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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

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. 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. G097 5003
Regular Panel Decision
May 31, 2011

KENNARD, JENNIFER K., PEOPLE v

The employer and carrier appealed a Workers' Compensation Law Judge (WCLJ) decision which found that Workers' Compensation Law (WCL) § 15(8)(d) relief was inapplicable to the Special Funds Conservation Committee. The WCLJ determined that the claimant did not have a prior permanent physical impairment before the current accident. The Board Panel affirmed the WCLJ's decision, emphasizing that § 15(8)(d) requires proof of a pre-existing permanent physical impairment. The Panel noted that while the claimant had prior compensable accidents, there was no final classification of a permanent partial disability (PPD) before the date of the current accident. Consequently, Special Funds relief was not warranted.

Special FundsPermanent Physical ImpairmentPrior AccidentsWCLJ DecisionAffirmationPre-existing ConditionClassificationBoard PanelWorkers' Compensation Benefits
References
2
Case No. MISSING
Regular Panel Decision
Apr 28, 1982

Claim of Terrell v. Carborundum Co.

This case involves an appeal from a Workers’ Compensation Board decision filed on April 28, 1982, concerning the Special Disability Fund's liability under Workers’ Compensation Law § 15(8). The Board initially found no evidence that the employer had prior knowledge of a permanent condition. However, the appellate court determined that the record demonstrated the claimant possessed a permanent physical impairment before being hired, and the employer had knowledge of this impairment and a good-faith belief in its permanency based on a pre-employment physical and X-ray report. Citing *Matter of Bellucci v Tip Top Farms* and other precedents, the court reversed the Board's decision and remitted the matter for further proceedings consistent with its findings.

Special Disability Fund LiabilityWorkers' Compensation Law Section 15(8)Pre-employment Physical ExaminationEmployer Knowledge of Pre-existing ConditionPermanent Physical ImpairmentCongenital Back ConditionBellucci RuleAppellate Division ReviewReversed and RemittedCredibility Assessment
References
3
Case No. MISSING
Regular Panel Decision

Bolton v. CNA Insurance Co.

Jerry Bolton, a heavy equipment operator, suffered a work-related injury in 1988, leading to complaints of neck and back pain. The Chancellor initially awarded him 60% permanent partial disability benefits and future medical expenses. The defendant, CNA Insurance Company, appealed, arguing against the inclusion of a physical therapist's opinion in determining permanent disability and questioning the causation due to a subsequent automobile accident. The Supreme Court affirmed that the work-related injury was the cause of Bolton's permanent disability, despite the intervening accident. However, the Court ruled that a physical therapist is not qualified to assess permanent impairment or physical restrictions. Consequently, the court found the evidence preponderated against the 60% disability award and remanded the case for further proceedings to determine the extent of permanent partial disability.

Worker's Compensation AppealPermanent Partial DisabilityMedical Expert CompetencyPhysical Therapist TestimonyVocational Disability AssessmentCausation of InjuryAutomobile Accident ImpactAMA Guidelines ApplicationScope of Practice LawMedical Impairment Rating
References
12
Case No. 2017-07-0589
Regular Panel Decision
Mar 04, 2019

Fingers, Joseph v. Nortek Global HVAC, LLC

Joseph Fingers, a machine operator for Nortek Global HVAC, LLC, sustained a compensable right hip injury after being struck by a forklift. Following surgery and treatment, Dr. Thomas Byrd determined Mr. Fingers had reached maximum medical improvement and assigned a three-percent permanent impairment to the body as a whole, along with permanent light- to medium-physical-demand restrictions. Mr. Fingers sought increased permanent partial disability benefits beyond this impairment rating. However, Nortek Global HVAC, LLC terminated Mr. Fingers for violating its attendance policy after he refused to return to work on light duty, despite the employer's accommodation offer. The Court found that Mr. Fingers' actions constituted misconduct and denied his claim for increased benefits, while still awarding him permanent partial disability benefits based on the three-percent impairment and entitlement to future medical treatment.

