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Case Law Database

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

Case No. MISSING
Regular Panel Decision

Menin v. Tully

The petitioner, an estate planner and life insurance agent, sought to review a State Tax Commission determination sustaining a deficiency assessment for unincorporated business taxes for various years between 1964 and 1974. The respondent concluded that the petitioner was an independent contractor rather than an employee. Petitioner worked under an agent’s career contract for New England Life Insurance Company and its general agent, but also sold insurance for other principals and operated with considerable independence, including maintaining his own office and incurring substantial business expenses. The court affirmed the determination, finding substantial evidence to support the conclusion that the petitioner was an independent contractor and therefore subject to the unincorporated business tax.

unincorporated business taxindependent contractorinsurance agentState Tax Commissiontax assessmentCPLR Article 78employer controlbusiness expensestax deficiencyappellate review
References
8
Case No. ADJ18498378
Regular
Oct 27, 2025

MARIA VENEGAS vs. MARATHON PETROLEUM COMPANY, ACE AMERICAN INSURANCE

Lien claimant, Premier Psychological Services, sought reconsideration of a Findings and Order from July 30, 2025, which denied its lien for medical-legal and medical treatment expenses. The Workers' Compensation Appeals Board (WCAB) granted the petition for reconsideration, rescinded the original F&O, and returned the matter to the trial level for further proceedings. The Board found that the medical-legal expenses were incurred for a contested claim and that the medical report from Dr. Mark Michaels constituted substantial medical evidence for an injury arising out of and in the course of employment, despite some curable deficiencies regarding interpreter information. The WCAB ordered further consideration of the medical treatment expenses and a potential updated utilization review.

Premier Psychological ServicesAdjudication Number ADJ18498378Opinion and Order Granting Petition for ReconsiderationDecision After ReconsiderationLien ClaimantPrimary Treating Physician (PTP)Dr. Mark MichaelsInjury Arising Out of and In the Course of Employment (AOE/COE)PsycheMedical-Legal Report
References
21
Case No. MISSING
Regular Panel Decision

Marshall v. Roth Brothers Smelting Corp.

A claimant sustained a work-related injury in July 1995 and received a schedule loss of use award, partly from a third-party settlement and a deficiency award from the employer's carrier. The case was closed until January 2006 when the claimant sought payment for prescription medication, leading to the case's reopening. The Workers' Compensation Board transferred liability to the Special Fund for Reopened Cases under Workers' Compensation Law § 25-a, as statutory time periods had elapsed and the third-party settlement did not influence their expiration. The Special Fund appealed, arguing that liability for deficiency compensation awards does not shift. The court affirmed the Board's ruling, clarifying that the exception for 'awards for deficiency compensation' in § 25-a (8) only applies when the calculation or payment was delayed due to third-party litigation or settlement, which did not occur in this case.

Workers' Compensation LawSpecial Fund for Reopened CasesLiability TransferDeficiency CompensationThird-Party SettlementStatutory Time PeriodsCase ReopeningAppellate DecisionWorkers' Compensation BoardJudicial Review
References
12
Case No. MISSING
Regular Panel Decision
Apr 21, 2005

Claim of Kusy v. South Orangetown Central School District

Claimant was injured in a work-related automobile accident in 1985, receiving workers’ compensation benefits and settling a personal injury action, with the State Insurance Fund (SIF) applying a $3,000 credit. After the case was reopened in 2003 for medical expenses, SIF attempted to shift liability to the Special Fund for Reopened Cases, citing Workers’ Compensation Law § 25-a. The Special Fund disputed this, contending the claim was for deficiency compensation, an exception under Workers’ Compensation Law § 25-a (8). Both the Workers’ Compensation Law Judge and the Board affirmed this, reasoning that SIF had already applied its credit against awards not in lieu of first-party benefits, meaning subsequent awards, including medical expenses, constituted deficiency compensation. The court affirmed the Board’s decision, holding that liability does not shift to the Special Fund when deficiency compensation is awarded, particularly since SIF’s payments for lost time beyond three years were not ‘basic economic loss,’ allowing SIF to properly exercise its credit.

Workers' CompensationSpecial Fund for Reopened CasesDeficiency CompensationThird-Party SettlementState Insurance FundWorkers' Compensation Law § 25-aInsurance Law § 5102Basic Economic LossCredit OffsetMedical Expenses
References
8
Case No. ADJ16511542
Regular
Apr 25, 2023

ZALANA GRAHAM-BRYANT vs. WKS FROSTY CORPORATION, ADMINISTERED BY SEDGWICK CMS

The Workers' Compensation Appeals Board granted applicant Zalana Graham-Bryant's Petition for Removal. The Board rescinded the WCJ's Order Compelling Applicant's Deposition due to procedural deficiencies. These deficiencies included the WCJ's failure to articulate the basis for the order and the defendant's insufficient efforts to meet and confer before seeking compulsion. The case was returned to the WCJ for further proceedings.

