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

Case No. MISSING
Regular Panel Decision
Jun 05, 2015

Claim of Lovegrove v. Regional Food Bank of Northeastern NY

In July 2013, the claimant sustained a back injury in a forklift accident, which was established for workers\' compensation benefits. Subsequently, the claimant sought to amend the claim to include a causally-related injury to the right shoulder blade area. The Workers’ Compensation Law Judge and the Workers’ Compensation Board denied this amendment, finding that the claimant had not provided sufficient competent medical evidence. On appeal, the court determined that the Board improperly rejected the uncontroverted medical testimony of the treating orthopedic surgeon, who unequivocally linked the shoulder injury to the accident. The independent medical examiner also found the causal connection plausible. Consequently, the Board\'s decision was reversed, and the matter was remitted for further proceedings consistent with the court\'s decision.

Workers' CompensationCausally Related DisabilityMedical EvidenceOrthopedic Surgeon TestimonyIndependent Medical ExaminationShoulder InjuryBack InjuryAppellate ReviewBoard Decision ReversalRemittal
References
3
Case No. ADJ1498961
Regular
Sep 23, 2010

DALE ARNOLD vs. RALPH'S AKA KROGER

This case involves an applicant's claim for workers' compensation benefits for a right shoulder injury. While the initial award recognized industrial injury to the applicant's left shoulder, right elbow, and right forearm, the defendant sought reconsideration, arguing the right shoulder injury was not work-related. The Appeals Board granted reconsideration, finding the applicant failed to meet the burden of proof for the right shoulder injury. They disagreed with the primary treating physician's opinion and found the agreed medical evaluator's opinion more persuasive, ultimately reversing the finding for the right shoulder.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardCumulative TraumaIndustrial InjuryLeft ShoulderRight ElbowRight ForearmRight ShoulderPrimary Treating Physician
References
0
Case No. SFO 0425862 SFO 0425863
Regular
May 14, 2008

William Bishop vs. IGC POLYCOLD SYSTEMS, ROYAL & SUN ALLIANCE

This case involves a workers' compensation applicant claiming injury to his right shoulder and seeking a new vocational rehabilitation plan. The Appeals Board affirmed the WCJ's denial of a new vocational plan and the finding of no industrial injury to the right shoulder. However, they reversed the WCJ to award benefits resulting from right shoulder surgery, deeming it a consequence of the compensable left shoulder injury.

Workers' Compensation Appeals BoardReconsiderationVocational Rehabilitation PlanIndustrial InjuryRight ShoulderLeft ShoulderTemporary DisabilityQualified Medical EvaluationCausationNon-Industrial
References
8
Case No. MISSING
Regular Panel Decision
Aug 04, 1995

Claim of Diliberto v. Hickory Farms, Inc.

The claimant was injured at work on December 30, 1987, sustaining injuries to his neck, shoulder blade, and left arm, with findings later expanded to include the lower back. The employer and its insurer disputed the causal relationship of the lower back injury. Although a Workers’ Compensation Law Judge found the lower back injury causally related, the Workers’ Compensation Board ultimately disallowed this claim due to a lack of credible medical evidence. The Board's decision was affirmed on appeal, as it was within the Board's authority to resolve conflicting expert medical testimony. Supporting the Board's finding, medical experts indicated no causal link, and the claimant did not report lower back pain until 16 months post-accident.

Causality DisputeMedical Expert TestimonyBoard DiscretionAffirmationLower Back PainDelayed SymptomsInjured WorkerEmployer LiabilityInsurance DisputeAppellate Division
References
3
Case No. ADJ3849140 (RDG 0119253)
Regular
Apr 04, 2011

THEMAS TRESLER vs. MOUNTAIN SATELLITE, STATE COMPENSATION INSURANCE FUND

This case involves a dispute over workers' compensation jurisdiction regarding a left shoulder injury. The defendant, SCIF, sought reconsideration of a WCJ's award of treatment for the shoulder, arguing lack of jurisdiction. The Appeals Board granted reconsideration, rescinded the prior award, and returned the matter for further proceedings. This decision acknowledges that the left shoulder claim may not have been definitively resolved by prior stipulations and requires the WCJ to determine if Labor Code section 5815 applies, potentially leading to a full hearing on the shoulder injury.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardIndustrial InjuryLow Back InjuryLeft Shoulder InjuryStipulation with Request for AwardDeclaration of Readiness to ProceedContinuing JurisdictionLabor Code Section 5909
References
5
Case No. ADJ8361032
Regular
Sep 04, 2019

CAROL WORKMAN vs. ST. THERESA/ST. JOSEPH SCHOOL

This case concerns Carol Workman's claim for benefits from the Subsequent Injuries Benefits Trust Fund (SIBTF) due to bilateral shoulder injuries. The Workers' Compensation Appeals Board (WCAB) overturned a prior decision and found Workman entitled to SIBTF benefits. This was based on evidence showing her current work-related shoulder injuries, when combined with prior non-industrial and industrial shoulder issues, met the statutory threshold for SIBTF eligibility. The Board found that the cumulative injury to her shoulders resulted in at least 5% permanent disability before adjustments, satisfying the requirement for SIBTF benefits.

