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

Case No. 15 Civ. 7543 (NSR)
Regular Panel Decision
Mar 22, 2017

Safe Step Walk in Tub Co. v. CKH Industries, Inc.

Plaintiff Safe Step Walk In Tub Co. sued Defendant CKH Industries, Inc. for non-payment of marketing fees. CKH counter-claimed, alleging violations of franchise laws, breach of agreements, unfair business practices, and fraud. Safe Step moved to dismiss CKH’s counter-claims. The court granted in part and denied in part the motion. It determined that the relationship between the parties could plausibly constitute a franchisor-franchisee relationship under the FTC Rule and various state laws, allowing certain counter-claims to proceed. However, claims under New York and Rhode Island's "Little FTC" Acts, breach of the implied covenant of good faith and fair dealing, and unfair competition were dismissed. The court also held that Tennessee law governs the contract disputes, while state franchise laws apply where Defendant's franchises are located. Additionally, the court found that oral modifications and part performance could sustain certain contract claims despite written-only modification clauses.

Franchise LawBreach of ContractUnfair CompetitionFraudMotion to DismissChoice of LawFederal Trade Commission ActState Franchise ActsPromissory EstoppelUnjust Enrichment
References
87
Case No. MISSING
Regular Panel Decision

Kruse v. Sands Brothers & Co., Ltd.

Peter Kruse petitioned the court to confirm a securities industry arbitration award of $300,960.08 against Sands Brothers & Co. and Peter Pak, who had failed to pay the award issued on June 18, 2002. Respondents filed a counter-petition to vacate the award. The court found that the respondents' challenge was improperly filed as a 'Counter-Petition to Vacate' rather than a formal motion, and also untimely, as it missed the three-month statutory deadline for seeking vacatur. Citing the narrow grounds for vacating arbitration awards under the Federal Arbitration Act and the strong federal policy favoring their enforcement, the court confirmed Kruse's award against Sands and Pak, jointly and severally. The court also granted post-award interest at a rate of 9% from July 18, 2002, until payment.

Arbitration Award ConfirmationFederal Arbitration Act (FAA)Vacatur MotionTimeliness of MotionSecurities ArbitrationPost-Award InterestJudicial Review of Arbitration AwardsDistrict Court DecisionArbitrator AuthorityDue Process
References
44
Case No. ADJ2186498 (FRE 0183762), ADJ4344567 (FRE 0183763), ADJ1298565 (FRE 0187558), ADJ4148705 (FRE 0213169)
Regular
Jul 02, 2010

DELORES GUILLEN vs. HORIZON HEALTH, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, RGIS INVENTORY SPECIALISTS, ZURICH AMERICAN INSURANCE

The Workers' Compensation Appeals Board granted Zurich American Insurance's petition for reconsideration. The Board rescinded the Arbitrator's decision and returned the case for further proceedings, citing deficiencies in the record. Specifically, the Board found that the record lacked clarity on stipulated issues, admissions, and admitted evidence, as required by established precedent. Therefore, the Arbitrator must develop the record to ensure a fair adjudication of CIGA's reimbursement claims.

CIGAZurich American InsuranceLegion Insurance Companyliquidationreimbursementstipulated awardcausationvocational rehabilitationcompromise and releasereconsideration
References
2
Case No. ADJ85664607
Regular
Nov 01, 2013

YANET DUARTE ORTUNI vs. LA PERLA MEXICANA A CORPORATION, INSURANCE COMPANY OF THE WEST

This case involves a defendant's petition to remove the matter due to the Presiding Workers' Compensation Judge's alleged denial of an expedited hearing on a PQME specialty dispute. The applicant countered that the PQME appointment had been canceled. The Appeals Board dismissed the petition as moot because the cancellation of the PQME appointment resolved the underlying dispute. Therefore, the Petition for Removal was dismissed.

Petition for RemovalPresiding Workers' Compensation JudgeExpedited HearingPanel Qualified Medical EvaluatorPQME specialtymootcancelled medical appointmentWorkers' Compensation Appeals Board
References
0
Case No. MISSING
Regular Panel Decision
Dec 07, 2007

Dechnik v. Fortunato Sons, Inc.

The defendant and third-party plaintiff appealed an order from the Supreme Court, Kings County, which granted the third-party defendant's motion for summary judgment, dismissing claims for common-law indemnification and contribution. The Supreme Court's decision was affirmed on appeal. The court found that the plaintiff did not sustain a grave injury as defined by Workers’ Compensation Law § 11, and thus no triable issue of fact was raised to counter the third-party defendant's showing.

