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

Case No. ADJ3619852 (VNO 0395419)
Regular
Apr 05, 2013

JESSIE SHERROD vs. COUNTY OF LOS ANGELES

In this workers' compensation case, the applicant, a physician, claimed temporary total disability (TTD) for a period during which the employer provided long-term disability (LTD) payments. The Workers' Compensation Appeals Board granted reconsideration, amending the original award. The Board found that while the employer is entitled to credit for LTD payments, the TTD indemnity due to the applicant must be calculated at the rate provided by Labor Code section 4661.5, which uses the rate in effect on the date of payment, not the rate at the time of injury. This decision ensures the applicant receives TTD at the statutorily current rate for the retroactive period.

Workers' Compensation Appeals BoardJessie SherrodCounty of Los AngelesPetition for ReconsiderationSupplemental Findings and AwardTemporary Total Disability IndemnityLong Term DisabilityLabor Code section 4661.5Agreed Medical ExaminerAverage Weekly Earnings
References
0
Case No. ADJ4690446 (LAO 0794129)
Regular
Jul 21, 2014

MYUNG CHUL KIM vs. PROTECTION PLUS, INC., ZENITH INSURANCE COMPANY

This case involves a dispute over the applicant's temporary total disability (TTD) indemnity period following a work injury. Initially, the Workers' Compensation Judge (WCJ) awarded TTD from January 20, 2001, to April 30, 2001. The Appeals Board amended this, extending TTD to January 14, 2004, based on a psychiatric evaluation. The defendant sought reconsideration, arguing TTD should have ended on June 18, 2002, per a prior report from Dr. Levine. The Board denied the defendant's petition, affirming TTD to January 14, 2004, as Dr. Levine's earlier report lacked an unequivocal permanent and stationary date and a psychiatrist's evaluation confirmed this later date.

Petition for ReconsiderationAmended Findings of Fact and AwardTemporary Total DisabilityPermanent DisabilityApportionmentPsychiatric OverlayPosttraumatic Stress DisorderPermanent and Stationary DateNeurological ConditionMedical Expert Opinion
References
3
Case No. MISSING
Regular Panel Decision

Cleary v. Board of Education

The petitioner, a substitute school teacher, sought retroactive membership in the New York State Teachers’ Retirement System after the enactment of Retirement and Social Security Law § 803. Respondent, her employer, denied her application. Petitioner then initiated a CPLR article 78 proceeding, which the Supreme Court granted, annulling the Hearing Officer's determination due to lack of a rational basis. The respondent appealed this decision. The Appellate Court affirmed the Supreme Court's judgment, concluding that the Hearing Officer's finding that the petitioner participated in a procedure requiring a formal decision to join the retirement system lacked a rational basis, as the evidence presented by the respondent, including W-4 forms, personnel notations, and general office practice testimony, was insufficient to meet the burden.

Retroactive membershipTeachers’ Retirement SystemCPLR article 78Rational basis reviewStandard office practiceEvidence sufficiencyConstitutional challengeSubstitute teacherPublic retirement systemNew York law
References
6
Case No. MISSING
Regular Panel Decision

Sibley, Lindsay & Curr Co. v. Bakery, Confectionery & Tobacco Workers International Union

Sibley, Lindsay and Curr Co. challenged the constitutionality of the Multiemployer Pension Plan Amendment Act of 1980 (MPPAA)'s retroactive withdrawal liability provisions. Sibley's had closed its bakery and withdrawn from a multiemployer pension fund on May 31, 1980, before the MPPAA was enacted on September 26, 1980, which made its withdrawal liability provisions retroactive to April 29, 1980, subjecting Sibley's to a $315,927.00 liability. The court applied the Nachman four-factor test to assess the due process implications of this retroactive application. It found that Sibley's reliance interest outweighed that of other parties, the new liability was drastically different from prior regulations, and imposing the burden retroactively was inequitable and lacked moderating provisions. Consequently, the court ruled that the retroactive application of MPPAA violated Sibley's Fifth Amendment due process rights, granting Sibley's motion for summary judgment and denying the defendants' cross-motions.

MPPAAERISAWithdrawal LiabilityRetroactive LegislationDue ProcessFifth AmendmentSummary JudgmentPension FundsConstitutional LawMultiemployer Plans
References
7
Case No. MISSING
Regular Panel Decision
Mar 31, 1989

Cutler v. Travelers Insurance

This opinion addresses a class action involving consolidated cases where plaintiffs, acting as class representatives, seek retroactive recovery of attorneys' fees and expenses from defendant workers' compensation carriers. The central issue is whether the holding in Matter of Kelly v State Ins. Fund (1983), which redefined equitable apportionment of litigation expenses under Workers’ Compensation Law § 29 (1) to include future compensation benefits, should be applied retroactively. Defendants argued against retroactivity, asserting that previously settled or adjudicated claims should not be reopened. The court, citing precedents such as Gurnee v Aetna Life & Cas. Co. (1982) and Becker v Huss & Co. (1977), determined that the amendment to Workers’ Compensation Law § 29 (1) merely clarified an existing statute rather than creating new liability, thereby supporting retroactive application similar to Kurcsics. Distinguishing the case from Ianielli v North Riv. Ins. Co. (1986), where a formal general release was involved, the court found that the instant cases lacked prior adjudication of contested issues or a general release, warranting retroactivity of the Kelly decision. Consequently, the court denied the defendants' motions for summary judgment, concluding that triable issues of fact existed.

