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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 Milner v. Country Developers, Inc.

The Special Disability Fund appealed decisions by the Workmen’s Compensation Board which imposed liability on the Fund for a claimant's injuries. The Board found that the employer, Country Developers, continued to employ the claimant, a carpenter, with knowledge of his pre-existing permanent physical impairment, triggering liability under subdivision 8 of section 15 of the Workmen’s Compensation Law. The claimant suffered a fracture of the nose and a hip dislocation in 1964, having a history of three ruptured disc surgeries and other conditions. The appeal centered on whether the employer had sufficient knowledge of the claimant’s permanent condition. Testimony from the employer’s foreman, Mr. Pahlck, indicated awareness of the claimant's back issues, including wearing a back brace and being favored by co-workers. The court affirmed the Board’s decision, reiterating that employer knowledge is a question of fact for the Board, and its findings, if supported by substantial evidence, will not be disturbed.

Workers' Compensation LawSpecial Disability FundEmployer LiabilityPre-existing Permanent ImpairmentEmployer KnowledgeSubstantial EvidencePermanent Partial DisabilityFracture of NoseHip DislocationRuptured Discs
References
3
Case No. MISSING
Regular Panel Decision

the Claim of Brigandi v. Town & Country Linoleum & Carpet

This case involves an appeal by an employer and its compensation carrier against decisions made by the Workers’ Compensation Board. The decedent, a carpet layer, died from cardiac arrest during work, with an autopsy revealing underlying coronary atherosclerotic disease. His widow was awarded death benefits. The employer’s carrier sought reimbursement from the Special Disability Fund under Workers’ Compensation Law § 15 (8), asserting a preexisting permanent physical impairment. However, the Board determined that there was no evidence that the decedent’s heart condition hindered his job potential before his death, thus releasing the Special Disability Fund from liability and holding the compensation carrier responsible. The employer's subsequent application for reconsideration was denied by the Board, leading to these appeals. The appellate court affirmed the Board's decisions, concluding that the Board rationally found no proof that the decedent's heart disease impaired his job potential, a necessary condition for reimbursement under WCL § 15 (8) (d).

Special Disability FundPreexisting Permanent ImpairmentCardiac ArrestCoronary Atherosclerotic DiseaseDeath Benefits ClaimEmployer ReimbursementCarrier LiabilityBoard Decision ReviewAppellate AffirmationMedical Evidence Interpretation
References
2
Case No. 2019 NY Slip Op 05367 [174 AD3d 1017]
Regular Panel Decision
Jul 03, 2019

Matter of City of Plattsburgh (Plattsburgh Permanent Firemen's Assn.)

The City of Plattsburgh, the appellant, appealed an order from the Supreme Court that denied its application to permanently stay arbitration with the Plattsburgh Permanent Firemen's Association. The dispute originated from a collective bargaining agreement (CBA) which stipulated a minimum staffing level of 36 firefighters and prohibited layoffs. When a firefighter retired, reducing the staff to 35, the City refused to fill the vacancy, citing financial reasons, leading the Firemen's Association to demand arbitration. The Supreme Court denied the City's application to stay arbitration and granted the Association's motion to compel. The Appellate Division reversed this decision, ruling that the disputed CBA provision was a job security clause. The court found that this clause did not explicitly demonstrate the City's intent to waive its right to reduce staffing for budgetary or economic reasons, thus violating public policy and rendering the dispute non-arbitrable. A concurring opinion further noted that the clause also violated public policy due to its unreasonable duration.

ArbitrationCollective Bargaining AgreementJob Security ClausePublic PolicyStaffing LevelsFirefighters UnionBudgetary ConstraintsAppellate DivisionCPLR Article 75Stay Arbitration
References
8
Case No. MISSING
Regular Panel Decision

Claim of Martone v. Niagara Frontier Transportation Authority-Metro

In 2005 and 2007, a bus driver (claimant) suffered work-related neck and back injuries. Initially, a Workers’ Compensation Law Judge found him permanently totally disabled. However, the Workers’ Compensation Board modified this, determining he had a permanent partial disability with a 75% loss of wage-earning capacity based on medical evidence and other factors. The claimant appealed this decision, arguing a lack of substantial evidence for the partial disability finding. The Appellate Division affirmed the Board's decision, noting medical reports indicating submaximal efforts, high medication dosages, symptom magnification, and the ability to ambulate, which supported the finding of partial disability. The court also upheld the 75% loss of wage-earning capacity, finding it supported by substantial evidence after considering the claimant's impairment, work restrictions, age, education, and work experience.

Permanent Partial DisabilityWage-Earning CapacityChronic Pain SyndromeLumbar Spine SurgeryMedical EvidenceSubmaximal EffortsSymptom MagnificationAppellate ReviewBoard DecisionMedical Treatment Guidelines
References
2
Case No. ADJ7816317, ADJ8290118
Regular
Apr 08, 2013

CANDY AMAYA vs. ATASCADERO STATE HOSPITAL

In two consolidated workers' compensation cases, both the applicant and defendant sought reconsideration of findings of permanent disability. The Administrative Law Judge (WCJ) admitted error in awarding 21% permanent disability for each of two left wrist injuries, conceding that the correct impairment should have been 6% Whole Person Impairment (WPI), translating to a 10% overall permanent disability award. The Workers' Compensation Appeals Board granted reconsideration, rescinded the original awards, and returned the matters to the trial level for redetermination of permanent disability. The Board took no position on issues of vocational expert rebuttals or cost recovery, allowing them to be raised in further proceedings.