Personal InjuriesSummary JudgmentCommon-Law IndemnificationContributionWorkers' Compensation LawGrave InjuryAppellate DivisionThird-Party ActionKings CountyCourt Order
References
5
Case No. 2011 NY Slip Op 30736(11)
Regular Panel Decision

Brewer v. Stonehill & Taylor Architects

The defendants established they did not create or have notice of the dangerous condition leading to the plaintiff's injuries, as work was completed and inspected two weeks prior to the accident without incident. The plaintiff's own testimony revealed he saw the molding only after falling, with no evidence of its duration on the floor. His vague account of other workers was insufficient to counter the defendants' prima facie case. Consequently, the Supreme Court's order denying the defendants' motions for summary judgment was unanimously reversed, and judgment was entered in their favor, dismissing the complaint.

Summary JudgmentPremises LiabilityNegligenceActual NoticeConstructive NoticeAppellate ReviewReversalMotions GrantedComplaint DismissedArchitectural Liability
References
1
Case No. ADJ8110632, ADJ8110825
Regular
Apr 26, 2019

DOMINGO HERNANDEZ vs. WMLS, INC., and TWIN CITY FIRE INSURANCE/THE HARTFORD, and SOUTHERN INSURANCE COMPANY, adjusted by MAKEL SERVICES, INC.

Defendant sought reconsideration of an award of future medical treatment for a 2010 back injury, arguing it was erroneous. The Workers' Compensation Appeals Board denied reconsideration, finding the award supported by evidence. Medical evaluations recommended continued home exercises, over-the-counter medication for the back, and cognitive behavioral therapy for the psyche. Labor Code section 4600 mandates provision of all treatment reasonably required to cure or relieve the effects of an industrial injury, which includes recommended conservative care.

Workers Compensation Appeals BoardJoint Findings and AwardPetition for ReconsiderationPanel Qualified Medical EvaluatorPQMEPermanent DisabilityFurther Medical TreatmentLabor Code Section 4600Low Back InjuryPsyche Injury
References
2
Case No. ADJ7850702
Regular
May 04, 2012

MARTA BLACHOWICZ vs. SKYWEST AIRLINES, SEDGWICK CLAIMS MANAGEMENT SERVICES

In this workers' compensation case, the defendant, Skywest Airlines, sought reconsideration of a February 21, 2012 decision. They claimed a mutual mistake in the mathematical calculation of permanent disability and asserted the stipulation for a job displacement voucher did not reflect the parties' true agreement. The applicant countered that the stipulation was a good-faith negotiated settlement. The Administrative Law Judge recommended denying reconsideration, finding the defendant failed to demonstrate mutual mistake. Ultimately, the Petition for Reconsideration was dismissed as withdrawn by the petitioner.

Workers Compensation Appeals BoardPetition for ReconsiderationDismissalSkywest AirlinesSedgwick Claims Management ServicesSan Luis ObispoPetition to Set AsideStipulated AwardMutual MistakeMathematical Error
References
0
Case No. MISSING
Regular Panel Decision

Sibley-Schreiber v. Oxford Health Plans (N.Y.), Inc.

This class action involves several plaintiffs challenging Oxford Health Plans' denial of insurance coverage for Viagra. Defendants moved to dismiss the complaint, alleging that the plaintiffs failed to exhaust administrative remedies. Plaintiffs countered that pursuing these remedies would have been futile given the defendants' public 'no pay' and 'six pill' policies and the lack of clear appeal processes. The court denied the defendants' motions to dismiss and for summary judgment, concluding that the plaintiffs had made reasonable efforts to seek coverage and that further administrative appeals would have been futile.

ERISAInsurance CoverageHealthcare BenefitsViagraErectile DysfunctionExhaustion of Administrative RemediesFutility DoctrineClass ActionMotion to DismissSummary Judgment
References
16
Case No. ADJ4406096 (LAO 0784412)
Regular

JOSE MORFIN vs. WHITE MEMORIAL MEDICAL CENTER

Defendant sought removal from a WCJ's order stipulating to two Agreed Medical Evaluators (AMEs), alleging the WCJ "forced" the agreement. Applicant's attorney and the WCJ countered that defense counsel had agreed to and proposed the AMEs, with the WCJ merely documenting the stipulation. The Appeals Board denied removal as defendant showed no prejudice, but initiated its own removal to address the attorney's alleged false statements and vexatious tactics. Consequently, the Board intends to impose sanctions of up to $2,500 on the defendant and its attorneys for filing a frivolous petition containing misrepresentations.

Workers' Compensation Appeals BoardPetition for RemovalAgreed Medical EvaluatorsWCJSanctionsBad Faith TacticsFrivolousUnnecessary DelayStipulationMisrepresentation of Facts
References
1
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