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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

Matter of Lichten v. New York City Transit Authority

Claimant, a bus driver, filed for workers' compensation benefits due to an occupational disease stemming from repetitive stress injuries to his legs, including his hips, knees, and feet, caused by his employment. The Workers’ Compensation Law Judge established the case for bilateral hips but disallowed the claim for bilateral knees. This disallowance was upheld by the Workers’ Compensation Board. Claimant appealed this decision. Medical testimony presented conflicting opinions regarding the causal relationship of claimant's knee condition to his work activities. The Board's decision to discredit the treating orthopedist's opinion was found to be supported by substantial evidence and was within its authority concerning credibility determinations. The appellate court affirmed the Board's decision.

Workers' CompensationOccupational DiseaseRepetitive Stress InjuryBilateral KneesCausal RelationshipMedical EvidenceCredibility DeterminationAppellate ReviewAffirmed DecisionBus Driver
References
6
Case No. MISSING
Regular Panel Decision

Claim of Simpson v. New York City Transit Authority

The claimant, identified as a bus driver who retired in 2011, applied for workers’ compensation benefits, alleging an occupational disease due to repetitive stress on his knees. The Workers’ Compensation Board initially disallowed the claim, crediting an independent medical examination by orthopedic surgeon Carl Wilson, who concluded the knee condition was not causally related to work, but rather due to age-related wear and tear and degenerative changes. This Court previously reversed and remitted the case due to the Board's misinterpretation of MRI results. On remittal, the Board again disallowed the claim, reaffirming Wilson's credible testimony. The Appellate Division now affirms the Board’s decision, finding Wilson's medical opinion, which was based on an examination and review of medical records, to be supported by a rational basis and substantial evidence.

occupational diseaseknee injuryrepetitive stressbus driverindependent medical examinationMRI resultsdegenerative changesosteoarthritiscausal relationshipsubstantial evidence
References
6
Case No. MISSING
Regular Panel Decision
Feb 01, 1978

Claim of Goss v. Hornblower & Weeks

Claimant, a stockbroker, sustained a compensable left knee injury in 1974, leading to surgery and a 10% schedule loss award. Subsequently, the claimant sought to have a right knee injury, sustained in 1975 after being struck by a bicycle while en route to a medical examination for his left knee, deemed a consequential injury. While the referee initially found the right knee injury compensable, the Workers' Compensation Board reversed this decision, concluding that the evidence did not establish a direct and natural link between the industrial left knee injury and the subsequent right knee injury. The appellate court affirmed the Board's determination, citing substantial evidence in the record to support the disallowance of the claim.

Workers' CompensationKnee InjuryConsequential InjurySchedule LossBoard ReversalAffirmationStockbrokerAccidentMedical ExaminationAppellate Review
References
1
Case No. ADJ3023725 (STK 0186210) ADJ 6853419
Regular
Mar 03, 2016

IGNACIO ROA vs. ROHRER BROTHERS/GENERAL PRODUCE; FREMONT COMPENSATION INSURANCE COMPANY, in liquidation CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, administered by SEDGWICK; XL SPECIALTY/BROADSPIRE; STATE COMPENSATION INSURANCE FUND

This case concerns applicant Ignacio Roa's petition for reconsideration of a workers' compensation award finding 20% permanent disability for a right knee injury with 50% apportionment to nonindustrial factors. Roa also sought to establish an industrial injury to his left knee as a consequence of the right knee injury and a cumulative trauma injury to both knees, which the Workers' Compensation Appeals Board denied. The Board affirmed the judge's findings, relying on Dr. Henrichsen's opinion that Roa's left knee symptoms were due to the natural progression of prior surgery and wear, not industrial factors. A dissenting opinion argued for further medical development, finding persuasive evidence of industrial contribution to the left knee condition.

Workers' Compensation Appeals BoardIgnacio RoaRohrer BrothersFremont Compensation Insurance CompanyCIGAXL SpecialtyState Compensation Insurance Fundpermanent disabilityapportionmentnonindustrial factors
References
5
Case No. MISSING
Regular Panel Decision

Claim of LaClaire v. Birds Eye Foods, Inc.

Claimant sustained work-related injuries to her left and right knees in 2007. The Workers' Compensation Board subsequently determined that her condition warranted a marked permanent partial disability classification, entitling her to continuing disability benefits rather than a schedule loss of use award. The employer and its workers' compensation carrier appealed this determination. The court affirmed the Board's decision, finding substantial evidence, including the claimant's orthopedic surgeon's testimony regarding crepitus, swelling, and severe pain, supported the marked permanent partial disability classification. Furthermore, the court concluded that the Board did not abuse its discretion in requiring additional proof concerning any overpayments made to the claimant.

