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

Case No. ADJ2778117 (RIV 0032584)
Regular
Dec 31, 2009

KEYIN MORALES vs. RALPHS GROCERY CO., SEDGWICK CLAIMS MANAGEMENT SERVICES

The WCAB granted the petition for reconsideration and amended the Findings and Award to find 18 1/2 percent permanent disability, after apportionment of 50 percent to applicant's non-industrial peripheral neuropathy.

ApportionmentPeripheral neuropathyCausationPermanent disabilityAgreed medical examinerWCJPetition for reconsiderationFindings and AwardWork restrictionsIndustrial injury
References
4
Case No. ADJ9509417
Regular
Apr 05, 2023

ELIZABETH ARBOGAST vs. CALIFORNIA HIGHWAY PATROL, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board affirmed an award for further medical treatment and attorney fees for an applicant diagnosed with ovarian cancer, hernia, peripheral neuropathy, and colon issues sustained during her employment with the California Highway Patrol. The Board found the applicant's ovarian cancer to be an insidious and progressive disease, warranting a reservation of jurisdiction over permanent disability. This reservation allows for future determination of permanent disability if the condition worsens or recurs.

Workers' Compensation Appeals BoardCalifornia Highway Patrolmedically uninsuredState Compensation Insurance FundAdjudication NumberOpinion and Decision After ReconsiderationFindings and Awardworker's compensation administrative law judgeovarian cancerhernia
References
11
Case No. MISSING
Regular Panel Decision
Jun 04, 2001

Claim of Keeley v. Jamestown City School District

The claimant, a teacher for Jamestown City School District, experienced various symptoms after renovations at the middle school in 1992, attributing them to chemical exposure. After stopping work and seeking medical attention, the School District filed a C-2 form. However, a Workers’ Compensation Law Judge and subsequently the Workers’ Compensation Board disallowed the claim, finding that the claimant failed to prove a causal relationship between the disability and employment. The record showed exposure to carpet adhesives and ventilation issues, but also noted the claimant's intermittent symptoms since 1988 and recurrence with household cleaners. While some medical experts diagnosed toxic peripheral neuropathy, toxic encephalopathy, and multiple chemical sensitivity, and linked them to work exposure, other experts disagreed. The Board weighed these conflicting medical opinions. The court affirmed the Board’s decision, concluding that substantial evidence supported the finding that no causal relationship was established.

Workers' CompensationCausally Related DisabilityChemical ExposureSchool RenovationsToxic Peripheral NeuropathyToxic EncephalopathyMultiple Chemical SensitivityConflicting Medical OpinionsBurden of ProofMedical Evidence
References
5
Case No. ADJ3744023
Regular
May 15, 2009

JOSEPH CRABTREE vs. MITCHELL BERMAN CABINET MAKER, STATE COMPENSATION INSURANCE FUND

In this workers' compensation case, the defendant sought reconsideration of an award finding an industrial injury to the applicant's abdomen/groin (hernia) and a resulting peripheral nerve injury causing 24% permanent disability. The defendant argued the peripheral nerve injury was not supported and the disability rating was incorrect due to misapplication of the AMA Guides. The Board denied reconsideration, adopting the judge's report and finding that the medical evidence supported the peripheral nerve injury and the AMA Guides were correctly applied. The Board found the agreed medical evaluator's conclusions were well-reasoned and supported by the evidence.

Workers Compensation Appeals BoardIndustrial InjuryHerniaPeripheral Nerve InjuryPermanent DisabilityAgreed Medical Evaluator (AME)AMA GuidesPetition for ReconsiderationMedical EvidenceWCJ
References
4
Case No. ADJ8878991
Regular
Jan 31, 2014

JAY SCHETTLER vs. ALLIED BEVERAGES, INC.; CYPRESS INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration of the administrative law judge's finding of injury. The applicant, a route salesman, claimed he stepped on glass, injuring his left foot, which was corroborated by medical records showing a cut and the applicant's delayed awareness due to diabetic neuropathy. Defense witness testimony also supported the applicant's claim of cutting his toe at work. The Board found the applicant's testimony credible and the medical evidence sufficient to establish the injury arose out of and in the course of employment.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Factterritory route salesmanmechanism of injurydiabetic neuropathycredibilitymedical recordsReport and Recommendationurgent care
References
1
Case No. MISSING
Regular Panel Decision
Sep 21, 2006

People v. Caridi

The defendant appealed a conviction for offering a false instrument for filing in the second degree, stemming from his false representation that workers on a HUD-funded project were paid the prevailing wage required by the federal Davis-Bacon Act. The defendant argued that state prosecution was preempted by federal law. The court disagreed, holding that the criminal proceeding was a valid exercise of the State’s police power with only a peripheral relationship to the Davis-Bacon Act, and there was no manifest Congressional intent to preempt state jurisdiction. Furthermore, the court found no conflict between state and federal law, as compliance with both was possible and state prosecution did not obstruct federal objectives.

