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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
Aug 16, 2001

People v. Telehany

The case involves an appeal from a judgment convicting the defendant of felony driving while intoxicated. The core issue was the trial court's erroneous removal of a sworn juror who had a passing acquaintance with a defense witness. The appellate court found that the juror's responses did not meet the 'grossly unqualified' standard under CPL 270.35 (1), as the juror unequivocally stated their acquaintance would not affect their impartiality. The erroneous dismissal of a juror is not subject to harmless error analysis. Consequently, the judgment was reversed, and a new trial was granted.

Juror DismissalGrossly Unqualified JurorImpartial JuryJury SelectionCriminal Procedure LawAppellate ReversalDriving While IntoxicatedFelony DWINew Trial GrantedTrial Error
References
6
Case No. ADJ8115084
Regular
Jun 02, 2014

MARY HAYWORTH vs. KCI HOLDINGS USA, INC., FIDELITY AND GUARANTY INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration, rescinding a prior finding that the applicant failed to establish a plainly erroneous fact in an Independent Medical Review (IMR) determination. The Board found the IMR decision was based on a plainly erroneous mistake of fact because it evaluated a request for dorsal medial branch block injections as though it were a request for facet injections, which are different procedures. Consequently, the medical treatment dispute is remanded to the Administrative Director for review by a different independent review organization or reviewer.

Workers' Compensation Appeals BoardIndependent Medical ReviewLabor Code Section 4610.5Plainly Erroneous Finding of FactMedical Treatment DisputeUtilization ReviewAdministrative DirectorDorsal Medial Branch BlockFacet InjectionsMTUS Guidelines
References
2
Case No. ADJ2068970 (STK 0167616)
Regular
Jul 21, 2016

Norman McAtee vs. Briggs & Pearson Construction, State Compensation Insurance Fund

The applicant seeks reconsideration of a WCJ's decision that dismissed his appeal of an Independent Medical Review (IMR) determination regarding pain medication. The IMR found the medication medically unnecessary, but the applicant argues this was based on a plainly erroneous finding of fact regarding the applicable treatment guidelines. The Appeals Board granted reconsideration, finding the IMR determination was indeed based on a plainly erroneous interpretation of the medical treatment guidelines. Consequently, the Board rescinded the WCJ's decision and remanded the case for a new IMR by a different reviewer.

Workers' Compensation Appeals BoardIndependent Medical ReviewPlainly Erroneous Finding of FactLabor Code Section 4610.6Medical Treatment GuidelineOpioid TherapyPermanent DisabilityVocational RehabilitationAdministrative Law JudgeReconsideration
References
1
Case No. ADJ10160818; ADJ1459849
Regular
Oct 27, 2025

PHILIP SCHULTZ vs. SAITEK INDUSTRIES, LTD.; CIGA

This case involves Philip Schultz, who filed an application for adjudication claiming a back injury. Travelers Indemnity Company (Travelers) sought reconsideration of a prior Appeals Board decision that erroneously identified Travelers as the workers' compensation carrier for Saitek Industries, Ltd. in 2001, despite Travelers having been dismissed from the case due to lack of coverage. The Appeals Board granted Travelers' petition for reconsideration, acknowledging its constitutional mandate to ensure substantial justice and correct clerical errors. The Board issued a notice of intention to amend its December 4, 2023 decision to strike the erroneous Finding 2, which incorrectly attributed coverage to Travelers.

Petition for ReconsiderationClerical ErrorWorkers' Compensation Appeals BoardDeclaraton of ReadinessCompromise and ReleaseCumulative InjurySubstantial JusticeDue ProcessNotice and Opportunity to Be HeardJurisdiction
References
18
Case No. ADJ8286511
Regular
May 30, 2017

HECTOR SANCHEZ BARRAGAN vs. T&T MARKETING SERVICES, INC., STATE COMPENSATION INSURANCE FUND

This case concerns the applicant's petition for reconsideration of a Workers' Compensation Appeals Board (WCAB) decision that upheld an Independent Medical Review (IMR) denial of a Norco prescription. The applicant argued the IMR determination exceeded the Administrative Director's authority due to a plainly erroneous application of Medical Treatment Utilization Schedule (MTUS) guidelines. The WCAB denied the petition, adopting the trial judge's report which found the IMR reviewer correctly applied medical expertise to select relevant MTUS sections for chronic opioid use. The Board determined the applicant failed to provide clear and convincing evidence of erroneous MTUS application or that the IMR decision was otherwise invalid.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardIndependent Medical ReviewUtilization ReviewNorcoMedical Treatment Utilization ScheduleAdministrative DirectorLabor CodeChronic Pain Medical Treatment Guidelines
References
1
Case No. MISSING
Regular Panel Decision

Claim of Sinacore v. Dreier Structural Steel, Inc.

