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

Case No. ADJ2709955 (MON 0356320)
Regular
Jun 21, 2017

Mario Cocola vs. California Hospital Medical Center

The Workers' Compensation Appeals Board denied Mario Cocola's petition for reconsideration, upholding the finding that he sustained $69\%$ permanent disability from industrial injuries. Cocola argued the administrative judge erred by disregarding the Agreed Medical Examiner's opinion that he was totally disabled from the open labor market due to orthopedic injuries. The Board agreed with the judge's report that the physician's opinion lacked sufficient objective basis for the change in work restrictions. A dissenting opinion argued the medical and vocational evidence supported a $100\%$ permanent disability finding and requested clarification from the medical examiner.

Petition for ReconsiderationFindings of Fact and Awardpermanent disabilitycumulative traumalumbar spinecervical spinepsychecervicogenic headachesEmergency Unit CoordinatorAgreed Medical Examiner
References
1
Case No. MISSING
Regular Panel Decision

Equal Employment Opportunity Commission v. Grief Bros.

This employment discrimination case, filed July 1, 2002, involves Michael Sabo (Plaintiff) who alleges constructive discharge based on sexual harassment and claims severe emotional pain and suffering. The Defendant moved for a mental examination of Sabo under Fed.R.Civ.P. 35 and to compel the production of his medical records. Sabo alleged severe humiliation, anxiety, depression, loss of self-esteem, sleeplessness, and weight gain, and admitted to a history of depression, past suicide attempts, and current psychiatric treatment with prescribed medications. The court granted the Defendant's motions, finding that Sabo had placed his mental condition in controversy due to the nature and severity of his claims and his medical history, justifying both the examination and the production of relevant medical records. The court also granted Defendant's request for costs associated with compelling the medical records, but denied the request for costs related to the Rule 35 motion itself, and denied Plaintiff's request for counsel or recording during the examination.

Employment DiscriminationSexual HarassmentConstructive DischargeEmotional DistressMental ExaminationRule 35Medical RecordsDepressionSuicide AttemptsCompensatory Damages
References
11
Case No. ADJ7430217
Regular
May 17, 2012

LETICIA FLORES vs. RABOBANK; CHUBB GROUP OF INSURANCE COMPANIES

The Workers' Compensation Appeals Board denied reconsideration of the applicant's claim for injuries sustained from continuous trauma at Rabobank. The Board adopted the WCJ's report, which found the applicant's orthopedic injuries arose out of and in the course of employment, relying heavily on the credible testimony of the applicant and the persuasive report of the Agreed Medical Examiner. Despite the defendant's arguments regarding lack of prior medical complaints and other activities, the WCJ found the applicant's testimony credible and the Agreed Medical Examiner's findings sufficient to support an award of temporary disability benefits. The Board affirmed the WCJ's findings, extending great weight to the credibility determination.

Workers' Compensation Appeals BoardPetition for ReconsiderationAgreed Medical ExaminerInjury AOE/COEContinuous TraumaTemporary DisabilityCredibility FindingLabor Code Section 3202.5Liberal ConstructionPreponderance of Evidence
References
6
Case No. MISSING
Regular Panel Decision
Feb 08, 1994

People v. France

This is a combined decision addressing motions to vacate homicide convictions in six separate cases. The defendants argued that the prosecutor failed to disclose dictation audiotapes made by the New York City Medical Examiner, which they claimed constituted 'Rosario' material. The court denied the motions, ruling that the Medical Examiner's Office is an independent agency, and therefore, the audiotapes were not under the control of the District Attorney and not 'Rosario' material. The decision further clarifies that CPL article 240 provides for pretrial discovery of written reports but not dictation tapes, unless they contain exculpatory material. The court emphasized the Medical Examiner's role as an independent expert, distinct from 'event' or law enforcement witnesses, and concluded that their dictation tapes are not 'statements' within the 'Rosario' jurisprudence.

Rosario materialDiscovery rulesCPL 440.10 motionHomicide convictionMedical Examiner audiotapeAutopsy reportProsecutorial dutyDuplicative equivalentIndependent agencyCPL Article 240
References
31
Case No. ADJ8606940
Regular
Apr 18, 2013

ANGELICA PEREZ vs. PERMANENTE MEDICAL GROUP, INC.

The Workers' Compensation Appeals Board denied defendant's petition for removal or reconsideration regarding the applicant's entitlement to multiple Panel Qualified Medical Examiners (PQMEs). The defendant contested the procedural validity of the applicant's PQME requests, while the applicant asserted proper procedure was followed due to the defendant's lack of response to an Agreed Medical Examiner offer. The Board found that the February 4, 2013 notation was not a final order, as PQME requests remained pending with the Medical Unit. Therefore, the petition was denied without prejudice to the Medical Unit's future determination on the propriety of the PQME requests.

