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Case Law Database

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

Case No. ADJ6456347
Regular
Jan 30, 2012

MARK WILLIAMS vs. CITY OF PASADENA

This case involves a police officer claiming industrial injury to his heart due to hypertensive heart disease, a condition he argued was distinct from previously compensated hypertension. The Workers' Compensation Appeals Board (WCAB) rescinded the administrative law judge's decision, finding the claim was not barred by res judicata. The WCAB clarified that while hypertension alone is not considered heart trouble, left ventricular hypertrophy, as diagnosed in the current claim, constitutes a distinct condition. The case is returned to the trial level for further proceedings on other unresolved issues.

res judicatahypertensive heart diseasepolice officerLabor Code section 3212.5heart trouble presumptionleft ventricular hypertrophystipulated awardindustrial injurypermanent disabilityapportionment
References
6
Case No. ADJ9506185
Regular
Jul 13, 2016

JIM NEWELL vs. COUNTY OF KERN

The Workers' Compensation Appeals Board denied the County of Kern's petition for reconsideration of an award to Jim Newell. The award was based on industrial cumulative trauma to the lumbar spine and hypertensive cardiovascular disease, including left ventricular hypertrophy (LVH). The County argued there was insufficient evidence of LVH and sought further medical development, specifically a cardiac MRI. The Board found that the existing medical evidence, including echocardiograms and expert testimony, constituted substantial evidence to support the LVH diagnosis, making further testing unnecessary.

Workers' Compensation Appeals BoardCounty of KernJim NewellSheriff's Sergeantcumulative traumalumbar spinecirculatory systemhypertensionhypertensive cardiovascular diseaseleft ventricular hypertrophy
References
2
Case No. 2007 NY Slip Op 32740(U)
Regular Panel Decision

Rivers v. New York City Department of Sanitation

The court upheld its decision to dismiss the petitioner's case, stating that the petition failed to present a legally sound cause of action. The court determined that the respondents' finding, which deemed the petitioner medically unqualified for a sanitation worker position, was based on rational grounds due to her suffering from left ventricular hypertrophy and elevated blood pressure. The court also affirmed that the respondents were justified in relying on the medical director's conclusions, even when faced with contradictory medical opinions from the petitioner's own physicians, citing prior case law to support this stance.

Medical DisqualificationSanitation WorkerLeft Ventricular HypertrophyElevated Blood PressureJudicial ReviewArbitrary and CapriciousRational BasisMedical Director OpinionConflicting Medical OpinionsPetition Dismissal
References
5
Case No. ADJ12288761
Regular
Dec 29, 2020

MICHAEL GOMEZ vs. CALIFORNIA INSTITUTION FOR WOMEN, STATE COMPENSATION INSURANCE FUND, STATE CONTRACT SERVICES

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding a finding of 62% permanent disability for a correctional officer with cumulative trauma. The core issue was whether Left Ventricular Hypertrophy (LVH), found by a QME, constituted "heart trouble" under Labor Code section 3212.2, triggering a presumption of industrial injury. The Board affirmed the WCJ's decision, relying on prior case law and expert medical opinions that LVH, even if minor, qualifies as "heart trouble" for purposes of the presumption. Defendant's arguments that LVH was not "heart trouble" and that medical opinions were contradicted were rejected as insufficient to rebut the presumption.

Workers' Compensation Appeals BoardCalifornia Institution for Womencorrectional officercumulative traumainternal organshypertensionGERDheart trouble presumptionLabor Code section 3212.2Left Ventricular Hypertrophy
References
13
Case No. ADJ10763960
Regular
May 20, 2019

DENNIS ROMERO vs. COUNTY OF SAN DIEGO

This case involves a workers' compensation appeal where the defendant, County of San Diego, sought reconsideration of an award granting the applicant, Dennis Romero, permanent disability. The defendant argued that the administrative law judge improperly overlapped factors of disability when assessing the applicant's $94\%$ permanent disability rating. The Appeals Board denied reconsideration, adopting the judge's report which found that the qualified medical evaluator considered factors beyond shortness of breath, such as left ventricular hypertrophy and lightheadedness, when determining impairments for hypertensive and coronary heart disease. The Board also cited legal precedent that the multiple disabilities rating schedule accounts for any overlap.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings Award and OrderDeputy SheriffIndustrial InjuryHeart InjuryHypertensionPermanent DisabilityHypertensive Heart DiseaseCoronary Heart Disease
References
1
Case No. MISSING
Regular Panel Decision
Apr 19, 1995

Claim of Tomlin v. Asplundh Tree Expert Co.

The claimant, a site manager for 23 years, began experiencing chest pains in February 1984. His employer granted him a medical leave and requested documentation. The claimant's treating physician, Patrick McAndrew, diagnosed essential hypertension, left ventricular hypertrophy, and chest pain of undetermined origin. The employer then used a disability claim form as a claim for a self-administered salary continuation plan, paying benefits under it. After an examination by the employer's physician, John Walters, who found no organic heart disease, the employer terminated the claimant, considering his absence a voluntary termination due to lack of a "bona fide" disability. The claimant subsequently filed for statutory disability benefits and a claim for discriminatory discharge with the Workers’ Compensation Board, alleging a violation of Workers’ Compensation Law § 241 for retaliation. The Board asserted jurisdiction, found discrimination, but reduced damages due to the claimant's failure to actively seek employment. The employer appealed, arguing lack of jurisdiction and insufficient evidence, but the decision was affirmed.

