CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

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. ADJ11913752
Regular
Nov 19, 2019

LAURA DOW vs. UCSF, administered by SEDGWICK CLAIMS MANAGEMENT SERVICES

This case concerns a dispute over the proper procedure for requesting a Qualified Medical Evaluator (QME) panel after a workers' compensation claim was denied. The Workers' Compensation Appeals Board (WCAB) granted removal, reversing a WCJ's decision. The WCAB found that the defendant's request for an orthopedic surgery QME panel was valid, initiated after the denial notice and statutory waiting period. They also determined that orthopedic surgery was an appropriate specialty, overriding the WCJ's order for a pain medicine panel. The parties are now directed to proceed with the orthopedic surgery QME panel.

QME panelPetition for RemovalOpinion and OrderFindings and OrdersMedical UnitPain MedicineOrthopedic SurgeryDenial NoticeQualified Medical EvaluatorLabor Code Section 4060
References
4
Case No. MISSING
Regular Panel Decision

Lawliss v. Quellman

Plaintiff sustained a right shoulder injury at work, leading his orthopedic specialist to recommend immediate surgery for a ruptured biceps. However, his employer's workers' compensation carrier disputed the need for surgery and mandated an independent medical examination (IME) by the defendant, an orthopedic specialist. The defendant reported to the carrier that surgery was unnecessary, advocating physical therapy instead. This advice resulted in the carrier denying surgery, and the plaintiff's subsequent physical therapy proved ineffective, as did delayed surgery, allegedly causing an 80% loss of shoulder use. Consequently, plaintiff initiated a medical malpractice action against the defendant, asserting that the negligent advice given during the IME caused the detrimental delay in his treatment. The Supreme Court denied the defendant's motion for summary judgment, a decision which the appellate court affirmed, citing the presence of factual questions regarding an implied physician-patient relationship, negligence, and foreseeable reliance.

medical malpracticeindependent medical examinationphysician-patient relationshipsummary judgmentworkers' compensationappellate decisionorthopedic injurynegligent advicedelayed surgeryloss of use
References
10
Case No. ADJ11861160
Regular
Oct 25, 2019

ADRIANA MARTINEZ vs. AVITUS, AMERICAN ZURICH INSURANCE COMPANY, GALLAGHER BASSETT SERVICES

This case involves a dispute over the selection of Qualified Medical Evaluator (QME) panels for an applicant with claimed injuries to multiple body parts. The Workers' Compensation Appeals Board (WCAB) granted the applicant's petition for removal, rescinded the prior decision, and found that the applicant's chiropractic QME panel request was proper while the defendant's orthopedic surgery panel request was improper. The WCAB determined that chiropractic medicine is the appropriate specialty and struck the orthopedic surgery panel, ordering the parties to proceed with the chiropractic QME. The WCAB clarified that while chiropractors cannot perform surgery or prescribe medication, they are qualified to evaluate injuries within their scope of practice.

QME panel disputeremoval petitionchiropractic specialtyorthopedic surgery specialtyLabor Code 4062.2Medical Directoradministrative law judgeWorkers' Compensation Appeals Boardproper panel selectioninvalid panel request
References
9
Case No. MISSING
Regular Panel Decision
Apr 09, 1997

Claim of Krisher v. Graver Tank Manufacturing Co.

The claimant appealed a decision by the Workers' Compensation Board (WCB) that found no causally related disability during the period of April 10, 1995, to June 17, 1996. The claimant had sustained a back injury in 1990, followed by surgery in 1994, and later developed a left knee injury, leading to surgery in February 1995. A Workers' Compensation Law Judge initially awarded benefits for reduced earnings, but the WCB modified this, concluding there was no causally related disability. The appellate court affirmed the WCB's decision, citing testimony from orthopedic surgeon Roy Wert that the claimant could return to work without restrictions by April 1995. Another orthopedic surgeon, George Fuksa, opined that the knee injury was preexisting and not a result of the back surgery.

