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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

Colindres v. Carpenito

Plaintiff Rochelle Colindres sought a protective order to deny defendants' demand for a medical report from her former treating psychologist, Diane Henry, or alternatively, relief from compliance with Uniform Rules for Trial Courts § 202.17(b)(1). Colindres argued that the defendants waived their right to the report as the independent medical examination (IME) already occurred, and that obtaining the report would be an undue hardship since Henry ceased treatment due to Colindres' attendance issues. Defendants Mario Carpenito, Jr., City of White Plains, and White Plains Parking Department opposed, asserting that the report was necessary to clarify alleged injuries, prepare for cross-examination, and facilitate settlement, highlighting Colindres' complex medical history predating the incident. The court denied both branches of Colindres' motion, finding that the rule applies broadly to personal injury actions, defendants did not waive their entitlement, and Colindres failed to prove it was impossible to obtain the report. The court ordered Colindres to exchange a compliant medical report from Diane Henry by March 27, 2017.

protective ordermedical report disclosurediscovery disputepsychological treatmentindependent medical examinationCPLR 310322 NYCRR 202.17waiver of discoveryundue hardshippersonal injury damages
References
12
Case No. MISSING
Regular Panel Decision

Claim of Clark v. Siara Management, Inc.

Claimant, a custodian, sustained two work-related injuries in 2000, and his workers' compensation benefits were approved. In 2003, the employer's workers' compensation carrier requested an independent medical examination (IME) by Charles Totero. Claimant moved to preclude Totero's report, arguing it was improperly mailed by UMC Medical Consultants, EC., an IME services company, instead of Totero himself, in violation of Workers' Compensation Law § 137. Both a Workers' Compensation Law Judge and the Board denied the motion, finding UMC, as Totero's direct employer and a registered IME company, was authorized to perform administrative services like mailing reports under 12 NYCRR 300.2 (e) (1). The appellate court affirmed the decision, concluding that the submission substantially complied with statutory requirements.

IME Report AdmissibilityWorkers' Compensation Law § 137Procedural ComplianceMedical Report MailingIME Services CompanyAppellate AffirmationStatutory InterpretationIndependent Medical Examiner12 NYCRR 300.2
References
1
Case No. MISSING
Regular Panel Decision

Claim of Coratti v. Jon Josef Hair & Colour Group

The Workers' Compensation Board denied a claimant's motion to preclude a workers’ compensation carrier’s consultant report, which was based solely on a review of medical records, not an independent medical examination (IME). The claimant argued non-compliance with Workers’ Compensation Law § 137 (1) (b), a provision requiring notice if an IME is performed. The Board concluded the statute does not apply to records-review-only reports. An appellate court affirmed, holding that the plain language of § 137 (1) (b) explicitly refers to practitioners who have performed or will perform an IME, thereby excluding those who solely review records. The court emphasized that statutory interpretation must adhere to plain language, leaving policy arguments to the Legislature.

IME reportsrecords reviewWorkers' Compensation Lawstatutory interpretationpreclusion motioncausationoccupational illnessdue processlegislative intent
References
3
Case No. ADJ1700793 (SAC 0307437) ADJ3714832 (SAC 0307399)
Regular
Jun 13, 2011

JUANITA BRADLEY (Deceased) vs. COUNTY OF PLACER

This case involves a dispute over liability for a medical-legal report cost. The defendant seeks reconsideration of a prior award holding them responsible for Dr. Adelberg's $4,237.50 report. The defendant argues the judge ignored a prior order for an Agreed Medical Evaluation (AME) and that the applicant's attorney improperly proceeded with Dr. Adelberg's exam. The Board granted reconsideration, preliminarily finding it may be inequitable to place the full cost on the defendant, and intends to split the expense between the defendant and applicant's attorney. A dissenting opinion argues the defendant's own correspondence shows an ongoing dispute regarding the AME, supporting the original award of liability.

Workers' Compensation Appeals BoardReconsiderationMedical-Legal ReportAgreed Medical EvaluationQualified Medical EvaluatorJoint Findings and AwardLabor Code Section 4062(a)Stipulation and OrderEquitable PowersLien Claimant
References
1
Case No. ADJ6704462
Regular
Sep 26, 2013

GÉRARDO ALVAREZ vs. SC ASSOCIATES, INC., STATE COMPENSATION INSURANCE FUND

This case involves a defendant's petition for removal challenging an order for supplemental medical reports. The Appeals Board denied removal, holding that the WCJ acted appropriately in allowing QME reports to be supplemented due to potential deficiencies in their adherence to regulations concerning the review of prior medical records and reporting of information considered. The Board found that the alleged non-compliance with specific procedural rules related to report preparation does not automatically render the reports inadmissible, and that further development of the record is permissible when no substantial evidence exists. Furthermore, the defendant failed to demonstrate irreparable harm or substantial prejudice required for the extraordinary remedy of removal.