References
3
Case No. MISSING
Regular Panel Decision

In re the Claim of Sweet

A claimant, formerly a sewage treatment worker for a municipality, left his job and moved to Hawaii after receiving a conditional job offer at a tropical fish farm and his girlfriend's relocation there. Upon arrival, he discovered the position was no longer available. The Unemployment Insurance Appeal Board subsequently ruled that the claimant was disqualified from receiving unemployment insurance benefits, determining he had voluntarily left his employment without good cause. The appellate court affirmed the Board's decision, finding substantial evidence that the claimant failed to verify the job offer before moving and had primarily relocated for personal reasons without definite employment.

Unemployment benefitsVoluntary quitGood cause for leavingJob availabilityRelocation for personal reasonsDisqualification for benefitsAppellate reviewSubstantial evidenceMunicipality employmentHawaii job offer
References
0
Case No. MISSING
Regular Panel Decision
May 09, 2006

Claim of Atkinson v. Joseph Baldwin Construction

This is an appeal from decisions of the Workers’ Compensation Board, filed March 29, 2006, and May 9, 2006, which clarified an earlier Board decision from April 23, 2002. The claimant sustained a compensable right shoulder injury in July 1998. Subsequently, the claimant alleged problems with his left shoulder were causally related to the 1998 accident. A Workers’ Compensation Law Judge (WCLJ) initially found no causal relationship for the left shoulder injury, a determination affirmed by the Board in April 2002, although the Board's decision ambiguously mentioned developing the schedule of loss of use for 'both arms.' Following further proceedings, the WCLJ reiterated the disallowance of the left arm claim. The Board then clarified its 2002 decision in 2006, stating that it had affirmed the finding of no causal relationship for the left arm and that only the right arm's schedule loss of use was to be developed. The Appellate Division found that the Board's 2006 decisions effectively amended its 2002 decision. Upon review, the court affirmed the Board’s determination, finding substantial evidence supported the conclusion of no causal relationship for the left arm, giving deference to the Board's credibility assessments and resolution of conflicting medical evidence. The court also rejected the argument that the issue of a consequential left shoulder injury remained open, as the Board's prior decision had disallowed any causally related left arm condition.

Workers' Compensation LawCausal RelationshipLeft Shoulder InjuryRight Shoulder InjuryMedical EvidenceCredibility AssessmentAppellate ReviewBoard ClarificationAmended DecisionSchedule Loss of Use
References
6
Case No. 534614
Regular Panel Decision
Feb 16, 2023

In the Matter of the Claim of Joseph Marcellino

The case involves an appeal from a Workers' Compensation Board decision concerning claimant Joseph Marcellino's eligibility for a schedule loss of use (SLU) award for permanent injuries to his left elbow and left thumb. Following an April 2015 accident, Marcellino had established claims for multiple injuries, undergoing surgery in 2016. Conflicting medical opinions arose between his treating orthopedic surgeon, Dimitro Christoforou, who assessed significant SLU percentages, and the carrier's orthopedic surgeon, Peter Spohn, who found minimal or no SLU for the left hand, wrist, and thumb. A Workers' Compensation Law Judge (WCLJ) credited Spohn's opinion, awarding 15% SLU for the left wrist but no permanency for the left elbow or left thumb. The Workers' Compensation Board affirmed this decision. On appeal, the Appellate Division, Third Judicial Department, affirmed the Board's decision, reiterating that the Board has the discretion to resolve conflicting medical opinions and reject medical evidence even without opposing proof, finding their determination supported by substantial evidence.

Workers' Compensation LawSchedule Loss of UsePermanent Partial DisabilityMedical EvidenceConflicting Medical OpinionsCredibility AssessmentAppellate DivisionWorkers' Compensation BoardOrthopedic InjuriesElbow Injury
References
7
Case No. 2020 NY Slip Op 06434 [188 AD3d 1403]
Regular Panel Decision
Nov 12, 2020

Matter of Liuni v. Gander Mtn.

Claimant Joseph D. Liuni sustained a left distal bicep tendon rupture in 2007, resulting in a 22.5% schedule loss of use (SLU) award for his left arm. In 2014, he established a workers' compensation claim for his right shoulder, which was later amended in 2016 to include a consequential injury to his left shoulder. A physician determined a 27.5% SLU for the left arm due to the 2016 injury, which, when combined with the prior award, totaled an overall 50% SLU. The Workers' Compensation Board modified a WCLJ's determination, ruling that the bicep and shoulder injuries are not eligible for separate SLU awards as they both fall under awards for the left arm. Consequently, the Board deducted the 2007 22.5% SLU from the 2016 27.5% SLU, resulting in a 5% SLU award for the left arm. The Appellate Division affirmed the Board's decision, emphasizing that Workers' Compensation Law § 15 (3) limits SLU awards to statutorily enumerated members and that separate awards for subparts of a body member would constitute an unauthorized monetary windfall.

Schedule Loss of Use (SLU)Workers' CompensationAppellate DivisionThird DepartmentLeft Arm InjuryBicep Tendon RuptureShoulder InjuryPrior Award DeductionMonetary WindfallStatutory Interpretation
References
5
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