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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
Jun 20, 1986

Claim of Foglia v. New York City Housing Authority

The claimant, a New York City Housing Authority police officer, sustained a compensable knee injury in 1974. The case was reopened in 1983 due to increased disability, and the Special Fund for Reopened Cases was put on notice for potential liability under Workers' Compensation Law § 25-a. The issue was whether there was an advance payment of compensation, which would relieve the Special Fund from liability. The claimant testified that he retired in 1983 but had been on limited duty performing clerical work at full salary since 1982 due to his injury. The Workers' Compensation Board determined that these full salary payments for lighter work constituted an advance payment of compensation. The court affirmed the Board's decision, finding substantial evidence to support the determination that an advance payment of compensation relieved the Special Fund from liability.

Workers' Compensation BoardAdvance PaymentSpecial FundReopened CasesDisabilitySchedule LossPolice OfficerLimited DutySubstantial EvidenceFactual Determination
References
2
Case No. MISSING
Regular Panel Decision

Poupard v. Mohonasen Central School District

The claimant, a librarian, sustained an employment-related injury. Following her injury, she received full salary for 27 weeks under a collective bargaining agreement, and then used 23 days of accumulated sick leave. The employer sought reimbursement for these advance payments. The referee and the Workers’ Compensation Board initially granted the full reimbursement. On appeal, the court modified the decision, holding that wages paid from accumulated sick leave, acquired through a collective bargaining agreement, are compulsory payments and thus not reimbursable under Workers’ Compensation Law § 25 (subd 4, par [a]). The matter was remitted for further proceedings consistent with this ruling, with costs awarded to the claimant.

Workers' CompensationReimbursementSick LeaveCollective Bargaining AgreementAdvance PaymentsOccupational DisabilityStatutory LimitationsAppellate ReviewEmployment InjuryReferee Decision
References
5
Case No. MISSING
Regular Panel Decision
Nov 02, 1990

Claim of Mortenson v. United Parcel Service

Claimant filed a workers' compensation claim on July 29, 1987, alleging a myocardial infarction from work performed on June 15, 1985. The claim was deemed untimely by the workers' compensation insurance carrier under Workers’ Compensation Law § 28, which requires claims within two years of the accident unless an advance payment of compensation was made. The claimant argued that continued wage payments from his employer constituted such an advance payment. However, the Workers’ Compensation Board concluded that these payments were part of company policy, irrespective of the injury's cause, and thus did not qualify as an advance payment. The Appellate Division affirmed the Board's decision, emphasizing that remuneration must be linked to an acknowledgment of liability under workers' compensation law to be considered an advance payment.

Workers' CompensationMyocardial InfarctionTimeliness of ClaimAdvance PaymentWage ContinuanceEmployer LiabilityInsurance CarrierBoard DecisionAppellate ReviewStatutory Interpretation
References
2
Case No. MISSING
Regular Panel Decision

Iannaci v. Independent Cement Corp.

The Special Fund for Reopened Cases appealed a Workers’ Compensation Board decision from April 7, 2008, which shifted liability to the Fund under Workers’ Compensation Law § 25-a for a claim reopened in 2007, originally stemming from a 1992 injury. The Board had affirmed a Workers’ Compensation Law Judge's decision, which, despite an affidavit from the claimant indicating unchanged wages for lighter duties, denied further record development on the issue of advance payments of compensation. The appellate court found the Board's determination, which stated "absolutely no evidence" supported the Special Fund's contention of advance payments, to be erroneous. It highlighted that unchanged wages for lighter work could constitute an advance payment, potentially relieving the Special Fund of liability. Consequently, the court reversed the Board's decision, citing a lack of substantial evidence, and remitted the matter for further development of the record regarding advance payments.

Workers' Compensation Law § 25-aSpecial Fund for Reopened CasesAdvance Payments of CompensationLighter DutiesSubstantial EvidenceRemittalBoard Decision AppealLiability ShiftReopened CaseWorkers' Compensation Board
References
12
Case No. MISSING
Regular Panel Decision

Faison v. City of New York Department of Human Resources

The case concerns an appeal from decisions of the Workers’ Compensation Board regarding liability for a claimant’s reopened case. The claimant sustained a permanent partial disability in 1991 and her case was closed in 1993. In 2001, she applied to reopen it. A Workers’ Compensation Law Judge and subsequently a Board panel found that the employer voluntarily made advance payments of compensation within three years of the application, thereby making the employer, not the Special Fund for Reopened Cases, liable for disability payments. The employer appealed this decision. The appellate court examined whether the employer's payment of wages, deducted from sick leave, constituted an 'advance payment of compensation' with an acknowledgment of liability. The court found that wages paid from sick leave are not advance payments of compensation, and there was no substantial evidence that the employer’s payments were made voluntarily in recognition of continuing liability. Therefore, the Board's decision was reversed, and liability was transferred to the Special Fund for Reopened Cases.

