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

Case No. ADJ3388364 (VNO 0526713) ADJ2633182 (VNO 0342427)
Regular
Oct 24, 2014

RICHARD FROMKNECHT vs. SUBSEQUENT INJURIES BENEFITS TRUST FUND

The applicant sought reconsideration of a decision denying him benefits from the Subsequent Injuries Benefits Trust Fund (SIBTF). The applicant claimed a pre-existing disability from a 1996 spinal injury caused further permanent disability with a subsequent 1998 spinal injury. However, both injuries became permanent and stationary concurrently, meaning there was no distinct pre-existing ratable disability at the time of the second injury. Therefore, the applicant did not meet the criteria for SIBTF benefits under Labor Code section 4751, and his petition for reconsideration was denied.

Subsequent Injuries Benefits Trust FundLabor Code section 4751Petition for ReconsiderationFindings and OrderStipulations with Requests for AwardsAgreed Medical Evaluatorapportionmentpermanent and stationarypreexisting disabilityindustrial injury
References
0
Case No. MISSING
Regular Panel Decision
Dec 31, 2013

Berroyer v. United States

The plaintiffs, William Berroyer, Sr. and his wife Ruth Berroyer, sued the United States under the Federal Tort Claims Act for personal injuries William sustained in an IRS facility on July 23, 2008. William tripped on an unsecured telephone cord, fell into a filing cabinet, and suffered a mild spinal cord injury due to concussion, leading to pain and some disability. The Court found the United States negligent for failing to maintain a safe conference room and awarded William $712,000 for past and future pain and suffering and past medical expenses, and Ruth $150,000 for loss of services. However, the Court declined to award for loss of earnings, citing lack of sufficient medical proof of inability to work and unreliable expert testimony regarding the extent of the plaintiff's claimed disability.

Federal Tort Claims ActPersonal InjurySpinal Cord InjuryNegligencePremises LiabilityTrip and FallIRS FacilityConcussion InjuryPain and Suffering DamagesLoss of Services
References
18
Case No. ADJ6993450
Regular
Dec 03, 2015

KIT DAWSON vs. SAN DIEGO TRANSIT, ACE AMERICAN INSURANCE COMPANY, TRISTAR RISK MANAGEMENT

The Workers' Compensation Appeals Board affirmed a prior decision awarding the applicant 100% permanent disability under Labor Code section 4662(a)(3) due to a severe spinal cord injury causing practically total paralysis. This injury was a compensable consequence of a motor vehicle accident, which itself was deemed a consequence of two prior industrial injuries. The Board found that the defendant failed to meet its burden of proof for apportionment, as there was no medical evidence linking the prior shoulder injuries to the applicant's current paralysis. Therefore, the applicant is entitled to the conclusive presumption of permanent total disability without apportionment.

Workers' Compensation Appeals BoardReconsiderationPermanent DisabilityApportionmentLabor Code Section 4662(a)Compensable Consequence InjuryMotor Vehicle AccidentSpinal Cord InjuryPractically Total ParalysisQuadriplegic
References
3
Case No. ADJ10550274
Regular
Mar 24, 2023

MEENA CHANDOK vs. SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Subsequent Injuries Benefits Trust Fund (SIBTF) sought reconsideration of a prior award finding the applicant permanently totally disabled due to a subsequent industrial injury combined with pre-existing disabilities. SIBTF argued that an elective tubal ligation and pre-existing cervical and thoracic spine impairments were improperly rated. The Workers' Compensation Appeals Board (WCAB) denied reconsideration, finding that the tubal ligation constituted a ratable impairment under the AMA Guides, and evidence of prior treatment for the spinal conditions predated the industrial injury. The WCAB adopted the reasoning of the Workers' Compensation Judge (WCJ), who found no legal basis to exclude an elective surgery from impairment rating and that SIBTF failed to rebut the applicant's medical evidence.

Subsequent Injuries Benefits Trust FundPre-existing disabilityRatable impairmentElective tubal ligationCervical spineThoracic spineAMA GuidesLabor Code section 4751FergusonProphylactic work restriction
References
12
Case No. GOL 0096107
Regular
Mar 05, 2008

MIGUEL ANGEL CRUZ vs. EARL CLARK, FARMERS INSURANCE EXCHANGE, SUBSEQUENT INJURIES BENEFITS TRUST FUND

This case concerns Miguel Angel Cruz's petition for reconsideration of a denial of Subsequent Injuries Benefits Trust Fund (SIBTF) benefits. The Workers' Compensation Appeals Board affirmed the denial, finding no evidence that Mr. Cruz's pre-existing degenerative spinal condition was "labor disabling" prior to his industrial injury. Crucially, the Board held that a retroactive prophylactic work restriction by a physician after the injury does not establish a pre-existing labor-disabling condition for SIBTF eligibility.

