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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 Joslin v. City of Albany Fire Department

The claimant appealed a Workers’ Compensation Board decision regarding the method of payment for his hearing loss benefits, specifically challenging the biweekly installment plan. The claimant argued that Workers’ Compensation Law § 49-bb, which governs occupational loss of hearing claims, mandated a different payment method. The court rejected this contention, asserting that Workers’ Compensation Law § 15 (3) (m), which covers schedule awards for hearing losses generally, and § 49-cc, which directs occupational loss of hearing compensation to align with § 15 (3), govern the payment. Consequently, the court affirmed that the claimant was entitled to biweekly scheduled payments, consistent with other schedule loss awards.

Hearing lossWorkers' CompensationOccupational diseaseSchedule awardBiweekly paymentsStatutory interpretationAppealCompensation benefitsWorkers' Compensation Board
References
2
Case No. MISSING
Regular Panel Decision

Taylor v. North River Ins. Co., New Jersey

Mrs. L. Jean Taylor was awarded workers' compensation death benefits as the surviving spouse of Walter O. Taylor. The respondent, North River Insurance Company, contested her right to benefits, despite admitting the fatal injury. The trial court found a valid common-law marriage and ordered attorneys' fees paid in a lump sum. The court of appeals reversed, mandating periodic payments. However, the Supreme Court of Texas, referencing Stott v. Texas Employers Insurance Ass’n, reversed the court of appeals' judgment and affirmed the trial court's lump sum award, citing TEX.REV.CIV.STAT.ANN. art. 8306 § 8(d) which authorizes lump sum awards when a carrier forces litigation in death benefits claims.

Workers' CompensationDeath BenefitsAttorneys' FeesLump Sum PaymentPeriodic PaymentCommon-Law MarriageTexas LawInsurance CarrierLitigationWrit of Error
References
1
Case No. MISSING
Regular Panel Decision
Feb 02, 1984

Krebbeks v. Regan

Petitioner, the widow of a Department of Transportation employee, applied for accidental death benefits after her husband's service-connected death in July 1981. Although her application for accidental death benefits was approved, these benefits were entirely offset by workers' compensation payments, leaving her with no current payments from the State Employees’ Retirement System. Subsequently, petitioner sought a lump-sum ordinary death benefit, which was denied because she was deemed eligible for accidental death benefits, even if offset. This appeal ensued after the denial of her application by a hearing officer and Special Term's concurrence. The court affirmed the denial, citing Retirement and Social Security Law § 60 (a) (3), which states an ordinary death benefit is not payable if an accidental death benefit is payable, with a narrow exception not applicable here.

Accidental Death BenefitsOrdinary Death BenefitsWorkers' Compensation OffsetRetirement and Social Security LawStatutory InterpretationDeath Benefits EligibilityPublic Employee BenefitsAdministrative Law AppealDeath Benefit Offset
References
2
Case No. 2020-08-0309
Regular Panel Decision
Jan 26, 2021

Bryant, Joshua v. Malco Theaters, Inc.

Joshua Bryant requested additional medical and temporary disability benefits for a head injury sustained while working for Malco Theaters Inc. The employer argued that Bryant filed his Petition for Benefit Determination (PBD) outside the applicable statute of limitations and had already paid all entitled benefits. Bryant received initial medical evaluations from various providers, including neurologists Dr. Alan Nadel and Dr. Mohammed Assaf. Dr. Nadel eventually placed Bryant at maximum medical improvement with no impairment and returned him to regular duty. Malco's claim handler stated the last payment of medical benefits was on March 22, 2019. Bryant filed his PBD on March 26, 2020, which was more than one year after the last payment. The Court concluded that Bryant's claim was barred by the one-year statute of limitations and consequently denied his request for benefits.

Statute of LimitationsHead Injury ClaimMedical BenefitsTemporary Disability BenefitsPetition for Benefit DeterminationMaximum Medical ImprovementNeurological EvaluationWorkers' Compensation Claims CourtClosed-Head InjuryDizziness
References
0
Case No. 2017-08-1205
Regular Panel Decision
Apr 27, 2018

Washington, John v. UPS Ground Freight, Inc.

John Washington, an employee of UPS Ground Freight, Inc., requested additional medical and temporary disability benefits for a September 7, 2017 work injury. UPS maintained it had paid all entitled benefits and had provided multiple panels of neurologists, which Mr. Washington largely rejected due to subjective concerns. The Court found that UPS had complied with its statutory duty to provide physicians, but Mr. Washington had not complied with his duty to choose one. The Court ordered UPS to allow Mr. Washington to choose another neurologist from the previously provided panels, warning that benefits could remain suspended if he failed to comply. The Court denied Mr. Washington's requests for payment of unauthorized emergency room bills, personal care assistant payments, additional temporary disability benefits, and adjustments to his wage rate calculation, concluding that his refusal to accept medical services justified the suspension of temporary benefits.

Workers' CompensationMedical BenefitsTemporary DisabilityExpedited HearingNeurology EvaluationPost-Concussion SyndromeWage Rate CalculationUnauthorized TreatmentPhysician PanelEmployee Non-Compliance
References
6
Case No. MISSING
Regular Panel Decision

Claim of Sciame v. Airborne Express, Inc.

