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

Case No. SFO 0490700
Regular
Mar 26, 2008

Mercedes Abarca vs. RITZ CARLTON HALF MOON BAY

The Board granted reconsideration, amending the original award to limit the payment for the interferential muscle stimulator (IMS) device and supplies. Initially, the Administrative Law Judge found the device necessary for the entire period claimed, but upon reviewing Dr. Wolfer's note, the Board limited coverage to November 19, 2005, to January 30, 2006. This amendment reflects that the IMS device was deemed necessary for the industrial injury only during this specific timeframe.

Workers' Compensation Appeals BoardSupplemental Findings & Awardinterferential muscle stimulator (IMS device)lien claimantRS Medicalself-procured medical expenseutilization reviewsubstantial evidencePetition for ReconsiderationWCJ report and recommendation
References
0
Case No. ADJ5827846
Regular
May 29, 2013

TSHEA PARTNER vs. SOUTHERN CALIFORNIA EDISON

This Workers' Compensation Appeals Board case denied reconsideration of a lien claim by Pinnacle Lien Services on behalf of Access Mediquip. The applicant received spinal stimulator implants, and the lien claimant sought payment for implantable devices. The Appeals Board adopted the judge's report, which found that the charges for the implantable devices were included in the payments made to the surgery center. The court determined that the lien claimant failed to provide sufficient evidence to prove the defendant's liability for these separately itemized devices.

Petition for ReconsiderationWorkers' Compensation Appeals BoardSouthern California EdisonPinnacle Lien ServicesAccess MediquipSpinal stimulatorImplantable devicesCPT codesAmbulatory Surgery CenterDe Anza Ambulatory Surgery Center
References
1
Case No. MISSING
Regular Panel Decision

Paisley v. Coin Device Corp.

Plaintiffs Dougal Paisley and Rohan Christie, employees of Coin Device Corporation, were terminated after being arrested for missing money, despite charges being dismissed. They subsequently filed an action against Coin Device Corporation, Biju Thomas, and Brian Gibbons, alleging malicious prosecution, wrongful termination, negligence, and loss of consortium. The Supreme Court initially denied the defendants' motion to dismiss these claims. On appeal, the higher court reversed this decision, ruling that the defendants were not liable for malicious prosecution as they merely provided information to the police, who made the arrest decision. Furthermore, the court found the wrongful termination claims invalid due to the plaintiffs' at-will employment status, and the negligence claims barred by Workers' Compensation Law, leading to the dismissal of all specified claims against the appellants.

malicious prosecutionwrongful terminationnegligenceloss of consortiumpunitive damagesat-will employmentWorkers' Compensation LawCPLR 3211appealemployer liability
References
7
Case No. ADJ1311571 (SAC 0331121)
Regular
Apr 23, 2010

JOSEPH BAKER vs. TINK, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration, rescinded a prior order, and returned the case for further proceedings. The dispute concerns reimbursement for an RS4i stimulator device, with the lien claimant arguing the initial utilization review denial was improper. The Board found the WCJ did not adequately address whether the RS4i device is equivalent to a TENS unit and how treatment guidelines apply to the applicant's chronic condition. Further development of the medical record is necessary to determine the reasonableness of the prescribed treatment.

RS4i stimulatorUtilization ReviewACOEM GuidelinesTENS unitchronic painacute low back painMedical Treatment Utilization Schedulelien claimantreconsiderationWCJ
References
1
Case No. MISSING
Regular Panel Decision
Apr 05, 2012

Barreto v. Metropolitan Transportation Authority

Plaintiff, an asbestos removal worker for P.A.L. Environmental Safety Corp. (PAL), fell into an uncovered manhole in January 2005 during a city environmental project. He brought claims against IMS Safety Corp., Metropolitan Transportation Authority (MTA), New York City Transit Authority (NYCTA), and the City of New York for common-law negligence and violations of Labor Law §§ 200, 240 (1), and 241 (6). The plaintiff was instructed by his supervisor to replace the manhole cover before dismantling the containment enclosure, but he failed to do so and fell in. The Supreme Court denied the plaintiff's cross-motion for partial summary judgment and granted the defendants' motions for summary judgment, dismissing the complaint. The appellate court affirmed, finding the plaintiff was the sole proximate cause of the accident for failing to use the available safety device (the manhole cover) and disregarding supervisor instructions. IMS was found not liable due to lack of supervisory authority, and other defendants were not liable under Labor Law § 200 or common-law negligence due to no supervision or notice of defect.

Personal InjuryLabor LawManhole AccidentNegligenceSummary JudgmentSole Proximate CauseSafety DeviceSite SafetyEmployer LiabilityContractor Liability
References
6
Case No. 2023 NY Slip Op 00908 [213 AD3d 1117]
Regular Panel Decision
Feb 16, 2023

Matter of Petre v. Allied Devices Corp.

