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

Case No. ADJ8543406
Regular
Jun 01, 2018

JOSE HERNANDEZ vs. ALBA CONSTRUCTION COMPANY, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration of a WCJ's denial of sanctions for delayed payment of interpreter services. The Board found that the interpreter services for the Compromise and Release were reasonable and necessary under AD Rule 9795.3. Defendant received the invoice on February 24, 2016, but did not pay it until August 2, 2017, exceeding the 60-day payment requirement of AD Rule 9795.4. Therefore, the Board rescinded the prior findings and returned the matter for further proceedings on the petitions for costs and sanctions.

WCABJoyce Altman InterpretersAD Rule 9795.4AD Rule 9795.3Labor Code Section 5813Petition for ReconsiderationFindings of FactCompromise and ReleaseInterpreter ServicesClaims Administrator
References
8
Case No. 2023 NY Slip Op 02305 [216 AD3d 630]
Regular Panel Decision
May 03, 2023

Lochan v. H & H Sons Home Improvement, Inc.

Ashram Lochan sued H & H Sons Home Improvement, Inc., 82 S 4 Associate Limited Liability Company, and Hassan Haghanegi for personal injuries sustained from falling off an unsecured ladder while painting, alleging Labor Law violations. The Supreme Court granted the plaintiff's motion for summary judgment on liability against 82 S 4 Associate Limited Liability Company and, in effect, searched the record to award summary judgment against Hassan Haghanegi, denying the defendants' cross-motion to dismiss. The Appellate Division modified the order by deleting the award of summary judgment against Hassan Haghanegi, finding it improperly searched the record. However, it affirmed the grant of summary judgment against 82 S 4 Associate Limited Liability Company, concluding the plaintiff established a prima facie case and defendants failed to raise a triable issue. The court also affirmed the denial of the defendants' cross-motion, ruling they failed to establish the plaintiff was the sole proximate cause, a recalcitrant worker, or a volunteer.

Ladder AccidentPersonal InjurySummary JudgmentAppellate ReviewLabor Law § 240(1)Sole Proximate CauseRecalcitrant Worker DefenseUnsecured LadderConstruction Site SafetyWorker Fall
References
18
Case No. MISSING
Regular Panel Decision

Claim of Everett v. A. S. Steel Rule Die Corp.

On review of submissions pursuant to section 500.4 of the Rules of the Court of Appeals (22 NYCRR 500.4), the order was affirmed, with costs, for the reasons stated in the opinion by Justice John T. Casey at the Appellate Division. Chief Judge Wachtler and Judges Jasen, Meyer, Simons, Kaye, Alexander and Titone concurred with the decision.

Appellate ReviewCourt of AppealsJudicial ConcurrenceRules of CourtCase Law ReferencePrior Decision AffirmationJudicial ReviewAppellate Division Opinion
References
2
Case No. MISSING
Regular Panel Decision
Sep 04, 2013

Matter of Madigan v. ARR ELS

In 1994, the claimant sustained a low back injury during employment as a machinist, leading to workers' compensation benefits. Liability for the case was transferred to the Special Fund for Reopened Cases in 2003. Due to poor surgical outcomes, the claimant has been on pain medication, including oxycontin, since at least 2007, with doses escalating. A consultant for the Special Fund questioned the necessity of the increased medication, prompting a hearing. A Workers’ Compensation Law Judge ruled that the pain medications should continue, with the Special Fund covering the costs, until new Board guidelines or physician recommendations advised otherwise. The Workers’ Compensation Board affirmed this decision, citing that their Medical Treatment Guidelines for chronic pain were still in draft form at the time. The appellate court subsequently affirmed the Board's decision, noting that the guidelines were not yet in effect at the time of the Board's ruling and that the Board's interim guidance was rational.

Workers' CompensationPain ManagementOpioid PrescriptionsMedical Treatment GuidelinesSpecial FundReopened CasesLumbar InjuryOxycontinAppellate ReviewAdministrative Law
References
4
Case No. MISSING
Regular Panel Decision
Mar 26, 1998

In Re Bagel Bros. Bakery & Deli, Inc.

This order addresses whether Federal Rule of Bankruptcy Procedure 1014(b) imposes an automatic stay on proceedings in a subsequently-filed bankruptcy case. The case involves three Chapter 11 cases of Bagel Bros. Maple, Inc. and Bagel Bros. Deli & Bakery, Inc. in the Western District of New York, which are related to earlier Chapter 11 cases of MBC in the District of New Jersey. MBC filed a motion in New Jersey seeking to transfer venue and requested that the New York court automatically stay its proceedings based on Rule 1014(b). Bankruptcy Judge Michael J. Kaplan ruled that Rule 1014(b) does not constitute an automatic or self-executing stay upon the mere filing of a motion. Instead, a judicial determination and order from the first-filed court (District of New Jersey) are required to impose such a stay, ensuring that substantive rights are not abridged and allowing for judicial discretion in emergency matters. Therefore, the proceedings in the Western District of New York are not automatically stayed.

