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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

Claim of Keselman v. New York City Transit Authority

Claimant, injured in 1986, initially established a right shoulder injury. The Workers’ Compensation Board affirmed this but denied a causally related neck injury in 1996. After another application in 1998 alleging a worsened neck condition, the Workers’ Compensation Law Judge found a causally related neck injury and permanent partial disability, awarding benefits from February 5, 1998, which the Board affirmed. Separately, the Board also ruled the employer was entitled to credit schedule payments against disability payments made after February 5, 1998. The court affirmed both decisions, finding substantial evidence supported the deterioration of the neck injury post-1996 and that schedule awards are independent of actual disability periods, thus allowing the employer's credit.

Workers' CompensationPermanent Partial DisabilitySchedule AwardDisability PaymentsNeck InjuryRight Shoulder InjuryCausally Related InjuryReopening CaseMedical EvidenceMRI
References
7
Case No. SAC 0340252
Regular
Oct 24, 2007

ROY HOWARD vs. MERCER STAFFING, aka AMERICAN STAFF RESOURCES, CASCADE NATIONAL INSURANCE, in liquidation, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION

This case concerns whether temporary disability payments should extend indefinitely after an industrial back and shoulder injury. The Appeals Board determined that Labor Code section 4656(c)(1) limits aggregate temporary disability payments to 104 weeks within a two-year period from the *first payment* of temporary disability, not the date disability is owed. Therefore, the award was amended to terminate payments on January 28, 2007, the two-year anniversary of the initial payment.

Labor Code section 4656(c)(1)temporary disability indemnitydate of commencement of temporary disability payment104 compensable weeksaggregate disability paymentspetition for reconsiderationFindings and AwardWorkers' Compensation Appeals Boardindustrial injurytruck driver
References
1
Case No. ADJ2759696 (VNO 0492027)
Regular
Oct 11, 2010

WOON YOUNG PARK vs. FILM PAYMENT SERVICES, INC., CHARTIS INSURANCE

The Board granted reconsideration, rescinding the WCJ's decision on the defendant's credit for overpaid temporary disability. The defendant is allowed credit for temporary disability payments made from March 26, 2009, to June 3, 2009, at the temporary disability rate. Further credit is granted for payments made from June 4, 2009, to December 7, 2009, at the permanent disability rate of $185.00 per week. The Board denied further credit due to insufficient evidence regarding post-AME report overpayments.

Petition for ReconsiderationPermanent DisabilityTemporary DisabilityCreditStipulated AwardAgreed Medical ExaminationPermanent and StationarySection 4909Abuse of DiscretionDue Process
References
0
Case No. SAC 345456
Regular
Jun 05, 2008

CONNIE SOTOLONGO vs. STATE OF CALIFORNIA / EMPLOYMENT DEVELOPMENT DEPARTMENT, STATE COMPENSATION INSURANCE FUND, STATE CONTRACT SERVICES

This case clarifies that Labor Code section 4656(c)(1) imposes an aggregate 104-week limit on temporary disability indemnity payments within a two-year period for any single injury. The Workers' Compensation Appeals Board held that this limit applies to both temporary total and temporary partial disability payments, regardless of the specific type of temporary disability. This interpretation aligns with the statutory language and the Legislature's intent to create a broad, time-based cap on temporary disability benefits.

Labor Code section 4656(c)(1)temporary total disabilitytemporary partial disabilityaggregate limitcompensable weekstwo-year periodIndustrial Disability LeaveSB 899legislative intentstatutory construction
References
10
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. SDO 0328208
Regular
Mar 17, 2008

ARMANDO ADAME vs. AUTOMOTIVE ENGINEERED PRODUCTS, INC. (dba JBA HEADERS), ZENITH INSURANCE COMPANY

The Appeals Board clarified that for Labor Code section 4656(c)(1) purposes, the commencement of temporary disability payments is the date the employer first mails a temporary disability indemnity check, not when EDD benefits begin. Furthermore, EDD benefits, even if reimbursed by the employer, do not count towards the 104-week cap on temporary disability payments. Consequently, the employer's liability for further temporary disability payments extends from the date of the first actual indemnity payment until October 6, 2007.