Permanent Partial DisabilityReopened CaseAdvance Payments of CompensationSick LeaveEmployer LiabilitySpecial Fund for Reopened CasesWorkers' Compensation Law § 25-aAppellate ReviewSubstantial EvidenceRemittitur
References
8
Case No. MISSING
Regular Panel Decision
Apr 29, 2002

Claim of Marker v. Bell Atlantic

The claimant's decedent died in New York in 1996 during an employer-sponsored program, having previously received a $50,000 death benefit from New Jersey workers' compensation. The claimant sought additional death benefits from the New York Workers’ Compensation Board in 2000, but the self-insured employer argued the claim was untimely under Workers’ Compensation Law § 28's two-year statute of limitations. The claimant invoked the 'advance payment' exception, citing a payment from the employer beyond the date of death. While the Workers’ Compensation Law Judge initially found this constituted a waiver of the statute of limitations, the Board reversed, concluding the payment was due to administrative delay and not an acknowledgment of liability. The Appellate Court affirmed the Board's decision, emphasizing that advance payments require an acknowledgment of liability and that a claim filed in another state with claimant's participation generally makes the advance payment rule inapplicable.

Workers' Compensation BenefitsTime-Barred ClaimStatute of LimitationsAdvance Payment ExceptionAcknowledgment of LiabilityAdministrative DelayInterstate ClaimNew Jersey Workers' CompensationNew York Workers' Compensation LawAppellate Review
References
6
Case No. MISSING
Regular Panel Decision

Claim of Feldman v. Presbyterian Hospital

Claimant sustained a compensable back injury in 1966, leading to a closed case in 1967. The case was reopened in 1980 after claimant experienced additional lost time from work in 1979 and received treatment at the employer's clinic. The primary issue was the liability of the Special Fund for Reopened Cases under Workers’ Compensation Law § 25-a, specifically whether payments made by the employer for clinic visits and sick leave constituted advance payments of compensation. The Workers’ Compensation Board affirmed the discharge of the Special Fund, finding that there was an advance payment and the employer knew the lost time was due to the 1966 injury. On appeal, the court affirmed the Board's decision, holding that the employer's discretionary full reimbursement for clinic visits during working hours, even when sick leave was presumed exhausted, qualified as an advance payment. Therefore, the insurance carrier remained liable as the case was reopened within three years of the last payment.

Workers' CompensationSpecial Fund for Reopened CasesAdvance PaymentEmployer LiabilityMedical TreatmentLost TimeSick LeaveAppellate ReviewWorkers' Compensation Law § 25-aDiscretionary Payments
References
7
Case No. MISSING
Regular Panel Decision

Moore v. Oneida, Ltd.

Claimant, after 33 years at Oneida, Ltd. and experiencing noise-related hearing loss, filed a compensation claim on October 30, 1981. The Administrative Law Judge determined a disability date of November 6, 1978, and awarded benefits, considering the employer-administered periodic hearing tests as an advance payment tolling the Statute of Limitations. However, the Workers’ Compensation Board reversed, finding no timely filing and no evidence of advance payment. On appeal, the court affirmed the Board's decision, concluding that the hearing tests were for the employer's benefit, not medical treatment, thus not constituting an advance payment under Workers' Compensation Law § 29.

Hearing LossStatute of LimitationsAdvance PaymentWorkers' Compensation LawMedical TreatmentEmployer's PurposeAppellate ReviewTimeliness of ClaimDisability CertificationWorkers' Compensation Board Decision
References
2
Case No. MISSING
Regular Panel Decision

Claim of Schroeder v. US Foodservice

In March 2003, the claimant sustained a work-related back injury and was awarded workers’ compensation benefits, leading to the case's closure. Seven years later, in August 2010, the employer sought to transfer liability to the Special Fund for Reopened Cases under Workers’ Compensation Law § 25-a. The Workers’ Compensation Law Judge and Board affirmed this transfer, determining that no advance payments had been made. However, the Special Fund appealed, arguing that the record lacked sufficient evidence to determine if the claimant received full wages while performing lighter duties, which could constitute advance payments and prevent the liability shift. The Court reversed the Board’s decision, remitting the matter for further development of the record on the issue of advance payments.

Workers' CompensationSpecial FundReopened CasesAdvance PaymentsLiability ShiftSubstantial EvidenceRemittalWorkers' Compensation Law § 25-aFactual DisputeBoard Decision Reversal
References
6
Case No. MISSING
Regular Panel Decision

In re Settlement Capital Corp.

Settlement Capital Corporation (SCC) sought court approval, under New York's Structured Settlement Protection Act (SSPA), to acquire $125,000 of a $225,000 annuity payment due to Richard C. Ballos on October 1, 2010. Ballos, a totally disabled father of two, agreed to transfer these rights for a net advance of $36,500, reflecting a 15.591% annual discount rate. The court, presided over by Justice Patricia E. Satterfield, denied the petition after a hearing on April 23, 2003. The decision hinged on a two-pronged test: whether the transfer was in Ballos's 'best interest' and if the transaction terms were 'fair and reasonable.' The court found that Ballos did not demonstrate 'true hardship' given his other income sources and previous transfer of structured settlement payments, concluding it was not in his or his dependents' best interest. Furthermore, the court deemed the 15.591% discount rate, resulting in Ballos receiving only 29% of the transferred amount, unconscionable and not 'fair and reasonable.'

Structured SettlementStructured Settlement Protection Act (SSPA)Annuity TransferDiscount RateBest Interest StandardFair and Reasonable StandardPayee ProtectionFinancial HardshipCourt ApprovalGeneral Obligations Law
References
12
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