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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

United Spinal Ass'n v. Board of Elections in the City of New York

Plaintiffs United Spinal Association and Disabled in Action brought an action against the Board of Elections in the City of New York (BOE) under Title II of the Americans with Disabilities Act and Section 504 of the Rehabilitation Act, alleging pervasive access barriers at poll sites. The Court previously denied a preliminary injunction. Both parties subsequently moved for summary judgment. The Court found no genuine dispute of material fact regarding the existence of pervasive and recurring accessibility barriers and deemed the BOE's accommodation methods insufficient. Consequently, the Court granted the plaintiffs' motion for summary judgment on liability and denied the defendants' cross-motion. The case is now referred to a Magistrate Judge for the determination of the appropriate remedy.

AccessibilityVoting RightsAmericans with Disabilities ActRehabilitation ActPoll SitesSummary JudgmentDisability DiscriminationBoard of ElectionsMeaningful AccessReasonable Accommodation
References
26
Case No. 2022 NY Slip Op 02031
Regular Panel Decision
Mar 23, 2022

Perez v. NES Med. Servs. of N.Y., P.C.

Francisco R. Perez and his wife sued NES Medical Services of New York, P.C. for medical malpractice, alleging failure to timely diagnose and treat a spinal epidural abscess. NES, which contracted with Lutheran Medical Center's emergency department, moved for summary judgment, arguing it was not vicariously liable as the physicians were independent contractors. The Supreme Court granted NES's motion. The Appellate Division, Second Department, reversed this decision, finding that NES failed to eliminate all triable issues of fact regarding the employment status of the emergency room physicians. The court emphasized that control over the method and means of work is critical in determining contractor vs. employee status, and NES did not provide sufficient evidence.

Medical MalpracticeVicarious LiabilityIndependent ContractorRespondeat SuperiorSummary JudgmentEmergency RoomSpinal Epidural AbscessAppellate ReviewEmployment StatusTriable Issues of Fact
References
12
Case No. ADJ9917545
Regular
Nov 30, 2018

Richard Ray vs. Jed Francis, Inc., Zurich American Insurance Group, American Claims Management

The Workers' Compensation Appeals Board denied a petition for reconsideration, upholding the finding that Richard Ray sustained an industrial injury. This injury, originating from an eye incident, led to a MRSA infection, epidural abscess, paraplegia, and severe permanent impairments. Medical evidence from IME Dr. Feinberg, Dr. Edington, and Dr. Baum established a medical probability that the initial eye injury caused the subsequent severe cascade of medical conditions. The Board affirmed the WCJ's credibility determination regarding the applicant's testimony, finding no substantial contrary evidence.

Workers' Compensation Appeals Boardindustrial causationepidural abscessMRSAparaplegiasubstantial medical evidenceindependent medical evaluatorarising out of and in the course of employmentmedical sequelaeapportionment
References
0
Case No. ADJ2320623
Regular
Oct 25, 2010

SAMIR SOLOMON vs. TRI VALLEY BUICK, PONTIAC, GMC, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION For CASUALTY RECIPROCAL EXCHANGE, In Liquidation

This case involves a workers' compensation claim for an automobile salesman injured on April 14, 2001, resulting in spinal and psychiatric injuries. The WCJ awarded temporary disability through June 22, 2004, 52¼% permanent disability, and further medical treatment for the psyche, but not the spine, denying defendant credit for civil damages. Both applicant and defendant sought reconsideration, arguing various evidentiary errors, particularly regarding the duration of temporary disability and the need for spinal treatment. The Appeals Board denied reconsideration of both petitions, affirming the WCJ's decision, though one Commissioner dissented, believing the applicant's temporary disability claim and spinal treatment need further development.

