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

Case No. MISSING
Regular Panel Decision

Claim of Anderson v. New York City Department of Design & Construction

Claimant appealed a Workers' Compensation Board decision from April 25, 2013, which denied his application to include a partial right rotator cuff tear under his existing 2002 work-related injury claim. The Board found that claimant failed to establish a causal link between the 2002 automobile accident and the 2009 rotator cuff tear, despite the opinion of his orthopedist. The orthopedist acknowledged that age-related degeneration could cause such tears independently of trauma. The Appellate Division affirmed the Board's decision, concluding there was substantial evidence to support the finding that the orthopedist's testimony did not convincingly prove a causal relationship.

Rotator cuff tearCausal relationshipWorkers' CompensationMedical evidenceDisabilityWork-related injuryAutomobile accidentShoulder painOrthopedist opinionSubstantial evidence
References
4
Case No. 2024-60-4531
Regular Panel Decision
Nov 12, 2024

DUVERGER, TONI v. SHOALS TECHNOLOGIES GROUP, INC.

Ms. Toni Duverger sought medical treatment for a right shoulder injury sustained during her employment with Shoals Technologies Group, Inc., specifically requesting an orthopedist referral. The employer contested the claim, citing a nurse practitioner's opinion that the injury was pre-existing and unrelated to work. However, the Court deemed the nurse practitioner unqualified to provide medical causation testimony. Instead, it relied on the expert medical opinion of Dr. Gregg Motz, an orthopedist, who concluded that Ms. Duverger's injury was clearly work-related and likely necessitated a rotator cuff repair. Based on this expert testimony, the Court granted Ms. Duverger's request, ordering Shoals Technologies to provide a panel of orthopedists for her evaluation and treatment.

Workers' compensationshoulder injuryorthopedist referralmedical causationnurse practitionerexpert medical opinionrotator cuff tearexpedited hearing orderTennessee labor lawemployer medical responsibility
References
4
Case No. 2018-01-0349
Regular Panel Decision
Jan 24, 2019

Rhodes, Jason v. Amazon.com, LLC

Jason Rhodes, an employee of Amazon, sustained a foot injury and sought medical care and temporary partial disability benefits. The dispute arose when Mr. Rhodes declined to see an orthopedist referred by Amazon's authorized treating physician, Dr. Natasha Ballard, citing distance, and instead saw Dr. Jesse Doty. Mr. Rhodes argued that Amazon's practice of directing referrals to a single orthopedist effectively usurped his right to choose a physician under Tennessee law. The Court found Amazon's method of compelling referrals to a specific specialist by removing the treating physician's neutrality was contrary to the spirit of the direct-referral statute. Consequently, the Court ordered Amazon to provide a new panel of orthopedists and to pay Mr. Rhodes temporary partial disability benefits for the period he was out of work.

Workers' CompensationExpedited HearingMedical BenefitsTemporary Partial DisabilityPhysician ChoiceEmployer Referral PolicyOrthopedist PanelCommunity of ResidenceMedical Treatment DisputeFoot Injury
References
4
Case No. OAK 0318766
Regular
Jul 11, 2007

DEVERIE LAUTENSCHLAGER vs. HARBOR VIEW HOLDINGS, TRAVELERS PROPERTY CASUALTY

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior award, finding insufficient evidence to support the administrative law judge's determination of a compensable psychiatric injury. The Board held that the opinions of the applicant's orthopedist and QME orthopedist were not substantial evidence, lacking proper psychiatric diagnosis and exceeding their expertise. The case was returned to the trial level for further development of the record regarding the psyche injury.

Workers Compensation Appeals BoardDeverie LautenschlagerHarbor View HoldingsTravelers Property CasualtyOAK 0318766ReconsiderationWCJFindings Award OrderBilateral Upper ExtremitiesPsyche Injury
References
0
Case No. ADJ9549773
Regular
Nov 13, 2015

EDWARD BAUTISTA vs. ARLON GRAPHICS, TRAVELERS

The Appeals Board dismissed the applicant's petition for reconsideration or removal, finding the WCJ's order was not a final determination. The WCJ correctly ordered the applicant to first discuss his anxiety symptoms and need for psychological referral with his primary treating orthopedist. Applicant is not entitled to a second opinion from a psychologist until the primary treating physician has diagnosed the anxiety or determined a referral is unnecessary. Commissioner Sweeney dissented, believing the applicant had an absolute right to an MPN second opinion for his psychiatric condition without first obtaining a referral from his orthopedist.

