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

Case No. No. 78
Regular Panel Decision
Oct 27, 2022

In the Matter of the Claim of Kayne Khalid Green

This case addresses whether unaccrued portions of a nonschedule workers' compensation award pass to beneficiaries of injured employees who die from causes unrelated to the work injury. The claimant, Kanye Khalid Green, son of the deceased employee Eric Watson, sought both accrued and unaccrued benefits after his father's death. A Workers' Compensation Law Judge and the Workers' Compensation Board initially awarded only the accrued, unpaid portion, denying the unaccrued benefits for the remaining cap weeks. The Appellate Division modified this, ruling that the claimant was entitled to the additional posthumous award. However, the Court of Appeals reversed the Appellate Division's order, clarifying that Workers' Compensation Law § 15 (3) (w) does not provide for any unaccrued portion of a nonschedule award to remain payable following an injured employee's death. The Court emphasized the fundamental difference between schedule and nonschedule awards, noting that nonschedule awards are dependent on actual earnings and continuance of disability, making unaccrued portions speculative and not transferable posthumously. The Court reinstated the original Workers' Compensation Board decision, awarding only the portion accrued but unpaid at the time of death.

Workers' Compensation LawNonschedule AwardPosthumous BenefitsPermanent Partial DisabilityBeneficiary RightsStatutory InterpretationAppellate Division ReversalCourt of AppealsAccrued BenefitsUnaccrued Benefits
References
13
Case No. 2022 NY Slip Op 06050 [209 AD3d 1233]
Regular Panel Decision
Oct 27, 2022

Contractors Compensation Trust v. $49.99 Sewer Man, Inc.

Contractors Compensation Trust, a self-insured trust providing workers' compensation coverage, sued member Thos. H. Gannon & Sons, Inc. for unpaid deficit assessments. The defendant sought summary judgment, claiming the action was barred by a six-year statute of limitations, arguing the claim accrued upon the approval of the deficit assessment. Supreme Court partially denied the defendant's motion and granted the plaintiff's cross-motion for summary judgment. The Appellate Division affirmed, ruling that the cause of action accrued when the defendant failed to make payments according to the established payment plan on March 3, 2014, rather than the earlier assessment approval date. Consequently, the Appellate Division concluded that the action, initiated in December 2019, was timely.

Workers' Compensation LawSelf-Insured TrustStatute of LimitationsBreach of ContractDeficit AssessmentPro Rata PaymentAccrual DateSummary JudgmentAppellate ReviewThird Department
References
9
Case No. 2017 NY Slip Op 27428
Regular Panel Decision
Dec 14, 2017

New York State Workers' Compensation Bd. v. Compensation Risk Mgrs., LLC

This action was brought by the New York State Workers' Compensation Board (WCB), as an assignee of former members of the Healthcare Industry Trust of New York (HITNY), against Compensation Risk Managers, LLC (CRM), HITNY trustees, and auditing firm UHY LLP. The WCB alleged mismanagement, breach of fiduciary duty, and negligent auditing, leading to the Trust's insolvency. Defendants moved to dismiss on grounds of standing, statute of limitations, and pleading particularity. The court dismissed certain derivative claims and negligent misrepresentation claims against some trustees due to standing issues and statute of limitations. All claims against UHY LLP were dismissed for lack of a near-privity relationship or prior precedent. An implied indemnity claim against the trustees was sustained. The WCB's cross-motion to consolidate related actions was denied.

Workers' Compensation LawGroup Self-Insured Trust (GSIT)Fiduciary DutyNegligenceNegligent MisrepresentationStatute of LimitationsStandingDerivative ActionImplied IndemnityAuditing Firm Liability
References
46
Case No. MISSING
Regular Panel Decision

Workers' Compensation Board v. Met-Impro Services, Inc.

This case involves four related actions under Workers' Compensation Law § 26 concerning the enforcement of a Workers' Compensation award. The Supreme Court had erroneously granted defendant Robert San Miguel's motion to vacate judgments against him. San Miguel, identified as the president of the corporate employers, was held personally liable for unpaid benefits under Workers’ Compensation Law § 26-a (1) (a). The court clarified that personal liability for corporate officers does not depend on active management or involvement in the underlying accident. Furthermore, there is no statutory basis to vacate a judgment merely because an officer was not specifically named in the initial administrative determination. Consequently, San Miguel's vague denial of involvement was insufficient, and his motion to vacate the judgments against him was denied.

Workers' CompensationPersonal LiabilityCorporate OfficerJudgment VacationAdministrative LawAppellate ReviewStatutory InterpretationEmployer LiabilityUnpaid BenefitsNew York Law
References
3
Case No. MISSING
Regular Panel Decision
Nov 12, 2003

Commissioners of State Insurance Fund v. Trio Asbestos Removal Corp.

This case involves an appeal from an order of the Supreme Court, Westchester County, concerning an action to recover unpaid workers' compensation insurance premiums. The plaintiff, an insurance fund, sought premiums from the defendant for policy periods between November 1993 and December 1996. The defendant moved for summary judgment, arguing that claims for estimated premiums for the periods from November 1993 to November 1996 were barred by the six-year statute of limitations, CPLR 213 (2). The Appellate Division modified the Supreme Court's order, agreeing that the claims for unpaid estimated premiums for those specific periods were time-barred. However, the court found that claims for final audit premiums issued after July 30, 1996, were not time-barred. Additionally, the Appellate Division granted summary judgment to the plaintiff, dismissing the defendant's counterclaim, on the grounds that such counterclaims against the State Insurance Fund are only cognizable in the Court of Claims.

