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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

Claim of Estrada v. Peepels Mechanical Corp.

The claimant's case was established for occupational disease resulting in bilateral hearing loss. A Workers’ Compensation Law Judge (WCLJ) determined the date of disablement and, after initial discharge, reinstated the State Insurance Fund (Fund) to produce an apportionment report between occupational disease and traumatic hearing loss. The Fund appealed this decision. The Workers’ Compensation Board subsequently found the Fund was not the proper party as it did not cover the employer on the date of disablement and reversed the order for the apportionment report. The employer and its workers’ compensation carrier then appealed the Board's decision. The higher court affirmed the Board’s decision, noting that a claim for traumatic hearing loss was never formally made or pending before the Board.

Occupational DiseaseBilateral Hearing LossApportionmentDate of DisablementWorkers' Compensation CarrierState Insurance FundBoard DecisionAppellate ReviewTraumatic Hearing LossWCLJ Decision
References
1
Case No. MISSING
Regular Panel Decision
May 20, 1996

Roman v. 1185 Avenue of the Americas Associates

This case involves an appeal from an order granting the plaintiff, Victor Roman, leave to amend his bill of particulars to include additional injuries. Roman filed an action in 1989 for injuries sustained in a 1987 job site accident, initially alleging traumatic degenerative arthritis and torn muscles in his left hip. After undergoing hip replacement surgeries in 1992 and 1994, a stipulation was made in 1994 with defendant A.J. Contracting Co., allowing for further discovery if the hip surgeries were later alleged to be causally related. In 1996, Roman moved to amend his bill of particulars to include these surgeries, supported by proof of workers' compensation coverage due to the causal connection. The court granted this motion, and the appellate court affirmed, citing the policy of freely allowing amendments in the absence of prejudice, which the defendants failed to demonstrate.

Personal injurySlip and fallConstruction accidentHip replacementBill of particularsLeave to amendStipulationCausal connectionWorkers' compensationPrejudice
References
1
Case No. ADJ8032740
Regular
Sep 17, 2014

LAURA RAMIREZ vs. LOYOLA MARYMOUNT UNIVERSITY, TRAVELERS

This case involved a custodian injured on the job, causing admitted industrial injury to her knee and lumbar spine. The Administrative Law Judge apportioned 50% of the permanent disability to pre-existing arthritis, a decision the applicant contested. The Workers' Compensation Appeals Board denied reconsideration, finding the apportionment supported by medical evidence indicating the industrial injury and pre-existing arthritis jointly necessitated knee replacement surgery. This aligns with precedent requiring apportionment to all causative factors, including underlying pathology.

ApportionmentPre-existing arthritisIndustrial injuryPermanent disabilityWCJPetition for reconsiderationLabor Code 4663PQMEOrthopaedic surgeonArthroplasty
References
4
Case No. WCK 0067792
Regular
Sep 20, 2007

ERNEST J. WILLIAMS vs. PINKERTON SECURITY, ESIS

This case involves an applicant who sustained an industrial injury to his right knee. The defendant sought reconsideration of the original award, arguing the judge erred in denying credit for temporary disability overpayments and in failing to apportion permanent disability to pre-existing arthritis. The Appeals Board granted reconsideration, rescinded the original award, and returned the matter for further proceedings. The Board found that apportionment to prior arthritis, even if it necessitated knee replacement surgery, is required under current law and that the Agreed Medical Evaluator's opinion on apportionment was sufficient.

WCABPinkerton SecurityErnest J. Williamsindustrial injuryright lower extremitypermanent disabilityapportionmenttemporary disability overpaymentAgreed Medical EvaluatorAME
References
8
Case No. MISSING
Regular Panel Decision

Claim of Guess v. Finger Lakes Ambulance

The claimant, a paramedic, suffered from post-traumatic stress disorder after responding to a fatal industrial accident where a victim conversed with her before succumbing to horrific injuries. While a Workers' Compensation Law Judge initially found the injury accidental, the Workers' Compensation Board later disallowed the claim, asserting that the stress was not greater than what a paramedic typically experiences. The appellate court affirmed the Board's decision, citing evidence that paramedics are routinely exposed to traumatic events. This ruling emphasizes that for a mental injury from psychic trauma to be compensable, the stress must exceed that of a similarly situated worker's normal work environment.

Post-Traumatic Stress DisorderParamedicAccidental InjuryPsychic TraumaWorkers' Compensation BenefitsStress-Related InjuryNormal Work EnvironmentTraumatic Event ExposureMental Injury CompensabilityAppellate Review
References
8
Case No. MISSING
Regular Panel Decision

Ornstein v. New York City Health & Hospitals Corp.

