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Case Law Database

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

Case No. ADJ6621190 (MF)
Regular
Jan 18, 2019

DEANNA CARROLL vs. WINCO HOLDINGS, INC., LIBERTY MUTUAL INSURANCE COMPANY

Applicant Deanna Carroll was previously declared a vexatious litigant in 2016, requiring pre-approval to file any requests with the Workers' Compensation Appeals Board (WCAB). In this decision, the WCAB reviewed a Petition for Removal for Cause filed by Carroll in propria persona on December 4, 2018. Finding no significant change in circumstances or newly discovered evidence since the prior determination, the WCAB declined to accept the petition for filing. Therefore, Carroll's petition was rejected as per the vexatious litigant pre-filing order.

Vexatious litigantpre-filing orderAppeals Board Rule 10782Petition for Removal for Causein pro pernew evidencechange in lawpresiding judgelicensed attorneydeclaration of readiness
References
0
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. ADJ966838 (SJO 0266465)
Regular
Jun 18, 2012

LOLA ROBINSON vs. SHELTER NETWORK, SUBSEQUENT INJURIES FUND of the STATE OF CALIFORNIA

The Workers' Compensation Appeals Board affirmed a prior award for applicant Lola Robinson against the Subsequent Injuries Benefits Trust Fund (SIBTF). The award compensated her for a combined permanent disability of 78%, stemming from a subsequent industrial injury to her upper extremity and pre-existing conditions of hepatitis C and a hysterectomy. The Board found that medical evidence established pre-existing whole person impairments from these conditions, meeting the "labor disabling" threshold for SIBTF benefits. The Board held that the physician's ratings under the AMA Guides constituted prima facie evidence of pre-existing impairment, which the SIBTF failed to rebut.

Subsequent Injuries FundSIBTFHepatitis CHysterectomyPermanent Partial DisabilityLabor DisablingAMA GuidesWhole Person ImpairmentWCJReconsideration
References
7
Case No. MISSING
Regular Panel Decision
Nov 03, 2010

Correa v. Orient-Express Hotels, Inc.

This is a wrongful death action where the plaintiffs allege that a decedent slipped and fell at premises owned by 21 Club, Inc., a company indirectly wholly-owned by the defendant. The defendant appealed the denial of their pre-answer motion to dismiss the complaint. The court affirmed the lower court's decision, rejecting the defendant's arguments based on documentary evidence and the exclusivity provisions of the Workers’ Compensation Law. The court clarified that the defendant's potential liability stems from ownership and/or control of the premises, not necessarily being an alter ego of 21 Club, Inc.

Wrongful DeathMotion to DismissCPLR 3211Corporate OwnershipAlter EgoPremises LiabilityWorkers' Compensation ExclusivityAppellate DivisionAffirmedProcedural Motion
References
4
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. ADJ1122093 (SAC 0279029) ADJ988134 (SAC 0267349)
Regular
Nov 20, 2018

BOBBIE SANDERS vs. EMPLOYMENT DEVELOPMENT DEPARTMENT, STATE COMPENSATION INSURANCE FUND

Applicant Bobbie Sanders, previously declared a vexatious litigant under Rule 10782, filed a Petition for Removal without court approval. Rule 10782 requires pre-filing authorization for pro se litigants, with exceptions for licensed attorneys. The Appeals Board denied the Petition for Removal because there was no significant change in circumstances or new evidence to warrant re-litigation of previously determined issues. Therefore, the document was not accepted for filing.

Vexatious litigantpre-filing orderAppeals Board Rule 10782Petition for Removalin pro perworkers' compensationEmployment Development DepartmentState Compensation Insurance FundADJ1122093ADJ988134
References
0
Case No. FRE 0159318
Regular
Nov 05, 2007

ROGELIO RODRIGUEZ vs. AMERICAN GRAPE HARVESTERS, STATE COMPENSATION INSURANCE FUND

This case involves Rogelio Rodriguez seeking workers' compensation for injuries to his right arm and psyche. The defendant, American Grape Harvesters and State Compensation Insurance Fund, petitioned for reconsideration of a 100% permanent disability award, arguing insufficient evidence and failure to consider pre-existing factors. The Workers' Compensation Appeals Board denied reconsideration, adopting the judge's report which found the evidence supported the 100% award and that pre-existing factors were properly addressed.