This case addresses the application of Workers’ Compensation Law § 15 (6) (a) concerning the maximum weekly benefits a claimant can receive for concurrent schedule and nonschedule awards. The court reaffirms its established precedent that these concurrent payments cannot exceed the statutory cap of $400 per week for 2004 injuries, irrespective of whether the nonschedule award stems from a permanent disability. This principle was also extended to include periodic payments for a schedule loss of use award and nonschedule award payments for temporary disability. The court concluded that the 2009 amendments to Workers’ Compensation Law §§ 15 and 25 did not indicate legislative intent to overturn this longstanding cap. Consequently, the Board's decision, which held that the claimant's receipt of maximum weekly benefits from a nonschedule award precluded additional benefits from a schedule loss of use award, was affirmed.

Workers' Compensation BenefitsBenefit MaximumsConcurrent AwardsSchedule Loss of Use AwardNonschedule AwardStatutory CapJudicial Precedent AffirmationWorkers' Compensation Law Interpretation2009 Amendments AnalysisPermanent Disability Benefits
References
11
Case No. 2017-06-0070
Regular Panel Decision
Aug 28, 2017

Baker, Tonya v. Electolux

Tonya Baker sought an expedited hearing for medical and temporary disability benefits after a workplace fall. She requested payment for medical bills, a change in her authorized treating physician, and temporary disability payments. Electrolux argued she was not entitled to these benefits, stating they provided medical treatment. The Court found Ms. Baker likely to succeed in obtaining a new panel of physicians but denied her requests for temporary disability benefits and payment of unauthorized medical bills, citing a lack of evidence for the latter and no doctor-issued restrictions for the former. The incident was deemed compensable, but Ms. Baker's ongoing pain after being released by the authorized physician led to the decision for a new panel.

Workers' CompensationExpedited HearingMedical BenefitsTemporary Disability BenefitsPanel of PhysiciansAuthorized Treating PhysicianSciaticaLumbar StrainWorkplace InjuryMedical Treatment Dispute
References
2
Case No. MISSING
Regular Panel Decision

Garden State Anesthesia Associates, PA v. Progressive Casualty Insurance

Garden State Anesthesia Associates (GSAA) sued Progressive Casualty Insurance Company for unpaid first-party no-fault benefits after providing services to Angela Gowan-Walker. Progressive delayed payment, citing the need for Gowan-Walker's examination under oath (EUO) and extensive medical and workers' compensation records. Although Gowan-Walker completed her EUO, Progressive continued to issue delay letters, requesting information primarily from third parties and Gowan-Walker's attorney, without directly contacting GSAA for verification. The court denied Progressive's motion for summary judgment, ruling that an insurer cannot indefinitely toll the 30-day payment period by requesting verification unrelated to the specific provider's claim or by failing to request verification directly from the provider.

No-fault benefitsSummary JudgmentInsurance LawVerification RequestDelay LetterEUOMedical RecordsInsurance ClaimsTimelinessTolling
References
9
Case No. 2016-06-1933
Regular Panel Decision
Apr 20, 2017

Williford, Douglas v. New Bern Transport

Douglas Williford sought medical and permanent disability benefits through an expedited hearing for a work-related left knee injury sustained while working for New Bern Transport, operating as Pepsi Company. Pepsi had initially provided temporary disability payments and medical treatment, including arthroscopic surgery by Dr. David Moore, who placed Mr. Williford at maximum medical improvement on May 7, 2015. However, Mr. Williford filed his Petition for Benefit Determination on October 11, 2016, more than one year after Pepsi's last temporary disability payment and medical bill payment. Pepsi raised the statute of limitations as a defense. The Court found that Mr. Williford failed to file his petition within the one-year statute of limitations and that his lack of knowledge regarding the law did not constitute an exception. Consequently, the Court denied Mr. Williford's claim for workers’ compensation benefits.

Workers' Compensation ClaimStatute of Limitations DefenseKnee Injury CompensationExpedited Hearing DenialMedical Benefits RequestPermanent Disability BenefitsPetition for Benefit DeterminationTimeliness of FilingEmployer Voluntary PaymentsMaximum Medical Improvement
References
7
Case No. 2016-01-0035 / 67325-2014
Regular Panel Decision
Aug 07, 2017

Findley, Jack v. Volswagen Group of America, Inc.

This case involves an employee, Jack Keith Findley, who sustained a back injury while working for Volkswagen. He sought temporary and additional permanent partial disability benefits, leading to a dispute over his impairment rating, maximum medical improvement date, and the compensability of his condition. The Court of Workers' Compensation Claims sided with Mr. Findley, awarding him the requested disability benefits and future medical care under Dr. Jolley, based on Dr. Hodges' medical opinion regarding his work-related injury and functional limitations. The court also allowed Volkswagen to offset short-term disability payments.

Workers' CompensationPermanent Partial DisabilityTemporary Partial DisabilityMedical BenefitsImpairment RatingMaximum Medical ImprovementVoluntary ResignationMedical Opinion ConflictBack InjuryLumbar Disc Herniation
References
5
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