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Case Law Database

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

Case No. ADJ2618825 (SAC 0304473)
Regular
Nov 24, 2010

WILLIAM ROSS vs. GOLDEN STATE EQUIPMENT REPAIR, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted reconsideration, rescinding a prior order that denied vocational rehabilitation benefits and a supplemental job displacement benefit. The WCAB found the applicant may have been denied due process by the Administrative Law Judge (ALJ) who issued the prior order without allowing the applicant to present evidence. While the WCAB agreed the applicant is not entitled to supplemental job displacement benefits due to the injury date, the matter is returned for further proceedings on vocational rehabilitation to determine if any vested rights exist. The WCAB also noted the ALJ erred in relieving counsel without the applicant's input.

Vocational rehabilitation benefitsSupplemental job displacement benefitLabor Code section 139.5Labor Code section 4658.5Date of injuryRepeal of benefitsDue processStatus conferenceOrder relieving counselReconsideration
References
2
Case No. MISSING
Regular Panel Decision
Jul 21, 1971

Claim of Wippert v. Peele Bros.

This appeal concerns a decision by the Workmen’s Compensation Board, which ruled that a claimant widow was entitled to supplemental benefits without deducting social security benefits received from her own earnings. The employer and insurance carrier appealed this decision. The central issue was whether social security benefits, regardless of their source, should be offset against supplemental benefits under subdivision 9 of section 25-a of the Workmen’s Compensation Law. The court found that the statute's language explicitly requires such an offset, irrespective of the social security benefits' originating source. Therefore, the court reversed the Board's determination, remitting the matter for recalculation of the supplemental benefit.

Workers' Compensation BenefitsSocial Security OffsetSupplemental AllowancesStatutory InterpretationAppellate DivisionBenefit ReductionLegislative HistoryClaimant WidowPublic PolicyBenefit Calculation
References
1
Case No. MISSING
Regular Panel Decision

Insurance Co. of State of the Pennsylvania v. Moore

This appeal addresses whether a worker's compensation carrier is entitled to a proportionate reduction in supplemental income benefits (SIBs) equal to the percentage of reduction for impairment income benefits (IIBs) for a prior compensable injury under the Texas Workers’ Compensation Act. Appellant, Insurance Company of Pennsylvania, sought an 11/17ths reduction in Appellee John H. Moore's SIBs, matching the reduction applied to his IIBs for a previous back injury. A hearing officer granted the IIB reduction but denied the SIB reduction. The trial court upheld this decision. The appellate court reversed, holding that Texas Labor Code § 408.084 is unambiguous and mandates that both IIBs and SIBs be reduced by the same proportion when contribution is warranted for a prior injury. Consequently, Appellant is entitled to an 11/17ths reduction of Appellee’s supplemental income benefits.

Workers' CompensationSupplemental Income Benefits (SIBs)Impairment Income Benefits (IIBs)Prior Compensable InjuryProportionate ReductionStatutory InterpretationTexas Labor CodeSummary JudgmentAppellate ReviewCommission Appeals Panel
References
24
Case No. ADJ9932467
Regular
Oct 16, 2017

THERESA MCFARLAND vs. REDLANDS UNIFIED SCHOOL DISTRICT

The Workers' Compensation Appeals Board denied an applicant's petition for reconsideration, affirming the WCJ's decision that "Return-To-Work" supplemental payments under Labor Code section 139.48 are not "compensation" as defined by Labor Code section 3207. Therefore, the applicant was not entitled to a second penalty under Labor Code section 5814 for the employer's delay in providing a Supplemental Job Displacement Benefit voucher, as that delay did not cause a delay in a compensable benefit. The Board found that the applicant's penalty claim for the voucher delay was already resolved and that imposing a second penalty for a non-compensable benefit delay would be unfair and against the principle of balancing justice.

Labor Code section 139.48Return-To-Work supplemental paymentscompensation definitionLabor Code section 3207Labor Code section 5814 penaltyLabor Code section 4658.7 voucherSupplemental Job Displacement Benefitcompromise and release agreementGage v. Workers' Comp. Appeals Bd.unreasonable delay
References
1
Case No. 2016-05-0727
Regular Panel Decision
Feb 28, 2017

Edwards, Malcolm S. v. Job Shoppe USA

Malcolm S. Edwards, an employee of Job Shoppe USA, filed for an expedited hearing seeking medical and temporary disability benefits for a neck injury sustained on May 10, 2016, during his second day of work. The employee, who had a history of neck problems and surgeries, alleged the injury occurred while lifting automobile seats. The Court found Edwards established a specific incident but failed to provide sufficient medical evidence to prove the incident was the primary cause of his current symptoms, thus denying temporary disability benefits. However, the Court ordered Job Shoppe to authorize a return visit to neurosurgeon Dr. Jacob Schwarz to allow him to address the question of causation, as the employer had prematurely terminated medical treatment before a definitive causation opinion was rendered.

