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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

Fernandez v. North Shore Orthopedic Surgery & Sports Medicine, P.C.

Frank Fernandez, an x-ray technician, sued his former employer, North Shore Orthopedic Surgery & Sports Medicine, P.C., for retaliation under Title VII after filing a national origin discrimination complaint. A jury found in favor of Fernandez, awarding back pay, front pay, and punitive damages. North Shore subsequently moved for judgment as a matter of law, a new trial, and to modify the damage awards. The court denied North Shore's motions for judgment and a new trial, affirmed the jury's back pay award, but vacated and reduced the front pay award from $160,000 to $50,000, and the punitive damages award from $100,000 to $50,000.

RetaliationTitle VIIEmployment DiscriminationBack PayFront PayPunitive DamagesMitigation of DamagesFederal Rules of Civil ProcedureJudicial DiscretionEquitable Relief
References
27
Case No. ADJ2868357 (LBO 0359096)
Regular
Jan 25, 2010

WARREN MACDONALD vs. WALMART STORES/SAM'S CLUB, AMERICAN HOME ASSURANCE, Administered By AVIZENT

In this workers' compensation case, the defendant sought reconsideration of the WCJ's finding that Dr. Wertheimer's opinions constituted substantial medical evidence. The defendant argued Dr. Wertheimer's conclusions lacked an objective basis, were inconsistent, and included a psychiatric diagnosis outside his orthopedic expertise. The Appeals Board reviewed the record, including Dr. Wertheimer's reports and depositions, and found his opinions sufficiently explained and supported. Therefore, the Board denied the Petition for Reconsideration, affirming the WCJ's finding.

WCABPetition to ReopenStipulationPermanent DisabilitySubstantial Medical EvidenceAgreed Medical EvaluatorAMENew and Further DisabilitySomatoform Pain DisorderOrthopedics
References
5
Case No. CV-22-1999
Regular Panel Decision
Mar 21, 2024

In the Matter of the Claim of Dennis Schuette

Claimant Dennis Schuette appealed a Workers' Compensation Board decision which ruled he was not entitled to a schedule loss of use (SLU) award for a right wrist injury. The Board affirmed the Workers' Compensation Law Judge's finding that medical permanency opinions from orthopedic surgeons Serge Menkin and Vito Loguidice, both suggesting a 73⅓% SLU, were not credible. This was due to the claimant's failure to disclose his bilateral carpal tunnel syndrome diagnosis, testing, and treatment during their examinations. The Board concluded that Maximum Medical Improvement (MMI) was not clearly established, making any SLU determination premature, and that the relationship between the carpal tunnel syndrome and the 2019 wrist injury remained unclear. The Appellate Division affirmed the Board's decision, finding it supported by substantial evidence.

Schedule Loss of UseMaximum Medical ImprovementCarpal Tunnel SyndromeIndependent Medical ExaminationCredibility of Medical TestimonyWorkers' Compensation Board DecisionAppellate DivisionRight Wrist InjuryOccupational Disease ClaimUndisclosed Medical Information
References
5
Case No. MISSING
Regular Panel Decision
Feb 28, 2002

Claim of Lebron v. MTA, Long Island Bus Authority

Claimant, a bus driver, sustained neck, shoulder, and back injuries in a work-related automobile accident. Initial medical opinions differed, with orthopedic surgeon Victor Gold diagnosing severe disability and independent medical examiner Robert Moriarty diagnosing moderate partial disability. Surveillance video showing claimant's activities led Moriarty to issue an addendum stating no disability, but the Workers’ Compensation Law Judge (WCLJ) largely discredited this, relying on Moriarty’s original diagnosis for a permanent moderate partial disability. The Workers’ Compensation Board affirmed this finding, and the employer's subsequent appeal, contending insufficient evidence, was denied by the Appellate Division. The court upheld the Board's determination, citing Gold's consistent testimony and the Board's authority to resolve conflicting medical evidence.

Workers' CompensationAutomobile AccidentCervical SprainLumbosacral SprainModerate Partial DisabilityIndependent Medical ExaminationSurveillance VideoConflicting Medical EvidenceProbative Weight of Expert TestimonyWorkers’ Compensation Board Appeal
References
3
Case No. MISSING
Regular Panel Decision

Doner v. Syracuse China Corp.

The claimant, a stamper at Syracuse China Corporation, suffered a left wrist injury on January 4, 1982, leading to a diagnosis of tendinitis and total disability. Initially, a hearing officer established causal relationship and awarded benefits. However, the employer later controverted the causal relationship of disability beyond February 10, 1982. An impartial orthopedic specialist, Dr. Louis Retz, examined the claimant and determined her condition, diagnosed as cervical dorsal outlet syndrome or plexitis, was directly related to the industrial accident. The employer's request for further medical testimony was denied, and the Workers' Compensation Board awarded further disability benefits. The employer appealed this decision, challenging Dr. Retz's qualifications and the denial of additional testimony. The appellate court affirmed the Board's decision, upholding its discretion in selecting an impartial specialist and denying further development of the record.