SIBTFSubsequent Injuries Benefits Trust Fundwhole person impairmentcumulative traumaacromegalybilateral shouldersrange of motionmotor deficitapportionmentdiminished future earning capacity
References
17
Case No. ADJ3481462 (OAK 0297878)
Regular
Sep 24, 2009

KATHRYN MILLS vs. BERKELEY UNIFIED SCHOOL DISTRICT, STATE COMPENSATION INSURANCE FUND

The defendant sought reconsideration of an award finding industrial injury to the applicant's left upper extremity and shoulder, causing temporary disability and need for further medical care. The applicant's treating physician, Dr. Nolan, provided opinions regarding her left shoulder and other body parts, while Dr. Cabayan also provided opinions on the left shoulder and other extremities. The Workers' Compensation Appeals Board granted reconsideration and amended the award, clarifying that future medical care is consistent with Dr. Cabayan's opinions for the left shoulder and Dr. Nolan's opinions for other body parts. The Board affirmed the award with this specific amendment.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardIndustrial InjuryInstructional AssistantLeft Upper ExtremityCompensable ConsequenceTemporary DisabilityFurther Medical CareSubstantial Evidence
References
0
Case No. MISSING
Regular Panel Decision
Sep 07, 2004

Claim of Senecal v. Allied Bendix

Claimant sustained a work-related left shoulder injury in 1991, leading to surgery in 1992 and retirement in 1995. In 2002, he sought workers' compensation benefits for a consequential right shoulder injury, claiming it resulted from favoring his left shoulder. While a Workers' Compensation Law Judge initially established a causally related consequential injury, a Board panel reversed this decision. The Appellate Division affirmed the Board's ruling, finding substantial evidence that the right shoulder condition, which manifested 10-11 years post-initial injury and 7 years post-retirement, was consistent with natural aging and not causally related to the prior work injury.

Workers' CompensationConsequential InjuryRight Shoulder PainLeft Shoulder InjuryCausationMedical EvidenceDegenerative ChangesSpecial Fund for Reopened CasesAppellate ReviewSubstantial Evidence
References
1
Case No. 524823
Regular Panel Decision
Feb 07, 2019

Matter of Napoli v. Edison

John Napoli, a mechanic, injured both shoulders in a 2003 work accident at the World Trade Center site. He was initially awarded a 20% schedule loss of use (SLU) for each shoulder. In 2012, his condition changed, and liability was transferred to the Special Fund for Reopened Cases. A Workers' Compensation Law Judge (WCLJ) found an additional 45% SLU for each shoulder, but the Workers' Compensation Board reversed this finding after an evaluation by an impartial specialist and crediting an independent medical examiner. The Appellate Division affirmed the Board's decision, concluding that the Board's finding that the additional deterioration in the condition of his shoulders was not causally related to the underlying accident was supported by substantial medical evidence.

Workers' CompensationSchedule Loss of UseShoulder InjuryCausationMedical EvidenceIndependent Medical ExaminationImpartial SpecialistReopened CasesAppellate ReviewSubstantial Evidence
References
11
Case No. ADJ7650286, ADJ7459699
Regular
May 03, 2016

MIGUEL RODRIGUEZ vs. LUANNE WELLS; CHUBB GROUP

This case involves two workers' compensation claims where the applicant sought reconsideration of a prior award. The applicant argued that his permanent disability award for a hernia was insufficient and that he should have received a finding of industrial injury to his left shoulder. The Appeals Board granted reconsideration, affirming previously awarded injuries to the low back, knees, psyche, and hernia. However, they rescinded the prior awards and deferred the issue of left shoulder injury, along with other related issues like permanent disability and further medical treatment for the shoulder, pending further proceedings at the trial level. The Board noted that while the shoulder injury was raised in amended applications and supported by some medical evidence, it was never formally adjudicated.

Workers' Compensation Appeals BoardPetition for ReconsiderationJoint Findings and AwardCumulative TraumaSpecific InjuryLandscaper/GardenerPermanent DisabilityFurther Medical TreatmentLeft Shoulder InjuryDr. Scott Rosenzweig
References
2
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