This case concerns an appeal from a Workers’ Compensation Board decision filed on June 1, 1982, regarding a claimant suffering from pneumoconiosis since January 14, 1973. The claimant was initially awarded benefits for permanent partial disability. The carrier appealed, arguing that under Workers’ Compensation Law § 39, prior to July 1, 1974, compensation was not payable for partial disability due to dust disease, making the award erroneous given the disablement date. The Board rejected the carrier’s application for review, citing laches. The Appellate Division reversed the Board's decision, finding that sustaining a clearly erroneous award by applying the doctrine of laches was an abuse of discretion, and remitted the matter for further proceedings.

pneumoconiosisoccupational diseasepermanent partial disabilitylachesWorkers' Compensation Lawabuse of discretionremittalbenefitscompensation ratedisability benefits
References
2
Case No. ADJ18918866, ADJ18919434
Regular
Jul 07, 2025

LOUIS ROGELIO SANCHEZ vs. FFBH MOTORS LLC, OCCUSURE CLAIMS SERVICES

The Workers' Compensation Appeals Board granted a petition for reconsideration filed by defendant Occusure Claims Services, challenging a monetary sanctions order issued by a WCJ. Occusure was sanctioned for failing to appear at status and mandatory settlement conferences, despite being served with an amended application joining them as a party. Occusure contended it was erroneously joined as AmTrust Claims administered the injury claims and its non-appearance was due to clerical oversight, not intentional disregard. The Board found that Occusure's due process rights were violated by not having an opportunity to be heard on its claims of erroneous joinder and procedural failures within its organization. Consequently, the Board rescinded the sanctions order and returned the case to the trial level for further proceedings to ensure a full hearing on these issues.

Labor Code section 5813Board Rule 10561Petition for ReconsiderationMonetary SanctionsAdministrative OversightExcusable NeglectCode of Civil Procedure section 473Labor Code section 5909Electronic Adjudication Management SystemApplication for Adjudication of Claim
References
6
Case No. MISSING
Regular Panel Decision

Priolo v. Secretary of Health & Human Services

Plaintiff Angelina Priolo challenged the Secretary of Health and Human Services' determination of an overpayment of mother's insurance benefits totaling $7,114.20. Priolo, a 69-year-old widow caring for her disabled son, sought a waiver of recovery, asserting she was without fault due to reliance on erroneous information from an SSA employee and that repayment would cause severe financial hardship. The Administrative Law Judge (ALJ) denied the waiver, finding Priolo at fault for not reporting her remarriage. District Judge McLaughlin reversed and remanded the case, concluding that the ALJ's decision lacked substantial evidence, specifically faulting the ALJ for failing to inquire into Priolo's credibility regarding the alleged erroneous advice and for not adequately analyzing the hardship component of the waiver criteria. The court instructed the ALJ on remand to clarify the overpayment period, assess plaintiff's credibility, and re-evaluate whether recovery would defeat the purpose of the Social Security Act or be against equity and good conscience.

Social Security ActOverpayment WaiverMother's Insurance BenefitsAdministrative ReviewJudicial ReviewCredibility DeterminationErroneous InformationFault DeterminationFinancial HardshipRemand Order
References
7
Case No. MISSING
Regular Panel Decision

Sheahan v. Brady

Plaintiff Danielle Sheahan, a white woman, was terminated from her position at the Internal Revenue Service (IRS) in April 1992, after being hired in May 1991. The defendant, the Secretary of the Treasury, claimed she was fired for submitting an altered college transcript. However, the plaintiff alleged racial and color discrimination, asserting that her mostly Black co-workers and supervisors conspired against her, fabricating the transcript alteration accusation. Sheahan pursued administrative remedies, first with the Merit Systems Protection Board (MSPB), which dismissed her complaint for lack of jurisdiction on October 16, 1992. Subsequently, she filed a charge with the Equal Employment Opportunity Commission (EEOC), which also dismissed her case on October 22, 1992, based on the erroneous belief that an MSPB appeal was still pending. Plaintiff then filed a civil suit in federal court on November 12, 1992. Critically, on November 9, 1992, the Treasury Department had filed a Request to Reopen the EEOC's October 22 decision. The court examined the requirements of Title VII of the Civil Rights Act, 42 U.S.C. § 2000e-16, specifically concerning the exhaustion of administrative remedies and the finality of EEOC actions. Under 29 C.F.R. § 1613.234, a timely request to reopen by either party renders an EEOC decision non-final for the purpose of initiating a civil action. Consequently, the defendant's request to reopen on November 9, 1992, made the EEOC's October 22 decision non-final before Sheahan filed her lawsuit on November 12, 1992. Therefore, the court concluded it lacked subject matter jurisdiction. The court granted the defendant's motion, dismissing the plaintiff's complaint without prejudice, and suggested that either party could renew a request to reopen the EEOC decision, anticipating it would be granted given the EEOC's original erroneous finding.

Federal employment discriminationTitle VIICivil Rights ActRacial discriminationColor discriminationWrongful terminationAdministrative exhaustionEEOC decision finalitySubject matter jurisdictionMotion to dismiss
References
11
Case No. RIV 81540
Regular
Apr 25, 2008

LEONARD KOLAR vs. TMI PRODUCTS, INC., TRUCK INSURANCE EXCHANGE

The Appeals Board granted removal because the Workers' Compensation Judge (WCJ) erroneously excluded an employer's designated representative, who was also a witness, from the applicant's testimony. This exclusion prejudiced the defendant. The Board struck the applicant's testimony and returned the case for further proceedings, but declined to disqualify the WCJ.

Petition for RemovalEmployer RepresentativeWitness ExclusionEvidence Code Section 777Applicant TestimonyIndustrial InjuryLeft Shoulder InjuryLeft Upper ExtremityEmployer DenialPriority Conference
References
1
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