Workers' Compensation Appeals BoardReconsideration DeniedPermanent DisabilityVocational RehabilitationOrthopedic InjuryPsychiatric DisabilityAgreed Medical ExaminerQualified Medical EvaluatorApportionmentNon-Industrial Factors
References
7
Case No. ADJ1438639 (GRO0024593) ADJ3262777 (GRO0025366)
Regular
Jul 06, 2011

DENNIS TIMMONS vs. CALIFORNIA MENS COLONY, STATE COMP. INS. FUND, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Workers' Compensation Appeals Board granted reconsideration to reverse a prior award of Subsequent Injuries Benefits Trust Fund (SIBTF) benefits to the applicant, Dennis Timmons. The applicant sought SIBTF benefits based on a claimed pre-existing disability from a 1991 injury, arguing it imposed a prophylactic restriction from very heavy work that contributed to his 2000 industrial injury. However, the Board found no substantial medical evidence of a ratable pre-existing disability at the time of the 2000 injury, as prior medical reports indicated no residual disability and the applicant returned to work without restrictions. The Board concluded that a retroactive prophylactic restriction, without evidence of actual prior work limitations, is insufficient to establish SIBTF eligibility.

Subsequent Injuries Benefits Trust FundSIBTFpre-existing disabilityindustrial injurypermanent disabilityapportionmentAgreed Medical ExaminerAMEprophylactic restrictionWCJ
References
2
Case No. ADJ10550274
Regular
Mar 24, 2023

MEENA CHANDOK vs. SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Subsequent Injuries Benefits Trust Fund (SIBTF) sought reconsideration of a prior award finding the applicant permanently totally disabled due to a subsequent industrial injury combined with pre-existing disabilities. SIBTF argued that an elective tubal ligation and pre-existing cervical and thoracic spine impairments were improperly rated. The Workers' Compensation Appeals Board (WCAB) denied reconsideration, finding that the tubal ligation constituted a ratable impairment under the AMA Guides, and evidence of prior treatment for the spinal conditions predated the industrial injury. The WCAB adopted the reasoning of the Workers' Compensation Judge (WCJ), who found no legal basis to exclude an elective surgery from impairment rating and that SIBTF failed to rebut the applicant's medical evidence.

Subsequent Injuries Benefits Trust FundPre-existing disabilityRatable impairmentElective tubal ligationCervical spineThoracic spineAMA GuidesLabor Code section 4751FergusonProphylactic work restriction
References
12
Case No. 2022 NY Slip Op 00522
Regular Panel Decision
Jan 27, 2022

Rodriguez v. Morel

In this case, plaintiff Nicholes W. Rodriguez appealed an order from Supreme Court, Bronx County, which granted summary judgment to defendants Rafael T. Morel et al., dismissing the complaint. The dismissal was based on the plaintiff's failure to demonstrate a serious injury under Insurance Law § 5102 (d) categories. Defendants presented prima facie evidence, including medical reports, showing normal range of motion and highlighting plaintiff's pre-existing conditions from a prior motor vehicle accident. The plaintiff failed to rebut this evidence, as his medical experts did not adequately address the issue of causation concerning the alleged new injuries versus pre-existing ones. Consequently, the Appellate Division, First Department, unanimously affirmed the lower court's decision, finding no triable issue of fact regarding causation or serious injury.

Motor Vehicle AccidentSerious Injury ThresholdInsurance Law 5102(d)Summary JudgmentPre-existing ConditionsCausationRange of MotionCervical SpineLumbar SpineRight Shoulder
References
8
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