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Case Law Database

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

Case No. MISSING
Regular Panel Decision
Mar 23, 2004

Matter of Rosenblum v. New York State Workers' Compensation Bd.

This case, Matter of Rosenblum v. New York State Workers' Compensation Bd., was heard by the Court of Appeals of the State of New York. The decision was rendered on March 23, 2004. The outcome of the case was that the appeal was withdrawn and discontinued. This indicates a resolution where further judicial review was halted by the appellant.

Appeal WithdrawnDiscontinuedWorkers' CompensationCourt of AppealsNew YorkCase Resolution
References
0
Case No. MISSING
Regular Panel Decision

Ovadia v. Office of Industrial Board of Appeals

The Court of Appeals remitted *Matter of Ovadia v Office of the Indus. Bd. of Appeals* (19 NY3d 138 [2012]) back to this Court. The determination of the Industrial Board of Appeals, dated December 14, 2009, which had affirmed an order directing petitioners to pay claimants unpaid wages, was unanimously annulled. The matter has been remanded for further proceedings. These proceedings specifically involve determining whether Ovadia made an enforceable promise to pay workers for their continued work following Bruten’s disappearance and whether the workers relied on this promise by continuing to work at the construction site for six days.

AnnulmentRemandUnpaid wagesIndustrial Board of AppealsCommissioner of Department of LaborWorkers' relianceEnforceable promiseCourt of AppealsAppellate reviewLabor Law
References
1
Case No. 2017 NY Slip Op 04184 [150 AD3d 1589]
Regular Panel Decision
May 25, 2017

New York State Workers' Compensation Board v. Program Risk Management, Inc.

The New York State Workers' Compensation Board, acting as administrator and successor to the Community Residence Insurance Savings Plan, initiated legal action against various entities and individuals after the trust became severely underfunded. Defendants include Program Risk Management, Inc. (administrator), PRM Claims Services, Inc. (claims administrator), individual officers of PRM, the Board of Trustees, and Thomas Gosdeck (trust counsel). The plaintiff sought damages for claims such as breach of contract, breach of fiduciary duty, and legal malpractice. The Supreme Court's order partially dismissed some claims and denied others. On cross-appeal, the Appellate Division, Third Department, modified the Supreme Court's order, notably reversing the dismissal of several breach of fiduciary duty claims and common-law indemnification against PRMCS, while affirming denials of motions to dismiss breach of contract, legal malpractice, and unjust enrichment claims. The court's decision was influenced by recent rulings in State of N.Y. Workers' Compensation Bd. v Wang.

Workers' Compensation LawGroup Self-Insured TrustBreach of ContractBreach of Fiduciary DutyLegal MalpracticeUnjust EnrichmentStatute of LimitationsEquitable EstoppelAlter Ego LiabilityCommon-Law Indemnification
References
20
Case No. 2019 NY Slip Op 01011 [169 AD3d 1477]
Regular Panel Decision
Feb 08, 2019

Matter of Riccelli Enters., Inc. v. State of N.Y. Workers' Compensation Bd.

This case involves an appeal stemming from an order of the Supreme Court, Onondaga County, which had granted partial summary judgment to Riccelli Enterprises, Inc., et al., and 3679 River Road, Inc., et al. These parties were respondents and intervenors-respondents, respectively, while the State of New York Workers' Compensation Board and others were the appellants. The Appellate Division, Fourth Department, reviewed the appeal. However, prior to a full merits decision, the appeal was dismissed. The dismissal was a result of a stipulation of discontinuance signed by the attorneys for all parties involved on January 15, 2019.

Workers' Compensation BoardAppellate DivisionSummary JudgmentAppeal DismissalStipulation of DiscontinuanceOnondaga CountyJudiciary LawFourth DepartmentProceduralCase Dismissal
References
2
Case No. 2015-1094 K C
Regular Panel Decision
Dec 22, 2017

V.S. Care Acupuncture, P.C. v. NY Cent. Mut. Fire Ins. Co.

This case involves an appeal brought by NY Central Mutual Fire Ins. Co. against V.S. Care Acupuncture, P.C., an assignee, concerning first-party no-fault benefits. The defendant appealed an order from the Civil Court that denied its motion for summary judgment to dismiss claims for services rendered between October 2009 and February 2010. The Appellate Term found that the defendant had properly mailed denial of claim forms and established that the amounts sought by the plaintiff exceeded the applicable workers' compensation fee schedule. Consequently, the Appellate Term reversed the lower court's order and granted the defendant's motion for summary judgment, dismissing the relevant parts of the complaint.

No-Fault BenefitsSummary JudgmentAppellate ReviewFee Schedule DefenseDenial of ClaimWorkers' Compensation Fee ScheduleInsurance LawFirst-Party BenefitsAssignee RightsCivil Court Order
References
1
Case No. 2019 NY Slip Op 05833
Regular Panel Decision
Jul 25, 2019

Matter of Durham v. Wal-Mart Stores, Inc.