Petition for RemovalOrder Re Supplemental ReportsDr. Ronald ZlotolowDr. Noel LustigQME reportsLabor Code Section 4628WCAB Rule 10606medical-legal reportinadmissibilityprior medical records
References
4
Case No. MISSING
Regular Panel Decision
Jul 07, 2004

Claim of Stoudenmyre v. Loretto Rest Nursing Home

Claimant, a personal care aide, sustained a foot injury and her workers' compensation claim was established. Subsequently, an independent medical examination (IME) report was requested to address permanency. Claimant moved to preclude the IME report, arguing it was improperly mailed by Brookside Consultants, Inc., an IME services company, instead of the physician, violating Workers' Compensation Law § 137. The Workers' Compensation Law Judge denied the motion, which the Board affirmed. This Court affirmed the Board's decision, ruling that properly registered IME services companies are authorized to perform administrative functions like mailing reports, thereby substantially complying with Workers' Compensation Law § 137, as established in Matter of Clark v Siara Mgt., Inc.

IME reportmailing proceduresWorkers' Compensation Lawadministrative functionspermanency of injuryindependent medical examinationmedical reportsreport submissionappellate reviewBoard affirmation
References
1
Case No. ADJ1471935 (LAO 0872244)
Regular
Mar 26, 2014

JESUS RIOS vs. BRYAN JONES dba THE K GROUP, TOKIO MARINE, UNISURED EMPLOYERS BENEFITS TRUST FUND

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to determine the admissibility of evidence obtained after the Mandatory Settlement Conference (MSC). The applicant sought to introduce supplemental medical reports from previously seen physicians and reports from new medical and vocational experts, arguing his condition worsened and the existing record was inadequate. The WCAB held that supplemental reports from the applicant's original physicians were admissible under Labor Code section 5502(d)(3) due to a changed condition, but reports from newly disclosed physicians and vocational experts were not. The majority affirmed the WCJ's decision to exclude the latter evidence, finding the applicant failed to demonstrate good cause or due diligence in obtaining it prior to the MSC.

Mandatory Settlement Conferencediscovery closurereopen recordsupplemental medical reportsvocational expertdue diligencegood causepermanent and stationaryAMA Guidesloss of earnings capacity
References
7
Case No. MISSING
Regular Panel Decision
Feb 21, 2006

Rivera v. Barnhart

Plaintiff Russell Rivera, Jr. challenged the Commissioner of Social Security's decision denying him Supplemental Security Income (SSI) benefits. The case was referred to Magistrate Judge Frank Maas, who issued a Report and Recommendation to remand the action for further administrative proceedings, citing deficiencies in the plaintiff's hearing. After defendant objected to a time limit, an Amended Report and Recommendation was issued, omitting the disputed time limitation. District Judge Richard J. Holwell, finding no clear error, adopted the Amended Report in its entirety, granting the Commissioner’s motion. The court's decision was based on the Administrative Law Judge's failure to fully develop the administrative record and adequately consider the treating physician’s opinion, Dr. Asbury, whose findings differed from a nonexamining medical consultant.

Social Security BenefitsSupplemental Security IncomeDisability DeterminationAdministrative Law Judge (ALJ) ReviewRemand OrderTreating Physician RuleMedical AssessmentHIV/AIDS ImpairmentHepatitis C DiagnosisProcedural Error
References
15
Case No. ADJ6950792
Regular
Sep 01, 2015

LILLIAN DUNN vs. COUNTY OF SAN BERNARDINO

This case concerns a petition for reconsideration and removal from a Workers' Compensation Appeals Board order. The Board denied the petition, adopting the reasoning of the Workers' Compensation Administrative Law Judge (WCJ). The WCJ determined that a Qualified Medical Examiner's (QME) report was not substantial evidence due to a failure to issue a supplemental report after reviewing additional medical records. Because the QME was unavailable to provide a supplemental report, the WCJ ordered a replacement QME, a decision upheld by the Board.

Workers' Compensation Appeals BoardPetition for ReconsiderationRemovalReplacement PanelQualified Medical ExaminerQMESupplemental ReportLabor Code Section 4062.5Rule 38Apportionment
References
1
Case No. MISSING
Regular Panel Decision

Perez v. Brookdale University Hospital & Medical Center

Eulalia Perez was admitted to Brookdale University Hospital on November 16, 2010, and treated for various medical conditions before being discharged on December 7. She died two days later. Her family, Ivan and Irma Perez, sued Brookdale and other defendants, alleging a violation of the Emergency Medical Treatment and Active Labor Act (EMTALA) and state-law claims of wrongful death and negligence. The court granted Brookdale's motion for summary judgment on the EMTALA claim, determining that the hospital fulfilled its EMTALA duties once Mrs. Perez was stabilized, and any subsequent issues were outside the statute's scope. Consequently, the court declined to exercise supplemental jurisdiction over the state-law claims, leading to the dismissal of all claims against all parties.

EMTALAEmergency Medical Treatment and Active Labor ActMedical MalpracticeNegligenceWrongful DeathSummary JudgmentSupplemental JurisdictionPatient DumpingHospital DischargeFederal Question Jurisdiction
References
8
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