Petition for RemovalOrder Compelling DepositionWCAB Rule 10390Meet and ConferMootnessIrreparable HarmSubstantial PrejudiceWCJ OpinionLabor Code Section 5313Rescinded Order
References
4
Case No. ADJ4676707 (RIV 0032408)
Regular
Mar 07, 2014

PAULA SHARPE vs. MANOR CARE, INC., ROYAL INSURANCE

In this workers' compensation case, the Appeals Board affirmed the original award of 15% permanent disability for an admitted neck injury. The applicant's petition for reconsideration, arguing for total disability based on vocational expert testimony and claiming inadequate compensation, was denied. The Board found the petition lacked merit, failed to cite evidence, and was deficient for not addressing contrary medical opinions. Additionally, the applicant's attorney received a strong admonishment for filing a deficient petition but was not sanctioned due to his timely apology and acceptance of responsibility.

Workers' Compensation Appeals BoardReconsiderationPermanent DisabilityApportionmentVocational ExpertAgreed Medical ExaminerSanctionWCJPetition for ReconsiderationCNA
References
0
Case No. ADJ8949526, ADJ8672351
Regular
Nov 05, 2018

ALFREDO ARGUETA vs. LA BREA DINING, ZENITH INSURANCE COMPANY

The Workers' Compensation Appeals Board denied reconsideration, upholding the administrative law judge's finding that the defendant was not liable for further payment on the lien claimant's invoices. The lien claimant argued the defendant's Explanation of Review (EOR) was deficient and thus they were not obligated to pursue a second bill review. The Board found this argument inconsistent with Labor Code section 4622, which requires timely objection to denied amounts, and adopted the WCJ's report. A dissenting opinion argued that a deficient EOR negates the requirement for a second bill review.

WCABLien claimantPetition for ReconsiderationExplanation of Review (EOR)Labor Code Section 4603.3Labor Code Section 4622Second Bill ReviewWCAB Rule 10451.1Perez v. Colorama Wholesale NurseryMedical-legal billing disputes
References
1
Case No. ADJ3496977 (AHM 0123782)
Regular
Aug 23, 2010

CARL DIXON vs. PHILLIPS BUICK, PONTIAC & MAZDA, CLARENDON NATIONAL INSURANCE COMPANY, Administered By AMERICAN ALL RISK LOSS ADMINISTRATORS, SECURITY INSURANCE COMPANY, Administered By LWP CLAIMS SOLUTIONS

The Workers' Compensation Appeals Board (WCAB) denied the defendant's petition for reconsideration, reaffirming that Labor Code § 4610 utilization review is mandatory for challenging medical treatment requests, even when an Agreed Medical Evaluator (AME) is involved. The WCAB also imposed $900 in sanctions on the Law Offices of Robin Jacobs for filing a deficient and unserved petition for reconsideration, and for failing to disclose a non-attorney's involvement. The applicant's attorney's response failed to adequately address these grounds, leading to the imposition of sanctions. The case is returned to the WCJ to correct prior decision deficiencies.

Workers' Compensation Appeals BoardPetition for ReconsiderationSanctionsUtilization ReviewAgreed Medical EvaluatorLabor Code § 4610Labor Code § 4062SandhagenWCAB RulesNon-attorney
References
1
Case No. MISSING
Regular Panel Decision

Guippone v. Bh S & B Holdings LLC

The court addresses a class action lawsuit under the WARN Act, where terminated employees sued the purchaser of their former employer, Steve & Barry's, for not providing 60 days' notice before a mass layoff. Defendants argued employees were 'part-time' because they worked for the new owner for less than six months. The court rejected this, stating that employment periods with both seller and purchaser should be aggregated for WARN Act purposes. However, the court granted the defendants' motions to dismiss without prejudice, citing the complaint's deficient pleading of facts and instructing the plaintiff to file an amended complaint addressing these deficiencies within twenty days.

WARN ActMass LayoffPlant ClosingEmployment LossAsset PurchaseSuccessor LiabilityPart-Time EmployeesPleading StandardsMotion to DismissBankruptcy
References
15
Case No. ADJ1329489
Regular
Sep 06, 2011

CHAVA COHEN vs. SHERIDAN ASSISTED LIVING, INC., STATE COMPENSATION INSURANCE FUND

This case concerns vocational consultant Judie Fogel's request for reconsideration of a prior Workers' Compensation Appeals Board (WCAB) decision. The WCAB previously rescinded an order for defendants to pay Fogel $1,700.00 for "medical legal expense for issues relating to the Ogilvie case," finding her testimony deficient and thus non-recoverable costs. Fogel argued her testimony addressed more than just Ogilvie issues, including average weekly wages, and that it was not necessary for her to independently calculate wage loss. The WCAB denied reconsideration, reiterating that Fogel was retained specifically for Ogilvie issues and her testimony remained deficient, citing precedent.

Vocational consultantReconsiderationOpinion and OrderMedical legal expenseOgilvie caseWage lossAverage weekly wagesPermanent disability ratingReimbursementEn banc decisions
References
4
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