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

Case No. ADJ7830020
Regular
Aug 03, 2015

Jodi Hefner vs. FIRST BAPTIST CHURCH OF VENTURA, MARKEL SERVICES

Applicant sought removal to disqualify an Agreed Medical Examiner (AME) due to alleged bias and lack of expertise, and to challenge the defendant's use of multiple attorneys at depositions. The Appeals Board denied the petition, finding no significant prejudice or irreparable harm. The WCJ's report, adopted by the Board, found the AME's conduct and statements did not demonstrate bias or a lack of expertise. Issues regarding the defendant's attorneys can be addressed through future protective orders.

Petition for RemovalAgreed Medical Examiner (AME)Disqualification of AMEUnethical ConductBiasMedical ExpertisePre-trial ConferenceWCJ OrderIrreparable HarmSignificant Prejudice
References
2
Case No. MISSING
Regular Panel Decision

Matter of New York State Correctional Officers and Police Benevolent Association, Inc. v. New York State Office of Mental Health

Petitioners, the New York State Correctional Officers and Police Benevolent Association, Inc. (NYSCOPBA) and Richard McPhillips, challenged an emergency regulation by the Office of Mental Health (OMH) that mandated unvaccinated personnel in psychiatric facilities wear face masks during influenza season, arguing it was arbitrary and capricious. The Supreme Court dismissed their application, leading to this appeal. The Appellate Division determined the case was not moot, as the subsequently adopted permanent regulation presented the same alleged infirmities. On the merits, the court upheld the regulation, granting OMH significant judicial deference due to its expertise. OMH's decision was based on Department of Health expertise, its own assessment of patient vulnerability, and the efficacy of masks. The court found that OMH adequately addressed concerns regarding communication and role modeling, and reasonably justified exemptions for visitors and attorneys. The judgment dismissing the petition was affirmed.

RegulationsPublic HealthMandatory MasksInfluenzaPsychiatric FacilitiesWorkers' RightsAdministrative LawJudicial DeferenceMootnessCPLR Article 78
References
9
Case No. SAL 0103596
Regular
Jan 07, 2008

CHRISTIE GAYNES vs. GRANITE ROCK COMPANY, ZURICH AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board dismissed the applicant's petition for reconsideration. The applicant sought to have a medical evaluation by an anesthesiologist or neurologist, arguing the chosen Agreed Medical Evaluator (AME), an orthopedist, lacked the necessary expertise for her specific nerve pain. The Board found the petition untimely and upheld the WCJ's recommendation for dismissal.

Workers' Compensation Appeals BoardPetition for ReconsiderationOrder Compelling AttendanceMedical EvaluationAgreed Medical Evaluator (AME)Qualified Medical Evaluator (QME)WCJReport and RecommendationDismissed PetitionTimeliness
References
0
Case No. ADJ9328357
Regular
Feb 02, 2017

KAREN SCHNEIDER vs. STATE OF CALIFORNIA, DEPARTMENT OF STATE HOSPITALS, COALINGA STATE HOSPITAL, legally uninsured, administered by STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied Karen Schneider's petition for reconsideration in case ADJ9328357. The Board adopted the reasoning of the workers' compensation administrative law judge (WCJ), finding no good reason to disregard the opinion of the agreed medical evaluator. The WCJ had properly relied on the AME's expertise and neutrality. Therefore, the petition for reconsideration was denied based on the record and the WCJ's report.

WCABPetition for ReconsiderationAgreed Medical EvaluatorAMEWCJCoalinga State Hospitallegally uninsuredState Compensation Insurance Funddenying reconsiderationPower v. Workers' Comp. Appeals Bd.
References
0
Case No. MISSING
Regular Panel Decision

Town of Greece v. Cuevas

The Town of Greece challenged PERB's determination that it committed an improper employer practice by refusing to formalize an agreement with a respondent union. PERB found that the Town negotiators violated the Taylor Law by not submitting the agreement for approval. The court confirmed PERB's determination, finding it supported by substantial evidence and not arbitrary or capricious, deferring to PERB's expertise in implementing the Taylor Law. The petition was dismissed.

