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

Case No. Appellate Division Docket No. 2022-000000
Regular Panel Decision
Oct 26, 2023

Matter of Howard v. Facilities Maintenance Corporation

Shamira Bell appealed a Workers' Compensation Board (WCB) decision regarding reimbursement for lost wage payments from the Special Disability Fund. The WCB had determined that the employer's application for reimbursement was untimely, filed more than two years after the final decision that the case was subject to Workers' Compensation Law § 15 (8) (d). The Appellate Division affirmed the WCB's decision, rejecting Bell's argument that the two-year period for filing a claim under Workers' Compensation Law § 15 (8) (d) should commence only after a final administrative award determined the total reimbursement amount. The court clarified that the two-year period begins upon the Board's final determination that the case falls under the specified section of the Workers' Compensation Law. In this instance, the Board's August 2019 decision established this final determination, rendering the employer's July 2022 reimbursement application untimely.

Workers' Compensation LawSpecial Disability FundReimbursement ClaimTimeliness of ApplicationWorkers' Compensation BoardAppellate DivisionSection 15 (8) (d)Final DeterminationLost Wage PaymentsStatutory Interpretation
References
13
Case No. ADJ4463692 (STK 0134961) ADJ2984651 (STK 0142920)
Regular
Jan 13, 2010

WILLIAM MART vs. CALAVERAS COUNTY; CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for FREMONT, In Liquidation

Defendant sought reconsideration of a WCJ's award of temporary disability benefits dating back to 2001. The Appeals Board granted reconsideration, rescinded the WCJ's decision, and deferred the issues of temporary disability and attorney fees. This action was based on precedent holding that jurisdiction to award temporary disability beyond the five-year limit exists if a timely petition to reopen for new and further disability was filed and the disability arose within that five-year period. The matter is returned to the trial level for further proceedings and clarification regarding specific periods of temporary disability, considering Labor Code section 4656(b).

Workers' Compensation Appeals BoardReconsiderationTemporary DisabilityPetition to ReopenNew and Further DisabilityLabor Code Section 5410Labor Code Section 5803Labor Code Section 5804Sarabi v Workers' Comp. Appeals Bd.Independent Medical Examiner (IME)
References
3
Case No. GRO 0022416
Regular
Mar 24, 2008

GERALD RICE vs. ALASCO RUBBER & PLASTICS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, CAMBRIDGE INTEGRATED SERVICES GROUP, FREMONT COMPENSATION INSURANCE COMPANY, NATIONAL SURETY/FIREMAN'S FUND

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior decision. The Board found that the California Insurance Guarantee Association (CIGA) is solely liable for the applicant's industrial injury benefits. This is because the insolvent insurer, Fremont Compensation Insurance Company, was the only insurer on the risk during the one-year period preceding the applicant's cumulative trauma injury.

WORKERS' COMPENSATION APPEALS BOARDCIGAFREMONT COMPENSATION INSURANCE COMPANYINSOLVENCYLIQUIDATIONCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONNATIONAL SURETY/FIREMAN'S FUNDALASCO RUBBER & PLASTICSLABOR CODE SECTION 5500.5CUMULATIVE TRAUMA INJURY
References
1
Case No. SRO 112972
Regular
Jun 12, 2008

STELLA JUAREZ vs. ARTERIAL VASCULAR ENGINEERING, NELSON STAFFING, CENTRE INSURANCE COMPANY by REM, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION by BROADSPIRE for CALIFORNIA COMPENSATION INSURANCE COMPANY, in liquidation

The California Insurance Guarantee Association (CIGA) has the right to seek contribution from Centre Insurance Company for workers' compensation benefits paid to an applicant with a cumulative trauma injury. CIGA's claim is not barred by the one-year limitation period for employer contribution claims under Labor Code section 5500.5(e), as CIGA is not an employer and Centre is considered "other insurance" under Insurance Code section 1063.1(c)(9). Therefore, the Appeals Board granted CIGA's petition for reconsideration and reversed the arbitrator's decision, awarding CIGA contribution from Centre.

CIGAContributionReconsiderationFindings Award and OrderLabor Code section 5500.5Insurance Code section 1063.1(c)(9)Cumulative TraumaGeneral EmployerSpecial EmployerOther Insurance
References
8
Case No. MISSING
Regular Panel Decision

Merrill Lynch, Pierce, Fenner & Smith, Inc. v. Sumi Ohnuma

This case involves Merrill Lynch seeking to permanently stay arbitration proceedings initiated by respondents before the National Association of Securities Dealers (NASD). The core issue is determining when a limited partnership investment is "acquired" for the purpose of a six-year arbitration eligibility period under NASD Code section 15. Merrill Lynch argued the "trade date" controlled, while respondents contended it was the "settlement date," the "effective date" of the partnership, or a later date of alleged misrepresentation. The court ultimately held that the "trade date," when respondents irrevocably committed to purchase, initiated the six-year period, thus barring their arbitration claims as they were filed beyond this timeframe. The court also rejected the respondents' arguments based on collateral, equitable, and judicial estoppel.

