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

Case No. ADJ1798944 (LBO 0326931)
Regular
Jun 13, 2018

MARIA FIGUEROA vs. HELP NET, INC., STATE COMPENSATION INSURANCE FUND

This case concerns a lien claimant's petition for reconsideration of a WCJ's decision disallowing his lien for chiropractic services provided between 2001 and 2005. The Appeals Board rescinded the WCJ's decision, finding the claimant's petition timely due to defective service. Crucially, the Board determined that the Medical Treatment Utilization Schedule (MTUS) was improperly applied; instead, the American College of Occupational and Environmental Medicine (ACOEM) guidelines, in effect during the treatment period, should govern the determination of reasonable and necessary care. The matter is remanded to the WCJ for further proceedings consistent with the ACOEM guidelines.

Workers' Compensation Appeals BoardLien ClaimantPetition for ReconsiderationFindings and OrderMedical Treatment Utilization Schedule (MTUS)American College of Occupational and Environmental Medicine (ACOEM)Labor Code Section 4600(b)SB 899Compromise and ReleaseAgreed Medical Examiner (AME)
References
3
Case No. MISSING
Regular Panel Decision

Diaz v. New York Downtown Hospital

The dissenting opinion by Mazzarelli, J., joined by Saxe, J., argues against granting summary judgment to New York Downtown Hospital in a case involving alleged sexual misconduct during a vaginal sonogram. The dissent asserts that the plaintiff's expert radiologist provided sufficient evidence, based on 1995 American College of Radiology (ACR) and American Institute of Ultrasound in Medicine (AIUM) guidelines, indicating the hospital's deviation from the standard of care by not ensuring a female chaperone was present. Mazzarelli, J., contends that these national guidelines explicitly recognized the risk of such misconduct and constitute generally accepted industry standards. The dissent also distinguishes the present case from precedents cited by the majority, emphasizing the probative value of expert testimony regarding custom and practice. Furthermore, it challenges the majority's unforeseeability argument, concluding that the guidelines delineated a foreseeable risk, thus necessitating the denial of the defendant's motion for summary dismissal.

Medical MalpracticeStandard of CareExpert TestimonySummary JudgmentDissenting OpinionRadiologySonogramHospital NegligenceProfessional GuidelinesSexual Misconduct
References
15
Case No. MISSING
Regular Panel Decision

National Union Fire Insurance Co. of Pittsburgh v. American Re-Insurance Co.

The case revolves around a dispute between National Union Fire Insurance Company and American Re-Insurance Company regarding a pollution exclusion clause in a reinsurance policy. National Union sought reimbursement from American Re after settling claims where employees were exposed to metalworking fluids. American Re denied coverage, arguing its pollution exclusion applied. The court, applying Ohio law, found American Re's pollution exclusion ambiguous due to its broad language and its intended purpose of covering environmental contamination. Consequently, American Re's motion for summary judgment was denied, and National Union's motion to strike American Re's defense was granted, requiring American Re to "follow the fortunes" of National Union.

ReinsurancePollution Exclusion ClauseContract InterpretationFollow the Fortunes DoctrineSummary JudgmentInsurance CoverageAmbiguity in ContractsOhio State LawDiversity JurisdictionIndustrial Contamination
References
31
Case No. MISSING
Regular Panel Decision

Curry v. American International Group, Inc. Plan No. 502

Curry, a former Regional Insurance Underwriting Manager for AIG, sued American International Group, Inc. Plan No. 502 and American International Life Assurance Co. of New York ("AI Life") under ERISA § 502(a) after her long-term disability benefits were terminated. Curry suffers from degenerative osteoarthritis and diabetes. AI Life initially approved her benefits but later terminated them, alleging she could perform a sedentary occupation, relying on unverified medical responses. The court found AI Life's decision to be arbitrary and capricious due to its reliance on unreliable medical opinions, failure to clarify the record, and disregard for Curry's doctors' reports. Consequently, the court granted Curry's motion for summary judgment, denying the defendants' motion, and ordered the reinstatement of her benefits with prejudgment interest and attorney's fees.

ERISALong-term disabilityBenefits terminationArbitrary and capricious standardConflict of interestMedical opinionUnreliable evidenceSummary judgmentOrthopaedic conditionsDiabetes
References
10
Case No. MISSING
Regular Panel Decision

In re the Arbitration between North Country Community College Ass'n & North Country Community College

Petitioner Michael Leahy, a tenured accounting professor, was terminated by North Country Community College for misconduct involving a heated verbal exchange with his supervisor. Leahy and his union, the North Country Community College Association of Professionals, filed a grievance that proceeded to arbitration. The arbitrator found serious misconduct but modified the penalty to a 15-month suspension without pay, along with anger management counseling, rather than termination. Petitioners sought to confirm the arbitration award, while respondents cross-moved to vacate it. The Supreme Court confirmed the award, and this appellate court affirmed that decision, concluding that the arbitrator did not exceed his authority in modifying the penalty and that the award was not irrational or violative of strong public policy.

Arbitration Award ConfirmationEmployee TerminationWorkplace MisconductCollective Bargaining AgreementArbitrator AuthorityPublic Policy ChallengePenalty ModificationAnger ManagementJudicial Review of ArbitrationDisciplinary Action
References
8
Case No. 96-CV-3879, 96-CV-6310
Regular Panel Decision

Schuloff v. Queens College Foundation, Inc.