Panel Qualified Medical ExaminersPQMEPetition for RemovalPetition for ReconsiderationIndustrial InjuryCumulative InjuryAgreed Medical ExaminerAMEMedical UnitAdministrative Law Judge
References
0
Case No. PAS 0042381
Regular
Jun 13, 2008

MARY JANE BOWDEN vs. MENTAL HEALTH, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior order because the record lacked substantial evidence to determine if the applicant's temporary total disability had ended. The Board found that the medical reports submitted by both parties were deficient and that agreed medical evaluations were never performed. The case was returned to the trial level for further development of the record, including evaluations by agreed medical examiners, to address the applicant's orthopedic and psychiatric disability status.

Temporary Total DisabilityPetition to Terminate LiabilityPermanent and StationaryAgreed Medical ExaminersSubstantial EvidenceDevelopment of RecordPsychiatric InjuryOrthopedic InjuryMedical ReportingDue Process
References
10
Case No. MISSING
Regular Panel Decision

Giles v. Gi Yi

The dissenting opinion by Justice Whalen challenges the majority's interpretation of 22 NYCRR 202.17, which mandates personal injury plaintiffs to secure an expert witness report on causation and provide it to the defense prior to the defendant's medical examination of the plaintiff. Whalen argues this requirement is an undue burden and is not explicitly outlined within the regulation's scope. The dissent emphasizes that 22 NYCRR 202.17 (b) (1) only requires disclosure of reports from 'medical providers who have previously treated or examined the party seeking recovery,' distinct from expert reports generated solely for litigation purposes. Furthermore, Justice Whalen asserts that expert disclosure is governed by CPLR 3101 (d), which does not necessitate such early disclosure, and finds that the Supreme Court's decision to compel was an abuse of discretion, concluding that Nero v Kendrick was wrongly decided.

Expert Witness DisclosureCausationMedical ExaminationPersonal InjuryCivil Procedure Law and Rules (CPLR)Uniform Civil Rules for the Supreme Court and County Court (22 NYCRR)Dissenting OpinionJudicial DiscretionPreclusionLitigation Expenses
References
2
Case No. 534963
Regular Panel Decision
Jun 01, 2023

Matter of Harris v. Department of Envtl. Protection

The claimant, Kevin Harris, a construction worker, filed a workers' compensation claim for work-related injuries to his right shoulder, wrist, and elbow. An orthopedic surgeon, Louis Rose, determined Harris had reached maximum medical improvement and assessed a schedule loss of use (SLU) for these injuries. The self-insured employer challenged Rose's report, arguing his examination was an independent medical examination (IME) and his report failed to comply with statutory and regulatory provisions for IME reports. The Workers' Compensation Board sua sponte agreed that Rose's examination was an IME and precluded his report and testimony due to untimely filing and failure to furnish it to required parties. Consequently, the Board found insufficient evidence for an SLU award. The Appellate Division affirmed the Board's decision, concluding that substantial evidence supported the IME classification and the preclusion of Rose's report due to non-compliance.

Workers' CompensationSchedule Loss of Use (SLU)Independent Medical Examination (IME)Medical Report PreclusionTimely FilingComplianceAppellate ReviewOrthopedic InjuryEmployer Self-InsuredRight Shoulder Injury
References
8
Case No. ADJ869205 (SAC 0294976) ADJ302322 (SAC 0354178)
Regular
Oct 11, 2010

Patricia Rush vs. The Permanente Medical Group; Athens Administrators Concord

This case involves Patricia Rush claiming cumulative trauma injuries to her knees and back, among other body parts, against The Permanente Medical Group. The Workers' Compensation Appeals Board granted reconsideration because the Administrative Law Judge's findings of industrial causation for knee injuries lacked substantial medical evidence, with conflicting and uncertain Qualified Medical Evaluator opinions. The Board rescinded the prior findings and ordered further development of the medical record, suggesting an Agreed Medical Examiner or a court-appointed physician to resolve the causation issue for the knee injuries. The matter is returned to the trial level for a new final determination after the record is further developed on all issues, including injury causation.

Workers' Compensation Appeals BoardPermanente Medical GroupAthens Administratorscumulative trauma injurykneesbackshouldershandswristsindustrial causation
References
0
Case No. ADJ3185622 (BAK 0149638) ADJ2237701 (BAK 0153467)
Regular
Jan 06, 2014

MARDI WHEELER vs. STATE OF CALIFORNIA, CDCR - WASCO STATE PRISON, Legally Uninsured; STATE COMPENSATION INSURANCE FUND/STATE CONTRACT SERVICES, Adjusting Agency

The Workers' Compensation Appeals Board granted reconsideration of a lower decision that awarded 79% permanent partial disability without apportionment between two industrial injuries. The Board found the orthopedic Agreed Medical Examiner's opinion lacked substantial evidence because it did not sufficiently apportion disability to each specific injury as required by law. Consequently, the matter was returned to the trial level to obtain a supplemental medical report from the examiner. This report must clarify the percentage of impairment attributable to each of the two work-related injuries.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and AwardPermanent Partial DisabilityApportionmentNon-industrial factorsAlmaraz-Guzman analysisSubstantial evidenceAgreed Medical Examiner (AME)Orthopedic
References
6
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