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

Case No. ADJ6875445
Regular
Aug 02, 2010

JOSE RIVAS vs. NNC MANAGEMENT, LLC/ADP TOTAL SOURCE, SPECIALTY RISK SERVICES

Defendant NNC Management, LLC/ADP Total Source sought removal of a WCJ's order to proceed to trial on both AOE/COE and temporary disability. The applicant claimed an injury in January 2009, and the employer denied it based on a post-termination defense. The defendant argues they were denied due process by being forced to litigate temporary disability without prior notice, as the initial proceedings focused solely on AOE/COE. The Appeals Board granted the petition for removal, amending the order to limit the August 4, 2010 trial to the AOE/COE issue only.

Petition for RemovalPost-termination defenseAOE/COETemporary DisabilityDue ProcessDeclaration of Readiness to ProceedPriority ConferenceMandatory Settlement ConferenceDiscoverySubstitution of Attorneys
References
0
Case No. MISSING
Regular Panel Decision

Normile v. Allstate Insurance

Chief Judge Cooke's dissenting opinion critiques the majority's interpretation of Insurance Law section 671 (subd 2, par [b]) regarding how collateral source payments affect an insurer's aggregate $50,000 liability for basic economic loss. The dissent argues that the majority's method, which allows insurers to reduce their total liability by these payments, leads to an incomplete recovery for injured parties, particularly when total losses exceed $50,000. Cooke proposes an alternative allocation where collateral source payments are first applied to cover losses beyond the $50,000 basic economic loss threshold. This approach, he contends, ensures that insurers pay the full $50,000 in first-party benefits and only take credit for collateral sources that would otherwise result in a double recovery within the basic economic loss limit, or for amounts exceeding the $50,000 threshold. The dissenting judge asserts that the Legislature did not intend to create such an inequity, where injured individuals are left with less than full compensation while insurers avoid their primary obligation.

Insurance Law InterpretationBasic Economic LossCollateral Source PaymentsNo-Fault InsuranceWorkers' Compensation BenefitsSocial Security Disability BenefitsDissenting OpinionAggregate LiabilityFirst-Party BenefitsDouble Recovery
References
2
Case No. ADJ9387304
Regular
Jan 20, 2023

Juan Guzman vs. ADP TOTAL SOURCE, INC./DURACITE, HELMSMAN MANAGEMENT SERVICES

Applicant sought reconsideration of a Workers' Compensation Appeals Board decision finding a 45% permanent partial disability for a 2013 injury. Applicant contended the injury caused permanent total disability, not partial. The Board granted reconsideration and the parties subsequently reached a settlement via a Compromise and Release agreement. The Board rescinded the original decision and remanded the case to the WCJ to consider the settlement, reserving judgment on the merits of the reconsideration petition.

Workers' Compensation Appeals BoardJuan GuzmanADP Total SourceHelmsman Management Serviceslumbar spine injuryhead injurypsyche injurygranite edge fabricatorpermanent partial disabilitypermanent total disability
References
0
Case No. MISSING
Regular Panel Decision

Brennan v. Bally Total Fitness

Kathryn Brennan filed a civil rights action against her former employer, Bally Total Fitness Corp., alleging sexual harassment under Title VII and disability discrimination under the ADA. Bally moved to dismiss the complaint as untimely and to compel arbitration based on its Employee Dispute Resolution Procedure (EDRP). The court denied Bally's motion to dismiss the Title VII claim, applying the 'continuing-violation exception' due to Brennan's allegations of ongoing harassment. The court also denied Bally's motion to compel arbitration, finding Bally's unilateral modifications to the EDRP invalid and raising questions of unconscionability regarding the original EDRP. The case is remanded for jurisdictional discovery and a possible hearing to determine the validity of the arbitration agreement.

Civil RightsSexual HarassmentDisability DiscriminationTitle VIIAmericans with Disabilities Act (ADA)Arbitration AgreementFederal Arbitration Act (FAA)Motion to DismissMotion to Compel ArbitrationContinuing Violation Exception
References
27
Case No. MISSING
Regular Panel Decision
Dec 21, 2000

Clarke v. One Source Facility Services, Inc.

This case concerns Sylvester Clarke's claims of employment discrimination and retaliatory discharge under Title VII against One Source Facility Services, Inc. Clarke, an African-American male, alleged discrimination stemming from a refusal of non-union work, which he claimed led to his removal from a position and a series of adverse employment actions. He pursued these grievances through union complaints and two administrative complaints with the New York State Division of Human Rights in 1996 and 1998. The court granted summary judgment to the defendant on the discrimination claim, finding a lack of evidence for racial animus. However, the court denied summary judgment on the retaliation claim, concluding that genuine issues of material fact existed regarding a potential pattern of retaliatory conduct by the employer following Clarke's protected activities.

