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Case Law Database

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

Case No. ADJ779674 (VNO 0477979)
Regular
Sep 21, 2012

CAESAR (CESAR) RIVAS vs. CITY OF LOS ANGELES

The Workers' Compensation Appeals Board (WCAB) is reconsidering a prior award in the case of Caesar Rivas v. City of Los Angeles. The WCAB intends to admit into evidence two previously marked-for-identification medical reports: one by Gary Halote and another by Dr. David Glaser. These reports were initially excluded due to objections but will now be admitted unless good cause to the contrary is shown within ten days. Upon expiration of this period, the case will be submitted for a decision after reconsideration.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardGary Halote reportDr. David Glaser reportNotice of Intention to Admit EvidenceMarked for IdentificationObjected to evidenceDecision After ReconsiderationPermissibly Self-Insured
References
0
Case No. ADJ3156337 (FRE 0209931) ADJ4199467 (FRE 0209932)
Regular
Nov 20, 2008

FRANK FLORES vs. NICKEL'S PAYLESS STORES, WAUSAU INSURANCE COMPANIES, EVEREST NATIONAL INSURANCE COMPANY, AMERICAN COMMERCIAL CLAIMS ADMINSITRATORS

The Workers' Compensation Appeals Board granted reconsideration of an award for a 1999 right foot and ankle injury, specifically addressing the defendant's claims of error in permanent disability calculation without apportionment and the exclusion of medical evidence. The Board intends to admit the Agreed Medical Evaluator's reports into evidence, which the WCJ had previously excluded. This decision will allow the Board to review all relevant medical evidence before making a final determination on apportionment and the applicant's claimed injuries.

Workers Compensation Appeals BoardIndustrial InjuryPermanent Partial DisabilityApportionmentAgreed Medical EvaluatorSubstantial Medical EvidenceAdmissibility of EvidencePetition for ReconsiderationAmended Findings Award and OrderMinutes of Hearing
References
0
Case No. MISSING
Regular Panel Decision
Jul 22, 2002

Claim of Ostuni v. Town of Ramapo

Claimant appealed from a decision of the Workers’ Compensation Board, filed July 22, 2002, which denied her application for reconsideration and/or full Board review of a prior decision. The prior decision had ruled that claimant did not sustain a work-related injury, citing insufficient credible evidence. The appellate court affirmed the Board's denial, finding that the Board fully considered all evidence and no new, previously unavailable evidence was offered to warrant altering its decision. Furthermore, the court found substantial evidence supported the Board’s September 2001 decision that claimant’s injuries were not compensable, as her recurring lower back pain stemmed from injuries predating or following the alleged November 1990 incident, rather than the incident itself. The court also upheld the Board's rejection of contrary testimony as not credible.

Workers' CompensationBack InjuryWork-Related InjuryReconsiderationBoard ReviewAppellate ReviewAbuse of DiscretionArbitrary and CapriciousSubstantial EvidenceMedical Testimony
References
5
Case No. ADJ8518632
Regular
May 09, 2017

HORACIO MONTOYA vs. CBC FRAMING, INC., ARCH INSURANCE COMPANY, A B GALLAGHER BASSETT

The WCAB granted the defendant's Petition for Removal regarding a prior WCJ order compelling a Functional Capacity Evaluation. Removal was granted because the WCJ's order was based on a medical report that had not been formally admitted into evidence, preventing meaningful review. The Board will now admit the defendant's medical report into evidence for the limited purpose of determining the Petition for Removal. This action is an extraordinary remedy due to the prejudice caused by relying on unadmitted evidence.

RemovalFunctional Capacity EvaluationIndustrial InjuryPrejudiceIrreparable HarmAdmitted EvidenceQualified Medical EvaluationExhibit AAdministrative Law JudgePetition for Removal
References
4
Case No. MISSING
Regular Panel Decision

People v. Rodriguez

The defendant, indicted for resisting arrest and DWI, filed a motion to prevent the District Attorney from using evidence of his refusal to take a chemical test at trial. The defendant argued that admitting such evidence violates his Fifth Amendment rights against self-incrimination, despite a 1973 amendment to Vehicle and Traffic Law § 1194 that permitted it. The court analyzed precedents, distinguishing between the non-testimonial nature of the test itself and the communicative nature of a refusal. It concluded that a refusal constitutes a communication, thus falling under Fifth Amendment protection. Consequently, the court granted the defendant's motion, ruling that such evidence is inadmissible.

