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

Case No. 13-ev-3288; 13-cv-4244
Regular Panel Decision

Alzheimer's Disease Resource Center, Inc. v. Alzheimer's Disease & Related Disorders Ass'n

This case involves two related lawsuits stemming from the disaffiliation of the Alzheimer’s Disease Resource Center, Inc. (ADRC) from the Alzheimer’s Disease and Related Disorders Association (the Association). In case 13-ev-3288, ADRC alleged unfair competition, false advertising, and other claims. The Court denied dismissal for false advertising under the Lanham Act, New York General Business Law § 349, and unjust enrichment, but granted dismissal for trademark infringement, common law unfair competition, UCC violations, conversion, tortious interference, and fraud. In case 13-cv-4244, ADRC alleged breach of contract and misappropriation of trade secrets related to donor lists. The Court granted the Association's motion to dismiss this complaint in its entirety. Punitive damages were stricken for Lanham Act and unjust enrichment claims.

Unfair CompetitionLanham ActFalse AdvertisingTrademark InfringementNew York General Business Law § 349Unjust EnrichmentMotion to DismissBreach of ContractTrade Secret MisappropriationConversion
References
55
Case No. ADJ8211363
Regular
Sep 23, 2014

LUIS GONZALES vs. ROBERT HEELY CONSTRUCTION, TRAVELERS INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration of an award finding cumulative trauma injury to the applicant's lungs from Valley Fever. The WCJ reserved jurisdiction over final permanent disability, deeming the disease insidious and potentially reoccurring, despite the applicant's current stable condition. The Board affirmed the WCJ's decision, citing medical evidence of potential relapse and the precedent allowing jurisdiction reservation for insidious progressive diseases. A dissenting opinion argued the medical evidence did not support classifying Valley Fever as insidious and progressive in this case, and thus jurisdiction should not have been reserved beyond the statutory limit.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and Awardcumulative trauma injuryValley Fevercoccidioidomycosisinsidious progressive diseasepermanent disabilityreservation of jurisdictionAgreed Medical Examiner
References
10
Case No. ADJ1232764
Regular
Mar 24, 2009

ALEXANDRA CULLEN-WRIGHT vs. CUMMINS & WHITE, LLP, STATE COMPENSATION INSURANCE FUND

Applicant sought reconsideration of a WCAB decision denying jurisdiction to amend a prior award, arguing her RSD constitutes an insidious, progressive disease exempting it from the five-year statute of limitations. The Board denied reconsideration, finding the applicant failed to demonstrate her RSD met the criteria for an insidious, progressive disease as defined in *General Foundry Service v. WCAB*. Furthermore, the Board noted the original decision did not reserve jurisdiction and no timely petition to reopen was filed to address this possibility. Therefore, the WCAB lacked jurisdiction to amend the award over five years post-injury.

Workers' Compensation Appeals BoardLabor Code Section 5804cumulative injurycomplex regional pain syndromeRSDagreed medical examinersubstantial evidencepermanent and stationarysympathetic ganglion blockpetition to set aside
References
8
Case No. ADJ1036120 (SDO 0330367)
Regular
Jul 08, 2013

JESSE SUMABAT vs. CALIFORNIA HIGHWAY PATROL

This case concerns whether the applicant's valley fever is an "insidious, progressive disease" for which jurisdiction over permanent disability can be reserved. The WCAB granted reconsideration, rescinded the initial award, and returned the matter to the trial level. This is because the medical evidence regarding the progressive nature of the applicant's condition was contradictory and required further development. The Board emphasized that the determination of a progressive disease must be supported by substantial medical evidence stating medical probability.

Valley FeverCoccidioidomycosisProgressive DiseaseInsidious DiseasePermanent DisabilityJurisdiction ReservationJackson DoctrineGeneral Foundry ServiceRuffin CaseMedical Probability
References
4
Case No. 2018 NY Slip Op 07432 [166 AD3d 621]
Regular Panel Decision
Nov 07, 2018

Matter of Progressive Advanced Ins. Co. v. New York City Tr. Auth.

This case involves an appeal by Progressive Advanced Insurance Company (Progressive) against the New York City Transit Authority (NYCTA) concerning an arbitration award. The dispute arose under Insurance Law § 5105 regarding a loss transfer claim, where NYCTA sought reimbursement from Progressive for workers' compensation benefits paid to its employee after a collision involving Progressive's insured. The central issue was whether a 20% no-fault offset applied to the workers' compensation wages, with the arbitrator ruling it did not, as a one-third offset had already been applied. Progressive's petition to vacate the award was denied by the Supreme Court, Queens County. The Appellate Division affirmed this denial, concluding that the arbitrator's determination was supported by a reasonable hypothesis and was not arbitrary or capricious.

