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

Case No. 2019 NY Slip Op 05820
Regular Panel Decision
Jul 25, 2019

Matter of Ellis v. First Student, Inc.

Claimant, Kevin Ellis, a school bus driver, sustained work-related injuries in November 2014 when struck by a vehicle. His initial claim for workers' compensation benefits was established for injuries to his back, left hip, and left knee. The Workers' Compensation Board later amended the claim to include causally-related injuries to his right knee and right shoulder, based on medical evidence and testimony. The employer and its carrier appealed this decision. The Appellate Division, Third Department, affirmed the Board's decision, finding substantial evidence to support the Board's determination that the injuries to the right knee and right shoulder were causally related to the work accident, crediting the testimony of orthopedist Charles Peralo over the conflicting opinion of physician Harvey Siegel.

Workers' CompensationCausally Related InjuryRight KneeRight ShoulderSchool Bus DriverSubstantial EvidenceMedical TestimonyCredibilityAppellate ReviewAmendment of Claim
References
13
Case No. 529417
Regular Panel Decision
Feb 06, 2020

Matter of Johnson v. City of New York

Thomas Johnson, a patient care technician, sustained work-related knee injuries in a February 2006 fall. He subsequently sustained additional work-related injuries in November 2009 to his neck, back, shoulder, and hips, for which he received schedule loss of use (SLU) awards for his right arm, left leg, and right leg. The Workers' Compensation Board later ruled on the permanency of his 2006 injuries, finding an 80% SLU for his left leg and a 40% SLU for his right leg. However, the Board reduced these new awards by his previously received SLU awards for the 2009 injuries, resulting in a final 30% SLU for his left leg and a 0% SLU for his right leg. The Appellate Division affirmed the Board's decision, confirming that SLU awards for the knee and hip are encompassed within leg awards, and prior leg SLU awards must be deducted from subsequent leg SLU awards.

Schedule Loss of UseKnee InjuriesHip InjuriesLeg ImpairmentPrior SLU Award DeductionAppellate Division ReviewIndependent Medical ExaminationTreating Physician ReportPermanent Impairment GuidelinesWork-related Accident
References
9
Case No. CV-23-1229
Regular Panel Decision
Dec 12, 2024

In the Matter of the Claim of Percival Webster

Percival Webster, the claimant, sustained a work-related right knee injury in April 2018, leading to a 50% schedule loss of use (SLU) award for his right leg. In March 2020, while working as a correction officer, he incurred a compensable right hip injury. Following conflicting medical evaluations by Dr. John Ioia and Dr. Adam Soyer regarding the SLU attributable to the hip injury, a Workers' Compensation Law Judge (WCLJ) credited Dr. Ioia's testimony and awarded a 50% SLU for the right leg based solely on the hip injury. The employer's carrier appealed, arguing for an offset against the prior knee injury award under Matter of Genduso. However, citing Matter of Johnson, the Workers' Compensation Board affirmed the WCLJ's decision, finding that the claimant sufficiently demonstrated the hip and knee injuries were separate pathologies. The Supreme Court, Appellate Division, Third Judicial Department, affirmed the Board's decision, concluding that Workers' Compensation Law § 15 (7) allows for multiple SLU awards for successive injuries to the same body member if an increased loss of use from the subsequent injury is proven.

Schedule Loss of UseRight Leg InjuryHip InjuryKnee InjurySuccessive InjuriesMedical EvidenceIndependent Medical ExaminationWorkers' Compensation Board AppealAppellate Division DecisionJudicial Precedent
References
6
Case No. ADJ9210498
Regular
Apr 04, 2017

ELEANOR DEFRANCO vs. MONTEREY FISH COMPANY, ENSTAR (US) INC., dba ENSTAR ADMINISTRATORS FOR SEABRIGHT INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a prior award that found industrial injury to applicant's right ankle, right shoulder, and back, but not her right knee. The WCAB rescinded the finding of industrial injury to the back, while otherwise affirming the prior decision. Specifically, the WCAB affirmed the finding that the applicant sustained industrial injury to her right ankle and right shoulder, and that medical treatment for her right knee is compensable to relieve the effects of the industrial injuries. The WCAB adopted the WCJ's reasoning for these decisions, including the application of the *Braewood* principle for treating the non-industrial knee condition.

Workers' Compensation Appeals BoardEleanor DefrancoMonterey Fish CompanyEnstarSeabright Insurance CompanyIndustrial InjuryRight AnkleRight ShoulderRight KneeBack Injury
References
1
Case No. CV-23-1229
Regular Panel Decision
Dec 12, 2024

Matter of Webster v. Office of Children & Family Servs.

Claimant Percival Webster, who previously received a 50% schedule loss of use (SLU) award for his right leg due to a 2018 knee injury, sustained a second compensable injury to his right hip in March 2020. An independent medical examination by John Ioia, credited by the Workers' Compensation Law Judge (WCLJ), assessed a 50% SLU of the right leg solely attributable to the hip injury. The employer's carrier contended that the new award should be offset by the prior knee injury award, citing *Matter of Genduso*. However, the Workers' Compensation Board affirmed the WCLJ's decision, relying on *Matter of Johnson v City of New York*, which permits separate SLU awards for distinct injuries to the same body member if the claimant proves the second injury caused an increased loss of use independently. The Board found sufficient medical evidence to support the finding that the hip injury was a separate pathology warranting a distinct 50% SLU award, a decision which the Appellate Division affirmed.

