenceAppellate ReviewInjury CausationRight Foot InjuryBack InjuryLeft Leg Injury
References
6
Case No. MISSING
Regular Panel Decision

Claim of Dillabough v. Jaquith Industries, Inc.

Claimant, who suffered an occupational injury to their right elbow, was deemed permanently partially disabled and awarded continuing workers' compensation benefits for reduced earnings after accepting a lower-paying position with the employer. The Workers' Compensation Board affirmed a Workers’ Compensation Law Judge’s decision. The employer appealed, arguing the injury was amenable to a schedule award rather than continuing benefits. However, the court affirmed the Board's decision, citing substantial evidence from a medical expert that the claimant's condition involved continuing pain, potential worsening, and a future need for surgery, justifying the award of continuing benefits.

Workers' CompensationPermanent Partial DisabilityReduced EarningsSchedule AwardContinuing BenefitsMedical Expert TestimonyPainSurgeryOccupational InjuryEmployer Appeal
References
6
Case No. ADJ1358769
Regular
Jan 08, 2013

JOSEPH ODDO vs. MARTIN & LEWIS DRYWALL, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, EXPLORER INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) denied CIGA's petition for reconsideration of the WCJ's findings. The WCJ found that the applicant's injury was a specific injury on April 28, 2000, and not a continuous trauma, and that CIGA failed to meet its burden of proof on this issue. The WCAB gave great weight to the WCJ's credibility findings regarding the applicant's testimony and the lack of substantial evidence supporting a continuous trauma injury during specific coverage periods. Therefore, CIGA's petition for reconsideration was denied.

Workers' Compensation Appeals BoardMartin & Lewis DrywallCalifornia Insurance Guarantee AssociationIntercare Insurance ServicesHIH Insurance CompanyExplorer Insurance CompanyInsurance Company of the WestPetition for ReconsiderationWorkers' Compensation Administrative Law JudgeContinuous Trauma
References
1
Case No. ADJ7632777
Regular
Apr 10, 2012

EFREN MARTINEZ vs. INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA

This case involves a petition for reconsideration by the defendant insurer regarding a Workers' Compensation Appeals Board decision. The defendant argued their name was mistyped, the date of injury was incorrect, and the amendment to include a continuous trauma claim was improper. The Board granted reconsideration to correct the insurer's name and amend the date of injury to November 12, 2010, acknowledging these as typographical errors. The Board affirmed the finding of industrial injury and upheld the amendment to reflect a continuous trauma claim, finding the defendant had sufficient notice.

Workers' Compensation Appeals BoardExpress Employment ProfessionalsInsurance Company of the State of PennsylvaniaSedgwick CMSReconsiderationFindings and AwardAdministrative Law JudgeEfren MartinezIndustrial InjuryToolmaker Helper
References
3
Case No. ADJ8844834
Regular
Nov 05, 2018

HECTOR GARCIA vs. BARRETT BUSINESS SERVICES, INC.

Applicant sustained industrial injury as a truck driver in 2013, resulting in multiple body part injuries and traumatic brain injury. The employer sought to overturn the WCJ's finding that their Utilization Review (UR) determination for applicant's continued inpatient care was untimely. The Appeals Board affirmed the WCJ's decision, finding the UR was indeed untimely under Labor Code section 4610(i) for failing to meet the 72-hour timeframe for concurrent review in cases of imminent health threats. Consequently, applicant's continued inpatient care at CNS was authorized.

Utilization ReviewLabor Code Section 4610(i)Concurrent ReviewTimelinessIndependent Medical ReviewInpatient CareCenter for Neuro SkillsRequest for AuthorizationPrimary Treating PhysicianMedical Treatment
References
4
Case No. ADJ394938 (OAK 0328377)
Regular
Dec 16, 2015

LONDON MORROW vs. GOLDEN GATE BRIDGE HIGHWAY AND TRANSPORTATION DISTRICT

This case concerns an applicant who sustained a right shoulder injury in 2003 and was awarded temporary disability indemnity for a new period of disability in 2015. The defendant challenged this award, arguing the Board lacked jurisdiction to grant temporary disability more than five years after the injury date, as the applicant had not been continuously disabled. The majority of the Board denied reconsideration, adopting the WCJ's report. However, a dissenting commissioner argued that Labor Code section 4656 and prior case law preclude jurisdiction for a new temporary disability period initiated more than five years post-injury, especially when disability was not continuous.

Workers' Compensation Appeals BoardPetition for ReconsiderationTemporary Disability IndemnityDate of InjuryJurisdictionLabor Code Section 4656Nickelsberg v. Workers' Comp. Appeals Bd.Continuous DisabilityNew Period of Temporary DisabilityPermanent and Stationary
References
1
Case No. MISSING
Regular Panel Decision

Lewis v. Toring Taxi Co.

The case is an appeal from a Workmen's Compensation Board decision filed on August 19, 1976. The majority affirmed the board's decision without opinion, while Justices Greenblott and Main dissented. The dissent argued that the claimant, a taxi driver, sustained an injury arising out of and in the course of his employment. The injury occurred during an argument with a passenger over a fare and waiting time, which began outside and continued into the Americana Hotel lobby in New York City, culminating in the claimant's fall. The dissenting judges asserted that the claimant did not abandon his employment, citing precedent that work-related arguments, even when continuing into different locations, maintain the continuity of employment.

Workers' Compensation LawTaxi DriverEmployment InjuryWork-Related DisputeCourse of EmploymentAppellant vs. RespondentConcurring OpinionDissenting OpinionAppeal BoardHotel Incident
References
3
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