CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

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

Case No. 2024 NY Slip Op 00599 [224 AD3d 428]
Regular Panel Decision
Feb 06, 2024

Matter of New Millennium Pain & Spine Medicine, P.C. v. Garrison Prop. & Cas. Ins. Co.

This case involves two appeals by New Millennium Pain & Spine Medicine, P.C. against Garrison Property & Casualty Insurance Company and GEICO Casualty Company. New Millennium sought to vacate master arbitration awards that denied its claims for no-fault benefits for medical services. The Supreme Court denied these applications. The Appellate Division, First Department, affirmed the Supreme Court's decisions, stating that an arbitrator's award will not be set aside unless it is irrational. The court also addressed the argument regarding a 20% wage offset in no-fault benefits, finding it unavailing under Insurance Law § 5102 (b). Ultimately, New Millennium was not entitled to attorneys' fees as it was not the prevailing party.

No-fault benefitsarbitration awardvacaturinsurance lawwage offsetappellate reviewmedical servicesno-fault policy exhaustionattorneys' feesCPLR Article 75
References
8
Case No. 534130
Regular Panel Decision
Nov 17, 2022

In the Matter of the Claim of Trina Yearwood

Claimant Trina Yearwood appealed a Workers' Compensation Board decision disallowing her claim for benefits related to bilateral wrist, hand, and thumb pain, diagnosed as an occupational disease from repetitive stress. A Workers' Compensation Law Judge initially established the claim, but the Board reversed it, citing the claimant's failure to disclose a prior 2014 medical treatment for hand problems to her medical providers and the Board. The Appellate Division affirmed the Board's decision, finding that the claimant's omission of relevant medical history prevented medical experts from forming credible opinions on the causal connection between her conditions and employment. The court concluded that the Board's determination was supported by substantial evidence.

Occupational DiseaseCarpal Tunnel SyndromeRepetitive Stress InjuryWorkers' Compensation BenefitsMedical EvidenceCausal ConnectionTreatment History OmissionIndependent Medical ExaminationCredibility of ClaimantAppellate Review
References
12
Case No. 2022 NY Slip Op 06524
Regular Panel Decision
Nov 17, 2022

Matter of Yearwood v. Long Is. Univ.

Claimant Trina Yearwood sought workers' compensation benefits for bilateral wrist, hand, and thumb pain, diagnosed as an occupational disease from repetitive stress. A Workers' Compensation Law Judge (WCLJ) initially established the claim. However, the Workers' Compensation Board reversed this decision and disallowed the claim because Yearwood failed to disclose a prior 2014 treatment history for hand problems to her treating physician, the IME physician, or the Board. The Appellate Division, Third Department, affirmed the Board's decision, finding that the Board rationally concluded the medical providers lacked sufficient understanding of claimant's complete medical history to proffer a credible opinion on causation, and thus her medical proof was insufficient.

Workers' Compensation BenefitsOccupational DiseaseRepetitive Stress InjuryCarpal Tunnel SyndromeMedical Evidence CredibilityTreatment History NondisclosureCausal ConnectionIndependent Medical ExaminationAppellate ReviewBoard Discretion
References
11
Case No. MISSING
Regular Panel Decision
May 05, 2000

Pain Resource Center v. Travelers Insurance

This case addresses a dispute regarding the payment of first-party no-fault benefits to a health provider, Pain Resource Center, as the assignee of John Hiotis, who was injured in an auto accident. The defendant, Travelers Ins. Co., challenged the validity of the assignment and the necessity of the medical services provided. The court affirmed the validity of the assignment under New York's Insurance Law and related regulations. However, based on conflicting expert testimonies, the court limited the compensable medical services to six hours and awarded the plaintiff $566.10, along with statutory interest and attorney's fees.

No-Fault InsuranceFirst-Party BenefitsAssignment ValidityMedical ServicesPeer ReviewInsurance LawHealth Provider ClaimAutomobile AccidentDamagesStatutory Interpretation
References
5
Case No. MISSING
Regular Panel Decision

Universal Acupuncture Pain Services, P.C. v. Lumbermens Mutual Casualty Co.

The New York court addresses a motion for reargument by Universal Acupuncture Pain Services, P.C. against Lumbermens Mutual Casualty Company concerning no-fault insurance claims. The central legal question is whether an expert witness's peer review report, created after a timely denial of a no-fault claim, can be admitted at trial, specifically under the Cirucci precedent regarding the specificity of denial grounds. The court grants the motion for reargument but upholds its initial ruling, which granted partial summary judgment on one of five claims. It clarifies that the expert's testimony must be strictly limited to the "concurrent or excessive care" ground initially stated by the insurer, excluding any new grounds like "medical necessity" not specified in the original denial. The court emphasizes that the issue of whether different treatment modalities constitute concurrent care for the same condition requires a trial for factual determination.