Arbitration EligibilityNASD Code Section 15Statute of LimitationsTrade DateSettlement DateLimited Partnership InvestmentsSecurities ArbitrationFraudulent ConcealmentCollateral EstoppelEquitable Estoppel
References
23
Case No. ADJ1932035 (ANA 0234626) ADJ2673288 (ANA 0234627) ADJ4019770 (ANA 0234628)
Regular
Jun 15, 2009

Elmer Bourland vs. LONG BEACH MEMORIAL MEDICAL CENTER

The Workers' Compensation Appeals Board denied reconsideration, upholding a prior order for a lifetime annuity of $900 per month. Defendant argued the original compromise and release agreement intended only a 15-year guaranteed payment period, not a lifetime annuity. However, the Board found the 1992 Order approving the settlement explicitly stated "lifetime annuity" and was not timely challenged by defendant. As no good cause such as fraud or mutual mistake was shown, the 1992 Order is now final and binding.

WORKERS' COMPENSATION APPEALS BOARDELMER BOURLANDLONG BEACH MEMORIAL MEDICAL CENTERTRISTAR RISK MANAGEMENTFindings and Orderlifetime annuityCompromise & Releaseindustrial injuryright kneeinternal system
References
14
Case No. MISSING
Regular Panel Decision
Jun 15, 1999

In re the Arbitration between State Insurance Fund & Country-Wide Insurance

The Supreme Court, New York County, affirmed an order dated June 15, 1999. This order granted a workers' compensation insurer's application to vacate an arbitration award that had denied its claim against an automobile liability insurer as time-barred. The court also denied the automobile insurer's cross-motion to confirm the award. The case was remanded for a rehearing on the workers' compensation insurer's claim for payments made to an injured worker within the three-year Statute of Limitations, commencing from December 4, 1994, the date of the arbitration proceeding. The court found that the arbitrator's acceptance of the Statute of Limitations defense was arbitrary and capricious, as precedent establishes a three-year limitation period from the date of the first payment, not the date of injury, only precluding recovery of payments made more than three years prior to the commencement of suit.

Automobile LiabilityArbitration Award VacatedStatute of Limitations DefenseJudicial Review StandardArbitrary and Capricious RulingInter-insurer ClaimRemand for RehearingAppellate AffirmationLegal PrecedentClaim Timeliness
References
2
Case No. MISSING
Regular Panel Decision

Kelly v. Cesarano, Haque & Khan, P. C.

Plaintiff sued an accounting firm for malpractice, alleging negligent advice regarding estate taxes which led her to pay $32,761. The defendant moved to dismiss the action, arguing it was barred by the three-year Statute of Limitations (CPLR 214 [6]). The plaintiff's claim accrued on April 14, 1994, before the amendment to CPLR 214 (6) which shortened the limitation period from six to three years for such claims. While prior rulings allowed a six-year period if the suit was commenced before the amendment's effective date, the court found the plaintiff's filing on October 29, 1997, was untimely. The court determined that even with a reasonable grace period post-amendment, the plaintiff failed to file within the three-year limit or a reasonable six-month window after the amendment's effective date, thus granting the defendant's motion to dismiss.

Accountant MalpracticeStatute of LimitationsCPLR 214 (6) AmendmentBreach of ContractNegligence ClaimEstate Tax LiabilityMotion to DismissTimeliness of ActionRetroactive ApplicationDue Process Considerations
References
12
Case No. MISSING
Regular Panel Decision

Cook v. Pension Benefit Guarantee Corp.

The Trustees of the Local 852 General Warehouseman’s Union Pension Fund sued the Pension Benefit Guarantee Corporation (PBGC) seeking reimbursement for pension benefits paid to retirees of two closed warehouses. The Fund argued for recovery based on equitable estoppel, asserting detrimental reliance on an initial PBGC determination that it would guarantee these benefits. The PBGC moved for summary judgment, contending that estoppel against a federal agency requires a showing of affirmative misconduct or manifest injustice. The Court found no evidence of affirmative misconduct by the PBGC and concluded that its change in determination, made to conform with Congressional intent, did not constitute manifest injustice. Consequently, the Court granted the PBGC's motion for summary judgment, ruling that equitable estoppel was inapplicable.

Equitable EstoppelFederal Agency EstoppelSummary JudgmentERISAPension BenefitsMulti-employer PlanPension Benefit Guarantee Corporation (PBGC)Affirmative MisconductManifest InjusticeDetrimental Reliance
References
10
Case No. MISSING
Regular Panel Decision

MacTaggart v. Gibbs & Cox. Inc.

This appeal concerns the dismissal of an action for failure to prosecute for over five years. The plaintiffs' primary excuse for the delay was their involvement in another litigation concerning similar issues. However, the court found that the issues in the two cases were not identical, and a significant period of a year and a half elapsed after the conclusion of the prior litigation without any further action on the present case. The court also considered the prejudice to the defendant, noting the difficulty and impracticability of recouping extra costs from clients related to contracts completed between February 1944 and December 1945. Consequently, the court affirmed the dismissal of the action.

failure to prosecutedismissal of actionappellate reviewdiscretionary powerprejudice to defendantdelay in litigationstipulationsamended complaintnote of issueextra compensation
References
1
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