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Case Law Database

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

Case No. 2015-2418 K C
Regular Panel Decision
May 25, 2018

Remedial Med. Care, P.C. v. Park Ins. Co.

This case involves an appeal from an order of the Civil Court concerning first-party no-fault benefits. The defendant, Park Insurance Co., sought summary judgment to dismiss the complaint filed by Remedial Medical Care, P.C., as assignee of Thomas Brown. The Civil Court initially denied the motion but found that the defendant had established timely mailing of denials. The Appellate Term modified the order, granting summary judgment to the defendant for a bill of services rendered on August 23, 2012, as it was paid according to the workers' compensation fee schedule. However, for the remaining bills, the defendant failed to prove timely mailing of IME scheduling letters, thus failing to demonstrate that the IMEs were properly scheduled or that the assignor failed to appear. Therefore, the denial of summary judgment for the remaining claims was affirmed.

Summary JudgmentNo-Fault BenefitsIndependent Medical Examination (IME)Timely MailingWorkers' Compensation Fee ScheduleAppellate TermCivil CourtDenial of ClaimFirst-Party BenefitsInsurance Law
References
3
Case No. MISSING
Regular Panel Decision

Mr. and Mrs. A. v. NY CITY DEPARTMENT OF EDUC.

This case addresses whether a school district can be ordered to make retroactive tuition payments directly to a private school for a child with disabilities, even when parents have not made upfront payments due to financial constraints. An Impartial Hearing Officer found that the New York City Department of Education (DOE) failed to provide a Free Appropriate Public Education (FAPE) to D.A., a child with autism, and that the Rebecca School was an appropriate placement, ordering DOE to pay tuition. A State Review Officer overturned the tuition remedy, arguing it only applied to out-of-pocket reimbursement. The District Court, however, concluded that the IDEA's provision for 'appropriate relief' includes the power to order retroactive direct tuition payments to ensure a FAPE is available regardless of a family's financial means. Consequently, the court granted the plaintiffs' motion for summary judgment and denied the defendants' motion.

Individuals with Disabilities Education Act (IDEA)Free Appropriate Public Education (FAPE)Special EducationPrivate School Tuition FundingRetroactive PaymentsSummary JudgmentAutism Spectrum DisorderIEP (Individualized Education Program)Burlington TestEquitable Remedies
References
36
Case No. MISSING
Regular Panel Decision

Guerrero Toro v. Northstar Demolition

Plaintiff Alexander Guerrero Toro, a pro se asbestos handler, sued NorthStar Demolition & Remediation LP under the Americans with Disabilities Act (ADA) and New York State Human Rights Law (NYSHRL), alleging failure to accommodate his carpal tunnel syndrome, wrongful termination, workplace harassment, and retaliation. After experiencing pain in his right arm, Plaintiff was placed on restricted duty, limiting his ability to perform essential job functions. Defendant provided various temporary light-duty assignments, but eventually, no suitable tasks remained due to seasonal changes and Plaintiff's ongoing limitations. Plaintiff also claimed harassment from co-workers and supervisors, and retaliation for filing administrative complaints. The court granted Defendant's motion for summary judgment, dismissing all claims, concluding that Plaintiff failed to demonstrate he could perform essential job functions with or without reasonable accommodation, or that a hostile work environment or retaliation existed based on admissible evidence. The NYSHRL claims were also dismissed, with some being jurisdictionally barred due to the election of remedies.

Americans with Disabilities ActDisability DiscriminationCarpal Tunnel SyndromeReasonable AccommodationHostile Work EnvironmentRetaliationSummary JudgmentPro Se LitigationEmployment LawNew York State Human Rights Law
References
122
Case No. MISSING
Regular Panel Decision
Nov 23, 1981

Malone v. Jacobs

This case involves an appeal by defendants Stephen and John Jacobs from a Supreme Court order denying their motion to dismiss the complaint filed by Daniel and Linda Malone. The Malones sought damages for personal injuries Daniel sustained in an automobile accident with Stephen Jacobs, with both men being volunteer firemen responding to an alarm. The appellate court determined that both were acting in the line of duty, making the Volunteer Firemen’s Benefit Law their exclusive remedy. Consequently, the order was reversed, granting defendants leave to amend their answer to assert this exclusive remedy defense, and summary judgment was granted, leading to the dismissal of the Malones' complaint. The court also affirmed that John Jacobs, as the vehicle owner, could rely on the same defense due to vicarious liability.

Volunteer Firemen's Benefit LawExclusive RemedySummary JudgmentAffirmative DefenseAutomobile AccidentPersonal InjuryLoss of ConsortiumLine of DutyVicarious LiabilityMotion to Dismiss
References
6
Case No. AD J8716290, ADJ9711169
Regular
Apr 06, 2016

CAROLYN WILSON vs. COUNTY OF ALAMEDA, YORK RISK SERVICES GROUP

The Workers' Compensation Appeals Board denied the defendant's Petition for Removal. Removal is an extraordinary remedy granted only upon a showing of substantial prejudice or irreparable harm, which was not demonstrated here. The WCAB adopted the WCJ's report, finding that reconsideration would be an adequate remedy if the matter proceeds to a final decision. The underlying issue involves an applicant's statutory right to appeal an Independent Medical Review decision, a matter appropriate for an evidentiary hearing.