Workers' CompensationCausally Related DisabilityBack InjuryKnee InjuryMedical OpinionOrthopedic SurgeonReduced EarningsAppellate ReviewSubstantial EvidencePreexisting Injury
References
1
Case No. MISSING
Regular Panel Decision
Jun 02, 2008

Claim of Laezzo v. New York State Thruway Authority

The claimant suffered a work-related slip and fall in 2002, leading to injuries including his head, neck, back, and knees. His morbid obesity contributed to his back and knee issues, prompting him to seek authorization for gastric bypass surgery. The Workers’ Compensation Law Judge approved the surgery, a decision affirmed by the Workers’ Compensation Board, which found the surgery causally related to the compensable injuries. The employer and its carrier appealed, challenging the causal link. The court affirmed the Board's decision, noting substantial evidence that the claimant's weight gain was a result of the sedentary lifestyle imposed by his injuries, and that the surgery would aid in his recovery.

Workers' CompensationConsequential InjuryGastric Bypass SurgeryMorbid ObesityMedical Treatment AuthorizationCausationKnee InjuryBack InjurySedentary LifestyleBoard Decision Appeal
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. CV-24-0652
Regular Panel Decision
May 29, 2025

Matter of Cahill v. New York State Dept. of Mental Hygiene

Claimant Lynn Cahill sustained a work-related knee injury in 1992, which led to a total knee replacement in 2012 and subsequent revision surgeries. In October 2020, she was diagnosed with a periprosthetic infection, managed with antibiotics. Her condition acutely worsened in September 2022, leading her orthopedic surgeon, Dr. Frank Lombardo, to recommend and perform immediate cement spacer surgery on October 4, 2022, due to risks of sepsis and amputation. The employer and carrier disputed liability, arguing the surgery lacked prior authorization. However, the Workers' Compensation Board, affirmed by the Appellate Division, Third Department, ruled that the surgery was performed on an emergency basis, thereby waiving the authorization requirement under Workers' Compensation Law § 13-a (5) and holding the carrier responsible for the costs.

Knee InjuryPeriprosthetic InfectionEmergency Medical CareSurgical AuthorizationAppellate DivisionWorkers' Compensation Board ReviewMedical NecessityChronic InfectionSepsisAmputation Risk
References
6
Case No. MISSING
Regular Panel Decision

Claim of Casiano v. CCIP/Union Settlement Home Care

In March 2001, claimant sustained a work-related back injury. Neurosurgeon Richard J. Radna recommended and performed decompression surgery despite the workers' compensation carrier denying preauthorization for the procedure. Both a Workers’ Compensation Law Judge and the Workers’ Compensation Board subsequently ruled that the surgery was not medically necessary, thereby absolving the carrier of liability for its cost. Claimant and Radna appealed this determination to the appellate court. Radna's appeal was dismissed due to lack of standing, and the Board's decision was affirmed, as it was within its purview to resolve the conflicting medical evidence presented by Radna and the carrier's neurosurgeon regarding the necessity of the surgery.

Workers' Compensation LawMedical NecessitySurgical ProcedurePreauthorization DenialNeurological InjuryConflicting Medical OpinionsAppellate ReviewStanding IssueCarrier LiabilityBack Injury
References
3
Case No. LAO 0811779, LAO 0811780
Regular
Mar 06, 2008

ELENA BLANKEVOORT vs. HUNTINGTON MEMORIAL HOSPITAL, S&B SURGERY CENTER

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded a trial judge's order disallowing a lien claim from S&B Surgery Center. The WCAB found that while S&B Surgery Center did have a required "surgical clinic" license, it failed to prove compliance with fictitious business name filing requirements. However, the WCAB returned the case to the trial level for further proceedings, allowing S&B Surgery Center an opportunity to correct this procedural defect to recover on its lien.

Fictitious business nameLien claimantSurgical clinic licenseBusiness and Professions Code section 17910Medical BoardDepartment of Health ServicesBurden of proofReconsiderationWorkers' Compensation Appeals BoardOutpatient setting
References
12
Showing 1-10 of 1,115 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational