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

Case No. MISSING
Regular Panel Decision

What Happened in Felix vs. Weber Metals Reconsideration?

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. MISSING
Regular Panel Decision
Jun 16, 2006

How Did the WCAB Rule in Hardgrove vs. Intercon Security?

Vanessa Cantu suffered severe injuries in a car accident and sued multiple parties. Her medical insurer, Fortis Benefits, intervened, seeking subrogation for medical benefits paid under the policy. After Cantu settled with the defendants, Fortis pursued recovery from Cantu. Cantu argued that the equitable "made whole" doctrine barred Fortis's claim because her total losses exceeded the settlement amount plus the benefits Fortis paid. The trial court and court of appeals sided with Cantu. The Texas Supreme Court reversed, holding that the "made whole" doctrine does not override an insurer's clear contractual subrogation rights. The Court affirmed the dismissal of Fortis's claims against Ford due to a pretrial agreement.

Insurance SubrogationMade Whole DoctrineContractual SubrogationEquitable SubrogationERISATexas LawInsurance Policy InterpretationPersonal InjuryAutomobile AccidentSettlement Proceeds
References
28
Case No. MISSING
Regular Panel Decision

What Did the WCAB Decide in Cuadra vs. Community Home Care?

Walter Vogel, a 73-year-old security guard, sustained a work-related shoulder and back injury, leading to a trial court finding of 100% permanent and total disability. The trial court declared Tennessee Code Annotated Section 50-6-207(4)(A)(i) unconstitutional for its age-related benefit caps and awarded Vogel lifetime benefits. On appeal, the Supreme Court reversed, upholding the constitutionality of the statute's age-based distinctions for permanent total disability benefits under the Equal Protection Clause and the Age Discrimination in Employment Act, finding them rationally related to the state's interest in tying workers' compensation to Social Security benefits. However, the Court found the statute's disparate treatment of permanent total versus permanent partial disability benefits for workers over sixty to be irrational, modifying the award to 260 weeks of benefits for the plaintiff.

Workers' CompensationAge DiscriminationEqual ProtectionConstitutional LawPermanent Total DisabilityPermanent Partial DisabilitySocial Security BenefitsWage LossJudicial ReviewStatutory Interpretation
References
19
Case No. MISSING
Regular Panel Decision
Feb 22, 1984

How Were Death Benefits Handled in Bocanegra vs. Sun-Gro Commodities?

The plaintiff, injured in May 1978 during maintenance work, was denied workers' compensation due to the absence of an employer-employee relationship. Subsequently, he sought reimbursement for medical expenses from the Hudson Valley District Council of Carpenters Benefit Funds (Benefit Funds) through a union insurance policy. Continental Assurance Company (Continental), Benefit Funds' insurer, rejected the claim, citing an employment-related injury exclusion in the policy. The plaintiff then initiated an action against Benefit Funds, which in turn filed a third-party action against Continental seeking indemnification. Continental's motion for summary judgment, asserting the exclusion, was denied by the County Court. The appellate court affirmed this denial, ruling that the exclusionary language was ambiguous and applied only in cases where a clear employer-employee relationship existed, a fact still to be determined.

Insurance Policy InterpretationEmployment StatusWorkers' Compensation ExclusionSummary Judgment MotionContractual AmbiguityGroup Health InsuranceMedical Expense ReimbursementThird-Party ActionAppellate ReviewEmployer-Employee Relationship
References
10
Case No. 2017 NY Slip Op 08460 [156 AD3d 404]
Regular Panel Decision
Dec 05, 2017

Can a WCJ Be Disqualified for Appearance of Bias?

The Appellate Division, First Department, reversed a Supreme Court order, dismissing third-party claims for common law indemnification, contribution, and contractual indemnification. The court found that the plaintiff did not sustain a 'grave injury' as defined in Workers' Compensation Law § 11, making common law indemnification and contribution claims unsustainable against the employer. The claim for contractual indemnification was deemed unenforceable under General Obligations Law § 5-322.1, as it would indemnify CAP Rents for its own potential negligence. Additionally, the claim for failure to procure insurance was dismissed because the reservation contract did not expressly and specifically require Schiavone to name CAP Rents as an additional insured. CAP Equipment Leasing Corporation was also found to lack standing to enforce the contract.

indemnificationcontributiongrave injuryWorkers' CompensationGeneral Obligations Lawcontractual indemnificationinsurance procurementadditional insuredsummary judgmentnegligence
References
7
Case No. MISSING
Regular Panel Decision

What Were the Key Rulings in Torrez vs. SuperShuttle?

The Trustees of the Local 852 General Warehouseman’s Union Pension Fund sued the Pension Benefit Guarantee Corporation (PBGC) seeking reimbursement for pension benefits paid to retirees of two closed warehouses. The Fund argued for recovery based on equitable estoppel, asserting detrimental reliance on an initial PBGC determination that it would guarantee these benefits. The PBGC moved for summary judgment, contending that estoppel against a federal agency requires a showing of affirmative misconduct or manifest injustice. The Court found no evidence of affirmative misconduct by the PBGC and concluded that its change in determination, made to conform with Congressional intent, did not constitute manifest injustice. Consequently, the Court granted the PBGC's motion for summary judgment, ruling that equitable estoppel was inapplicable.