Plaintiff Anita Schuloff filed two separate lawsuits against Queens College Foundation, Inc. and Brooklyn College Foundation, Inc., which were consolidated due to identical legal issues. Schuloff alleged violations of 26 U.S.C. § 6104 for the defendants' failure to promptly provide federal tax returns for public inspection, along with claims under 42 U.S.C. § 1983 and New York Freedom of Information Law. The defendants moved to dismiss the complaints under Federal Rules of Civil Procedure 12(b)(1) and 12(b)(6). The Court granted the motions to dismiss under Rule 12(b)(6), ruling that 26 U.S.C. § 6104 does not create a private cause of action, thus precluding the related § 1983 claims. Consequently, the Court declined supplemental jurisdiction over the state law claims, dismissing both complaints in their entirety.

Private Cause of ActionTax-Exempt Organizations26 U.S.C. § 610442 U.S.C. § 1983Rule 12(b)(6)Motion to DismissFederal JurisdictionStatutory InterpretationLegislative HistorySupplemental Jurisdiction
References
28
Case No. MISSING
Regular Panel Decision

Meling v. St. Francis College

Barbara Meling sued St. Francis College and its president, Donald Sullivan, alleging wrongful termination due to physical disabilities, violating the Americans with Disabilities Act and the Rehabilitation Act. A jury found in Meling's favor, awarding $225,000 in compensatory damages and $150,000 in punitive damages. The defendants' motions for judgment as a matter of law, a new trial, and to set aside punitive damages were denied, upholding the jury's verdicts. The court also granted Meling $141,251 in back pay with interest and ordered her reinstatement as an Assistant Professor of Physical Education. However, her request for reinstatement with tenure was denied, as the court opted not to intervene in the university's tenure decision-making process.

Disability discriminationWrongful terminationAmericans with Disabilities ActRehabilitation ActCompensatory damagesPunitive damagesBack payReinstatementTenureAcademic freedom
References
24
Case No. MISSING
Regular Panel Decision

Neeld v. American Hockey League

Plaintiff Gregory P. Neeld, a one-eyed individual, sought a preliminary injunction against the American Hockey League (AHL) to challenge its by-law (Article 13(e)) prohibiting one-eyed players from participating in professional hockey. Neeld alleged violations of 42 U.S.C. § 1983 and New York's Human Rights Law § 296(1)(a). The court dismissed the § 1983 claim for lack of state action but found a probability of success on the state human rights claim, noting that visual impairment can only be a bar if it's a bona fide occupational qualification. The court also addressed diversity jurisdiction, dismissing a non-diverse defendant to retain the state claim. Ultimately, the court granted a preliminary injunction, preventing the AHL and its New York franchises from applying Article 13(e) to Neeld within the state.

Disability DiscriminationProfessional HockeyPreliminary InjunctionHuman Rights LawState ActionDiversity JurisdictionOccupational QualificationSports LawIrreparable HarmNew York Law
References
21
Case No. MISSING
Regular Panel Decision
Apr 15, 1983

American White Cross Laboratories, Inc. v. North River Insurance

Vincent Yeager, an employee of American White Cross Laboratories, Inc. (American), was injured during employment, leading to a lawsuit against a machine manufacturer, who then brought a third-party action against American for indemnification. American was covered by both a workers’ compensation policy from the State Insurance Fund and a general liability policy from North River Insurance Co. North River disclaimed liability, citing exclusions for workers’ compensation obligations and bodily injury to employees. American then initiated a fourth-party action against North River for contribution. The Supreme Court initially denied American's summary judgment motion and granted North River's cross-motion to dismiss, with leave to replead for indemnification. This court reversed, holding that North River's exclusions do not insulate it from American’s claims because the employer's liability to a third-party tort-feasor for an employee's injury arises from equitable apportionment, not directly from workers' compensation law, thus granting American's motion for summary judgment and denying North River's cross-motion.

Insurance coverage disputeGeneral liability policyWorkers' compensation exclusionContribution between tort-feasorsIndemnificationSummary judgmentFourth-party actionDole-Dow doctrineEquitable apportionmentEmployer liability
References
2
Case No. MISSING
Regular Panel Decision

Figueroa v. Manhattanville College

The plaintiff Charles Figueroa suffered serious injuries after falling 35 to 40 feet from a ladder at Manhattanville College. He and his wife sued Manhattanville College, alleging a violation of Labor Law § 240 (1). The college subsequently initiated a third-party action against Figueroa's employer. The plaintiffs moved for partial summary judgment on liability, providing evidence of safety regulation violations and lack of safety equipment. The Supreme Court denied their motion, citing an issue of fact regarding whether Figueroa fell from the ladder or the roof. The appellate court reversed the Supreme Court's order, granting the plaintiffs' motion for partial summary judgment on liability, finding that the defendant's opposition was based on mere speculation regarding the fall's location. The case was remitted for further proceedings.

Personal InjuryLadder FallLabor LawAbsolute LiabilitySummary JudgmentAppellate ReviewWorkplace AccidentSafety RegulationsPremises LiabilityNew York Law
References
8
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