Employment DiscriminationRetaliatory DischargeTitle VIISummary JudgmentMcDonnell-Douglas FrameworkPrima Facie CasePretextRacial DiscriminationUnion GrievanceAdministrative Complaint
References
21
Case No. ADJ6857380
Regular
Oct 18, 2010

MEIJI MAX HORI vs. ADP TOTAL SOURCE, SPECIALTY RISK LA HABRA

The Appeals Board granted the defendant's petition for removal, rescinding the order to take the case off calendar due to an incomplete medical record. The Board found the Agreed Medical Examiner's (AME) reports inconclusive on whether employment was the predominant cause of the applicant's psychiatric injury, stating further refinement requires factual determination, not medical opinion. The applicant, bearing the burden of proof, failed to demonstrate due diligence in further discovery before the Mandatory Settlement Conference. The case is returned to the trial level for a new trial, where the judge can further develop the record if necessary after evidence is admitted.

Workers' Compensation Appeals BoardPetition for RemovalAgreed Medical EvaluatorPsychiatric InjuryPredominant CauseLabor Code Section 3208.3Burden of ProofMedical RecordIncomplete RecordPetition for Removal Granted
References
2
Case No. MISSING
Regular Panel Decision

Claim of Harrington v. L.C. Whitford Co.

The claimant, a construction worker, experienced a severe exacerbation of pre-existing asthma after exposure to burning lead paint fumes in June 1996. A certified pulmonologist, Richard Evans, determined the exposure caused a permanent and total disability. A Workers' Compensation Law Judge (WCLJ) found an accidental injury causing permanent and total disability, which the Workers' Compensation Board affirmed in August 2001. The employer and carrier appealed, arguing the condition was pre-existing and only temporarily aggravated. The appellate court affirmed the Board's decision, finding substantial evidence to support that the work-site exposure significantly exacerbated the claimant's stabilized asthma, leading to a permanent and total disability.

Workers' CompensationPermanent Total DisabilityAsthma ExacerbationOccupational ExposureLead Paint FumesPre-existing ConditionMedical Expert TestimonySubstantial EvidenceAppellate ReviewIndustrial Accident
References
14
Case No. MISSING
Regular Panel Decision

Matter of Brady v. Northeast Riggers & Erectors

In March 2012, the claimant, a union construction laborer, sustained a work-related back and abdomen injury. A Workers' Compensation Law Judge (WCLJ) initially found the claimant attached to the labor market but deemed a total industrial disability finding premature because permanent disability had not yet been classified. The Workers’ Compensation Board upheld this determination. The claimant appealed, arguing the Board erred in declining to classify him with a temporary total industrial disability. The Court affirmed the Board's decision, asserting that a classification of temporary total industrial disability cannot be made without a prior determination of permanency.

Workers' CompensationIndustrial DisabilityPermanent DisabilityTemporary DisabilityLabor MarketAppellate DivisionBoard DecisionPremature DeterminationGainful EmploymentWork History
References
6
Case No. MISSING
Regular Panel Decision

Claim of Kowalchyk v. Wade Lupe Construction Co.

The claimant, a carpenter over 60 with an 11th-grade education, fractured his back and wrist in August 1985 while on a construction jobsite. Initially, his physician, Dr. James Slavin, considered him totally disabled, and he received total disability benefits from his employer's carrier. However, in December 1985, the employer reduced benefits to a partial disability rate, relying on a report from their consultant, Dr. Edward Pasquarella. The claimant subsequently filed for compensation, leading to a determination by the Workers’ Compensation Law Judge and ultimately the Workers’ Compensation Board that he had a total industrial disability. The employer appealed this decision, arguing it lacked substantial evidence. The court affirmed the Board's decision, considering the claimant’s physical limitations, age, work experience, and limited education, concluding he had no marketable skills outside carpentry.

Workers' CompensationTotal Industrial DisabilityPartial DisabilityMedical Testimony ConflictEarning Capacity AssessmentAppellate ReviewVocational RehabilitationAge & Education FactorsCarpenter InjuryScaffold Accident
References
3
Case No. MISSING
Regular Panel Decision

Matter of Williams v. Preferred Meal Systems

Claimant, a driver, suffered injuries to his right knee and back in 2009 while making a delivery, leading to an established workers' compensation claim. The claim was later amended to include consequential adjustment disorder, and the Workers' Compensation Board ultimately found that claimant had sustained a permanent total disability from May 2012 onward. The employer, workers’ compensation carrier, and policy administrator appealed this decision, arguing that further proof was needed regarding claimant's vocational and functional capacity. The court affirmed the Board's decision, holding that extensive evidence of vocational and functional capacity is not required when medical proof demonstrates a permanent total disability and inability to engage in any gainful employment, as benefits continue for life in such cases. The court found substantial evidence in the opinions of treating and independent medical examination orthopedists to support the finding of permanent total disability.

Workers' CompensationPermanent Total DisabilityWage-Earning CapacityMedical ProofVocational CapacityFunctional CapacityAppellate ReviewNew York LawDisability BenefitsClaimant Rights
References
4
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