Petition for RemovalIndependent Medical ReviewLabor Code Section 4610.6Utilization ReviewSubstantial PrejudiceIrreparable HarmEvidentiary HearingWorkers' Compensation Appeals BoardWCJ ReportJurisdiction
References
3
Case No. ADJ4415679 (OAK 0259031) ADJ2701101 (WCK0050594)
Regular
May 10, 2010

Stanley Sanders vs. REMEDY INTELLIGENT STAFFING, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for RELIANCE NATIONAL INSURANCE COMPANY, OREGON STEEL MILLS, INC. dba NAPA PIPE

The Workers' Compensation Appeals Board reversed a judge's decision, ruling that Napa Pipe, a self-insured special employer, is liable for applicant Stanley Sanders' workers' compensation benefits. Despite an agreement between the general employer (Remedy Temp) and Napa Pipe attempting to limit liability to Remedy Temp's insurer (Reliance), Napa Pipe's joint and several liability as a special employer cannot be contractually eliminated. Because Napa Pipe's self-insurance was not excluded for special employees and constitutes "other insurance" under Insurance Code § 1063.1(c)(9), CIGA is relieved of its obligation to provide benefits following Reliance's insolvency. Therefore, Napa Pipe must now provide all workers' compensation benefits and administer the claim.

Workers' Compensation Appeals BoardStanley SandersRemedy Intelligent StaffingCalifornia Insurance Guarantee AssociationReliance National Insurance CompanyOregon Steel MillsNapa PipeADJ4415679ADJ2701101Opinion and Decision After Reconsideration
References
24
Case No. MISSING
Regular Panel Decision

In re the Arbitration between Continental Baking Co. & Genuth

The court unanimously affirmed the order, awarding $20 in costs and disbursements to the petitioner-respondent. The demand for arbitration was deemed sufficiently broad to allow arbitrators to determine fault in an altercation between Superintendent Shinn and employee Kuliek. Additionally, the arbitration demand permits the arbitrators to decide an appropriate remedy. The court stated that the permissible extent of the remedy should not be considered in advance of the award, and any concerns regarding the arbitrators exceeding their powers can be addressed after the award is rendered.

ArbitrationAltercationEmployee DisputeSuperintendentFault DeterminationRemedyScope of PowersJudicial ReviewCostsDisbursements
References
0
Case No. ADJ8663592, ADJ8663593
Regular
Feb 09, 2018

EDY GOMEZ vs. ADAMS AND BROOKS, INC., GALLAGHER BASSETT

The Workers' Compensation Appeals Board denied the defendant's Petition for Removal, upholding the WCJ's report. Removal is an extraordinary remedy requiring a showing of substantial prejudice or irreparable harm, which the defendant failed to demonstrate. The Board agreed with the WCJ that the defendant's arguments regarding discovery and alleged lack of notice were insufficient to warrant removal, as reconsideration would be an adequate remedy. The Board noted that the applicant's potential unawareness of a hearing was a weak excuse, but still appropriate grounds for rescheduling the settlement conference.

Petition for RemovalWorkers' Compensation Appeals BoardMandatory Settlement ConferenceSubstantial PrejudiceIrreparable HarmReconsiderationDue Process of LawEqual ProtectionWCJ ReportApplicant Counsel
References
2
Case No. ADJ2294426
Regular
Mar 02, 2018

SONA SIMONIAN vs. COUNTY OF LOS ANGELES

Here's a summary of the case for a lawyer: The Workers' Compensation Appeals Board denied a Petition for Removal, deeming it an extraordinary remedy not warranted in this case. The petitioner, a lien claimant, argued the Administrative Law Judge (ALJ) improperly expanded a lien conference to include a costs and sanctions petition, violating due process and causing prejudice. The Appeals Board found the petitioner failed to demonstrate substantial prejudice or irreparable harm, or that reconsideration would be an inadequate remedy. The ALJ's decision to consolidate the lien claim with the sanctions issue was deemed appropriate for judicial economy, particularly given the age of the lien claimant.

Removal PetitionAppeals BoardWCJ ReportSubstantial PrejudiceIrreparable HarmReconsiderationConstitutional Due ProcessLien ClaimSanctionsCosts
References
3
Case No. MISSING
Regular Panel Decision

Meehan v. Patchogue-Medford School District

Bradley Meehan, a student with Attention Deficit Disorder, sued the Patchogue-Medford School District under various federal and state disability laws, alleging the school failed to provide appropriate educational services for his needs. The School District filed a motion to dismiss the complaint, asserting that Meehan had not exhausted his administrative remedies as required by the Individuals with Disabilities Education Act (IDEA). Meehan contended that his efforts to pursue administrative relief were obstructed by the School District. The Court, presided over by Judge Spatt, denied the defendant's motion to dismiss, ruling that Meehan's failure to exhaust administrative remedies was excusable because the School District prevented him from accessing proper administrative hearings. Therefore, Meehan's federal and state law claims were permitted to proceed.

Individuals with Disabilities Education ActAmericans with Disabilities ActRehabilitation Act of 1973New York State Executive LawSpecial Education NeedsAttention Deficit DisorderExhaustion of Administrative RemediesMotion to DismissDue Process RightsSchool District Negligence
References
14
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