RetroactivityWorkers' CompensationSummary JudgmentClass ActionLitigation ExpensesAttorneys' FeesEquitable ApportionmentInsurance LienFuture BenefitsStatutory Interpretation
References
11
Case No. ADJ748314 (GRO 0033412) ADJ2119704 (GRO 0033413)
Regular
May 18, 2009

GEORGE DIGEROLAMO vs. RALPH'S GROCERY STORE; Permissibly Self-Insured, Adjusted By SEDGWICK CLAIMS MANAGEMENT SERVICES

This case concerns George Digerolamo's entitlement to temporary total disability (TTD) indemnity for left knee injuries sustained before April 19, 2004. The defendant sought reconsideration, arguing that Labor Code sections 4656(c)(1) and 4656(b) limited the TTD payments. The Workers' Compensation Appeals Board denied reconsideration, affirming that because Digerolamo's injuries predated April 19, 2004, the limitations on TTD duration did not apply. The Board also confirmed jurisdiction to award TTD commencing more than five years after the date of injury when the issue remained unresolved.

WCABPetition for ReconsiderationJoint Findings and AwardTotal Temporary DisabilityTDILabor Code section 4656Cumulative TraumaSpecific InjuryRetail ClerkLeft Knee Injury
References
4
Case No. ADJ2887074 (SFO 0429767) ADJ3128893 (SFO 0451527)
Regular
Mar 09, 2009

RAMON MAGANA vs. STANFORD UNIVERSITY, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION By Its Servicing Facility INTERCARE INSURANCE SERVICES, For RELIANCE INSURANCE, In Liquidation

This case involves a dispute over temporary total disability (TTD) benefits for an applicant with right knee and leg injuries. The defendant, CIGA, sought reconsideration of a WCJ's award of continuing TTD, arguing the applicant's condition was permanent and stationary by a specific date and that jurisdiction for TTD had expired. The Appeals Board found the medical evidence regarding the applicant's current TTD status and the commencement/duration of such disability to be insufficient. Consequently, the Board granted reconsideration, rescinded the WCJ's decision, and returned the matter for further development of the medical record, potentially through an Agreed Medical Evaluator or court-appointed physician.

Workers' Compensation Appeals BoardCalifornia Insurance Guarantee AssociationCIGAIntercare Insurance ServicesReliance Insuranceliquidationreconsiderationtemporary total disabilityTTDpermanent and stationary
References
0
Case No. MON 258668
Regular
Apr 23, 2008

HILDA E. LLERENA-HOJJATI vs. SBC/PACIFIC BELL, HELMSMAN MANAGEMENT SERVICES

The Workers' Compensation Appeals Board (WCAB) reviewed a case where the applicant sought temporary total disability (TTD) indemnity. The WCAB amended a prior award, removing TTD benefits commencing May 23, 2006, because they began more than five years after the date of injury and applicant had returned to work. However, the WCAB affirmed the award of TTD indemnity for the period of October 13, 2003, through July 14, 2004, as it fell within the five-year jurisdictional limit. The WCAB also granted applicant's attorney fees but deferred calculation of both TTD indemnity and fees pending further evidence on earnings.

Workers Compensation Appeals BoardReconsiderationTemporary Total DisabilityPetition to ReopenNew and Further DisabilityFive-Year RuleJurisdictionAgreed Medical EvaluatorTreating PhysicianGastric Bypass Surgery
References
4
Case No. ADJ10755627 ADJ9735622
Regular
Dec 24, 2018

ANTHONY KOUTRIS vs. CITY OF LOS ANGELES

The Workers' Compensation Appeals Board denied the City of Los Angeles' petition for reconsideration of an award granting temporary total disability (TTD) benefits to applicant Anthony Koutris. The defendant challenged the TTD period from February 8, 2017, to March 9, 2017, arguing it lacked sufficient medical evidence. The Board adopted the judge's report, finding that applicant's testimony and a doctor's report constituted substantial evidence of TTD during that period. A dissenting opinion argued that medical evidence was lacking for the February 8 to March 8, 2017 period, suggesting TTD should have commenced on March 9, 2017.

Workers' Compensation Appeals Boardlegally uninsuredModified Findings and Awardtemporary total disabilitysubstantial credible medical evidencePetition for ReconsiderationApplicant's testimonyDr. Pelton's reportdissenting opinionconcurrent scientific medical evidence
References
1
Case No. ADJ286130
Regular
Jul 07, 2010

RUDY D' ANGELICO vs. ADM INDUSTRIES, INC., DBA AMTECH ELEVATOR

This case involves an employer's petition for reconsideration of a Workers' Compensation Appeals Board decision regarding temporary total disability (TTD) and an EDD lien. The Board denied reconsideration, upholding the finding that the applicant was entitled to additional TTD from April 6, 2006, to August 8, 2007, based on medical reports indicating ongoing treatment and inability to work. The employer's arguments regarding insufficient evidence for TTD and waiver of the EDD lien were rejected. The Board found the primary treating physician's opinion supported the TTD award, and the EDD lien was allowed to prevent double recovery without prejudicing the employer.

Workers' Compensation Appeals BoardReconsiderationTemporary Total DisabilityEDD LienEmployer LiabilityMedical TreatmentPermanent and Stationary DateQualified Medical ExaminerMedical ReportsPrimary Treating Physician
References
1
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