Workers' Compensation Appeals BoardIndustrial InjuryPermanent DisabilityVocational ExpertScheduled DisabilityReconsiderationFindings and AwardsWPIAMA GuidesApportionment
References
0
Case No. 533901
Regular Panel Decision
Apr 14, 2022

In the Matter of the Claim of Vincent Gambardella

In this workers' compensation appeal, claimant Vincent Gambardella challenged a decision by the Workers' Compensation Board. Gambardella, a bus maintainer, sustained multiple work-related injuries in 2018. A WCLJ initially established permanent partial disability and schedule loss of use (SLU) awards, finding a 35% SLU of his left arm, 15.80% SLU of his right third finger, and a nonschedule permanent impairment of his lower back. Due to his voluntary retirement in April 2020, he was deemed ineligible for a nonschedule award but was granted an SLU award by the WCLJ. The Board reversed, asserting that SLU awards were only for claimants who returned to pre-injury wages. The Appellate Division disagreed, holding that an SLU award is appropriate when no initial award is made based on a nonschedule permanent partial disability classification, regardless of whether the claimant returned to work or voluntarily retired. The court found that voluntary retirement, like returning to work at preinjury wages, precludes a nonschedule award, thus making the claimant eligible for an SLU award for his permanent impairments. The case was remitted to the Workers' Compensation Board for further proceedings consistent with this decision.

Schedule Loss of UsePermanent Partial DisabilityVoluntary RetirementWage-Earning CapacityWorkers' Compensation LawAppellate ReviewRemittalDuplicative CompensationLabor Market AttachmentImpairment Rating
References
13
Case No. ADJ11065177
Regular
Apr 09, 2019

FRANK ROMANO vs. PROVIDENCE HEALTH AND SERVICES, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board granted reconsideration, rescinding a prior award that found 4% permanent disability. The Board found the orthopedist's apportionment of lumbar spine impairment to nonindustrial daily activities to be unsubstantiated. Specifically, the doctor could not identify specific nonindustrial activities causing impairment or link them to the found impairment. Therefore, the Board awarded an unapportioned 7% permanent disability for the applicant's industrial lumbar spine injury.

Workers' Compensation Appeals BoardPetition for ReconsiderationPermanent DisabilityApportionmentSubstantial Medical EvidenceMedical OpinionLumbar Spine DRE Category IIWhole Person ImpairmentAMA GuidesMuscle Spasm
References
9
Case No. ADJ10815810
Regular
May 06, 2019

Derrell Meek vs. Corcoran State Prison, State Compensation Insurance Fund

The Workers' Compensation Appeals Board granted reconsideration of an administrative law judge's decision, overturning the finding of 86% permanent disability. The Board found that the physician's initial assessment of 75% whole person impairment for hypertensive cardiovascular disease, as per the AMA Guides, was appropriate. This 75% impairment was then adjusted to permanent total disability, recognizing that the scheduled rating adequately addressed the applicant's condition. The decision ultimately awarded permanent total disability indemnity and ongoing medical treatment.

Workers' Compensation Appeals BoardCorcoran State PrisonState Compensation Insurance FundDerrell Meekcorrectional officercirculatory systempermanent disabilityMilpitas Unified School District v. Workers' Comp. Appeals Bd. (Guzman)alternative impairment analysisAMA Guides
References
1
Case No. ADJ1030139 (STK 0203781)
Regular
Nov 19, 2014

GERALD REESE vs. MICRODENTAL LABORATORIES, AMERICAN HOME ASSURANCE, AIG CLAIMS SERVICES

The Appeals Board granted reconsideration to review the permanent disability rating for applicant Gerald Reese, who sustained an industrial injury in 2006. The primary issue was whether to include a deconditioning impairment, rated by a PQME using analogy, into the permanent disability award. The Board affirmed the WCJ's decision but amended it to defer the issue of permanent disability for further proceedings. This deferral is to allow the WCJ to issue rating instructions based on the established legal framework for incorporating AMA Guides impairments, even those addressed by analogy.

PQMEdeconditioningAMA Guideswhole person impairmentanalogyLabor Code section 4660Almaraz/Guzman IIMilpitas Unified School Dist.City of Sacramento v. Workers' Comp. Appeals Bd.rating instructions
References
3
Case No. ADJ7984284; ADJ8138424
Regular
Nov 25, 2020

Barbara McGinnis vs. Coalinga-Huron School District

The Workers' Compensation Appeals Board denied the defendant school district's petition for reconsideration of an award. The original award found the applicant sustained industrial injuries resulting in 100% permanent disability due to numerous impairments, including chronic pain, fibromyalgia, and TMJ. The Board affirmed the finding of permanent total disability, agreeing with the judge that the applicant's impairments, when added together, reached 100% and that apportionment was moot. The Board also found substantial medical evidence supported adding impairments rather than using the Combined Values Chart.

Workers' Compensation Appeals BoardJoint Findings and AwardPetition for ReconsiderationPermanent Total DisabilityApportionmentCombined Values ChartIndustrial InjuryCumulative TraumaFibromyalgiaTMJ
References
3
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