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Case Law Database

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

Case No. ADJ9519541
Regular
Jul 26, 2019

Sonia Young-Mitchell vs. SECURITAS SECURITY SERVICES

This case involves an applicant seeking permanent total disability benefits after an admitted industrial injury to her back, lower extremities, right ankle, and left knee. The applicant argues the Workers' Compensation Judge (WCJ) erred by apportioning 10% of her left knee disability to a pre-existing asymptomatic condition. The Appeals Board granted reconsideration, finding that the Agreed Medical Examiner (AME) impermissibly apportioned to the cause of the injury rather than pre-existing pathology. Consequently, the Board amended the award to find the applicant 100% permanently totally disabled, returning the matter for a new award.

Workers Compensation Appeals BoardSonia Young-MitchellSecuritas Security ServicesSedgwick Claims Management Servicespermanent total disabilityapportionmentleft knee injurycompensable consequencevocational evidenceAgreed Medical Examiner
References
4
Case No. MISSING
Regular Panel Decision
Jul 30, 1982

Claim of Terwilliger v. Green Fuel Economizer, Inc.

The claimant appealed a Workers' Compensation Board decision, challenging both the apportionment of his award between an industrial accident and a pre-existing condition, and the board's finding of moderate disability. The court emphasized that full compensability hinges on whether the industrial accident activated a previously dormant and non-disabling pre-existing condition. Despite the claimant's attending physician testifying that his pre-existing condition was asymptomatic prior to the accident, the record contained evidence of prior low back problems. The court reiterated that resolving conflicting medical evidence, concerning both apportionment and the degree of disability, falls exclusively within the Board's purview. Since the Board's decision was supported by substantial evidence, the appellate court affirmed it.

Workers' CompensationApportionmentPre-existing conditionDisabilityMedical evidenceConflicting testimonySubstantial evidenceAppellate reviewIndustrial accidentBoard decision
References
3
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. 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. SAL 0112833
Regular
Jan 11, 2008

MICHAEL MERCIER vs. INTEL CORPORATION, PSI, administered by BROADSPIRE CLAIM SERVICES

The Workers' Compensation Appeals Board (WCAB) granted the defendant's petition for reconsideration, reinstating an earlier award that apportioned 20% of the applicant's permanent disability to pre-existing factors. The WCAB found the Agreed Medical Evaluator's (AME) opinion on apportionment to be substantial evidence under current law, even though the pre-existing conditions were asymptomatic prior to the industrial injury. This decision reverses the WCJ's later finding of 32% permanent disability without apportionment.

Workers' Compensation Appeals BoardIndustrial InjuryFabrication TechnicianLower Back InjuryPermanent DisabilityApportionmentAgreed Medical EvaluatorDr. ConradPre-existing FactorsDegenerative Change
References
3
Case No. ADJ3125678
Regular
Jul 01, 2011

CLORIA HSI vs. LOS ANGELES UNIFIED SCHOOL DISTRICT; Permissibly Self-insured, Administered by SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

The Workers' Compensation Appeals Board denied reconsideration of an apportionment decision. The applicant claimed her back injury and subsequent disability were entirely work-related and that she had no prior back issues. However, an Agreed Medical Evaluator (AME) found that pre-existing degenerative disc disease and scoliosis, evidenced by an MRI, were responsible for 50% of the applicant's permanent disability. The Board upheld the WCJ's decision to apportion based on the AME's opinion, as apportionment is permissible even for asymptomatic pre-existing conditions.