Fifth AmendmentSelf-incriminationChemical Test RefusalDWIAdmissibility of EvidenceConstitutional RightsTestimonial EvidenceImplied Consent LawPreclusion MotionCriminal Procedure
References
19
Case No. ADJ9725074
Regular
May 25, 2016

RAFAEL GIL vs. WEBCOR BUILDERS, ZURICH INSURANCE

The Workers' Compensation Appeals Board affirmed a prior decision finding the applicant sustained an industrial injury to his head, neck, back, and right shoulder. The Board upheld the award of temporary disability, finding the applicant's testimony credible, supported by medical evidence. Defendants argued insufficient evidence for temporary disability, but the Board found no contrary evidence of substantial weight. The WCJ's findings on credibility and factual determinations were given great weight and were affirmed.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardTemporary Disability IndemnityWCJCredibility DeterminationsIndustrial InjuryContrary EvidenceAffirm DecisionScott Co. v. Workers' Comp. Appeals Bd.
References
0
Case No. ADJ352576
Regular
Jul 15, 2016

SARA VILLEGAS vs. CALIFORNIA ELWYN INSTITUTE, ZENITH INSURANCE COMPANY

In Case No. ADJ352576, the Workers' Compensation Appeals Board (WCAB) dismissed Sara Villegas's Petition for Reconsideration as untimely filed. The petition was filed over 25 days after the WCJ's decision was served, a jurisdictional deadline. In Case No. ADJ7671630, the WCAB denied LA Leasing's Petition for Reconsideration, adopting the WCJ's report that found the petitioner's contentions regarding medical evidence and consolidation were without merit. The WCAB found the WCJ's decision was supported by substantial medical evidence and that the petitioner failed to provide contrary evidence. Both orders were issued on July 15, 2016.

Workers' Compensation Appeals BoardPetition for ReconsiderationUntimely FilingJurisdictional Time LimitWCJ ReportAgreed Medical ExaminerTemporary DisabilityStipulation with Request for AwardSpecific InjuryCumulative Trauma
References
4
Case No. MISSING
Regular Panel Decision

In re Captain Kishka, Inc.

Captain Kishka, Inc., a company providing musical talent, appealed a decision by the Unemployment Insurance Appeal Board. The Board had found that Kishka's relationship with its performers was that of employer-employee, rather than independent contractors. Kishka contended this finding lacked substantial evidence and was contrary to legal authority. The court, however, emphasized that the existence of an employment relationship is a factual question, and the Board's findings are conclusive if supported by substantial evidence. Despite the possibility of other interpretations, the evidence presented was deemed sufficient to support the Board's determination of an employer-employee relationship. Consequently, the Board's decision was affirmed.

Employment RelationshipIndependent ContractorUnemployment InsuranceAppeal Board DecisionSubstantial EvidenceEmployer ControlMusical Talent IndustryPerforming ArtistsWorkers' Compensation InsuranceAppellate Review
References
6
Case No. No. 46
Regular Panel Decision
May 16, 2024

The Matter of the Claim of Justin Timperio v. Bronx-Lebanon Hospital

This case clarifies the operation of the rebuttable presumption under New York Workers' Compensation Law § 21 (1). The claimant, Justin Timperio, a resident at Bronx-Lebanon Hospital, was injured during a workplace shooting. While the Workers' Compensation Board found his injuries compensable, the Appellate Division reversed, citing a lack of evidence regarding the assailant's motivation. The Court of Appeals reversed the Appellate Division, holding that when an injury occurs in the course of employment, it is presumed to arise out of employment unless substantial evidence to the contrary exists. The Court emphasized that a lack of evidence concerning the assailant's motivation does not, by itself, rebut this presumption, especially in the absence of any established personal animosity between the parties.

Workplace ShootingWorkers' CompensationRebuttable PresumptionCourse of EmploymentArising Out of EmploymentLack of MotivationAssault InjuryStatutory InterpretationAppellate ReviewNew York Law
References
14
Case No. 2022 NY Slip Op 05574
Regular Panel Decision
Oct 06, 2022

Matter of Molander v. New York City Tr. Auth.

Claimant Richard Molander, a mason, has an established workers' compensation claim for various health issues but worked full duty without lost time until February 2020. His New York driver's license was revoked in January 2020 due to an alcohol-related driving offense. Shortly after, he sought a medical evaluation and presented a note for modified duties to his employer, who stated no such work was available, leading to him ceasing work. A Workers' Compensation Law Judge and the Workers' Compensation Board denied his claim for causally-related lost time, finding his testimony not credible and medical evidence insufficient to prove a worsening condition necessitated his departure. The Appellate Division, Third Department, affirmed the Board's decision, concluding that substantial evidence supported the finding that Molander's withdrawal from the labor market was voluntary and not directly caused by a disability, noting a lack of objective medical evidence to the contrary.

Workers' CompensationOccupational DiseaseLost Time BenefitsDisability ClaimMedical CausationCredibility AssessmentAppellate ReviewLabor Market WithdrawalDriver's License RevocationModified Work Duty
References
5
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