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

Case No. 2021-06-0210
Regular Panel Decision
Mar 27, 2024

Dawson, Beandy v. Optum services, Inc.

Brandy Dawson, a nurse for Optum Services, Inc., sustained injuries in June 2019 after a fall. While Optum accepted the initial claim, Dawson later developed symptoms consistent with thoracic outlet syndrome, which her authorized physicians struggled to diagnose or relate to her employment. Despite an authorized physician's referral to a brachial plexus specialist, Optum denied further specialized treatment. Dawson sought her own expert, Dr. Robert Thompson, who diagnosed neurogenic thoracic outlet syndrome and causally linked it to her work fall, recommending surgery. The Court found Dr. Thompson's opinion compelling, concluding that Dawson's thoracic outlet syndrome is work-related and that Optum unjustly denied treatment, thus granting medical treatment with Dr. Thompson and temporary total disability benefits.

Thoracic Outlet SyndromeNeurogenic TOSBrachial Plexus InjuryWork-Related InjuryMedical Treatment DisputeTemporary Disability BenefitsExpert Medical OpinionCausationPhysician ReferralDenial of Benefits
References
5
Case No. ADJ9709726
Regular
Jun 25, 2015

LAURA NUNEZ vs. SUTTER PACIFIC MEDICAL FOUNDATION, SUTTER HEALTH

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The defendant challenged the finding of industrial injury AOE/COE for thoracic outlet syndrome, arguing it wasn't an issue for trial and the medical evidence was insufficient. The Board found that thoracic spine injury was an issue and that Dr. Avery's opinion provided substantial medical evidence to support the thoracic outlet syndrome finding. Any potential defects in the original WCJ opinion were cured by the WCJ's subsequent report.

Thoracic outlet syndromeAOE/COEPetition for Reconsiderationsubstantial medical evidenceG. James Avery M.D.Steven Bratman M.D.industrial injuryapportionmentWCJlabor code 5313
References
1
Case No. MISSING
Regular Panel Decision

Smith v. Smith's Transfer Corp.

The employer appealed a trial court's award of forty-five percent permanent partial disability and other worker’s compensation benefits to a typist, Mrs. Smith. Mrs. Smith developed thoracic outlet syndrome, experiencing symptoms aggravated by her work activities. The employer argued that the action was barred by the statute of limitations, there was no injury by accident arising out of and in the course of employment, and medical proof did not establish permanent impairment. The Supreme Court of Tennessee reversed the trial court's decision, finding that while Mrs. Smith’s work aggravated her pre-existing condition by increasing pain, it did not cause or advance the severity of her thoracic outlet syndrome or result in any other disabling condition. Therefore, her condition did not constitute an "injury by accident" under the Worker’s Compensation Act.

Worker's CompensationThoracic Outlet SyndromeCarpal Tunnel SyndromeOccupational AggravationPre-existing ConditionStatute of LimitationsMedical CausationPain as DisabilityTennessee Supreme CourtReversed Judgment
References
4
Case No. ADJ3361459
Regular
Oct 15, 2012

Christiane Flynn vs. YOLANDA'S OF VENTURA, AMERICAN HOME ASSURANCE CO.

The Workers' Compensation Appeals Board granted reconsideration and amended its prior decision regarding Christiane Flynn's injury. The applicant sustained injuries including right shoulder, brachial nerve, upper extremities, thoracic outlet syndrome, complex regional pain syndrome, psyche, and fibromyalgia. Her permanent disability was found to be 100% total, entitling her to weekly indemnity payments. A substantial attorney fee of $47,451.89 was deemed reasonable and ordered payable.

Christiane FlynnYolanda's of VenturaAmerican Home AssuranceAIG Claim ServicesADJ3361459VEN 0112129ReconsiderationAdministrative Law JudgeWaitressOccupational Group 322
References
0
Case No. MISSING
Regular Panel Decision
Jun 25, 2001

Claim of Ritton v. AT&T—New York

Claimant appealed an amended Workers' Compensation Board decision concerning her disability rate. She had established occupational diseases including bilateral carpal tunnel syndrome, myofascial pain syndrome, thoracic outlet, and neck, arm, and shoulder injuries. Initially receiving total disability benefits, the Board later found only a mild to moderate disability for the period from March 1998 to September 1999, crediting the employer's physician, Syed Ehtisham, over the claimant's physician, Michael Lax. The court affirmed the Board's decision, finding substantial evidence to support the mild to moderate disability finding and upholding the Board's authority in resolving conflicting medical opinions.