Workers' Compensation Appeals Boardapportionmentpermanent disabilityagreed medical evaluatordegenerative disc diseasescoliosislumbar spinedextroscoliosisnonindustrial causesasymptomatic condition
References
4
Case No. ADJ8032740
Regular
Sep 17, 2014

LAURA RAMIREZ vs. LOYOLA MARYMOUNT UNIVERSITY, TRAVELERS

This case involved a custodian injured on the job, causing admitted industrial injury to her knee and lumbar spine. The Administrative Law Judge apportioned 50% of the permanent disability to pre-existing arthritis, a decision the applicant contested. The Workers' Compensation Appeals Board denied reconsideration, finding the apportionment supported by medical evidence indicating the industrial injury and pre-existing arthritis jointly necessitated knee replacement surgery. This aligns with precedent requiring apportionment to all causative factors, including underlying pathology.

ApportionmentPre-existing arthritisIndustrial injuryPermanent disabilityWCJPetition for reconsiderationLabor Code 4663PQMEOrthopaedic surgeonArthroplasty
References
4
Case No. ADJ8134312
Regular
Sep 15, 2016

ERNIE GALLEGOS vs. GROTH BROTHERS CHEVROLET, AUTO DEALERS COMPENSATION OF CALIFORNIA, CORVEL

The applicant sustained a right knee injury, leading to a total knee replacement. The original award granted permanent disability without apportionment, which the defendant appealed. The Appeals Board granted reconsideration, finding that apportionment to pre-existing knee conditions was legally permissible even after total knee replacement. The case is remanded for a new award based on the Qualified Medical Evaluator's 50% apportionment to pre-existing pathology. A dissenting opinion argues the medical evidence lacked sufficient reasoning to support apportionment.

WORKERS' COMPENSATION APPEALS BOARDERNE GALLEGOSGROTH BROTHERS CHEVROLETAUTO DEALERS COMPENSATION OF CALIFORNIACORVELADJ8134312PETITION FOR RECONSIDERATIONFINDINGS AND AWARDPERMANENT DISABILITYAPPORTIONMENT
References
5
Case No. 2023 NY Slip Op 00238 [212 AD3d 507]
Regular Panel Decision
Jan 19, 2023

Joseph v. Edun

In this personal injury action, plaintiff James Joseph alleged injuries after being hit by defendant Shabeer Edun's vehicle. Plaintiff claimed post-traumatic stress disorder, anxiety, depression, and the exacerbation of pre-existing asymptomatic conditions. Defendant moved to compel discovery of plaintiff's college and past medical records, arguing these were relevant to the causation and extent of the claimed injuries, especially given notes about a college trauma and allegations of aggravated pre-existing conditions. The Supreme Court denied defendant's motion. On appeal, the Appellate Division, First Department, modified the order, compelling the plaintiff to provide authorizations for college records and specific past medical records, including those from Jacobi Hospital (2014), Jamaica Hospital (2015), and Lenox Hill Radiology (2015 X-ray), affirming the decision otherwise.

Personal InjuryDiscoveryMedical RecordsPsychological InjuriesPre-existing ConditionsAppellate ProcedureEvidenceTraumaCausationExacerbation
References
5
Case No. MISSING
Regular Panel Decision
May 08, 1984

Claim of Pezzolanti v. Green Bus Lines, Inc.

The claimant, a mechanic, suffered a left wrist injury in October 1980 when a loose steering wheel struck his wrist after hitting a pothole. This incident revealed a pre-existing, asymptomatic giant cell tumor in his left radius. Following a biopsy and surgical removal of the tumor on January 8, 1981, the claimant continued to experience pain and disability, necessitating a second surgery in 1982. The self-insured employer challenged the Workers' Compensation Board's decision, arguing against a continued causally related disability beyond the initial surgery date, asserting that the accident did not aggravate the tumor. However, the Board affirmed its decision, supported by medical testimony that while the trauma did not cause or aggravate the tumor itself, it acted upon the pre-existing condition to cause a new, occupationally disabling pain and disability that extended beyond the tumor's surgical removal.

Causally Related DisabilityPre-existing ConditionGiant Cell TumorWork InjuryTrauma AggravationMedical Expert TestimonySurgical ExcisionOccupational DisabilityAppellate ReviewWorkers' Compensation Board Decision
References
3
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