Workers' Compensation InsuranceUnpaid PremiumsStatute of LimitationsSummary JudgmentCounterclaimInstallment PaymentsEstimated PremiumsAudit AdjustmentAppellate DivisionNew York Law
References
2
Case No. MISSING
Regular Panel Decision

Matter of Petrillo v. Comp USA

Claimant appealed a Workers' Compensation Board decision that found she violated Workers’ Compensation Law § 114-a and disqualified her from future wage replacement benefits. The employer's workers' compensation carrier alleged claimant failed to report employment while receiving benefits, specifically a part-time training position at a florist. Claimant initially testified she was unpaid but later admitted receiving $430, though she maintained it was for vocational evaluation, not actual employment. The Board found claimant made false representations regarding material facts and imposed permanent disqualification from wage replacement benefits. The Appellate Division affirmed the Board's determination, finding it supported by substantial evidence and the discretionary penalty warranted.

Workers' Compensation Law § 114-aFraudMisrepresentationPermanent DisqualificationWage Replacement BenefitsSubstantial EvidenceCredibility DeterminationAppellate ReviewWorkers' Compensation Board DecisionFalse Representation
References
5
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. MISSING
Regular Panel Decision

Claim of Knoll v. Chemung County

Claimant, an employee of Chemung County, injured his back and used accrued sick leave and vacation time for wage replacement during disability. The Workers’ Compensation Board found a compensable injury and ordered awards paid to the County as reimbursement. The County, however, only partially restored claimant's leave, leading to a dispute. A Workers’ Compensation Law Judge and the Board ruled that the claimant's accrued leave must be fully restored. The County appealed this decision. The appeals court reversed the Board's determination, referencing *Matter of Jefferson v Bronx Psychiatric Ctr.*, and stated that full restoration would result in a windfall for the claimant, a disproportionate outcome. The matter was remitted to the Board for further proceedings consistent with the court's decision.

Workers' CompensationLeave AccrualsReimbursementDisabilityWage ReplacementSick LeaveVacation TimeDouble RecoveryOverpaymentAppellate Review
References
1
Case No. No. 12
Regular Panel Decision
Apr 01, 2021

The Matter of the Claim of Estate of Norman Youngjohn v. Berry Plastics Corporation

Decedent Norman Youngjohn, employed by Berry Plastics Corporation, suffered work-related injuries to his right shoulder and left elbow in 2014, leading to a workers' compensation claim. Before his permanent partial disability benefits claim for a schedule loss of use (SLU) award was resolved, Youngjohn died in March 2017 from a heart attack unrelated to his work injuries. He left no surviving spouse, minor children, or qualifying dependents. His estate sought the full value of the posthumous SLU award, arguing that 2009 amendments to the Workers' Compensation Law, which permitted lump sum SLU payments, rendered WCL § 15 (4) (d) inapplicable. This section limits an estate's recovery for unaccrued SLU benefits to reasonable funeral expenses in cases of unrelated death without qualifying survivors. The Workers' Compensation Board limited the award to funeral expenses, while the Appellate Division held that the estate was entitled to the portion accrued up to the date of death plus reasonable funeral expenses. The New York Court of Appeals affirmed the Appellate Division's order, concluding that the 2009 amendments on lump sum payments did not implicitly alter WCL § 15 (4) (d)'s limitation on an estate's recovery of posthumous SLU awards. The Court emphasized that section 15 (4) (d) remains in effect and must be harmonized with the amendments, limiting recovery to benefits accrued before death and reasonable funeral expenses for the remainder.

Workers' Compensation LawPermanent Partial DisabilitySchedule Loss of Use (SLU)Lump Sum PaymentEstate RecoveryFuneral ExpensesStatutory InterpretationAccrual of BenefitsNew York Court of AppealsUnrelated Death
References
35
Case No. MISSING
Regular Panel Decision

Claim of McKenzie v. New York Jockey Injury Compensation Fund

Claimant, an exercise rider at Belmont Racetrack, suffered pelvic injuries in December 2003 while working a horse. Despite an expired license, a Workers’ Compensation Law Judge (WCLJ) established his case and determined he was a covered employee of the New York Jockey Injury Compensation Fund, holding the Fund responsible for medical treatment. The Workers’ Compensation Board upheld this decision. The Appellate Division affirmed, referencing *Matter of Adames v New York Jockey Injury Compensation Fund, Inc.* (15 AD3d 696 [2005]), which established that an exercise rider is a covered employee of the Fund under relevant Workers’ Compensation Law and Racing, Pari-Mutuel Wagering and Breeding Law provisions, irrespective of license expiration. The court found the Fund’s remaining contentions lacked merit.

Exercise RiderWorkers' CompensationJockey Injury Compensation FundExpired LicenseCovered EmployeeThoroughbred RacingPelvic InjuryAppellate DecisionBoard DecisionStatutory Interpretation
References
1
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