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

Case No. 2017 NY Slip Op 04412
Regular Panel Decision
Jun 07, 2017

Aprile-Sci v. St. Raymond of Penyafort R.C. Church

Kathleen Aprile-Sci, a volunteer Eucharistic Minister, allegedly tripped and fell at St. Raymond of Penyafort R.C. Church. The Workers' Compensation Board (WCB) determined her injury was work-related and she was entitled to benefits, a decision she did not object to. Subsequently, Aprile-Sci and her husband commenced a personal injury action against the church. The church moved for summary judgment based on the exclusivity provisions of the Workers' Compensation Law. The Supreme Court denied the motion, but the Appellate Division reversed, holding that the WCB's final and conclusive determination barred a collateral attack in a plenary action.

Workers' Compensation LawExclusivity DoctrineSummary JudgmentAppellate ReviewVolunteer StatusPersonal Injury ClaimWCB DeterminationCollateral AttackTriable Issues of FactDiocese Insurance
References
13
Case No. 13-ev-3288; 13-cv-4244
Regular Panel Decision

Alzheimer's Disease Resource Center, Inc. v. Alzheimer's Disease & Related Disorders Ass'n

This case involves two related lawsuits stemming from the disaffiliation of the Alzheimer’s Disease Resource Center, Inc. (ADRC) from the Alzheimer’s Disease and Related Disorders Association (the Association). In case 13-ev-3288, ADRC alleged unfair competition, false advertising, and other claims. The Court denied dismissal for false advertising under the Lanham Act, New York General Business Law § 349, and unjust enrichment, but granted dismissal for trademark infringement, common law unfair competition, UCC violations, conversion, tortious interference, and fraud. In case 13-cv-4244, ADRC alleged breach of contract and misappropriation of trade secrets related to donor lists. The Court granted the Association's motion to dismiss this complaint in its entirety. Punitive damages were stricken for Lanham Act and unjust enrichment claims.

Unfair CompetitionLanham ActFalse AdvertisingTrademark InfringementNew York General Business Law § 349Unjust EnrichmentMotion to DismissBreach of ContractTrade Secret MisappropriationConversion
References
55
Case No. MISSING
Regular Panel Decision

Genesco, Inc. v. JOINT COUNCIL 13, UNITED SHOE WKRS. OF AMER.

The plaintiff, Genesco, Inc., a shoe manufacturer, sued Joint Council 13, United Shoe Workers of America, AFL-CIO, alleging four causes of action. The first cause of action claimed a breach of collective bargaining agreements and a no-strike clause. The second alleged violations of Section 303 of the L.M.R.A. by inducing other employers to cease doing business with Genesco. The third and fourth causes of action were common law torts alleging inducement of other labor organizations to breach contracts and a scheme to destroy Genesco's business. The court dismissed the first cause of action, finding no valid contract existed at the time of the strike. The second cause of action survived dismissal, while the third and fourth causes of action were dismissed with leave to amend, as they were deemed arguably within the exclusive jurisdiction of the National Labor Relations Board.

Labor DisputeCollective Bargaining AgreementNo-Strike ClauseArbitration ClauseUnfair Labor PracticeNational Labor Relations BoardJurisdictionPreemptionPendent JurisdictionDiversity Jurisdiction
References
22
Case No. ADJ8555039
Regular
May 26, 2016

JENNIFER SHARPSHAIR vs. CALIFORNIA STATE BOARD OF EQUALIZATION, STATE COMPENSATION INSURANCE FUND

The applicant sought reconsideration of an amended award that reduced her permanent disability benefits without an evidentiary hearing. The WCJ recommended granting reconsideration and rescinding both the original and amended awards due to procedural error. The Appeals Board adopted the WCJ's recommendation, granting reconsideration and returning the case to the trial level for further proceedings. This decision specifically rescinds the April 4, 2016 award and the April 20, 2016 amended award.

Petition for ReconsiderationAmended AwardPermanent Disability BenefitsEvidentiary HearingWCJ ReportRescinded AwardTrial LevelFurther ProceedingsWorkers' Compensation Appeals Board
References
0
Case No. ADJ 10459549, ADJ 10459544
Regular
Jul 07, 2017

SAUL MEJIA VALLADARES vs. SERVICON SYSTEMS, INCORPORATED

In this case, the Appeals Board affirmed the Arbitrator's denial of the applicant's specific injury claim from March 7, 2016, due to credibility issues and lack of substantial evidence. However, the Board rescinded the denial of the cumulative trauma claim from April 2011 to April 2016. The Board found that medical records indicated prior orthopedic complaints within the cumulative trauma period, necessitating further medical evaluation despite the applicant's credibility issues on other claims. Therefore, the cumulative trauma claim is returned to the Arbitrator for further development of the medical record.

Workers' Compensation Appeals BoardReconsiderationCumulative TraumaSpecific InjuryArbitratorCredibility DeterminationMedical EvaluationLabor Code Section 4060Carve-out CaseLabor Code Sections 3201.5
References
7
Case No. MISSING
Regular Panel Decision
Apr 17, 1990

Claim of Rogers v. Evans Plumbing & Heating

The claimant appealed a decision from the Workers’ Compensation Board, filed on April 17, 1990, which ruled his application untimely. The claimant had applied on August 31, 1988, to review two Workers’ Compensation Law Judge decisions from August 5, 1985, and October 1, 1985, denying compensation benefits for a period between February 7, 1983, and September 23, 1985. The Board correctly determined that the claimant's application was untimely as it was filed more than 30 days after the original decisions, citing Workers’ Compensation Law § 23 and 12 NYCRR 300.13 (a). The Board's decision to not entertain the untimely application was found to be neither arbitrary nor capricious. The higher court subsequently affirmed the Board's decision.