Workers' CompensationMedical EvidenceCausal RelationshipDisability BenefitsOrthopedic SurgeryTendinitisThoracic Outlet SyndromeImpartial SpecialistBoard DiscretionAppellate Review
References
2
Case No. ADJ10917207
Regular
Aug 13, 2019

CARMEN ROJO vs. K & M MEAT COMPANY, STARR INDEMNITY & LIABILITY COMPANY

This case involves a dispute over the necessity of an additional Qualified Medical Evaluator (QME) panel in orthopedic surgery. The Applicant sought reconsideration of an administrative law judge's (ALJ) order for a new orthopedic QME panel, arguing it was an abuse of discretion and prejudicial. The Appeals Board granted reconsideration, finding the original QME's referral for an orthopedic evaluation was for treatment, not a recommendation for a new medical-legal evaluation. Consequently, the Board amended the ALJ's findings, holding there was no good cause for an additional orthopedic QME panel and denying the defendant's request.

QME panelorthopedic surgeryreconsiderationremovalFindings & Orderchiropractic QMEmedical-legal evaluationgood causesupplemental pleadingmedical dispute
References
9
Case No. ADJ7264915
Regular
Jul 15, 2013

ANA GONZALES vs. WAL-MART ASSOCIATES, INC., ACE AMERICAN INSURANCE

This case involves an applicant who sustained industrial psychiatric injury but whose orthopedic claims were denied due to insufficient medical evidence. The Appeals Board denied the applicant's petition for reconsideration, finding the applicant failed to present substantial medical evidence of industrial causation for her orthopedic complaints. A dissenting commissioner argued that the primary medical evaluator's report was deficient and lacked substantial evidence, warranting further development of the record on orthopedic injuries and other claims. The dissent emphasizes the Board's duty to ensure substantial justice, suggesting it should have ordered further investigation on the denied orthopedic issues.

WCABPetition for ReconsiderationFindings and Orderindustrial injurypsychelow backneckright shoulderright wristright elbow
References
11
Case No. MISSING
Regular Panel Decision

Depczynski v. Adsco/Farrar & Trefts

This case addresses a workers' compensation claim for occupational hearing loss, focusing on the interpretation of Workers’ Compensation Law § 49-bb concerning the 90-day limitations period. The central question is whether 'knowledge' to trigger this period requires a formal medical diagnosis or the claimant's admitted awareness of the injury and its work-related cause is sufficient. The claimant, employed by Farrar & Trefts (later Adsco Manufacturing Corp.), experienced significant noise exposure and recognized his hearing loss and its occupational link in 1980. However, he did not receive a medical diagnosis until January 1991, having filed his claim in December 1989. The Workers’ Compensation Board dismissed the claim as untimely, finding the claimant had knowledge in 1980, but the Appellate Division reversed, requiring a medical diagnosis for 'knowledge.' The Court of Appeals reversed the Appellate Division, ruling that the claimant's admitted awareness of his injury and its cause in 1980 initiated the limitations period, irrespective of a formal medical diagnosis. Consequently, the court deemed the claim, filed over two years from the disablement date, as untimely and dismissed it.

Occupational hearing lossWorkers' Compensation LawStatute of LimitationsDelayed discovery ruleMedical diagnosis requirementCausation awarenessEmployer liabilityInsurance carrierJudicial interpretationWorkers' Compensation Board
References
12
Case No. ADJ7558173
Regular
Oct 28, 2014

JESSIE MOORE vs. PASADENA AREA COMMUNITY COLLEGE DISTRICT

The Workers' Compensation Appeals Board granted reconsideration, rescinded the prior award, and found the applicant was not temporarily totally disabled after her retirement. The Board determined that while the applicant stated her retirement was reluctant, the primary reasons cited were hostile work environment and emotional stress, not solely orthopedic injuries. Medical evidence did not substantially support the claim that the admitted orthopedic injuries alone rendered her temporarily totally disabled. Consequently, temporary disability benefits were not awarded for the orthopedic injuries.

Workers' Compensation Appeals BoardJessie MoorePasadena Area Community College DistrictKeenan & Associatesstatute of limitationstemporary disabilitycumulative traumacervical spinelumbar spineleft wrist
References
7
Case No. ADJ2434971 (OAK 0238163)
Regular
Dec 02, 2010

ANA RODRIGUEZ vs. SHERATON PALACE HOTEL, TOKIO MARINE

The Workers' Compensation Appeals Board denied reconsideration of a finding that the applicant, Ana Rodriguez, did not sustain new and further permanent disability subsequent to a 1997 stipulated award. The judge found her testimony regarding increased orthopedic and psychiatric symptoms to be not credible. Medical evidence from Dr. Edington indicated no orthopedic increase in disability since the award, and the psychiatric disability became permanent and stationary concurrently with the orthopedic condition. Therefore, the judge concluded there was no "new and further" disability as defined by Labor Code Section 5410.

Workers' Compensation Appeals BoardPetition for ReconsiderationDeniedCredibility FindingGarza v. Workers' Comp. Appeals Bd.Stipulated AwardPetition to ReopenNew and Further DisabilityOrthopedic DisabilityPsychiatric Disability
References
2
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