Public Employment Relations BoardImproper Employer PracticeCollective Bargaining AgreementTaylor Law ViolationCivil Service LawJudicial ReviewAdministrative DeterminationPublic Sector Labor LawUnion AgreementEmployer Obligations
References
6
Case No. ADJ8491619 ADJ9586677
Regular
May 17, 2019

Edward GAA vs. Intercare Holdings Insurance, The Hartford

The Workers' Compensation Appeals Board granted applicant's petition for removal, overturning a prior order that denied a rheumatological evaluation. While dismissing the petition for reconsideration, the Board found good cause for an additional QME panel in rheumatology, acknowledging the orthopedic QME's limited expertise in this specialty. The applicant must still attend a re-evaluation with the orthopedic QME, who must review a job analysis.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalQualified Medical Evaluator (QME)Rheumatological evaluationOrthopedic QMECumulative traumaIndustrial injuryMedical-legal issuesBias
References
1
Case No. OAK 0318766
Regular
Jul 11, 2007

DEVERIE LAUTENSCHLAGER vs. HARBOR VIEW HOLDINGS, TRAVELERS PROPERTY CASUALTY

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior award, finding insufficient evidence to support the administrative law judge's determination of a compensable psychiatric injury. The Board held that the opinions of the applicant's orthopedist and QME orthopedist were not substantial evidence, lacking proper psychiatric diagnosis and exceeding their expertise. The case was returned to the trial level for further development of the record regarding the psyche injury.

Workers Compensation Appeals BoardDeverie LautenschlagerHarbor View HoldingsTravelers Property CasualtyOAK 0318766ReconsiderationWCJFindings Award OrderBilateral Upper ExtremitiesPsyche Injury
References
0
Case No. ADJ3132204 (AHM 0076439) ADJ3910647 (RIV 0069381)
Regular
Mar 04, 2013

LYNETTE WINTER vs. COUNTY OF RIVERSIDE

The Workers' Compensation Appeals Board granted reconsideration, overturning a prior decision that denied treatment at the Kerlan Jobe Clinic. The Board found that while Kerlan Jobe was located outside the standard MPN mileage/time parameters, the applicant's selection was reasonable given her complex spinal condition and the clinic's expertise. Defendant is now obligated to authorize treatment with a Kerlan Jobe physician. All other issues remain deferred.

WCABPetition for ReconsiderationMedical Provider Network (MPN)Kerlan Jobe ClinicDetrimental RelianceContract FormationExpedited HearingMinutes of HearingReport and RecommendationIndustrial Injury
References
0
Case No. ADJ2591770 (LBO 0345670)
Regular
Oct 24, 2008

RACHEL JENNINGS vs. THE SUTTON PLACE HOTEL, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration to amend a prior finding of 100% permanent disability, attributing 60% permanent disability after apportionment. This decision followed the opinion of an Agreed Medical Evaluator who concluded 40% of the applicant's disability was due to prior causes, such as a diving accident and subsequent surgeries. The Board found the AME's apportionment opinion, based on medical history and expertise, constituted substantial evidence and was not speculative.

Workers' Compensation Appeals BoardIndustrial InjuryPermanent DisabilityApportionmentAgreed Medical Evaluator (AME)Spinal FusionLumbar SpineCervical SpineDegenerative Disc DiseaseRadiculitis Lumbosacral
References
6
Case No. ADJ8179824
Regular
Nov 18, 2015

Patrick Miglas vs. Sangera Automotive Group, CompWest Insurance Company

The Workers' Compensation Appeals Board denied the employer's Petition for Reconsideration in the case of Patrick Miglas. The Board found that the employer failed to demonstrate that the Qualified Medical Evaluators' opinions finding industrial causation for Miglas' neck, heart, and psyche injuries were not substantial evidence. The Board also admonished the applicant's attorney for procedural errors in the petition. The employer's arguments challenging the medical opinions lacked the necessary medical expertise and were therefore unconvincing.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ reportadministrative law judgeLabor Code §5903Labor Code 5952Qualified Medical EvaluatorsQMEindustrial causationneck injury
References
4
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