Arbitration AwardLoss TransferInsurance LawWorkers' Compensation BenefitsNo-Fault OffsetAppellate ReviewStatutory InterpretationEvidentiary SupportArbitrary and CapriciousReasonable Hypothesis
References
9
Case No. ADJ7441132
Regular
Jul 20, 2012

Patrick O'Brien vs. COUNTY OF SAN DIEGO

The Workers' Compensation Appeals Board granted reconsideration to amend the original award. The Board found that the applicant's skin cancer was not an insidious progressive disease, reversing the prior reservation of jurisdiction over permanent disability. This decision aligns with previous rulings that such reservation is only appropriate for diseases with a demonstrable likelihood of future progression or recurrence. Consequently, the finding of injury was amended to specify the exact locations and types of skin damage.

Workers' Compensation Appeals BoardPatrick O'BrienCounty of San DiegoSheriff Sergeantindustrial injuryskin damagesolar skin damagecancerinsidious progressive diseasepermanent disability
References
11
Case No. ADJ9137744
Regular
Apr 21, 2023

CHARLES MONTIERTH vs. CITY OF SAN DIEGO, PERMISSIBLY SELF-INSURED

This case concerns whether the applicant's skin cancer qualifies as an insidious progressive disease. The Appeals Board affirmed the WCJ's finding that it does, based on evidence of a significantly elevated risk of recurrence and potential for increased disability, justifying reserved jurisdiction over permanent disability. This ruling aligns with precedent allowing for such reservation in cases of progressive diseases with uncertain future outcomes. Therefore, the original Findings and Award are affirmed.

Insidious progressive diseaseJackson doctrineReservation of jurisdictionPermanent disabilitySkin cancerMalignant melanomaBasal cell carcinomaActinic keratosesLifetime surveillanceMedical monitoring
References
10
Case No. ADJ8249857
Regular
Jan 19, 2016

LARRY ADAIR vs. CITY OF SAN DIEGO

The applicant sought reconsideration of a workers' compensation award for skin cancer, arguing the permanent disability rating was insufficient and jurisdiction should be reserved due to the progressive nature of the disease. The Appeals Board granted reconsideration, affirming the original award but amending it to include a finding that the applicant is entitled to the presumption of compensability for skin cancer under Labor Code section 3212.1. The Board found no substantial evidence that the applicant's skin cancer was an insidious progressive disease warranting jurisdiction reservation, as it had been excised and declared permanent and stationary.

ADJ8249857Petition for ReconsiderationAmended Findings and Awardarising out of and in the course of employmentAOE/COEpermanent disabilityreservation of jurisdictionsubstantial medical evidenceprimary treating physicianpanel qualified medical evaluator
References
0
Case No. ADJ6836868
Regular
Feb 03, 2012

STEPHEN SEAVELLO vs. COUNTY OF SAN DIEGO

This case concerns a deputy sheriff diagnosed with skin cancer, with a presumption that it arose from his employment. The Workers' Compensation Appeals Board reversed the administrative law judge's finding that the skin cancer was an "insidious disease process" and the subsequent reservation of jurisdiction over permanent disability. The Board determined that the applicant's condition was found to be permanent and stationary, and not a progressive insidious disease, thus precluding jurisdiction beyond the statutory five-year limit for amendments. Consequently, the original award of 4% permanent disability and need for future medical treatment was reinstated, but without the reservation of jurisdiction.

Workers' Compensation Appeals BoardStephen SeavelloCounty of San DiegoSkin CancerDeputy SheriffPermanent DisabilityFuture Medical TreatmentInsidious Disease ProcessReservation of JurisdictionLabor Code Section 5804
References
8
Case No. MISSING
Regular Panel Decision
Mar 23, 2000

Ramnarine v. Memorial Center for Cancer & Allied Diseases

Jagdeo Ramnarine, an employee of Memorial Sloan-Kettering Cancer Center, suffered a laceration at the Memorial Center for Cancer and Allied Diseases. He subsequently filed a negligence lawsuit. The defendant, Memorial Center, moved for summary judgment, arguing that the plaintiff's claim was barred by the Workers’ Compensation Law § 11, as both the Center and the Hospital operate as a single integrated employer despite their separate legal entities. The Supreme Court initially denied this motion. However, the appellate court reversed the decision, granting summary judgment to the defendant. The court found substantial evidence supporting the integrated employer argument, thereby limiting the plaintiff's remedy to workers' compensation benefits and dismissing the complaint and all cross-claims against the defendant.

Workers' Compensation ExclusivityIntegrated Employer DoctrineSummary Judgment ReversalNegligence ClaimCross Claims DismissedCorporate Alter EgoCommon ControlBronx CountyAppellate DivisionLabor Law
References
11
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