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Case Law Database

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

Case No. 2015-260 K C
Regular Panel Decision
May 05, 2016

Telsey v. Harris Water Main & Sewer Contrs., Inc.

Jerry Telsey (plaintiff) sued Harris Water Main & Sewer Contractors, Inc. (defendant) in a small claims action for $2,800. Telsey claimed defendant should have immediately determined he didn't need a new water main, despite entering into a contract for installation. Defendant argued that subsurface plumbing issues often require excavation to identify the source of problems. The Civil Court dismissed the action, and Telsey appealed. The Appellate Term, Second Department, reviewed the case under the 'substantial justice' standard for small claims and affirmed the judgment, finding that substantial justice was done between the parties.

Small ClaimsContract DisputeWater Main InstallationSubsurface PlumbingAppellate ReviewSubstantial JusticeCivil CourtKings CountyExcavationAffirmed Judgment
References
4
Case No. MISSING
Regular Panel Decision

In re the Claim of Vasquenz

The claimant appealed a decision from the Unemployment Insurance Appeals Board, which determined he was ineligible for benefits effective January 18, 1965, due to a lack of total unemployment. The claimant, a construction worker, was a vice-president of a corporation formed by his wife, and the board found he devoted substantial time to the family business beyond his laborer duties, acting as the actual entrepreneur. The court, led by Judge Reynolds, affirmed the Board's findings, stating that the decision was supported by substantial evidence and was neither arbitrary nor capricious. Justices Gibson, Aulisi, and Staley, Jr., concurred with the decision, while Justice Taylor did not vote. The ruling highlighted the board's prerogative in interpreting "total unemployment" when supported by a rational basis.

Unemployment benefitsTotal unemploymentConstruction industryCorporate officerEntrepreneurial activitiesAppeals Board decisionSubstantial evidenceRational basisFamily businessSlack season
References
1
Case No. MISSING
Regular Panel Decision

Kaplan v. Einy

This personal injury case arose from a plaintiff's fall down an elevator shaft in a building owned by the Einy defendants. Extensive discovery disputes ensued, marked by defense counsel's obstructive conduct and refusal to provide information on topics like business entities, payroll, and post-accident repairs. Following a Special Referee's report that omitted key discovery items, Justice Moskowitz confirmed it, while Justice Miller later compelled further disclosure. The Appellate Division reversed Justice Moskowitz's order, emphasizing broad disclosure rules and the defendants' dilatory tactics, and affirmed Justice Miller's order to ensure substantial justice, finding the law of the case doctrine inapplicable due to changed circumstances.

Discovery DisputePersonal InjuryElevator AccidentReferee ReportCPLRLaw of the CasePost-Accident RepairsPhotographic EvidenceAppellate ReviewObstructive Counsel
References
18
Case No. ADJ7264915
Regular
Jul 15, 2013

ANA GONZALES vs. WAL-MART ASSOCIATES, INC., ACE AMERICAN INSURANCE

This case involves an applicant who sustained industrial psychiatric injury but whose orthopedic claims were denied due to insufficient medical evidence. The Appeals Board denied the applicant's petition for reconsideration, finding the applicant failed to present substantial medical evidence of industrial causation for her orthopedic complaints. A dissenting commissioner argued that the primary medical evaluator's report was deficient and lacked substantial evidence, warranting further development of the record on orthopedic injuries and other claims. The dissent emphasizes the Board's duty to ensure substantial justice, suggesting it should have ordered further investigation on the denied orthopedic issues.

WCABPetition for ReconsiderationFindings and Orderindustrial injurypsychelow backneckright shoulderright wristright elbow
References
11
Case No. MISSING
Regular Panel Decision

Claim of Keesler v. Dunn & McCarthy, Inc.

The dissenting opinion, written by Justice Weiss and joined by Justice Casey, concerns a workers' compensation case. The dissent focuses on whether a claimant's materially and substantially changed condition, following a 1974 lump-sum settlement, is attributable to a third accident or an earlier disability. Based on Dr. De Luca's testimony, which indicated the claimant's disability would likely have remained constant without the third accident, the dissent concludes that the new accident precipitated the change to total disability. Therefore, the dissenting justices argue that the previously closed cases should not be reopened for reapportionment under Workers’ Compensation Law § 15 [5-b].

