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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
Jun 02, 2008

Claim of Laezzo v. New York State Thruway Authority

The claimant suffered a work-related slip and fall in 2002, leading to injuries including his head, neck, back, and knees. His morbid obesity contributed to his back and knee issues, prompting him to seek authorization for gastric bypass surgery. The Workers’ Compensation Law Judge approved the surgery, a decision affirmed by the Workers’ Compensation Board, which found the surgery causally related to the compensable injuries. The employer and its carrier appealed, challenging the causal link. The court affirmed the Board's decision, noting substantial evidence that the claimant's weight gain was a result of the sedentary lifestyle imposed by his injuries, and that the surgery would aid in his recovery.

Workers' CompensationConsequential InjuryGastric Bypass SurgeryMorbid ObesityMedical Treatment AuthorizationCausationKnee InjuryBack InjurySedentary LifestyleBoard Decision Appeal
References
2
Case No. MISSING
Regular Panel Decision

Claim of Casiano v. CCIP/Union Settlement Home Care

In March 2001, claimant sustained a work-related back injury. Neurosurgeon Richard J. Radna recommended and performed decompression surgery despite the workers' compensation carrier denying preauthorization for the procedure. Both a Workers’ Compensation Law Judge and the Workers’ Compensation Board subsequently ruled that the surgery was not medically necessary, thereby absolving the carrier of liability for its cost. Claimant and Radna appealed this determination to the appellate court. Radna's appeal was dismissed due to lack of standing, and the Board's decision was affirmed, as it was within its purview to resolve the conflicting medical evidence presented by Radna and the carrier's neurosurgeon regarding the necessity of the surgery.

Workers' Compensation LawMedical NecessitySurgical ProcedurePreauthorization DenialNeurological InjuryConflicting Medical OpinionsAppellate ReviewStanding IssueCarrier LiabilityBack Injury
References
3
Case No. LAO 0811779, LAO 0811780
Regular
Mar 06, 2008

ELENA BLANKEVOORT vs. HUNTINGTON MEMORIAL HOSPITAL, S&B SURGERY CENTER

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded a trial judge's order disallowing a lien claim from S&B Surgery Center. The WCAB found that while S&B Surgery Center did have a required "surgical clinic" license, it failed to prove compliance with fictitious business name filing requirements. However, the WCAB returned the case to the trial level for further proceedings, allowing S&B Surgery Center an opportunity to correct this procedural defect to recover on its lien.

Fictitious business nameLien claimantSurgical clinic licenseBusiness and Professions Code section 17910Medical BoardDepartment of Health ServicesBurden of proofReconsiderationWorkers' Compensation Appeals BoardOutpatient setting
References
12
Case No. 532932
Regular Panel Decision
Jan 06, 2022

In the Matter of the Claim of Thomas Lazalee

Claimant Thomas Lazalee, a truck driver, had established work-related occupational diseases in both hands, undergoing multiple surgeries between 2018 and 2019. His treating physician, Raymond Stefanich, periodically classified him as temporarily totally disabled post-surgery, during which time the employer, Wegman's Food Markets, Inc., voluntarily paid temporary total disability benefits. At an April 2020 hearing, the employer accepted an amendment to the claim but requested to cross-examine Dr. Stefanich regarding the degree of disability following the October 2019 surgery. Both the Workers' Compensation Law Judge and the Board denied this request as untimely. The Appellate Division affirmed the Board's decision, finding that the employer's request was untimely and disingenuous, given their prior voluntary payments and the uncontroverted medical reports.

Occupational DiseaseCarpal Tunnel SyndromeTrigger ThumbTemporary Total DisabilityCross-Examination RequestUntimely RequestTreating PhysicianMedical Report AdmissibilityWorkers' Compensation Board DecisionAppellate Review
References
8
Case No. unavailable
Regular
Jul 12, 2007

MORA vs. SOUTH BAY UNION SCHOOL DISTRICT, KEMPER INSURANCE COMPANY

This case concerns a lien claim by Beach Cities Surgery Center for medical treatment provided to an applicant injured in an admitted industrial incident. The WCJ initially disallowed the lien because the Surgery Center failed to prove its licensure/accreditation at the time of treatment. Although the petition for reconsideration appeared untimely, the Board accepted it as timely based on affidavits indicating hand delivery. Ultimately, reconsideration was denied on the merits, upholding the WCJ's original disallowance of the lien claim.

Workers' Compensation Appeals BoardLien claimantReconsiderationFindings and OrderIndustrial injuryLicensed or accreditedMedical treatmentLien claim disallowedPetition for reconsiderationUntimely filing
References
0
Case No. MISSING
Regular Panel Decision

Claim of Wallace v. Nestles Chocolate Co.