Claimant Esther J. Durham suffered work-related injuries, prompting her employer, Wal-Mart Stores, Inc., to seek reimbursement from the Special Disability Fund, alleging preexisting conditions contributing to her disability. A Workers' Compensation Law Judge initially approved the reimbursement claim, but the Workers' Compensation Board later reversed, citing statutory bars on evidence submission and insufficient medical proof from the employer. On appeal, the Appellate Division, Third Department, affirmed the Board's decision. The court agreed that the employer's pretrial conference sheet was inadmissible due to statutory deadlines and that the employer failed to demonstrate a materially and substantially greater disability as required for reimbursement, thereby discharging the Special Disability Fund from liability.

Workers' Compensation ReimbursementSpecial Disability FundPreexisting ImpairmentMaterially and Substantially Greater DisabilityPretrial Conference SheetStatutory Deadline for EvidenceMedical Proof SufficiencyWorkers' Compensation Law § 15(8)(d)Appellate ReviewEmployer Liability
References
9
Case No. ADJ19199519; ADJ19199522
Regular
Feb 18, 2025

LAURA RODRIGUEZ vs. 99 CENTS ONLY STORES, SELF-INSURER'S SECURITY FUND

The Self-Insurers' Security Fund (SISF) petitioned for reconsideration or removal of a Workers' Compensation Judge's (WCJ) order denying its joinder in a case involving injured applicant Laura Rodriguez and the bankrupt 99 Cents Only Stores. The WCJ had ruled that SISF, having assumed the insolvent employer's liabilities, only needed to file a notice of change in administrator, not a joinder petition. The Appeals Board dismissed the petition for reconsideration as the order was not final, but granted the petition for removal. As its Decision After Removal, the Appeals Board rescinded the WCJ's December 2, 2024 order, finding due process violations due to the summary denial without a hearing, and returned the matter to the trial level for further proceedings.

Self-Insurers' Security Fundjoinderremovalreconsiderationinsolvent self-insurerliquidationadministrative law judgeorderdue processsubstantial evidence
References
16
Case No. 2018 NY Slip Op 08227
Regular Panel Decision
Nov 29, 2018

Matter of Kelly v. New York State Workers' Compensation Bd.

In 2006, claimant Grace Kelly established a workers' compensation claim for an occupational disease. The State Insurance Fund (SIF) repeatedly sought to transfer liability to the Special Fund for Reopened Cases, which was denied by Workers' Compensation Law Judges. The Workers' Compensation Board affirmed these denials and assessed $500 penalties against both SIF and its counsel, Walsh and Hacker, for filing an application for review without reasonable grounds. Walsh and Hacker appealed the penalty imposed against them to the Appellate Division, Third Department. The Appellate Division found insufficient evidence to support the Board's finding that Walsh and Hacker's application lacked reasonable grounds, and therefore reversed the penalty against them, modifying and affirming the Board's decision.

PenaltiesAppellate ReviewSpecial Fund for Reopened CasesWorkers' Compensation Law § 25-aWorkers' Compensation Law § 114-aAttorney SanctionsAdministrative LawBoard DecisionJudiciary Law § 431
References
4
Case No. ADJ2727430 (OAK 0287969)
Regular
May 22, 2009

RHONDA ANDERSON vs. TARGET STORES, P.S.I., SEDGWICK CLAIMS MANAGEMENT SERVICES

In *Anderson v. Target Stores*, the Workers' Compensation Appeals Board reconsidered an award of attorney fees under Labor Code § 4607. The Board granted reconsideration, finding the applicant was not entitled to the fees. This decision was based on the Supreme Court's ruling in *Smith v. Workers' Comp. Appeals Bd.*, which limited § 4607 attorney fees to cases where an employer seeks to terminate an entire award of medical treatment, not just challenge a specific treatment request. Therefore, the Board vacated the prior award of attorney fees.

Workers' Compensation Appeals BoardLabor Code §4607Attorney FeesReconsiderationUtilization ReviewPrimary Treating PhysicianSmith v. Workers' Comp. Appeals Bd.Interferential UnitStipulations with Request for AwardNew and Further Disability
References
3
Case No. 532391
Regular Panel Decision
Nov 18, 2021

Matter of Richman v. New York State Workers' Compensation Bd.

Claimant, Rebecca Richman, appealed three decisions from the Workers' Compensation Board regarding her claim for a work-related right shoulder injury. She alleged a fall at work on January 19, 2018, but did not seek medical treatment for 19 months. A Workers' Compensation Law Judge initially established the claim, but the Board reversed, finding that Richman failed to submit sufficient, credible medical evidence to demonstrate a causally-related injury and denied her claim. The Board subsequently denied her application for reconsideration and/or full Board review. The Appellate Division affirmed the Board's decisions, concluding that the Board's finding of no causally-related injury was supported by substantial evidence and that the Board did not abuse its discretion in denying reconsideration.

Workers' Compensation ClaimCausation (Medical)Shoulder InjuryMedical Evidence SufficiencyBoard ReversalAppellate Division ReviewBurden of ProofCredibility of EvidenceOsteoarthritis DiagnosisDelayed Medical Treatment
References
8
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