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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

Claim of Forshee v. Gates Albert, Inc.

The claimant appealed a decision by the Workers’ Compensation Board regarding the apportionment of his workers' compensation award. The claimant had prior back injuries in 1988 and 1995, leading to lump-sum settlements, and suffered another work-related back injury in 2007. Initially, a workers’ compensation law judge attributed the disability solely to the 2007 injury. However, the Board modified this, apportioning 20% to the 2007 injury and dividing the remainder between the 1988 and 1995 injuries. The appellate court affirmed the Board’s decision, finding substantial evidence, including the opinion of a board-certified orthopedic surgeon, supported the apportionment.

Workers' CompensationApportionmentPermanent Partial DisabilityBack InjuryPrior InjuriesLump-sum SettlementOrthopedic SurgeonMedical OpinionSubstantial EvidenceAppellate Review
References
5
Case No. ADJ2628303
Regular
Apr 01, 2014

GLORIA CAIRES vs. SHARP HEALTHCARE, ACE AMERICAN INSURANCE

The Appeals Board rescinded the original award and returned the case for further proceedings due to insufficient medical evidence on apportionment. Specifically, the Board found that the opinions of the orthopedic and psychiatric medical evaluators regarding the apportionment of permanent disability lacked substantial medical evidence. The orthopedic evaluator's apportionment methodology, referencing an AMA Guides example, was deemed improper under current Labor Code sections 4663 and 4664. The psychiatric evaluator's apportionment was also found insufficient as it did not adequately explain how psychiatric permanent disability should be apportioned separately from injury causation.

Workers' Compensation Appeals BoardPermanent Disability ApportionmentQualified Medical Evaluator (PQME)Agreed Medical Evaluator (AME)American Medical Association Guides to the Evaluation of Permanent ImpairmentRange of Motion MethodDiagnosis-Related Estimate (DRE) MethodCompensable ConsequenceCausation of Permanent DisabilitySubstantial Medical Evidence
References
12
Case No. ADJ9674255
Regular
Jul 10, 2017

YAN LIU vs. HAWAIIAN GARDENS CASINO, INSURANCE COMPANY OF THE WEST

This case concerns an applicant who alleges both orthopedic and psychiatric injuries from her employment as a casino dealer. While the Board affirmed the finding of orthopedic injury, it deferred the issue of psychiatric injury. The Board clarified that Labor Code § 4660.1(c) does not bar psychiatric claims arising directly from employment events, but it requires a medical apportionment of causation between direct psychiatric injury and injury as a consequence of physical injury. The matter was returned to the trial level for further development of the record regarding the psychiatric injury and its apportionment.

AOE/COELabor Code Section 4660.1(c)psychiatric injurycompensable consequenceviolent actsubstantial medical evidencetreating physicianQMEcontinuous traumaharassment
References
10
Case No. MISSING
Regular Panel Decision

Claim of Huss v. Tops Markets, Inc.

In 1985, claimant sustained a right shoulder injury while employed by Dunlop Tire, resulting in a permanent partial disability. In 1998, he re-injured the same shoulder while working for Tops Markets, Inc., leading to a new workers' compensation claim. An impartial specialist attributed 85% of the disability to the 1985 injury and 15% to the 1998 injury. Although a Workers' Compensation Law Judge initially rejected apportionment, the Board reversed and applied the 85/15 apportionment. Claimant appealed, contending apportionment was unwarranted due to his disclosure of the prior injury and lack of prior disability symptoms. The Appellate Division affirmed the Board's decision, finding substantial medical evidence to support the apportionment.

Workers' CompensationPermanent Partial DisabilityApportionmentPrior InjuryShoulder InjuryCausal RelationshipMedical Expert TestimonyBoard DecisionAppellate ReviewExacerbation
References
3
Case No. MISSING
Regular Panel Decision
Apr 10, 2003

Claim of Peck v. Village of Gouverneur

Claimant, a volunteer firefighter, sustained head, chest, and neck injuries in a 2000 work-related accident. During surgery for these injuries, cancerous growths were discovered along his spine, prompting the employer to request apportionment of his workers' compensation award. Both the treating physician and the employer-retained physician affirmed the causal relationship between the fracture and the work-related accident. The Workers’ Compensation Law Judge and the subsequent Workers’ Compensation Board both ruled against apportionment. The appellate court affirmed, citing that apportionment is inappropriate when a claimant's prior non-compensable condition did not hinder their ability to perform duties.

