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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

Howell v. County of Albany

A correction officer's General Municipal Law § 207-c benefits were suspended by the Albany County Sheriff after he refused a light duty assignment following a workplace injury in September 2009. The officer initiated a CPLR article 78 proceeding, alleging due process violations because the Hearing Officer supposedly refused to consider proof of post-traumatic stress disorder and relied on evidence outside the record. The Court determined that the petitioner was afforded due process, noting that a predetermination hearing was held where he presented witnesses and cross-examined the respondents'. The Court found no violation of procedural due process as the petitioner did not raise a genuine dispute regarding his PTSD diagnosis before the hearing. Ultimately, the Court confirmed the determination to suspend benefits and dismissed the petition.

Due ProcessGeneral Municipal Law 207-cLight Duty AssignmentDisability BenefitsCorrection OfficerAdministrative HearingProcedural Due ProcessWorkers' Compensation ClaimPost-Traumatic Stress DisorderCredibility Assessment
References
8
Case No. ADJ10387978
Regular
Aug 13, 2019

MELE LATU vs. HEWLETT PACKARD ENTERPRISE SERVICES, SUBSEQUENT INJURIES BENEFITS TRUST FUND

This case involves a denied petition for reconsideration regarding Subsequent Injuries Benefits Trust Fund (SIBTF) benefits. The applicant settled her industrial injury claim for $937,166, then sought SIBTF benefits. The Board denied the petition because the applicant failed to prove a pre-existing "labor disabling" condition, which is a requirement for SIBTF eligibility even after statutory changes. Medical evidence indicated the applicant was asymptomatic and functional prior to her industrial injury, and any apportionment was to asymptomatic pathology, not a labor-disabling condition.

Subsequent Injuries Benefits Trust FundSIBTFLabor Code section 4751labor disablingpermanent partial disabilityapportionmentSenate Bill 899SB 899asymptomatic pathologyEscobedo v. Marshalls
References
2
Case No. ADJ7832100
Regular
Jan 09, 2017

William Reid vs. Subsequent Injuries Benefits Trust Fund

This case involves a Subsequent Injuries Benefits Trust Fund (SIBTF) claim where the applicant, William Reid, sought benefits due to a cumulative injury to his feet and back. The SIBTF petitioned for reconsideration, arguing the applicant's subsequent injury alone did not meet the statutory threshold for benefits and that prior impairments were asymptomatic or improperly assessed. The Workers' Compensation Appeals Board denied the petition, adopting the WCJ's report. The WCJ found the applicant met the 5% opposite and corresponding impairment threshold with a combined permanent disability rating of 10% from his feet and back, and that pre-existing conditions like hypertension and gout qualified as disabling impairments. Ultimately, the WCJ concluded the applicant was rendered totally permanently disabled, establishing SIBTF liability.

Subsequent Injuries Benefits Trust FundLabor Code section 4751opposite and corresponding thresholdpermanent disabilitycumulative traumaasymptomatic impairmentvocational rehabilitation consultantOrthopedic AMEDr. DevorDr. Panting
References
1
Case No. ADJ10083989
Regular
Sep 12, 2016

LUIS PARTIDA vs. ABOVE ALL ROOFING, STATE COMPENSATION INSURANCE FUND

This case concerns a defendant's petition for reconsideration and removal of a WCJ's order deeming a prior stipulation a "continuing award" of temporary disability benefits. The defendant argued this prejudiced their right to present evidence of the applicant's employment and that the stipulation only set the rate and start date, not ongoing benefits. The Board denied both petitions, finding the defendant's subsequent payment of benefits beyond the stipulation date established it as a continuing award. Furthermore, the Board noted that under Labor Code section 4651.1, a rebuttable presumption of continuing disability exists until a petition to terminate liability is properly filed and overcome.

Petition for ReconsiderationPetition for Removalcontinuing awardtemporary disability indemnityStipulations and Awarddue processexpedited trialrebuttable presumptionterminate liabilityLabor Code
References
2
Case No. ADJ284423
Regular
Jun 24, 2011

MANUEL CASTILLO vs. DAVID INY, UNINSURED EMPLOYERS BENEFITS TRUST FUND, LANDMARK VIEW, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board dismissed petitions for reconsideration from SCIF and the applicant after an amended award corrected errors. The applicant sustained injuries, including to his right and left lower extremities and psyche, from an uninsured employer. The Uninsured Employers Benefits Trust Fund's petition for reconsideration was denied, upholding the finding of permanent disability and temporary total disability indemnity. The Board adopted the WCJ's report, denying UEF's claims that the AME's opinions were not substantial evidence and that the rating methods were improperly applied.