ADJ9549773Arlon GraphicsTravelersPetition for ReconsiderationPetition for RemovalWorkers' Compensation Appeals BoardWCJLabor Code Section 4616.3Labor Code Section 4616.4Administrative Director Rules
References
4
Case No. 2024-60-3877
Regular Panel Decision
Jan 28, 2025

DAVIDSON, JAMES v. GIBSON GUITAR

James Davidson injured his left shoulder while working for Gibson Guitar. Despite a medical referral to an orthopedist, Gibson failed to provide a panel of orthopedists for almost two years and later dismissed an authorized physician's surgery recommendation. The Court found Mr. Davidson is likely to prevail on medical benefits and awarded attorney's fees due to Gibson's unreasonable delays in treatment. However, his request for temporary disability benefits was denied due to insufficient proof of wages. Gibson was also referred to the Compliance Program for failing to provide timely medical treatment and a panel of orthopedic physicians.

Medical BenefitsAttorney's FeesTemporary Disability BenefitsShoulder InjuryLabral TearSurgical RecommendationTimely Medical TreatmentCompliance Program ReferralExpedited HearingMedical Causation
References
6
Case No. MISSING
Regular Panel Decision

Browne v. DiNapoli

The petitioner, a police officer, sought accidental and performance of duty disability retirement benefits after being injured in 2005. His applications were denied, and this denial was upheld after a hearing, finding he was not permanently incapacitated. The petitioner initiated a CPLR article 78 proceeding to challenge this determination. The court considered conflicting medical evidence, including the petitioner's evidence of a 30% shoulder loss of use and radiculopathy, and an orthopedist's report for the New York State and Local Retirement System concluding the petitioner was not disabled. The court ultimately confirmed the respondent's determination, citing substantial evidence from the orthopedist's rational and fact-based medical opinion.

Disability RetirementPolice Officer InjuryAccidental DisabilityPerformance of Duty DisabilityCPLR Article 78Medical IncapacitationConflicting Medical EvidenceOrthopedic EvaluationRadiculopathyShoulder Injury
References
4
Case No. MISSING
Regular Panel Decision

Bermejo v. New York City Health & Hospitals Corp.

The plaintiff's attorney secretly videotaped an Independent Medical Examination (IME) and revealed it at trial, causing a mistrial. The trial judge, Justice Duane A. Hart, accused the defendant's orthopedist of perjury and threatened his career. On appeal, the court found the attorney's secret recording and non-disclosure a violation of CPLR 3101(i) and deemed the conduct frivolous. The appellate court also determined that the orthopedist did not lie and that the trial judge's intimidation made him unavailable as an expert witness. The court reversed the trial court's decision, granting the defendants a new IME and ordering the plaintiff's counsel to pay the defendants' costs. The case was remitted to a different Justice for further proceedings.

Personal injuryIndependent Medical ExaminationVideotaping IMEDiscovery rulesAttorney misconductMistrialPerjury allegationsJudicial biasAppellate procedureSanctions
References
38
Case No. 2019-01-0368
Regular Panel Decision
Dec 19, 2019

Ibarra, Grecia M. v. Amazon Fulfillment Services, Inc.,

Ms. Grecia M. Ibarra, an employee, filed a claim alleging a low back injury from repetitively lifting heavy boxes while working for Amazon. An expedited hearing was held to determine her entitlement to a panel of orthopedists, which Amazon disputed, citing lack of timely notice, an identifiable injury, and causation. The Court found that Ms. Ibarra provided timely notice to Amazon and sustained a gradual, identifiable injury. Although Dr. Ballard, the panel physician, did not provide a causation opinion, the Court ruled that denying the claim on that basis at this stage was premature. Consequently, the Court ordered Amazon to provide Ms. Ibarra an orthopedist panel for her back injury.

Workers' CompensationBack InjuryGradual InjuryTimely NoticeCausationOrthopedist PanelExpedited HearingCumulative TraumaRepetitive MotionEmployer Liability
References
1
Case No. MISSING
Regular Panel Decision

Claim of Douglas Smith v. Tompkins County Courthouse

Claimant, a deputy sheriff for Tompkins County, suffered a back injury in a motor vehicle accident. His orthopedist prescribed a supervised swimming program for rehabilitation, including instruction, which the insurance carrier initially rejected. A referee and the Workers’ Compensation Board affirmed the necessity of this treatment. The Appellate Division reversed, interpreting Workers’ Compensation Law section 13 narrowly. However, the Court of Appeals reversed the Appellate Division's decision, reinstating the Board's determination and holding that supervised swimming, when prescribed by an orthopedist for a back injury, constitutes 'other attendance or treatment' under section 13 and is therefore an authorized medical treatment, emphasizing a liberal construction of the Workers’ Compensation Law.

Workers' Compensation LawMedical Treatment AuthorizationRehabilitative MeasuresSwimming TherapyBack InjuryDeputy SheriffInsurance Carrier ObligationStatutory InterpretationLiberal ConstructionAppellate Division Reversal
References
7
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