Workers' CompensationPermanent Partial DisabilitySchedule Loss of UseKnee InjuriesAppellate ReviewSubstantial EvidenceMedical OpinionCredibility AssessmentOverpaymentsDisability Benefits
References
6
Case No. ADJ4016735 (BAK 0147536)
Regular
Jun 11, 2012

COLLEEN PARHAM vs. KERN RADIOLOGY MEDICAL GROUP, LEGION INSURANCE GROUP

This case involves an applicant seeking bilateral knee replacement surgery due to an admitted industrial back injury. The applicant argues the surgery is necessary to enable further treatment for her back, specifically a spinal cord stimulator. The defendants contested this, claiming the knee condition was independent and unrelated to the industrial injury. The Appeals Board granted reconsideration, finding the knee surgery reasonably required to relieve the industrial back injury, citing *Bolton* and *Rowan*, even if the knee condition itself was not industrial. The Board rescinded prior findings, awarding the knee surgery and deferring issues of permanent disability and temporary disability.

Workers' Compensation Appeals BoardReconsiderationFindings of FactBilateral Knee ReplacementIndustrial InjuryBack InjurySpinal Cord StimulatorTemporary Total DisabilityPermanent and StationaryQualified Medical Evaluator
References
8
Case No. ADJ8336436
Regular
Mar 25, 2016

CARMEN NAVARRO vs. VENICE COMMUNITY HOUSING CORPORATION, ATHENS ADMINISTRATORS

Here's a summary for a lawyer: The Workers' Compensation Appeals Board (WCAB) denied Carmen Navarro's petition for reconsideration. Navarro sought to establish her right knee injury as a compensable consequence of a prior admitted left knee injury. The WCJ's report, adopted by the WCAB, found the right knee injury to be non-industrial. Medical evidence, particularly from QME Dr. Williamson, indicated the right knee pain arose independently in August 2013, distinct from the earlier left knee injury and treatment period. The Board specifically rejected any consideration of "rashly undertaken" activity as irrelevant to the legal analysis.

WCABPetition for ReconsiderationWorkers' Compensation Appeals BoardVenice Community Housing CorporationAthens AdministratorsADJ8336436Los Angeles District OfficeWCJcompensable consequenceleft knee injury
References
1
Case No. ADJ8765068, ADJ8765078, ADJ8841406
Regular
Nov 18, 2015

WILLIAM MCBURNEY vs. ALL THAT GLITTERS, EMPLOYERS COMPENSATION INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) is granting reconsideration on its own motion to correct a clerical error in a prior decision. The error incorrectly identified the physician authorized for surgery; the original decision will be affirmed with this correction. Specifically, Order A is amended to authorize Michael Laird, M.D. for a left total knee arthroplasty, not Dr. James Strait.

Workers' Compensation Appeals BoardReconsiderationClerical ErrorAgreed Medical EvaluatorPrimary Treating PhysicianLeft Total Knee ArthroplastyJoint Findings and OrderFindings of Fact Award and OrdersOpinion and Decision After ReconsiderationSan Luis Obispo
References
0
Case No. MISSING
Regular Panel Decision

In re the Claim of Donlin v. West Babylon Fire District

In October 1998, a volunteer firefighter claimant broke a metatarsal bone in his right foot, leading to subsequent left knee, lower back, and right knee problems. While the initial foot and left knee injuries were found to be causally related, the employer and its workers’ compensation carrier disputed the causal link of the back and right knee pain. A Workers’ Compensation Law Judge (WCLJ) determined that the claimant sustained a permanent partial disability, including consequential back and right knee injuries, resulting in a 75% or greater loss of earning capacity. The Workers’ Compensation Board affirmed this determination. The carrier appealed the Board's decision, but the Appellate Division affirmed, citing sufficient expert medical testimony supporting the Board's decision and upholding the WCLJ’s denial of an adjournment for the carrier’s absent medical expert.

Volunteer Firefighters' Benefit LawWorkers' Compensation Board AppealPermanent Partial DisabilityLoss of Earning CapacityCausal RelationMedical Expert TestimonyAdjournment DenialWCLJ AuthorityAppellate ReviewSteamfitter Injury
References
4
Case No. ADJ8858239, ADJ8858240
Regular
Oct 13, 2016

ANTOINETTE MIRANDA vs. CALIFORNIA DEPARTMENT OF CORRECTIONS, legally uninsured

This case concerns the timeliness of an Independent Medical Review (IMR) determination for a left knee total arthroplasty. The WCJ found the IMR determination was late and the WCAB had jurisdiction, but denied the surgery due to insufficient evidence of medical necessity. The Appeals Board granted reconsideration, affirming the denial of treatment but clarifying that the timeframe for IMR issuance under Labor Code section 4610.6(d) is directory, not mandatory. Therefore, the late IMR determination is valid, and the applicant is bound by its decision regarding the medical necessity of the proposed surgery.

Independent Medical ReviewUtilization ReviewLabor Code Section 4610.6(d)Directory vs. Mandatory TimeframeMedical NecessityLeft Knee Total ArthroplastyWCJWCABPetition for ReconsiderationReport and Recommendation
References
4
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