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

Case No. MISSING
Regular Panel Decision

Perfect Dental, PLLC v. Allstate Insurance

In this consolidated action, plaintiffs Perfect Dental Care, P.C., Zodiac Dental, PLLC, and Smooth Dental PLLC (Dental PCs) sought unpaid insurance claims from Allstate Insurance Company and State Farm Mutual Automobile Insurance Company (Insurers). The Insurers countersued alleging insurance fraud and unjust enrichment, and initiated a third-party action against various individuals and entities. The Insurers moved for partial summary judgment, seeking a declaratory judgment that Dental PCs could not recover for services provided by dentists and physical therapists, and for summary judgment on their fraud and unjust enrichment counterclaims. The court denied summary judgment concerning dentists' services, finding a triable issue of fact regarding their employment status. However, it granted summary judgment for the Insurers regarding physical therapy services, as Dental PCs conceded these services were provided by non-employees. Consequently, the court also denied summary judgment on the fraud and unjust enrichment claims, as their resolution depended on the unresolved employment status of the dentists.

Insurance ClaimsHealthcare ServicesContract LawSummary JudgmentProfessional CorporationsIndependent ContractorsEmployment LawFraud AllegationsUnjust EnrichmentDeclaratory Judgment
References
17
Case No. MISSING
Regular Panel Decision
Mar 02, 2007

DiTolla v. Doral Dental IPA of New York, LLC

Plaintiff Dr. William J. DiTolla initiated a class action against unnamed defendants for an accounting, alleging mismanagement of funds under an agreement where dentists provided services to Medicaid-insured individuals. The agreement stipulated that defendants would pay dentists according to a defined fee schedule. The Supreme Court, Nassau County, granted the defendants' motion to compel arbitration based on an arbitration clause in the agreement. The appellate court reversed this decision, ruling that the arbitration clause, which covered disputes regarding payment and failure to perform obligations, did not encompass a claim solely for an accounting without specific allegations of wrongdoing or damages. Consequently, the motion to compel arbitration was denied.

Class ActionAccounting ClaimArbitration ClauseMotion to Compel ArbitrationContract DisputeDental ServicesMedicaidFund MismanagementAppellate ReviewReversed Order
References
3
Case No. ADJ18840391; ADJ18840406
Regular
Mar 07, 2025

Carmen Romo vs. Austin D. Hoover, DDS, Dental Corporation; The Dentists Insurance Company

The Petition for Removal of the decision issued on January 17, 2025 has been withdrawn by the petitioner. Consequently, the Workers' Compensation Appeals Board has ordered the petition to be dismissed.

Petition for RemovalDismissedWithdrawnWorkers' Compensation Appeals BoardDeputy CommissionerCommissionerAdjudication NumbersApplicantDefendantsDental Corporation
References
0
Case No. ADJ8410459
Regular
Oct 22, 2019

DIETRA WALKER vs. YMCA METROPOLITAN LOS ANGELES

The Workers' Compensation Appeals Board (WCAB) granted the applicant's Petition for Reconsideration, overturning the trial judge's decision to strike a Qualified Medical Evaluator's (QME) report. The WCAB found no disqualifying conflict of interest for Dr. Gabriel, despite co-authored articles and past professional association with another dentist, Dr. Schames. Furthermore, the Board deemed the defendant's motion to strike Dr. Gabriel untimely due to a nearly three-year delay after his deposition. The case is affirmed with an amendment finding Dr. Gabriel free of conflict, and the defendant's motion is denied.

QMEconflict of interestdisqualifying conflict of interestlachesestoppelpetition for reconsiderationremovalmotion to strikeAOE/COEdeposition
References
4
Case No. ADJ1456139
Regular
Apr 09, 2012

JOYCE TIGHE vs. LONG BEACH UNIFIED SCHOOL DISTRICT

The Workers' Compensation Appeals Board denied reconsideration of a decision disallowing a lien claim from The Dental Trauma Center. The lien claimant's attorney failed to comply with Board regulations, including proper formatting and exhibit identification. The Board adopted the judge's report, which found that the lien claimant failed to meet its burden of proof in demonstrating that its dental services were reasonable and necessary to cure or relieve the effects of the applicant's stipulated industrial injuries, which did not include dental issues. Furthermore, the report of a consulting dentist, admitted over objection, also indicated that many of the services and charges were unreasonable or excessive.