Uninsured Employers Benefits Trust FundIllegally UninsuredFindings and AwardPetition for ReconsiderationAmended Findings and AwardTemporary Total Disability IndemnityPermanent DisabilityAmerican Medical Association GuidesSchedule for Rating Permanent DisabilityAdministrative Law Judge
References
3
Case No. ADJ705744 (AHM 0148879)
Regular
Feb 05, 2013

PATRICK MURRAY vs. BALTAZAR PEREZ, DBA PERFORMANCE AIR AND MECHANICAL, UNINSURED EMPLOYERS BENEFITS TRUST FUND, CALIFORNIA COMPENSATION INSURANCE COMPANY

The Workers' Compensation Appeals Board denied Patrick Murray's petition for reconsideration, upholding the findings of the Workers' Compensation Judge (WCJ). The WCJ's report, which was adopted by the Board, determined that Murray was not an employee of California Auto Collision on the date of his injury. The Uninsured Employers Benefits Trust Fund's (UEBTF) petition for reconsideration was dismissed as skeletal and would have been denied on its merits as well. The Board found that the evidence supported the conclusion that Murray was an employee of Baltazar Perez, DBA Performance Air and Mechanical, and not California Auto Collision.

Workers' Compensation Appeals BoardPetition for ReconsiderationUninsured Employers Benefits Trust FundSkeletal PetitionWCAB Rule 10846Employee StatusIndependent ContractorControl TestSecondary IndiciaBorello Factors
References
1
Case No. ADJ3447817 (SJO 0260464)
Regular
Dec 10, 2012

LIZABETH RUIZ vs. SUBSEQUENT INJURIES BENEFITS TRUST FUND (SIBTF)

This case concerns Lizabeth Ruiz's petition for reconsideration of the denial of Subsequent Injuries Benefits Trust Fund (SIBTF) benefits. Ruiz argued she had a pre-existing "labor disabling" psychiatric condition prior to her subsequent industrial injury. The Board affirmed its prior decision, holding that Ruiz failed to meet her burden of proof to establish that her pre-existing condition was labor-disabling and compensable at the time of the subsequent injury. The Board reiterated that retroactive medical evaluations are insufficient without contemporaneous evidence of such disability, and denied the petition to reopen the record.

Subsequent Injuries Benefits Trust FundSIBTFlabor disablingpermanent disabilitycumulative traumapsychiatric conditioncontemporaneous evidencerating methodologyadministrative law judgepetition for reconsideration
References
6
Case No. ADJ7570196
Regular
Apr 21, 2017

ERIK SPEARMAN vs. SUBSEQUENT INJURIES BENEFITS TRUST FUND, administered by THE DIRECTOR OF THE DEPARTMENT OF INDUSTRIAL RELATIONS

The Workers' Compensation Appeals Board (WCAB) dismissed the Petition for Reconsideration filed by the Subsequent Injuries Benefits Trust Fund. The petition was dismissed because it was untimely, filed more than 25 days after the WCJ's decision. The WCAB emphasized that the filing deadline is jurisdictional and that a petition must be *received* by the Board within the allowed time. If the petition had been timely, it would have been denied on the merits.

SUBSEQUENT INJURIES BENEFITS TRUST FUNDPetition for Reconsiderationuntimely filingjurisdictionalAppeals BoardWCJ decisiondeadlineproof of filingmailingservice
References
4
Case No. ADJ8411218
Regular
Jul 07, 2014

Rafael Becerra vs. PV MART dba BUY LOW MARKET, INC., EMPLOYERS COMPENSATION INSURANCE CO., KEYANOOSH GHAMARI dba CODE 3 SECURITY, UNINSURED EMPLOYERS BENEFITS TRUST FUND

The Workers' Compensation Appeals Board denied the Uninsured Employers Benefits Trust Fund's petition for reconsideration. Applicant's petition was granted to amend the original Findings and Order. The Board found that PV Mart dba Buy Low Market, Inc. was not a special employer of the applicant, Rafael Becerra. Consequently, PV Mart and its insurer were dismissed as party defendants, and the applicant was deemed an employee of Keyanoosh Ghamari dba Code 3 Security at the time of injury.

Workers' Compensation Appeals BoardUninsured Employers Benefits Trust FundSpecial Employment RelationshipGeneral EmploymentBorrowing EmployerLending EmployerRight to ControlCredibility DeterminationBuy Low MarketCode 3 Security
References
8
Case No. ADJ1787355 (SAC 0336410) ADJ1318220 (SAC 0338049)
Regular
Aug 06, 2012

MARY JANE EIDMAN vs. LAW OFFICES OF THOMAS PLUMB, PARADISE CHEVROLET, STATE COMPENSATION INSURANCE FUND, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Workers' Compensation Appeals Board denied the Subsequent Injuries Benefits Trust Fund's (SIF) petition for reconsideration, affirming the finding of total permanent disability due to a prior condition combined with a later industrial injury. The Board granted the applicant's petition, reversing the original decision to make the applicant personally liable for a medical-legal report. SIF is now liable for the reasonable cost of Dr. Abeliuk's report, which is deemed a necessary medical-legal expense for the applicant's claim. The case was returned for further proceedings to determine the cost of Dr. Abeliuk's report.

Workers' Compensation Appeals BoardSubsequent Injuries Benefits Trust Fundpermanent disabilitymedical-legal expensereconsiderationadministrative law judgesubstantial medical evidencequalified injured workermedical reportingliability
References
5
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