Workers Compensation Appeals BoardArmando AdameAutomotive Engineered ProductsZenith Insurance CompanyLabor Code section 4656(c)(1)Temporary Total DisabilityTemporary Disability IndemnityEmployment Development DepartmentUnemployment Compensation DisabilityHawkins v. Amberwood Products
References
2
Case No. 2018 NY Slip Op 05652 [164 AD3d 1000]
Regular Panel Decision
Aug 02, 2018

Matter of Robinson v. Workmen's Circle Home

Barbara Robinson, a certified nurse's assistant, filed a claim for workers' compensation benefits for a work-related right shoulder injury in 2011. She received temporary disability payments totaling $133,807.48. In 2016, a Workers' Compensation Law Judge (WCLJ) awarded her a 42.50% schedule loss of use (SLU) to her right arm, amounting to $102,494.50, less prior payments. Robinson appealed the WCLJ's decision, arguing that the employer's carrier should not be credited for temporary partial disability payments against the SLU award. The Workers' Compensation Board disagreed, ruling that the carrier could credit all prior disability payments. The Appellate Division, Third Department, affirmed the Board's decision, finding no basis to differentiate between temporary total and temporary partial disability payments for credit purposes, thereby preventing an unjustifiable double recovery for the claimant.

Workers' CompensationSchedule Loss of UseTemporary Disability PaymentsCreditDouble RecoveryAppellate DivisionWork-Related InjuryRight Shoulder InjuryCarrier ReimbursementLegal Precedent
References
7
Case No. MISSING
Regular Panel Decision

Pollock v. Trustmark Insurance

Plaintiff Dr. Allan Pollock sued Trustmark Insurance Company for breach of a disability insurance policy and violation of New York General Business Law § 349 after Trustmark ceased payments. The case was removed to federal court by Trustmark based on diversity of citizenship, claiming the amount in controversy exceeded $75,000. Pollock cross-moved for remand, arguing the amount in controversy was below the jurisdictional threshold. The court analyzed whether accrued payments, attorney's fees, potential statutory penalties, and future payments could be aggregated to meet the $75,000 requirement. The court found that only accrued payments ($55,000) plus reasonable attorney's fees and a $1,000 statutory penalty could be considered, and these did not reasonably exceed $75,000. Consequently, the federal court lacked subject matter jurisdiction, and the case was remanded to state court.

Jurisdictional DisputeDiversity JurisdictionAmount in ControversySubject Matter JurisdictionRemandBreach of ContractDisability InsuranceNew York General Business LawAttorney's FeesStatutory Penalties
References
25
Case No. MISSING
Regular Panel Decision
Jul 09, 1984

Claim of Holmes v. Cornell University

A claimant challenged Cornell University's denial of disability benefits, arguing he was not an academic employee excluded from coverage under the Disability Benefits Law. The Workers’ Compensation Board affirmed an administrative law judge's decision, ruling the claimant was not engaged in a professional capacity and thus eligible for benefits. Cornell appealed, but the court affirmed the board's decision, finding its interpretation of the statute within its area of competence was not irrational. The court noted Cornell had previously deducted disability benefit payments from the claimant's paycheck, further supporting the board's classification.

Disability Benefits LawProfessional CapacityAcademic EmployeeCoverage ExclusionWorkers' Compensation BoardStatutory InterpretationPayroll DeductionsEligibility for BenefitsAppellate Review
References
1
Case No. MISSING
Regular Panel Decision

Linger v. Anchor Motor Freight, Inc.

Claimant sustained permanent partial disabilities from two 1977 accidents and one 1980 accident, leading to separate awards from different employers and their respective insurance carriers. Initially, the claimant received concurrent benefits exceeding the statutory maximum rate. Upon discovering these concurrent payments, a joint hearing was held. An Administrative Law Judge apportioned the award, which was subsequently affirmed by the Workers' Compensation Board, stating that concurrent awards exceeding the statutory maximum for a permanent partial disability were impermissible. The claimant appealed this decision, arguing for a per-accident application of the statutory maximum. However, the appellate court affirmed the Board's decision, asserting that the Workers' Compensation Law establishes an overall maximum rate for permanent partial disability regardless of the number of accidents or employments.

Permanent Partial DisabilityConcurrent AwardsStatutory MaximumApportionmentMultiple AccidentsWage LossJudicial PrecedentAdministrative Law JudgeWorkers' Compensation BoardInsurance Carriers
References
2
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