Subsequent Injuries Benefits Trust Fundpre-existing conditionlabor disablingpermanent disabilityapportioned disabilityindustrial injuryprimary treating physiciandegenerative changeslumbar spineprophylactic work restriction
References
7
Case No. ADJ3715225
Regular
Mar 16, 2009

MICHAEL COYER vs. COUNTY OF SAN BERNARDINO

The Workers' Compensation Appeals Board denied reconsideration of its prior decision. The Board found that the applicant's back and spinal cord injury did not arise out of his employment as a firefighter. This was because the injury occurred while the applicant was on paid administrative leave and performing a personal task of protecting his own roof, without departmental authorization or assistance. The Board determined the applicant was not performing his firefighter responsibilities at the time of the injury.

Industrial injuryBack injurySpinal cord injuryFirefighterPaid administrative leavePersonal undertakingDepartmental authorizationLabor Code section 3600.4Petition for reconsiderationOpinion and Decision After Reconsideration
References
0
Case No. ADJ4016735 (BAK 0147536)
Regular
Jun 11, 2012

COLLEEN PARHAM vs. KERN RADIOLOGY MEDICAL GROUP, LEGION INSURANCE GROUP

This case involves an applicant seeking bilateral knee replacement surgery due to an admitted industrial back injury. The applicant argues the surgery is necessary to enable further treatment for her back, specifically a spinal cord stimulator. The defendants contested this, claiming the knee condition was independent and unrelated to the industrial injury. The Appeals Board granted reconsideration, finding the knee surgery reasonably required to relieve the industrial back injury, citing *Bolton* and *Rowan*, even if the knee condition itself was not industrial. The Board rescinded prior findings, awarding the knee surgery and deferring issues of permanent disability and temporary disability.

Workers' Compensation Appeals BoardReconsiderationFindings of FactBilateral Knee ReplacementIndustrial InjuryBack InjurySpinal Cord StimulatorTemporary Total DisabilityPermanent and StationaryQualified Medical Evaluator
References
8
Case No. 2018 NY Slip Op 02693 [160 AD3d 1238]
Regular Panel Decision
Apr 19, 2018

Matter of Nock v. New York City Dept. of Educ.

Claimant Tykeisha D. Nock, a school lunch helper, filed for workers' compensation benefits due to spinal cord, lower back, leg, foot, and thigh injuries. The Workers' Compensation Law Judge initially established the claim due to the employer's untimely notice of controversy. However, the Workers' Compensation Board reversed this decision, finding that the claimant failed to provide sufficient proof of a causally-related injury. The Appellate Division affirmed the Board's decision, emphasizing the claimant's burden to demonstrate a causal connection between her injuries and employment through competent medical evidence. The court clarified that the Board's decision did not prevent the claimant from submitting further medical evidence in the future to establish this causal link.

Workers' CompensationSpinal InjuryCausal RelationshipMedical EvidenceUntimely NoticeAppellate ReviewClaim DisallowanceSchool Lunch HelperEmployer LiabilityBoard Decision
References
8
Case No. CV-23-0221
Regular Panel Decision
Apr 25, 2024

In the Matter of the Claim of Annette Bosque

Annette Bosque, a home health care aide, sustained severe injuries, including a subarachnoid hemorrhage and spinal cord injuries, after falling in a patient's home. She filed a claim for workers' compensation benefits, which the employer, Prime Support Inc., and its carrier controverted. A Workers' Compensation Law Judge (WCLJ) found the injuries to be work-related and awarded benefits. The carrier appealed to the Workers' Compensation Board, which affirmed the WCLJ's decision. On further appeal to the Supreme Court, Appellate Division, Third Judicial Department, the carrier's arguments were rejected. The Court affirmed the Board's decision, finding it supported by substantial evidence and relying on the statutory presumption of compensability for unwitnessed or unexplained accidents occurring during the course of employment.

Workers' Compensation BenefitsAccidental InjuryCourse of EmploymentArising Out of EmploymentWorkers' Compensation Law § 21(1)Presumption of CompensabilityUnwitnessed AccidentEmployer's DefensesPrehearing Conference StatementSubstantial Evidence Review
References
12
Case No. MISSING
Regular Panel Decision
Jan 24, 2002

Machado v. City of New York

The defendant City of New York appealed an order from the Supreme Court, Richmond County, regarding damages for personal injuries. The case involved a construction worker who sustained severe injuries, including a spinal fracture and knee destruction, after a trench wall collapse in 1996, for which he obtained summary judgment against the City under Labor Law § 240. The Supreme Court had granted the plaintiff's motion to set aside the jury's inadequate verdict on damages, ordering a new trial unless the City agreed to increased awards for past and future pain and suffering. The Appellate Division affirmed this order, agreeing that the jury's award deviated materially from reasonable compensation. This decision upholds the conditional directive for a new trial on damages.

Personal InjuryConstruction AccidentTrench CollapseLabor LawDamagesPain and SufferingJury VerdictAppellate ReviewNew TrialSpinal Fracture
References
5
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