Workers' Compensation LawExpedited HearingMedical BenefitsTemporary Disability BenefitsCausation StandardPre-existing ConditionTreating PhysicianEmployer ObligationsNeck InjuryCervical Radiculopathy
References
5
Case No. Dkt. # 6, Dkt. # 7
Regular Panel Decision
Feb 05, 2013

Crayton v. Astrue

Plaintiff appeals the denial of supplemental security income benefits by the Commissioner of Social Security. Plaintiff filed an application for Supplemental Security Income benefits in 2009, alleging inability to work due to various medical conditions. An Administrative Law Judge (ALJ) denied the application, and the Appeals Council denied review, making the ALJ's decision final. The District Court reviews the Commissioner's decision, finding that while the ALJ's assessment of exertional limitations was supported by substantial evidence, the ALJ failed to apply the Psychiatric Review Technique (PRT) in analyzing non-exertional limitations. Consequently, the court remands the matter for further proceedings consistent with its opinion, specifically for proper application of the PRT.

Supplemental Security IncomeSocial Security ActDisability BenefitsAdministrative Law JudgePsychiatric Review TechniqueRFCExertional LimitationsNon-exertional LimitationsDepressionAnxiety
References
15
Case No. ADJ11298015
Regular
May 27, 2025

Elideth Balderrama Ramirez vs. Hotcakes No 6 Inc IHOP 817, Preferred Employers San Diego

Elideth Balderrama Ramirez sought reconsideration of a WCJ's finding that she was precluded from a second Return-to-Work Supplement Program (RTWSP) benefit, despite receiving a second Supplemental Job Displacement Benefit (SJDB) voucher. The applicant contended that her second voucher was 'subsequent' to her first RTWSP payment, fulfilling an exception in Rule 17302(b). The Appeals Board clarified that the exception refers to the date of injury being subsequent, not the voucher issuance date. As the record lacked a finding on the cumulative trauma date of injury, the Board rescinded the previous order and returned the case to the trial level for this determination.

Return-to-Work Supplement ProgramSupplemental Job Displacement BenefitSJDB vouchercumulative trauma injuryspecific injurydate of injuryLabor Code section 139.48Rule 17302Rule 17309Administrative Procedures Act
References
7
Case No. SRO 0141948
Regular
Aug 08, 2008

DANIEL J. KOFFLER vs. INDEPENDENT ORDER OF FORESTERS, THE TRAVELERS CASUALTY COMPANY OF AMERICA

The Workers' Compensation Appeals Board granted reconsideration to address a defendant's claim that the judge improperly awarded vocational rehabilitation benefits. The Board found that Labor Code Section 139.5, the basis for the awarded benefits, does not apply to injuries occurring after January 1, 2004, which was the applicant's injury date. Therefore, the Board amended the Compromise and Release to delete the provision for vocational rehabilitation benefits, as the applicant had also settled any claim to supplemental job displacement benefits.

Compromise and ReleaseVocational Rehabilitation BenefitsSupplemental Job Displacement BenefitsLabor Code Section 139.5Labor Code Section 4658.5Industrial InjuryPsyche InjuryMental StressNervous SystemDate of Injury
References
0
Case No. ADJ10887310
Regular
Jan 30, 2023

OSCAR MARTINEZ vs. SECURITA AMERICA, INC., GALLAGHER BASSETT, EVEREST NATIONAL INSURANCE

The applicant, Oscar Martinez, was injured on May 3, 2017, resulting in a 3% permanent disability. He returned to his regular job duties with his employer, Securita America, Inc., but was laid off approximately five months later due to his employer's contract ending. While Martinez subsequently worked for a new employer at the same location and performing similar duties, the Board found that this did not satisfy the requirement of returning to the "same job for the same employer" for at least 12 months. Therefore, the Appeals Board amended the prior finding, ruling that Martinez is entitled to a Supplemental Job Displacement Benefit (SJDB) voucher.

Supplemental Job Displacement BenefitSJDB voucherpermanent partial disabilityemployer's dutyregular work offermodified work offeralternative work offer12-month durationRule 10133.31(c)substantial evidence
References
3
Case No. MISSING
Regular Panel Decision

Furch v. Bucci

A firefighter for the City of Binghamton sought supplemental wage benefits under General Municipal Law § 207-a, claiming arteriosclerosis and acute myocardial infarction were job-related. After initial denials and an administrative hearing, the application was again denied. The Supreme Court partially dismissed his CPLR article 78 petition but transferred a substantial evidence question to this Court. This Court affirmed due process and the non-binding nature of a workers' compensation decision regarding arteriosclerosis. However, it ruled that respondents were bound by the workers' compensation finding that the myocardial infarction was causally related to employment. Consequently, the matter was remitted to determine the petitioner's entitlement to benefits for any period of disability solely attributable to the myocardial infarction.

Firefighter benefitsGeneral Municipal Law Section 207-aWorkers' Compensation LawCPLR Article 78Myocardial InfarctionArteriosclerosisCausal RelationDue ProcessAdministrative LawRes Judicata
References
7
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