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Case Law Database

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

Case No. 2017-01-0228
Regular Panel Decision
Aug 16, 2017

Ducros, James v. Metro Roofing and Metal Supply Co.

James Ducros, an employee of Metro Roofing and Metal Supply Co., Inc., filed a request for an expedited hearing to have Dr. Woody Kennedy designated as his authorized treating physician after a wrist injury. Initially, Metro Roofing authorized Dr. Kennedy but delayed in offering a panel of physicians for a month, from which Ducros ultimately selected Dr. Peter Lund. Ducros argued coercion regarding the late-offered panel. The Court denied Ducros' request, finding that despite the employer's delay in providing a panel, which could incur a penalty, Ducros had a statutory duty to accept the offered medical benefits and had treated with Dr. Lund for almost a year. The Court referred Metro Roofing to the Penalty Unit for investigation due to its failure to timely offer a panel of physicians.

Workers' CompensationMedical BenefitsPhysician AuthorizationPanel of PhysiciansExpedited HearingPenalty AssessmentEmployer ObligationsDelayed Panel OfferTreating PhysicianWrist Injury
References
3
Case No. ADJ815944
Regular
Jan 14, 2010

LINDALAIVAREZ vs. BLUE DIAMOND GROWERS, TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

The Workers' Compensation Appeals Board denied a Petition for Removal, upholding the WCJ's decision to deny a new QME panel. The applicant's attempt to obtain a new panel was deemed impermissible "doctor-shopping" by delaying objection to a late supplemental QME report until after receiving and reviewing it, and finding it favorable. The Board applied the principle that parties cannot exploit delays in medical reports for strategic advantage. Therefore, removal was denied as the conduct did not justify a new panel appointment.

Petition for RemovalQME panelmedical-legal reportdoctor-shoppinguntimely reportsupplemental reportobjectionwrit deniedAppeals Board panel decisionadministrative law judge
References
4
Case No. G107 435
Regular Panel Decision
Jun 02, 2023

Matter of Marku v. ABM Industries

This case concerns the claim of Denise Perry under the Workers' Compensation Law. The Workers' Compensation Law Judge (WCLJ) previously found that the employer, Adventist Home Care, established a violation of Workers' Compensation Law § 114-a by the claimant for willfully making false statements to obtain benefits. Consequently, the WCLJ disallowed indemnity benefits and imposed both mandatory and discretionary penalties. A Board Panel decision filed on February 17, 2022, affirmed the WCLJ's findings. The claimant subsequently filed an application for reconsideration on March 18, 2022, which the Board Panel reviewed. After considering the claimant’s arguments, the Board Panel determined that the application did not raise new issues or present new material evidence, nor did it demonstrate an erroneous statement of material fact or law in the prior decision. Therefore, the Board Panel, by a majority vote, affirmed its prior decision.

Workers' Compensation FraudFalse RepresentationIndemnity Benefits DisallowanceWCL § 114-a PenaltyApplication for Reconsideration DeniedBoard Panel AffirmationWillful MisrepresentationWorkers' Compensation Law Judge DecisionEmployer Established Violation
References
0
Case No. MISSING
Regular Panel Decision

Texas Workers' Compensation Insurance Fund v. Texas Workers' Compensation Commission

The Texas Workers’ Compensation Insurance Fund, now Texas Mutual, challenged an appeals panel decision by the Texas Workers’ Compensation Commission which awarded lifetime income benefits to claimant Leonard D. Watts. Watts, a truck driver for Mono Chem Corporation, sustained a leg injury in 1994, leading to severe medical conditions and ultimately the loss of use of both feet. A hearing officer initially denied lifetime benefits due to insufficient evidence of a causal connection to the original injury, but the appeals panel twice reversed this decision, rendering a new decision in favor of Watts. Texas Mutual sought judicial review, arguing the appeals panel exceeded its statutory authority and improperly engaged in factual-sufficiency review. The district court set aside the appeals panel's decision. This court, however, reversed the district court's decision, affirming the appeals panel’s award of lifetime income benefits to Watts, holding that the appeals panel acted within its statutory authority.

Workers' CompensationLifetime Income BenefitsAppeals Panel ReviewJudicial ReviewFactual SufficiencyStatutory AuthorityCausationRes JudicataCollateral EstoppelTexas Labor Code
References
13
Case No. MISSING
Regular Panel Decision

Colton v. Riccobono

A petitioner initiated an Article 78 proceeding to compel the Administrative Judge and Clerk of the Medical Malpractice Part of Supreme Court, New York County, to immediately assemble a medical malpractice panel for her underlying wrongful death action. She argued that the delay in forming the panel unconstitutionally deprived her of access to the courts. The court affirmed the Appellate Division's dismissal of her petition. It found no clear legal right to mandamus, no demonstration of egregious delay compared to other malpractice cases, and noted that alternative remedies, such as transferring the matter to another county, were available through judicial discretion.