Workers' CompensationDisability BenefitsCarpal Tunnel SyndromeMyofascial Pain SyndromeThoracic Outlet SyndromeMedical TestimonyConflicting Medical EvidenceAppellate ReviewCredibility DeterminationOccupational Disease
References
2
Case No. MISSING
Regular Panel Decision

Matter of Bland v. Gellman, Brydges & Schroff

This case involves consolidated appeals from several decisions by the Workers’ Compensation Board concerning a claimant. The appeals address issues such as a variance request for aquatic therapy for thoracic outlet syndrome, the causal relationship of fibromyalgia and myofascial pain syndrome, the degree of partial impairment and loss of wage-earning capacity, entitlement to Botox therapy for migraines, and reimbursement for medical and travel expenses. The Court affirmed the Board's findings regarding the application of Shoulder Injury Medical Treatment Guidelines, the denial of aquatic therapy, the lack of causal relationship for fibromyalgia, the 50% loss of wage-earning capacity, and the denial of reconsideration for medical/travel expenses and labor market attachment. One appeal related to fibromyalgia care and Botox therapy was dismissed as the claimant was no longer aggrieved.

Workers' CompensationAppellate ReviewAquatic TherapyThoracic Outlet SyndromeFibromyalgiaMyofascial Pain SyndromeWage-Earning CapacityMedical Treatment GuidelinesVariance RequestReconsideration
References
23
Case No. 2020-08-0327
Regular Panel Decision
Sep 20, 2024

Hardy, Michelle v. Ollie's Bargain Outlet, Inc.

Michelle Hardy, an employee, suffered an arm injury leading to complex regional pain syndrome. She selected Dr. Greg Kyser for psychiatric treatment, but her care was terminated due to the carrier, PA Manufacturers Indem. Co., failing to pay bills and refusing an updated agreement. Hardy requested continued treatment with Dr. Kyser, but the Court denied this, ruling it lacked authority to compel the carrier to meet Kyser's demands. The Court ordered Hardy to choose a new physician from a panel offered by Ollie's Bargain Outlet, Inc. in June 2024. Furthermore, the Court referred Ollie's for penalties due to delayed payment and failure to timely offer a new physician panel, also granting attorney's fees to Hardy's counsel.

Workers' CompensationMedical BenefitsPhysician PanelTreatment DenialUnpaid Medical BillsPenaltiesAttorney's FeesExpedited HearingComplex Regional Pain SyndromePsychiatric Treatment
References
4
Case No. GOL 0092095
Regular
Nov 05, 2007

CINDY NICHOLSON vs. SANTA BARBARA MTD, WORKERS' COMPENSATION ADMINISTRATORS

The Workers' Compensation Appeals Board granted reconsideration and amended a finding of fact regarding the applicant's industrial injury. The amended finding clarifies that the applicant sustained injury to her neck, shoulders, and thoracic outlet syndrome, but not to her wrists or bilateral upper extremities. The Board otherwise affirmed the original decision.

Workers' Compensation Appeals BoardReconsiderationAmended Finding of FactIndustrial InjuryNeck InjuryShoulder InjuryThoracic Outlet SyndromeBus DriverDate of InjuryMedical Condition
References
0
Case No. MISSING
Regular Panel Decision

Katz v. International Ladies' Garment Workers' Union

Plaintiff Leo I. Catz, operating Helene’s Retail Outlet, seeks a temporary injunction to prevent picketing by unnamed defendants (a union). The retail outlet is located in the same building as Helene Manufacturing Co., which performs manufacturing operations for Smart Sue, Inc., a 'struck' plant. The defendants concede their picketing targets both the manufacturer and the retail outlet. The central issue is whether the retail outlet is a separate entity or has a unity of interest with Helene Manufacturing Co., thereby making the picketing lawful. The court reviews evidence regarding shared premises, employees, and financial operations, suggesting an integrated business. Ultimately, the court denies the injunction, citing arguable federal pre-emption by the National Labor Relations Board due to the involvement of interstate commerce, thus limiting the state court's jurisdiction. The court also found the picketing to be reasonable, peaceful, and not misleading.

Labor disputePicketingInjunctionSecondary boycottUnity of interestFederal pre-emptionNational Labor Relations BoardRetail outletManufacturingJurisdiction
References
7
Case No. ADJ7420955, ADJ6424323
Regular
Sep 13, 2016

WBC UNIVERSAL vs. ELECTRIC INSURANCE COMPANY, SEDGWICK CMS

This case involves a petition for reconsideration of a Workers' Compensation Appeals Board award. The applicant sought to include permanent disability ratings for his right knee and meralgia paresthetica of the groin, which were denied by the WCJ. The Agreed Medical Evaluator (AME) determined that while the applicant's October 2009 injury exacerbated his right knee, prior injuries were the cause of permanent disability. The AME also opined that the meralgia paresthetica was due to complications of thoracic outlet syndrome, unrelated to the claimed industrial injury. Therefore, the Board denied the applicant's petition for reconsideration.

Workers' Compensation Appeals BoardFindings and AwardReconsiderationAgreed Medical EvaluatorAOE/COEPermanent DisabilityMeralgia ParestheticaThoracic Outlet SyndromeIndustrial ExacerbationPrior Injuries
References
0
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