Workers' CompensationApportionmentVolunteer FirefighterWork-Related InjuryPre-existing ConditionCancer DiagnosisCausally RelatedMedical Expert TestimonyEmployer AppealBoard Decision Affirmed
References
4
Case No. MISSING
Regular Panel Decision

Claim of McClam v. American Axle & Manufacturing

Claimant suffered two right shoulder injuries, one in 1997 while working for CF Motorfreight, and another in 2000 while working for American Axle & Manufacturing. After the second injury, American Axle sought apportionment of the workers' compensation award, which was initially granted by a Workers’ Compensation Law Judge but limited to medical treatment. The Workers’ Compensation Board subsequently determined that any apportionment should be deferred until a finding of permanency is made. American Axle appealed this deferral, arguing against the limitation of apportionment. However, the appellate court dismissed the appeal, ruling that the Board's decision was an unappealable interlocutory decision, thus avoiding piecemeal review of workers’ compensation issues.

Workers' CompensationApportionmentShoulder InjurySchedule Loss of UseInterlocutory AppealDeferral of AwardPermanency FindingBoard ReviewMedical ExaminationEmployer Liability
References
6
Case No. MISSING
Regular Panel Decision

Claim of Kuczynski v. Trinity Foundry

This case involves an appeal from a Workers’ Compensation Board decision concerning the apportionment of liability for a claimant's chronic obstructive pulmonary disease (COPD). The claimant, who had worked at various foundries including Kennedy Valve (under ITT Grinnell and later McWane Inc.) and Trinity Foundry, filed a claim after a COPD diagnosis in 2004. A Workers’ Compensation Law Judge initially established the claim and found Kennedy Valve/McWane liable. The Board subsequently apportioned liability among ITT Grinnell (71%), Trinity (28%), and Kennedy Valve/McWane (1%). Trinity and its workers’ compensation carrier appealed this apportionment. The appellate court affirmed the Board's decision, concluding that substantial evidence supported the finding that the claimant contracted COPD prior to his 1994 employment with Kennedy Valve/McWane, thus justifying the apportionment of liability among the employers.

chronic obstructive pulmonary diseaseCOPDworkers' compensationoccupational diseaseapportionmentfoundry workemployer liabilitymedical expert testimonyappellate reviewliability distribution
References
4
Case No. MISSING
Regular Panel Decision

Claim of Rafferty v. Four Corners, LLC

Claimant sustained two work-related back injuries, one in 1996 causing permanent partial disability and another in 2003 affecting his back and neck. A Workers’ Compensation Law Judge determined that claimant had a marked partial disability and apportioned it equally between both accidents. The Workers’ Compensation Board affirmed this apportionment decision, prompting the claimant's appeal. The Appellate Division affirmed the Board's finding, concluding that substantial medical evidence and the claimant's work history supported the application of apportionment for his current disability. The finding of apportionment, however, did not extend to medical treatment for the claimant's neck and upper right extremity.

ApportionmentDisabilityWorkers' Compensation AwardWork-Related InjuryBack InjuryNeck InjuryPermanent Partial DisabilityMedical EvidencePrior Compensable InjurySocial Security Disability Benefits
References
3
Case No. MISSING
Regular Panel Decision

Claim of Morin v. Town of Lake Luzerne

The claimant appealed a Workers’ Compensation Board decision from December 9, 2010, which applied apportionment to his workers’ compensation award, allocating 50% to a 2009 work-related back injury and 50% to a 2004 back injury. The appellate court clarified that apportionment is inapplicable when a preexisting condition was not due to a compensable injury and the claimant was fully employed and capable of performing job duties despite the condition. Evidence showed the claimant's 2004 back injury was not work-related, and he had worked full-time for over four years before the 2009 injury. The court emphasized that the key factor for apportionment is whether the prior condition was disabling, not merely symptomatic. Therefore, the Board’s decision to apportion the award was reversed as it lacked substantial evidence, and the case was remitted for further proceedings.

ApportionmentPreexisting InjuryWorkers' Compensation LawMedical EvidenceDisabling ConditionAppellate DivisionReversed DecisionRemandBack Injury ClaimEmployer Liability
References
10
Case No. MISSING
Regular Panel Decision
Nov 16, 2011

Claim of Wiess v. Mittal

Claimant, a steel worker from 1965 to 2008, filed an occupational hearing loss claim. His initial employer, Bethlehem Steel Corporation, was succeeded by Arcelor Mittal. A Workers' Compensation Law Judge apportioned the award based on the claimant's length of service with each employer. Bethlehem appealed, arguing Arcelor had not satisfied notice requirements and challenging the apportionment method. The Workers' Compensation Board determined Bethlehem had actual knowledge of the claimant's hearing loss through annual testing and credible testimony, and affirmed apportionment based on length of service. The appellate court affirmed the Board's decisions, finding no error in the Board's findings regarding actual knowledge or apportionment method.

Occupational hearing lossApportionmentActual knowledgeNotice requirementsEmployer liabilityWorkers' Compensation Law § 49-eeMedical evidenceBurden of proofAdverse inferenceIndustrial injury
References
8
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