Workers' Compensation Appeals BoardLong Beach Unified School DistrictPermissibly Self-InsuredADJ1456139LBO 0298310Order Denying ReconsiderationLien ClaimantPetition for ReconsiderationWCJReport of Administrative Law Judge
References
1
Case No. ADJ4503675 (MON 0306061)
Regular
Apr 18, 2011

ARTHUR WILSON vs. CAPISTRANO UNIFIED SCHOOL DISTRICT; Permissibly Self-Insured, Administered By CORVEL CORPORATION

The Workers' Compensation Appeals Board granted reconsideration to rescind an award for dental treatment. The Board found the administrative law judge erred by admitting and relying on the reports of Dr. Esagoff, a non-treating dentist, as they were not obtained in compliance with relevant Labor Code sections regarding medical-legal procedures and treating physician reports. The case is returned to the trial level for applicant to obtain a proper report from a designated treating physician, with Dr. Esagoff's reports to be stricken. Issues of industrial causation for dental treatment must follow former Labor Code section 4062 procedures.

Workers' Compensation Appeals BoardCapistrano Unified School DistrictCORVEL CORPORATIONInjury to teethCompensable consequenceAdmitted industrial injuryRight kneeCustodianDr. Jacob EsagoffD.D.S.
References
5
Case No. MISSING
Regular Panel Decision

Nghiem v. United States Department of Veteran Affairs

Plaintiff, an Asian-American geriatric dentist, alleged racial and ethnic discrimination and other torts following her 1993 termination from the Veteran Affairs Medical Center in Bronx, New York. She sued the United States Department of Veterans Affairs and four individual supervisors. Defendants moved to dismiss the complaint for lack of subject matter jurisdiction and as time-barred. The court granted the defendants' motion, dismissing all federal claims, including those under 42 U.S.C. § 1981, 42 U.S.C. § 1983, and Title VII, and declined supplemental jurisdiction over the remaining state law claims, dismissing them without prejudice.

Employment DiscriminationRacial DiscriminationWrongful TerminationCivil RightsDue ProcessStatute of LimitationsSubject Matter JurisdictionMotion to DismissFederal EmploymentVeterans Affairs
References
70
Case No. MISSING
Regular Panel Decision

Sternberg v. New York City Health & Hospitals Corp.

Dr. Douglas M. Sternberg, a dentist, was fired by the New York City Health and Hospitals Corporation (HHC) after failing a medical clearance exam due to his hepatitis C infection. He filed a lawsuit alleging employment discrimination under the Americans with Disabilities Act (ADA), the New York State Human Rights Law (NYSHRL), and the New York City Human Rights Law (NYCHRL). Dr. Sternberg moved for partial summary judgment on the issue of liability. The Court granted his motion in part, finding that he was qualified to perform his job, but denied it in part due to remaining factual disputes regarding HHC's intent to discriminate.

Employment DiscriminationADANYSHRLNYCHRLHepatitis CMedical ClearanceTerminationSummary JudgmentDisabilityHealthcare Worker
References
11
Case No. MISSING
Regular Panel Decision

Claim of Hailoo v. State Insurance Fund

The claimant, a self-insured dentist, was initially awarded workers' compensation benefits for bilateral carpal tunnel syndrome. During a hearing, she falsely stated her dental license was current, later correcting that it had been suspended, prompting a request for clarification by her counsel. Despite this, the Workers' Compensation Board summarily found a violation of Workers’ Compensation Law § 114-a, imposing mandatory and discretionary penalties, including permanent disqualification from future benefits. The Board further determined that the claimant voluntarily withdrew from the labor market from December 2002. The appellate court reversed these decisions, ruling that the claimant was denied due process by not being afforded an opportunity to be heard before the Board made its findings and imposed penalties, and remitted the matter for further proceedings.

Workers' CompensationDue ProcessFalse StatementMisrepresentationLicense SuspensionLabor Market AttachmentPenaltiesAppellate ReviewRemandProcedural Error
References
8
Case No. MISSING
Regular Panel Decision

Kletter v. Fleming

This case involves an appeal from an order that granted the plaintiff's motion to dismiss the defendant's counterclaim alleging a violation of Labor Law article 6. The defendant, a dentist, worked for the plaintiff under a contract and, after termination, filed counterclaims for nonpayment and Labor Law violations. The Supreme Court dismissed the Labor Law counterclaim and precluded the defendant from presenting proof for corrective work payment. The appellate court affirmed, ruling that Labor Law article 6 was inapplicable as the claim was a common-law contractual remuneration claim and not a substantive violation. It also upheld the preclusion regarding payment for corrective work, citing the clear terms of the contract and the parol evidence rule, which barred extrinsic evidence of additional payment terms.

breach of contractlabor law violationwage disputecontractual remunerationparol evidence rulesummary judgmentpreclusion motionappellate reviewdentist employmentemployer-employee dispute
References
8
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