This case addresses the viability of claims for emotional and psychological injury, specifically AIDS phobia and post-traumatic stress disorder, following an HIV exposure. The plaintiff, a nurse, was accidentally pricked by a contaminated needle and subsequently developed severe emotional distress. The Supreme Court had allowed her claims for post-traumatic stress disorder to extend beyond the established six-month limitation for AIDS phobia. However, this appellate court reversed that decision, ruling that all related emotional damages must adhere to the six-month period, based on the scientific consensus regarding the likelihood of HIV infection detection.

AIDS PhobiaHIV ExposureEmotional DistressPost-Traumatic Stress DisorderNegligent Infliction of Emotional DistressSix-Month Limitation RuleMedical ConsensusObjective StandardNeedle Stick InjuryWorkers' Compensation Psychiatrist
References
19
Case No. MISSING
Regular Panel Decision
Nov 30, 2015

Claim of Gramza v. Buffalo Board of Education

Claimant, a teacher, sustained a work-related injury to his left shoulder and neck in 2005 and was subsequently classified with a permanent partial disability. The employer sought reimbursement from the Special Disability Fund, citing the claimant's preexisting medical conditions, including rheumatoid arthritis and hypertension. The Workers' Compensation Board granted this application, prompting an appeal from the Fund. The court affirmed the Board's decision, finding substantial evidence that the claimant's rheumatoid arthritis was a permanent condition restricting hand use and hindering general employability. An independent medical reviewer's opinion further supported that the claimant's overall disability was significantly greater due to the combined effect of both conditions.

Workers' CompensationSpecial Disability FundReimbursementPreexisting ImpairmentRheumatoid ArthritisPermanent Partial DisabilityMaterially and Substantially Greater DisabilityGeneral EmployabilityIndependent Medical ReviewerAppellate Division
References
6
Case No. MISSING
Regular Panel Decision
Mar 01, 2006

Sanchez v. City of New York

The Supreme Court, New York County, denied plaintiffs’ motion to vacate a settlement pertaining to an infant plaintiff's emotional injuries. The appellate court unanimously affirmed this denial. Plaintiffs, including the infant's guardian, claimed they only discovered the true extent of the infant's emotional injuries, including post-traumatic stress syndrome, in the summer of 2005 following an examination by a social worker. However, the court found that these psychological injuries were known from the case's inception in 2001 and were appropriately considered when the settlement was agreed upon in December 2004. Evidence, including a 2001 psychiatric evaluation, confirmed the infant's diagnosis of post-traumatic stress disorder prior to the settlement agreement.

Settlement DisputeInfant's RightsPost-Traumatic Stress DisorderVacating SettlementCompromise OrderPsychological HarmSearch Warrant ExecutionAppellate AffirmationParental GuardianJudicial Discretion
References
2
Case No. 2021 NY Slip Op 04075
Regular Panel Decision
Jun 24, 2021

Matter of Traverso v. DiNapoli

Petitioner Manuel Traverso Jr., a former State Police investigator, sought accidental disability retirement benefits due to post-traumatic stress disorder, manic depression, and anxiety stemming from his dangerous undercover narcotics work. His duties involved interacting with drug cartels and informants, exposing him to traumatic events. After a panic attack in 2015, he was diagnosed and deemed unable to work, leading to his application for benefits. The New York State and Local Retirement System and subsequently the Comptroller denied his application, ruling that his disability was not the result of an 'accident' as defined by Retirement and Social Security Law § 363, but rather from the inherent risks of his job. The Appellate Division, Third Department, confirmed the Comptroller's determination, finding substantial evidence that the stress causing his mental injuries was an ordinary part of his duties. Consequently, the court dismissed his petition, affirming that his injuries were not accidental.

Accidental Disability Retirement BenefitsPost-Traumatic Stress DisorderUndercover Narcotics InvestigatorState PoliceRetirement and Social Security LawCPLR Article 78 ProceedingComptroller's DeterminationSubstantial EvidenceOrdinary Course of Job DutiesMental Injuries
References
10
Case No. GRO 0029816, GRO 0029817
Significant

Marlene Escobedo vs. Marshalls, CNA Insurance Co.

The Appeals Board affirmed the WCJ's decision to apportion 50% of the applicant's permanent disability to a preexisting degenerative arthritis, holding that Labor Code section 4663, as amended by SB 899, permits apportionment based on causation from non-industrial factors supported by substantial medical evidence.

SB 899apportionmentcausationpermanent disabilitypreexisting arthritismedical evidencesubstantial evidenceLabor Code section 4663compensable consequenceQME
References
58
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