Schedule Loss of UseWorkers' Compensation Board DecisionRight Hip InjuryRight Knee InjuryIncreased Loss of UseMedical Expert TestimonyIndependent Medical ExaminationOffsetting Disability AwardsStatutory InterpretationPrior Injury
References
6
Case No. ADJ1991870
Regular
Sep 07, 2010

TOM DRENNAN vs. SUPERIOR INSPECTION SERVICES, FIREMAN'S FUND INSURANCE COMPANY

This case involves an employer's petition for reconsideration of a WCJ's award finding industrial injury to the applicant's left knee, both hips, and gastrointestinal system as consequential to an admitted right knee injury. The defendant argues that a prior 2005 WCJ decision denying consequential injury to the left knee and hips is res judicata. The Appeals Board granted reconsideration, amending the award to remove the left knee and hip injuries, holding that the 2005 decision was final and the five-year time limit to reopen under Labor Code sections 5410 and 5804 had passed. The finding of consequential injury to the gastrointestinal system and 29% permanent disability remain affirmed.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardCompensable ConsequencesRes JudicataIndustrial InjuryLeft KneeHipsGastrointestinal SystemPermanent Disability
References
2
Case No. ADJ 924444 (LAO 0841815) ADJ 7065158
Regular
May 09, 2018

CESAR ESPINOZA vs. FLOWSERVE CORPORATION, TRAVELERS INSURANCE COMPANY

The Workers' Compensation Appeals Board affirmed a joint award of 100% permanent disability for an applicant who sustained a specific injury to his right shoulder, left knee, and back, and a cumulative trauma injury to his bilateral shoulders, knees, back, and right knee. The Board found the applicant's industrial injuries were "inextricably intertwined," justifying an unapportioned award as per *Benson*. Furthermore, the Board relied on the vocational expert's opinion that the applicant was unable to find and sustain gainful employment due to his injuries, without considering non-industrial factors. The defendant's arguments regarding erroneous permanent total disability findings and the need for separate apportionment were rejected.

ApportionmentInextricably IntertwinedCumulative TraumaSpecific InjuryPermanent Total DisabilityAgreed Medical Examiner (AME)Vocational ExpertJoint AwardBenson v. WCABDiminished Future Earning Capacity
References
4
Case No. MISSING
Regular Panel Decision

Claim of Hilbrandt v. Village of Red Hook

The claimant, a volunteer emergency medical technician, was injured on August 26, 2005. Her initial workers’ compensation claim was established for left ankle/leg and consequential right shoulder injuries. In April 2008, she sought to amend her claim to include a consequential right hip injury. The Workers’ Compensation Law Judge (WCLJ) dismissed the right hip claim as time-barred under Workers’ Compensation Law § 28, a decision upheld by the Workers’ Compensation Board. On appeal, the court affirmed the Board's decision, finding that while Volunteer Firefighters’ Benefit Law § 41 should have been applied, the claim for the right hip injury was time-barred under either statute as it was a direct injury from the 2005 accident and not claimed until April 2008.

Volunteer Firefighters' BenefitsStatute of LimitationsTime-barred ClaimConsequential InjuryDirect InjuryRight Hip InjuryEmergency Medical TechnicianDutchess CountyMedical EvidenceAppellate Review
References
6
Case No. ADJ1445862
Regular
Mar 22, 2011

Stuart Rubin vs. Delta Air Lines/ACE American Insurance as administered by ESIS

This case concerns an employee's cumulative trauma claim against Delta Airlines for injuries to his spine, right shoulder, and right knee. The defendant sought reconsideration of the original award, arguing the claim was barred by the statute of limitations and the medical evidence did not support injury to the shoulder and knee. The Appeals Board granted reconsideration, rescinded the original award, and returned the matter for further proceedings. The Board found that the earlier medical report, relied on by the defendant, may not have been based on a complete history and that Dr. Green's apportionment was specifically for surgeries, not necessarily cumulative trauma to the shoulder and knee.

Cumulative traumaStatute of limitationsAgreed Medical ExaminerPetition for reconsiderationFindings and AwardLabor Code section 5405Medical evidenceApportionmentTollingClaim form
References
5
Case No. 2019 NY Slip Op 09070
Regular Panel Decision
Dec 19, 2019

Matter of Felicello (Marlboro Cent. Sch. Dist.)

Claimant Frank Felicello, a physical education teacher, sustained work-related injuries in October 2013, and his claim was established in July 2014 for injuries to his right shoulder, right knee, right hip, and lower back. After his retirement in August 2014, the employer raised the issue of whether Felicello violated Workers' Compensation Law § 114-a, alleging he falsely testified that his physicians had advised him to retire due to his injuries. A Workers' Compensation Law Judge and subsequently the Workers' Compensation Board found that Felicello's testimony regarding his reasons for retirement was

Workers' Compensation LawFraudFalse TestimonyMisrepresentationIndemnity BenefitsVoluntary Withdrawal from Labor MarketDisqualificationAppellate ReviewSubstantial EvidenceCredibility Determination
References
10
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