Claimant Gheorghe Petre appealed a decision from the Workers' Compensation Board that denied his application for reconsideration and/or full Board review. The underlying Board decision had affirmed a Workers' Compensation Law Judge's ruling, which amended the claimant's work-related injury claim and directed his doctor to seek prior authorization for Gabapentin. The Appellate Division, Third Department, reviewed the Board's denial, limiting its scope to whether the Board had abused its discretion or acted arbitrarily. Finding no new evidence, material change in condition, or improper consideration of issues by the Board, the Appellate Division affirmed the Board's decision. Thus, the claimant's appeal for reconsideration and/or full Board review was ultimately denied.

Workers' CompensationAppellate ReviewBoard DiscretionReconsiderationInjury ClaimMedical ExpensesDrug FormularyGabapentinProcedural Due ProcessAdministrative Law
References
7
Case No. ADJ854108 (OAK 0281808)
Regular
Oct 07, 2008

PATRICIA BECK vs. INTEGRATED DEVICES TECHNOLOGY, SAFETY NATIONAL CASUALTY CORPORATION, MATRIX ABSENCE MANAGEMENT, RANDSTAND, CIGA ON BEHALF OF LEGION INSURANCE IN LIQUIDATION, BROADSPIRE

This case involves an applicant who sustained an industrial injury to her left thumb, hand, and wrist while employed by both a general employer (Randstand) and a special employer (Integrated Devices Technology, IDT). The Workers' Compensation Appeals Board (WCAB) granted reconsideration to correct minor errors in the original Findings and Award, specifically regarding citations to the Insurance Code and the identification of the general employer. The WCAB affirmed the original decision that IDT's insurer, Safety National Casualty Corporation, constitutes "other insurance," thereby relieving CIGA of liability for the claim.

Workers' Compensation Appeals BoardIntegrated Devices TechnologySafety National Casualty CorporationMatrix Absence ManagementRandstandCIGALegion InsuranceBroadspirespecial employergeneral employer
References
2
Case No. ADJ6857073
Regular
Jun 06, 2014

ENEIDA SOLIS vs. SUN VIEW VINEYARDS, STATE COMPENSATION INSURANCE FUND

The Appeals Board denied Rehab Solutions' petition for reconsideration, upholding the WCJ's disallowance of its lien. Rehab Solutions failed to meet its burden of proof by providing substantial medical evidence that the interferential stimulator was necessary and appropriate for the applicant. The WCJ correctly found that the lien claimant did not demonstrate the reasonable value of services exceeded the amount already paid by the defendant. Consequently, the Board found no error in disallowing the lien.

Lien claimantPetition for ReconsiderationFindings of Fact & OrderWCJsubstantial evidencemedical treatmentreasonable valueutilization reviewQualified Medical Evaluatorinterferential stimulator
References
0
Case No. MISSING
Regular Panel Decision

Kennedy v. Pine Hill Coffee Service, Inc.

Gerald Kennedy, an employee of Sahlem’s Roofing, sustained injuries after falling from a roof while working on a building owned by defendant James DeMarco and occupied by Pine Hill Coffee Services, Inc. Plaintiffs moved for partial summary judgment, arguing a violation of Labor Law § 240 (1) due to the defendants' failure to provide adequate safety equipment. Defendants contended that a co-employee acting as a 'spotter' constituted a safety device and that Kennedy was a recalcitrant worker for continuing to work when the 'spotter' left. The court rejected the argument that a human 'spotter' is a safety device under Labor Law § 240 (1), emphasizing the requirement for physical safety devices. Finding that the absence of proper safety devices was the proximate cause of Kennedy’s injuries, the court granted the plaintiffs' motion for partial summary judgment.

Labor Lawabsolute liabilityconstruction accidentfall from heightsafety devicesrecalcitrant workerproximate causeNew York Lawsummary judgmentowner liability
References
7
Case No. MISSING
Regular Panel Decision

Gallagher v. New York Post

Hugh Gallagher, an ironworker, sustained injuries after falling through an uncovered opening at a work site owned by NYP Holdings, Inc., while cutting metal decking. He and his wife sued NYP, alleging violations of Labor Law §§ 200, 240 (1), and 241 (6), specifically failure to provide safety devices. NYP contended that safety devices were available and that Gallagher's premature return to work after a prior injury was the sole proximate cause of his fall. The Supreme Court and Appellate Division initially denied summary judgment for plaintiffs, citing factual disputes regarding device availability and Gallagher's conduct. However, the Court of Appeals reversed, finding plaintiffs made a prima facie showing of a Labor Law § 240 (1) violation, and NYP failed to demonstrate that Gallagher knew of available safety devices and unreasonably chose not to use them, or that his prior injury was the sole proximate cause. The Court of Appeals granted plaintiffs' motion for partial summary judgment on liability.

Ironworker injuryConstruction accidentFall from heightLabor Law § 240 (1)Scaffolding LawSafety devicesProximate causeSummary judgmentAppellate reviewPersonal injury
References
5
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