Workers' Compensation Appeals BoardIndustrial InjurySpine InjuryPsychiatric InjuryTemporary DisabilityPermanent DisabilityApportionmentMedical TreatmentCivil DamagesReconsideration
References
1
Case No. ADJ2969856 (SAL 0073653)
Regular
Apr 01, 2009

PINA vs. MEYER TOMATORES, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, INTERCARE

This case involves a defendant seeking reconsideration of findings that they failed to respond to a request for an epidural injection authorization and that a treating physician provided reasonable and necessary care. The Board dismissed a second petition concerning a WCJ's report, deeming it not a final order. The Board granted reconsideration of the initial petition solely to order the defendant to authorize the epidural injection. All other aspects of the original award were affirmed.

Workers Compensation Appeals BoardPetition for ReconsiderationEpidural InjectionReasonable and Necessary TreatmentUtilization ReviewBoard Rule §10510Floyd Skeren & KellyWCJ Report and RecommendationFinal OrderAggrieved Party
References
1
Case No. ADJ4480206 (POM 0274117)
Regular
Sep 23, 2008

JESUS MORALES vs. EXCEL CABINETS, INC., STATE COMPENSATION INSURANCE FUND

The Board granted reconsideration to clarify that the industrial injury includes the applicant's psyche, as stipulated, and requires related medical treatment. Defendant waived its right to object to the recommended spinal surgery due to failure to timely object per Labor Code Section 4062(b). The Board awarded updated diagnostic workup and the recommended spinal surgery, while affirming the need for further development on temporary disability and average weekly earnings.

WCABReconsiderationFindings and AwardSpinal SurgeryLabor Code Section 4062(b)Second Opinion ReportTreating PhysicianIndustrial InjuryPsycheTemporary Disability
References
4
Case No. ADJ4577451 (WCK 0063127) ADJ336675 (WCK 0063128)
Regular
Sep 10, 2013

EDUARDO GUERRA vs. POMEROY CORPORATION, TRAVELERS INSURANCE COMPANY

The Appeals Board granted reconsideration to review the WCJ's award of total temporary disability and future medical treatment, including spinal surgery. The Board rescinded the WCJ's decision because the record regarding the necessity of spinal surgery was not fully developed. Specifically, Dr. Harf's second opinion report was incomplete due to unobtained diagnostic tests, preventing a definitive recommendation on surgery. The case is returned to the trial level to further develop the medical evidence on the surgery issue and other deferred matters.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardTemporary Disability IndemnitySpinal SurgerySecond Opinion PhysicianUtilization ReviewPenaltiesDiscoveryDeclaration of Readiness to Proceed
References
6
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. VNO 0504152
Regular
Feb 01, 2008

Debi Surgenor vs. RALPH'S GROCERY COMPANY, SEDGWICK CMS

The Workers' Compensation Appeals Board granted reconsideration to defer the issue of applicant's need for cervical epidural injections due to an inadequate trial record, specifically concerning claim and stipulations for a cervical injury. However, the Board affirmed the original finding that lumbar epidural injections are medically necessary to treat the applicant's industrial injury, supported by medical evidence and demonstrated benefit from prior treatment. The case highlights the importance of a complete and stipulated record for medical treatment claims in workers' compensation proceedings.

Workers' Compensation Appeals BoardRalph's Grocery CompanySedgwick CMSDebi Surgenorcervical epidural injectionslumbar epidural injectionsUtilization Review denialACOEM guidelinesradiculopathyelectrodiagnostic testing
References
1
Case No. ADJ288083 (RDG 0128539)
Regular
Jun 01, 2010

JACOB VERVALIN vs. MISSION UNIFORM & LINEN, TRAVELERS INSURANCE

The Appeals Board rescinded the original decision, finding that the WCJ erred in admitting a supplemental AME report and authorizing spinal surgery based on it. The Board determined that the proper procedure under Labor Code sections 4610 and 4062 for disputing spinal surgery recommendations was not followed. Specifically, the medical opinions from Dr. Jones and Dr. Pappas were found to be based on inadequate reviews of the applicant's medical records, necessitating further development of the record. Consequently, the case was returned to the trial level for additional proceedings and a new decision.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardIndustrial InjurySpinal SurgeryAgreed Medical Examination (AME)Utilization Review (UR)Labor Code Section 4610Labor Code Section 4062Second Opinion Report
References
5
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