Bankruptcy ProcedureAutomatic StayFederal Rule of Bankruptcy Procedure 1014(b)Venue TransferChapter 11 ReorganizationInter-district BankruptcyJudicial InterventionSubstantive RightsFranchise AgreementsCash Collateral Disputes
References
12
Case No. ADJ8608456 MF\nADJ8608504\nADJ8523009\nADJ8551858\nADJ8609068
Regular
Oct 07, 2015

HORACIO CABRERA, Deceased MARIBEL BARAJAS, Widow, Guardian Ad\nLitem for LITZY CABRERA, LESLY\nCABRERA, MARIA CABRERA AND\nKASSANDRA CABRERA; BRIANNA\nCABRERA, for herself and Guardian Ad Litem for STEFANI ARIAS, ANTONIO SOLARES, MODESTO DOMINGUEZ, JOHNATHAN ALONSO vs. MV CONTRACTING, STAR INSURANCE COMPANY

In this workers' compensation case, the employer sought reconsideration of a ruling finding a fatal motor vehicle accident and related injuries industrial. The employer argued the administrative law judge erred in admitting evidence and presuming compensability due to a failure to issue timely denial notices. The employer also contended the "going and coming rule" barred the claims as the accident occurred during a standard commute. The Board denied reconsideration, affirming the judge's findings that the injuries were industrial and not barred by the going and coming rule, largely adopting the judge's reasoning.

WCABPetition for ReconsiderationDenying PetitionRulings and Order Admitting EvidenceFindings of FactMotor Vehicle AccidentIndustrial InjuriesFatal Industrial InjuryDependentsNotice of Denial
References
0
Case No. ADJ10348591 ADJ10349019
Regular
Jan 07, 2019

MIGUEL VELAZQUEZ, SERVANDO VELAZQUEZ vs. ARTEMIO ARCE, SOLOMON MARTINEZ

The Workers' Compensation Appeals Board denied a defendant's petition for reconsideration, upholding a prior finding that liens for interpreting services were not barred by AD rule 9792.5.5. This rule, requiring a second review request for fee schedule disputes, did not apply because the interpreter services were not subject to an applicable fee schedule at the time of service. Therefore, the lien claimant's failure to request a second review did not preclude the WCAB from adjudicating the lien dispute. The Board reasoned that AD rule 9792.5.5 and associated statutes only mandate the second review process for disputes concerning amounts under an "applicable fee schedule."

Workers' Compensation Appeals BoardAD Rule 9792.5.5Official Medical Fee ScheduleIndependent Bill ReviewExplanation of ReviewLabor Code section 4603.2Senate Bill 863Threshold IssueFee Schedule DisputeInterpreter Services
References
0
Case No. ADJ4213823 (AHM 01440-4)
Regular
Jun 02, 2010

RODOLFO PLASCENCIA (Deceased), TERESA PLASCENCIA (Widow) vs. LOS ANGELES DODGERS, ACE USA, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board reversed a prior award, ruling that applicant Rodolfo Plascencia's neck injury sustained from a fall was not compensable. The Board found that the applicant's blood alcohol level of .187% was a material and substantial cause of his fall, thus barring compensation under Labor Code section 3600(a)(4). The majority credited expert testimony indicating the intoxication impaired judgment and physical ability, making it the probable cause of the fall in the absence of other evidence. A dissenting opinion argued the defendant failed to meet its burden of proof and that reasonable doubt should favor the employee, citing lack of evidence for intoxication being the sole cause and the possibility of other fall factors.

Labor Code section 3600(a)(4)intoxication defensematerial and substantial factorblood alcohol level.187%addiction substance abuse expertwaiver of objectioncommon knowledgeslip and fallreasonable inferences
References
25
Case No. MISSING
Regular Panel Decision
Dec 04, 1997

Claim of D'Accordo v. Spare Wheels & Car Shoppe of Sayville

A claimant, an automobile salesperson, was injured in an accident while driving an employer-provided vehicle to complete a sale to his brother-in-law. The Workers' Compensation Board ruled that the accident arose out of and in the course of his employment, a decision challenged by the employer and its insurance carrier. The appellate court affirmed the Board's determination, citing sufficient evidence that the claimant's activity, though off-schedule, was work-related. This was supported by coworker testimony regarding the employer's encouragement of off-site sales and the claimant's history of sales to family members, establishing a factual basis for the Board's resolution that the activity was reasonable and work-related.

Workers' CompensationAccidental InjuryCourse of EmploymentAutomobile SalesWork-Related ActivityAppellate ReviewBoard DecisionEmployer LiabilityInsurance CarrierFactual Question
References
3
Case No. MISSING
Regular Panel Decision

Matter of Castler v. National Grid

Claimant sustained a low back injury in 2006, receiving workers' compensation benefits. In 2013, chiropractor Douglas Van Vorst treated him for two exacerbations after incidents involving shoveling snow and lifting a kayak. The employer's carrier disputed the medical bills, arguing the treatments did not comply with Workers’ Compensation Board Medical Treatment Guidelines (MTG). A Workers’ Compensation Law Judge initially ruled in favor of the medical provider, but the Workers’ Compensation Board reversed, finding insufficient documentation for the exacerbation. On appeal, the court examined the documentation and found that Van Vorst adequately detailed how the exacerbations occurred, objective changes from baseline, expected treatments, and claimant's response, satisfying the MTG requirements. The court concluded that the Board’s finding lacked substantial evidence and therefore reversed the Board's decision, remitting the matter for further proceedings.

Medical Treatment GuidelinesExacerbation of InjuryLow Back InjuryChiropractic TreatmentObjective Functional ImprovementVariance Request12 NYCRR 324.212 NYCRR 324.3Substantial EvidenceRemittal
References
5
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