False Instrument FilingDavis-Bacon ActFederal PreemptionState Police PowerSupremacy ClauseCriminal ProsecutionPrevailing WageHUD Funded ProjectConstruction ProjectConcurring Opinion
References
6
Case No. MISSING
Regular Panel Decision

Tahir v. Progressive Casualty Insurance

This case addresses a no-fault health services provider's claims for compensation for current perception threshold (CPT) and sensory nerve conduction threshold (sNCT) testing. The defendant insurer argued these tests were not compensable under Medicare and constituted provider fraud. The court rejected the Medicare defense, clarifying that New York's no-fault statute relies on workers' compensation fee schedules, not Medicare standards. Furthermore, the court categorized the fraud defense as a medical necessity issue, requiring timely assertion with supporting evidence. Finding the insurer failed to meet its burden, the court ruled in favor of the plaintiff, entitling them to attorney fees and statutory interest.

No-fault insuranceCPT testingsNCT testingMedical necessityProvider fraudMedicare compensationWorkers' compensation fee schedulesElectrodiagnostic testSensory neuropathyChiropractic services
References
26
Case No. MISSING
Regular Panel Decision

Newsome v. Astrue

Gordon C. Newsome challenged the Commissioner of Social Security's final determination denying him social security disability benefits. The Administrative Law Judge (ALJ) had found Newsome not disabled, attributing his impairments primarily to alcohol abuse and a temporary hip fracture. The District Court identified several legal errors by the ALJ, including improper assessment of neuropathy and DVT diagnoses, mischaracterization of a treating physician's report, and failure to adequately develop the record regarding the materiality of alcohol abuse to Newsome's physical limitations. Consequently, the Plaintiff's motion for judgment on the pleadings was granted, the Commissioner's cross-motion was denied, and the case was remanded to the ALJ for further proceedings consistent with the court's decision.

Social Security DisabilityAlcohol AbuseSeizure DisorderPancreatitisNeuropathyDeep Vein Thrombosis (DVT)Credibility AssessmentTreating Physician RuleRemandAdministrative Law Judge (ALJ)
References
54
Case No. MISSING
Regular Panel Decision

O'DELL v. Barnhart

Plaintiff William O'Dell sought disability insurance benefits due to carpal tunnel syndrome, ulnar neuropathy, and tendinitis, which he claimed prevented him from working since 1996. The Commissioner of Social Security, Jo Anne B. Barnhart, denied benefits, asserting O'Dell retained the residual functional capacity to perform other work. After an Administrative Law Judge and the Appeals Council upheld the denial, O'Dell initiated this review action in the District Court under 42 U.S.C. § 405(g). The District Court, presided over by Judge Larimer, affirmed the Commissioner's final determination, concluding that the ALJ's findings were supported by substantial evidence regarding O'Dell's capacity for other work in the national economy.

Social Security ActDisability Insurance BenefitsResidual Functional CapacityTreating Physician OpinionAdministrative Law JudgeVocational Expert TestimonyCarpal Tunnel SyndromeUlnar NeuropathyTendinitisFederal District Court Review
References
6
Case No. 534831
Regular Panel Decision
Oct 12, 2023

In the Matter of the Claim of Susan Zuhlke

Susan Zuhlke appealed two decisions by the Workers' Compensation Board concerning a schedule loss of use (SLU) award for her right leg injuries. Zuhlke, a teacher, suffered right ankle and knee/tibia fractures in October 2018, later including fibular neuropathy. While a 25.8% SLU for her right foot was stipulated, a dispute arose over the right knee, with the Board ultimately affirming a 15% SLU based on the carrier's medical consultant's opinion and denial of reconsideration. The Appellate Division affirmed the Board's determination, finding substantial evidence supported the 15% SLU award for the right knee, consistent with impairment guidelines and prior Board decisions regarding tibial plateau fractures.

Workers' CompensationSchedule Loss of UseSLURight Leg InjuryTibial Plateau FractureFibular NeuropathyMaximum Medical ImprovementImpairment GuidelinesMedical OpinionsAppellate Review
References
9
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