Equitable EstoppelFederal Agency EstoppelSummary JudgmentERISAPension BenefitsMulti-employer PlanPension Benefit Guarantee Corporation (PBGC)Affirmative MisconductManifest InjusticeDetrimental Reliance
References
10
Case No. 535144
Regular Panel Decision
Nov 17, 2022

Why Was Removal Denied in Rush vs. California Correctional Institution?

Hope J. Jennings, a supermarket clerk, sustained a work-related shoulder injury in 2007, leading to established workers' compensation benefits. She was classified with a nonschedule permanent partial disability in 2012, subject to a durational cap for wage loss benefits, which expired in November 2018. Following a causally-related cervical fusion surgery in July 2019, claimant sought temporary total disability benefits, arguing these should not count towards the permanent partial disability cap. The Workers' Compensation Board, on full Board review, rescinded an earlier decision and ruled that the expiration of the durational cap did not preclude claimant from seeking temporary total disability benefits after subsequent surgeries. The Appellate Division affirmed the Board's decision, clarifying that temporary total disability benefits under Workers' Compensation Law § 15 (2) are distinct from permanent partial disability benefits under § 15 (3) (w) and are not subject to the latter's durational caps.

Workers' CompensationTemporary Total DisabilityPermanent Partial DisabilityDurational CapWage Loss BenefitsCervical Fusion SurgeryShoulder InjuryAppellate ReviewStatutory InterpretationWorkers' Compensation Law § 15
References
4
Case No. Civ. A. No. 3:93-CV-0171-G.
Regular Panel Decision
Aug 31, 1993

What Did the WCAB Clarify in Ontiveros vs. Savers Stores?

Walter Mills was injured during his employment and sought benefits under his employer's Injury Benefits Plan. He subsequently filed a civil action alleging wrongful termination in retaliation for filing a workers' compensation claim under Texas law. Defendants removed the case to federal court, asserting ERISA preemption. The court granted the defendants' motion to dismiss Mills' claims against the Injury Benefits Plan, finding them preempted by ERISA. However, the court denied the dismissal of Mills' state law claims against Schepps-Foremost, Inc., d/b/a Oak Farms Dairies. Ultimately, the court remanded the remaining state law claims against Schepps-Foremost, Inc. to the County Court at Law Number 5 of Dallas County, Texas, due to a lack of federal subject matter jurisdiction.

ERISA preemptionWorkers' CompensationRetaliatory dischargeTexas lawFederal jurisdictionMotion to dismissRemandEmployee benefitsCivil procedureDallas County
References
18
Case No. 2022 NY Slip Op 06531
Regular Panel Decision
Nov 17, 2022

Why Was Reconsideration Denied in Gomez vs. Dorothy Stevens?

Claimant, Hope J. Jennings, a supermarket clerk, suffered a work-related shoulder injury in 2007, leading to a classification of nonschedule permanent partial disability with a 50% loss of wage-earning capacity in 2012, subject to a 300-week durational cap for benefits. Following further causally-related surgeries in 2017 (shoulder) and 2019 (cervical fusion), claimant sought temporary total disability benefits after the durational cap on her permanent partial disability benefits had expired. The Workers' Compensation Board (WCB) ultimately ruled that the expiration of the durational cap on permanent partial disability benefits does not preclude a claimant from seeking temporary total disability benefits following a causally-related surgery. The Appellate Division, Third Department, affirmed the Board's decision, emphasizing that Workers' Compensation Law § 15 (2) (temporary total disability) and § 15 (3) (w) (permanent partial disability) operate under distinct statutory provisions, and the durational cap applies only to benefits payable under the latter paragraph.

Workers' Compensation Law § 15Temporary Total DisabilityPermanent Partial DisabilityDurational CapWage Loss BenefitsCervical Fusion SurgeryShoulder InjuryReclassification of DisabilityStatutory InterpretationAppellate Review
References
4
Case No. MISSING
Regular Panel Decision

Why Was Reconsideration Dismissed in Sabino vs. Johnson Pump Company?

Plaintiff Claude Jeffries, a retired electrician, sued the Pension Trust Fund of the Electrical Industry under ERISA, seeking to include pension credits from 1969-1975 in his current benefits. He alleged the Plan should have declared a partial termination during a 1975-1979 New York recession, which would have vested his benefits. The defendant moved to dismiss the complaint, arguing lack of standing and statute of limitations, while plaintiff moved for class certification for similarly affected members. The court denied the defendant's motion to dismiss the claim for benefits, finding it timely, but granted dismissal for the breach of fiduciary duty claim as time-barred. The plaintiff's motion for class certification was denied due to insufficient evidence for numerosity, with leave to refile after discovery.

ERISAPension BenefitsClass CertificationMotion to DismissStatute of LimitationsFiduciary DutyPartial TerminationBenefit ForfeitureUnemploymentLabor Union
References
15
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