Untimely ApplicationWorkers' Compensation LawAppellate ReviewBoard DecisionProcedural TimelinessJudicial ReviewAppealSection 23NYCRR 300.13Claimant Benefits
References
1
Case No. 533245
Regular Panel Decision
Feb 09, 2023

In the Matter of the Claim of Adam Schulze

Claimant, a firefighter, sustained a work-related neck and back injury in April 2012 and was classified as permanently partially disabled in 2015. The self-insured employer, City of Newburgh Fire Department, paid full salary under General Municipal Law § 207-a (1). In 2016, claimant's disability retirement was approved, and the employer began paying the difference between his pension and regular wages per General Municipal Law § 207-a (2). Claimant sought retroactive workers' compensation awards from April 2016. The Workers' Compensation Law Judge and the Workers' Compensation Board ruled that the employer was not entitled to reimbursement for payments made under General Municipal Law § 207-a (2) against workers' compensation awards, as these payments were not considered 'wages'. The Appellate Division affirmed, holding that supplemental retirement benefits under General Municipal Law § 207-a (2) do not constitute wages for reimbursement purposes under Workers' Compensation Law § 25 (4) (a) or § 30 (2), aligning with prior precedent.

Firefighter disabilityWorkers' compensation benefitsGeneral Municipal LawReimbursementSupplemental pension paymentsAccidental disability retirementPerformance of duty disabilityAppellate DivisionThird Judicial DepartmentWorkers' Compensation Board jurisdiction
References
1
Case No. ADJ6905551
Regular
May 24, 2010

Donald Laytham vs. SUTTER CENTER FOR PSYCHIATRY

This case concerns whether an industrial injury claim was barred as post-termination under Labor Code § 3600(a)(10). The applicant faxed a claim form on April 10, 2009, before receiving his termination notice on April 14, 2009, which was dated April 10, 2009, and mailed April 13, 2009. The Board affirmed the finding that the employer had sufficient notice of the injury prior to termination via the faxed claim form. Therefore, the claim was not barred as post-termination.

Workers' Compensation Appeals BoardReconsiderationFindings of FactIndustrial InjuryFacilities and Project CoordinatorClaim FormPost Termination ClaimLabor Code Section 3600(a)(10)Labor Code Section 5401(c)Labor Code Section 5402(a)
References
1
Case No. 2019 NY Slip Op 00333 [168 AD3d 1240]
Regular Panel Decision
Jan 17, 2019

Matter of Vazquez v. Skuffy Auto Body Shop

Luis Vazquez, an auto body technician, sustained a work-related back injury in 2013 and received workers' compensation benefits. His benefits were suspended in November 2015, and upon his application for reinstatement, the carrier alleged a violation of Workers' Compensation Law § 114-a due to undisclosed work for a landscaping business. Initially, a Workers' Compensation Law Judge found no violation, but the Workers' Compensation Board reversed this decision, determining that Vazquez knowingly made material misrepresentations about his return to work and was subject to mandatory disqualification of benefits from April 25, 2016, to December 28, 2016, and future indemnity benefits after December 29, 2016. The Appellate Division, Third Department, affirmed the Board's decision, finding substantial evidence supported the Board's determination that Vazquez violated Workers' Compensation Law § 114-a by making false representations and omissions regarding his work activity to obtain benefits. The court also found no abuse of discretion in the Board's imposition of a penalty disqualifying him from future indemnity benefits, citing a pattern of deceit.

Workers' Compensation Law § 114-aFraudulent MisrepresentationDisqualification of BenefitsUndisclosed Work ActivityCredibility AssessmentSubstantial EvidenceAppellate ReviewWorkers' Compensation BoardIndemnity BenefitsLandscaping Business
References
5
Case No. 2016-910 K C
Regular Panel Decision
Jan 12, 2018

Precious Acupuncture Care, P.C. v. Hereford Ins. Co.

This case concerns an action by Precious Acupuncture Care, P.C., as assignee of James Hough, against Hereford Insurance Company to recover assigned first-party no-fault benefits. Plaintiff sought the unpaid balance of five claims for services rendered between December 2013 and April 2014. Defendant cross-moved for summary judgment, asserting that the amounts claimed exceeded the workers' compensation fee schedule. The Civil Court initially granted plaintiff's motion, ruling that defendant was precluded from the defense due to untimely denial. However, the Appellate Term reversed this decision, clarifying that under 11 NYCRR 65-3.8 (g) (1) (ii); (2), for services rendered after April 1, 2013, payment is not due for fees exceeding permissible charges, irrespective of timely denial. Consequently, the Appellate Term vacated the prior order, denied plaintiff's motion, and granted defendant's cross-motion for summary judgment dismissing the complaint.

No-Fault BenefitsSummary JudgmentFee Schedule DefenseAppellate ReviewTimely DenialWorkers' Compensation Fee ScheduleMedical BillingInsurance LawCivil CourtAppellate Term
References
5
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