Workers' Compensation Lawdissentapportionmentlump-sum settlementdisabilitythird accidentmedical evidencecausationreapportionment
References
3
Case No. ADJ7359029
Regular
Dec 10, 2012

CARL HAMPTON vs. NAVARRO'S TOWING, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration, rescinded a prior award, and returned the case for further development of the medical record. The applicant sought to overturn a finding that he did not sustain an industrial injury to his low back. While the applicant was found credible, there was a lack of substantial medical evidence to prove causation. The Board found a complete absence of medical reports addressing industrial causation, necessitating further proceedings to ensure substantial justice.

Industrial injuryLow back injuryReconsiderationFindings and AwardWCJSubstantial medical evidenceIndustrial causationPreponderance of the evidenceDevelop the recordAgreed medical evaluator
References
5
Case No. ADJ9800708
Regular
Aug 20, 2019

KAREN SULLIVAN vs. LOS ANGELES UNIFIED SCHOOL DISTRICT

The Workers' Compensation Appeals Board rescinded a prior Finding and Order due to insufficient evidence. The case involves a teacher claiming industrial injury to her hips and spine, with conflicting medical opinions. The Board remanded the case to the trial level to properly admit and consider additional evidence from physicians who previously reported. The ultimate goal is to develop a complete record to ensure substantial justice and a decision based on substantial evidence.

WCABPetition for RemovalFindings and OrderAOE/COEPrimary Treating PhysicianQualified Medical EvaluatorAggravationIndustrial InjuryDeposition TranscriptMedical Report
References
16
Case No. ADJ6937895
Regular
Jan 29, 2014

OSVALDO CALLEROS vs. EL CHOLO CAFÉ, EVEREST NATIONAL INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and rescinded an order dismissing a lien claimant's lien. Although the lien claimant missed a conference and filed an objection late, the Board found that the treatment was authorized by the defendant and that returning the matter to the trial level would achieve substantial justice. The Board emphasized the public policy favoring disposition of cases on their merits, and that returning the case would allow for fair and equitable resolution without substantial prejudice to the defendant.

Lien ClaimantReconsiderationOrder Dismissing LienEquitableUnjust EnrichmentAuthorized TreatmentLien ConferenceNotice of Intention to DismissObjectionSubstantial Justice
References
11
Case No. ADJ6739372 ADJ6855448
Regular
Mar 04, 2013

KIMBERLY WESLEY BOSTON vs. COUNTY OF ALAMEDA, SEDGWICK CMS

The Appeals Board rescinded a prior award, finding insufficient medical evidence to support industrial causation for the applicant's gastrointestinal injuries. Dr. Hammerman's opinion was deemed not substantial medical evidence as he did not adequately explain how he reached a causation conclusion without an initially recommended endoscopy. The case is returned to the trial level for further medical development of the record regarding gastrointestinal complaints. The Board emphasized its duty to ensure substantial justice and develop undeveloped matters.

WCABADJ6739372ADJ6855448industrial injurypsychegastrointestinal systempermanent disabilitysubstantial medical evidenceagreed medical examinerconsulting physician
References
11
Case No. ADJ10075517
Regular
Dec 15, 2017

PAUL ROYCE vs. STATE OF CALIFORNIA, Legally Uninsured

The WCAB granted reconsideration of a decision denying a workers' compensation claim for respiratory issues. While the sole medical expert found the aspergillosis to be industrial, the judge deemed the opinion lacking substantial evidence due to vagueness. The Board found it unjust to penalize the applicant with a "take nothing" order when the opinion, though flawed, was unrebutted. Therefore, the case is remanded for further medical development, potentially with an expert more specialized in aspergillosis, to ensure substantial justice and a complete record.

Workers' Compensation Appeals BoardPetition for ReconsiderationIndustrial InjuryAspergillosisChronic Obstructive Pulmonary DiseaseMedical EvidenceIndustrial CausationFurther Development of RecordAgreed Medical EvaluatorLabor Code Section 5701
References
5
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