Article 78 ProceedingMedical Malpractice PanelMandamusAccess to CourtsDue ProcessJudiciary Law § 148-aCourt DelayJudicial DiscretionAppellate DivisionNew York Supreme Court
References
22
Case No. MISSING
Regular Panel Decision

Matter of Burns v. New York State Workers' Compensation Board

Claimant sought workers' compensation benefits due to injuries from an automobile accident. As an employee of the Workers’ Compensation Board, his claim was processed through a neutral outside arbitration process. An arbitrator established his claim and average weekly wage. Claimant appealed, arguing his average weekly wage should have been calculated differently due to a recent promotion, as per Workers’ Compensation Law § 14 (2). An arbitration panel declined to address this argument because it was not raised before the arbitrator. The appellate court affirmed the panel's decision, citing that the panel could decline review of issues not previously raised, consistent with 12 NYCRR 300.13 [e] [1] [iii].

ArbitrationAverage Weekly WageWorkers' CompensationAppellate ReviewIssue PreservationAdministrative LawProcedural Due ProcessStatutory InterpretationWorkers’ Compensation Board
References
2
Case No. MISSING
Regular Panel Decision

Claim of Mulligan v. Workers' Compensation Board

The claimant, a former workers' compensation law judge, appealed the denial of reduced earning benefits, which stemmed from his claim that stress from his job caused him to voluntarily withdraw from the labor market. He had previously received benefits for a 1995 angina attack. An arbitrator and subsequent arbitration panel concluded that he voluntarily withdrew from the labor market, a determination the claimant contested, asserting his retirement was due to work-related stress. The court, led by Judge Carpinello, found substantial evidence supported the panel's decision, noting the claimant never complained of stress to supervisors, sought accommodations, or applied for disability retirement. The court affirmed the arbitration panel's decision, denying the claimant's appeal.

Voluntary Withdrawal from Labor MarketReduced Earning BenefitsWorkers Compensation BenefitsArbitration Panel DecisionSubstantial EvidenceDisability RetirementJob-Related StressAppellate ReviewLabor Market WithdrawalClaim Denial
References
8
Case No. 2022-08-0195
Regular Panel Decision
Sep 02, 2022

Evans, Antron v. Family Dollar Stores, Inc.

Mr. Antron Evans requested a panel of psychiatrists, attorney's fees, and payment of a medical bill following a store robbery where he sustained a head injury. Family Dollar, the employer, contended he was not entitled to a psychiatric panel without a referral from an authorized physician, disputed the medical bill, and denied wrongfully denying the claim for attorney's fees. The Court denied Mr. Evans's requests for a psychiatric panel and payment of the emergency room bill, citing the statutory requirement of a panel physician's referral for psychiatric services and lack of proof for the medical bill. However, the Court granted his request for attorney's fees due to Family Dollar's five-month delay in timely initiating medical benefits. Additionally, Family Dollar was referred to the Compliance Program for potential penalties concerning the late filing of the First Report of Injury and the untimely provision of a panel of physicians.

Workers' CompensationMedical Benefits DenialAttorney's Fees GrantEmployer PenaltiesExpedited HearingPsychiatric ReferralStatutory InterpretationLate Claim ProcessingFirst Report of Injury DelayPost-Traumatic Stress
References
6
Case No. 2022-08-1404
Regular Panel Decision
Feb 23, 2026

BRITT, BREEAHNA v. CENTER FOR YOUTH MINISTRY TRAINING

Breeahna Britt, an employee, sought medical benefits for a head, neck, and upper-body injury, specifically requesting her physical therapist to be named as her authorized treating physician. The employer, Center for Youth Ministry Training, initially disputed the lack of a valid physician panel but later conceded, offering a Colorado neurologists' panel during the expedited hearing. The Court denied Ms. Britt's request for the physical therapist to be authorized, citing her failure to establish a doctor/patient relationship with a physician, specifically a neurologist. However, the Court affirmed Ms. Britt's entitlement to a new panel of neurologists in Colorado and referred the employer to the compliance program for penalties due to their delay in providing a valid panel.

Workers' CompensationMedical BenefitsPhysician PanelAuthorized Treating PhysicianEmployee RelocationEmployer ObligationNeurologyPenalty AssessmentExpedited HearingTennessee Law
References
3
Case No. WCB No. G076 2707
Regular Panel Decision
Dec 09, 2021

Matter of Duncan v. John Wiley & Sons, Inc.

This Board Panel Decision concerns an appeal by the applicant, Joseph Lafayette, regarding a Workers' Compensation Law Judge's (WCLJ) finding on the causal relationship of his back injury. The applicant sustained injuries to his back, neck, and shoulder during his employment. The WCLJ had previously established a causal relationship for the neck and shoulder injuries but disallowed the claim for the back injury. Upon review, the Board Panel determined that the medical evidence in the record supports a causal relationship between the claimant's employment and his lower back injury. As a result, the Panel modified the WCLJ's decision to establish a causal relationship for the back injury, while affirming the other aspects of the original decision.

Workers' CompensationBack InjuryNeck InjuryShoulder InjuryCausal RelationshipMedical EvidencePanel ReviewWCLJ DecisionModificationAppeal
References
2
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