The claimant appealed a Workers' Compensation Board decision denying death benefits for her decedent, a forklift operator who died post-surgery for a work-related hand injury. The decedent experienced respiratory and cardiac arrest due to myocardial infarction, exacerbated by pre-existing conditions and inadequate postoperative care. The Board concluded the death was not causally related to the compensable injury. The appellate court affirmed the decision, finding that while the surgery provided the occasion for inadequate treatment, it did not directly cause the death, which stemmed from the progression of his underlying cardiac condition.

Workers' CompensationMyocardial InfarctionPostoperative ComplicationsCausationPreexisting ConditionInadequate Medical CareAppellate ReviewBoard DecisionDeath BenefitsHand Injury
References
3
Case No. MISSING
Regular Panel Decision

Palmer v. State University of New York Upstate Medical University

The claimant, an orthopedic hand surgeon, developed cervical radiculopathy and degenerative disc disease due to the physical strain of performing hand surgery and filed for workers' compensation benefits. His claim was controverted by the State University of New York Upstate Medical University and its carrier, as well as the Research Foundation of New York and its carrier. The Workers' Compensation Board determined that the claimant was a dual employee of both the University and the Foundation and that his condition constituted a causally related occupational disease. The University and its carrier appealed this decision. The appellate court affirmed the Board's findings, concluding there was substantial evidence to support both the dual employment status and the existence of a recognizable link between the claimant's condition and the distinctive features of his occupation.

Occupational DiseaseCervical RadiculopathyDegenerative Disc DiseaseDual EmploymentWorkers' Compensation BenefitsHand Surgery StrainMedical OpinionAppellate ReviewCausationEmployer Liability
References
8
Case No. 532932
Regular Panel Decision
Jan 06, 2022

Matter of Lazalee v. Wegman's Food Mkts., Inc.

Claimant Thomas Lazalee, a truck driver, established claims for work-related occupational diseases in both hands, undergoing multiple surgeries. The employer, Wegman's Food Markets, Inc., initially paid temporary total disability benefits but later sought to cross-examine treating physician Raymond Stefanich regarding the degree of disability following a 2019 surgery. A Workers' Compensation Law Judge and the Board denied the employer's request as untimely, noting the employer had accepted liability and paid benefits for months without challenging the disability status. The Appellate Division, Third Department, affirmed the Board's decision, finding no basis to disturb the finding that the request for cross-examination was untimely, thereby waiving the employer's right.

Workers' Compensation Board DecisionOccupational Disease ClaimCarpal Tunnel SyndromeTrigger ThumbTemporary Total Disability BenefitsEmployer's Right to Cross-ExamineTimeliness of RequestMedical ReportsWaiver of RightsAppellate Review of Board Decision
References
7
Case No. 2018 NY Slip Op 03919
Regular Panel Decision
May 31, 2018

Hernandez v. Seadyck Realty Co., LLC

The plaintiff, Angel Hernandez, injured his right hand while working for P.A. Painting and Decorating, Corp. and subsequently underwent four surgeries and collected Workers' Compensation benefits. He sued Seadyck Realty Co., LLC, who then brought a third-party claim against P.A. Painting and Decorating, Corp. for common-law contribution and indemnification. The Supreme Court granted summary judgment to P.A. Painting, dismissing the third-party claims. The Appellate Division, First Department, unanimously affirmed this decision, finding that the plaintiff had not suffered a 'grave injury' as defined in Workers' Compensation Law § 11, despite severe limitations in his right hand, because none of the experts found a total loss of use or limitation to just 'passive use'.

Summary JudgmentCommon-Law ContributionIndemnificationGrave InjuryWorkers' Compensation BenefitsAppellate DivisionMedical Expert ReportsOccupational TherapyOrthopedic SpecialistGrip Strength
References
2
Case No. MISSING
Regular Panel Decision
Apr 15, 2003

Claim of Paradise v. Goulds Pump

In March 1993, the claimant suffered a cervical and thoracic spine strain/sprain while lifting a heavy carton at work. Although he initially recovered, he later developed recurring neck pain and numbness in his left hand. Neurosurgeon Webster Pilcher diagnosed nerve root compression at C5 and C6, attributing it to the 1993 work-related injury and recommending surgery. The employer's workers’ compensation carrier declined coverage. The Workers’ Compensation Board subsequently found a causal relationship between the injury and the claimant's current condition, authorizing the surgery. The employer and carrier appealed, contending that the Board's finding was based on speculative medical opinion. The court affirmed the Board's decision, finding that Pilcher's opinion had a rational basis and was supported by substantial evidence.

Workers' CompensationNerve Root CompressionCervical SpineThoracic SpineCausationMedical OpinionSubstantial EvidenceNeurosurgeonSpinal InjuryAppeal
References
2
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