Hip InjuryPermanent Partial DisabilityIncreased Benefits DenialEmployee MisconductAttendance PolicyLight Duty WorkMedical Impairment RatingFuture Medical CareEmployer AccommodationForfeiture of Benefits
References
2
Case No. 2016-08-1353
Regular Panel Decision
Aug 01, 2018

Dumas, Robert v. Republic Services

Robert Dumas, a 61-year-old trash collector, suffered a compensable right-shoulder injury in July 2014 while employed by Republic Services. Despite multiple surgeries and therapies, his pain and stiffness persisted, leading to conflicting medical opinions regarding his permanent impairment. The treating physician, Dr. Giel, assessed a 6% impairment, but the court ultimately accepted Dr. Saenz's 10% impairment rating based on loss of motion measurements. Considering Mr. Dumas's age, extensive manual labor history, lack of transferable skills, and significant physical restrictions, the Court concluded he was permanently and totally disabled and awarded him permanent total disability benefits.

Workers' CompensationPermanent Total DisabilityShoulder InjuryRotator Cuff TearDistal Clavicle ExcisionAdhesive CapsulitisVocational ImpairmentFunctional Capacity EvaluationMaximum Medical ImprovementAMA Guides
References
3
Case No. 2019-01-0366
Regular Panel Decision
Sep 29, 2021

Lewallen, Denise v. Home Healthcare of East Tennessee, Inc.

Ms. Denise R. Lewallen sought permanent total disability benefits after sustaining multiple physical injuries in a motor vehicle accident while working for Home Healthcare of East Tennessee, Inc. The employer disputed her entitlement to permanent total disability benefits, a hernia claim, and an alleged mental injury (PTSD). Medical examinations by Dr. Scott Smith and Dr. Paul Johnson confirmed significant impairments and restrictions, with Dr. Smith ultimately adopting permanent light-duty restrictions. Ms. Lewallen's credible testimony regarding her inability to work due to pain and physical limitations was considered. The Court found Ms. Lewallen permanently and totally disabled, granting her permanent total disability benefits and denying her hernia and PTSD claims.

Permanent Total DisabilityMotor Vehicle AccidentOrthopedic InjuriesCervical Disc HerniationPTSD ClaimHernia ClaimMedical Impairment RatingFunctional Capacity EvaluationVocational DisabilityCertified Nursing Assistant
References
7
Case No. ADJ7713711
Regular
Mar 11, 2016

JULIANA MASTERS vs. STATE OF CALIFORNIA, DEPARTMENT OF MOTOR VEHICLES

The Appeals Board denied reconsideration of the WCJ's decision, upholding the finding that applicant's sleep impairment, though present, was subsumed by the physical upper extremity impairments and thus not separately ratable. The Board found the Agreed Medical Examiner's opinion on sleep disorder impairment was not substantial evidence as it was predicated on pain already accounted for in the physical injury ratings per the AMA Guides. Therefore, the applicant's permanent disability rating remained at 69%. A dissenting opinion argued the Agreed Medical Examiner's opinion should be followed, as it addressed distinct impairments beyond pain and was supported by relevant case law.

Workers' Compensation Appeals BoardAmended Findings of Fact and AwardsIndustrial InjuryUpper ExtremitiesPsycheBook BinderSleep ImpairmentAMA GuidesPermanent DisabilityAgreed Medical Examiner
References
9
Case No. 2015-01-0149
Regular Panel Decision
Nov 04, 2016

Ringer, Lamar v. Welding Ceramics, Inc.

Lamar Ringer, a press operator, injured his neck, left shoulder, and arm at Welding Ceramics, Inc. on November 19, 2014. He sought treatment, including from orthopedic surgeon Dr. Jay E. Jolley, II, who diagnosed a large C5/C6 disc herniation and recommended surgery, which Ringer declined. Dr. Jolley rated Ringer's impairment at 6% to the whole body and released him to regular duty, but Ringer experienced increased pain upon returning to work. Another physician, Dr. Jerry L. Smith, rated Ringer's impairment at 10% and placed permanent restrictions. The court found Dr. Jolley's impairment rating methodology incorrect due to documented radicular symptoms and accepted Dr. Smith's 10% rating, awarding permanent partial disability benefits. The court denied additional temporary disability benefits, finding Ringer reached maximum medical improvement, and also denied his request for a new treating physician panel.

Permanent Partial DisabilityImpairment RatingAMA Guides Sixth EditionRadiculopathyDisc HerniationAuthorized Treating PhysicianRebuttal of PresumptionTemporary Disability BenefitsChange of Physician PanelFunctional Capacity Evaluation
References
9
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