No-Fault InsurancePeer ReviewExpert Witness TestimonySummary Judgment MotionInsurance Law InterpretationSpecificity of DenialConcurrent Medical CareAcupuncture TreatmentChiropractic TreatmentPhysical Therapy
References
7
Case No. MISSING
Regular Panel Decision

Claim of Feliciano v. New York City Health & Hospitals Co.

Claimant sought workers' compensation benefits for bilateral carpal tunnel syndrome. Initially, a Workers' Compensation Law Judge ruled the left hand claim time-barred by Workers' Compensation Law § 28 and established August 28, 2006, as the disability date for the right hand. On appeal, the Workers' Compensation Board affirmed the right hand's disability date but, on its own motion, set December 2003 as the disability date for the left hand, thereby confirming the left hand claim was untimely. The claimant appealed, arguing against two disability dates for a single claim. The court affirmed the Board's decision, finding substantial evidence supported treating the hand injuries as discrete occupational diseases with separate disablement dates and upheld the time-bar for the left hand claim.

Workers' CompensationOccupational DiseaseCarpal Tunnel SyndromeTime-barred ClaimDate of DisablementBilateral InjuriesAppellate ReviewWorkers' Compensation BoardJudicial ReviewStatute of Limitations
References
6
Case No. POM 0244323, POM 0260214
Regular
Jan 14, 2008

BERTHA KOCIAN vs. CLOUGHERTY PACKING dba FARMER JOHN

The Workers' Compensation Appeals Board granted reconsideration to correct a clerical error in the date of injury for applicant's bilateral hand and right knee cumulative trauma claim, changing it to 1980-March 22, 2001. The Board affirmed the original decision denying apportionment of permanent disability to pre-existing conditions, finding defendant failed to provide substantial medical evidence to support their claim. Applicant sustained industrial injury to her bilateral hands and right knee, resulting in 67 percent permanent disability.

KocianClougherty PackingFarmer JohnPOM 0244323POM 0260214Petition for ReconsiderationFindings and Awardssausage stufferindustrial injuryright knee
References
0
Case No. 2018 NY Slip Op 05544
Regular Panel Decision
Jul 26, 2018

Matter of Schmerler v. Longwood Sch. Dist.

Claimant Susan Schmerler, a school security guard, initially established a claim for work-related injuries to her neck, back, and hands from a September 2013 incident. She later sought to amend her claim to include bilateral hip and knee injuries. A Workers' Compensation Law Judge denied the amendment due to insufficient evidence of a causal relationship. The Workers' Compensation Board affirmed this decision and subsequently denied reconsideration. The Appellate Division, Third Department, affirmed the Board's decisions, crediting the testimony of an orthopedic surgeon who found no causal relationship between the workplace incident and the claimant's hip and knee pain, despite conflicting medical opinions.

Workers' Compensation LawCausal ConnectionHip InjuriesKnee InjuriesClaim Amendment DenialMedical Expert TestimonySubstantial Evidence StandardAppellate ReviewOrthopedic ExaminationBoard Decision Affirmed
References
6
Case No. MISSING
Regular Panel Decision
Jul 17, 2001

Claim of Jones v. HSBC

The case involves an appeal from a Workers’ Compensation Board decision concerning the applicability of Workers’ Compensation Law § 25-a. The claimant, an accounts clerk for Marine Midland Bank, developed carpal tunnel syndrome from repetitive keyboarding in 1991, leading to an occupational disease claim. After surgery in 1994, the case was closed in 1995 with an award for a 15% schedule loss of use of her right hand. Subsequently, the claimant experienced increased pain and new bilateral diagnoses in 1998, prompting a new claim and modification of the original claim to include additional body parts. The central dispute was whether the Special Fund for Reopened Cases was responsible for further medical payments. The Board affirmed that § 25-a applied, holding the Fund liable for treatment after September 11, 1998. The appellate court affirmed the Board's decision, finding its determination that the case was truly closed in 1995 and subsequently reopened was supported by substantial evidence.

Workers' Compensation Law § 25-aSpecial Fund for Reopened CasesCase Reopening CriteriaOccupational Disease ClaimCarpal Tunnel SyndromeRepetitive Motion InjurySchedule Loss of Use AwardMedical Payments ResponsibilityAppellate Division AffirmanceSubstantial Evidence Review
References
13
Case No. MISSING
Regular Panel Decision

Claim of Curtis v. Xerox

The claimant, employed for 33 years in data entry, developed severe pain in her wrists, hands, and fingers, leading to a workers’ compensation claim. The Workers’ Compensation Law Judge initially denied benefits, finding no prima facie evidence. However, the Workers’ Compensation Board twice reversed, first directing the employer to produce medical records and later drawing an inference of a causally related occupational disease due to the employer's failure to comply. The Board also precluded lay testimony regarding the nonexistence of these records. On appeal by the employer and carrier, the Appellate Division affirmed the Board’s decision, holding that the Board properly precluded the testimony and drew a negative inference. The court also found substantial medical evidence from treating and independent physicians supported the finding of a work-related occupational disease and confirmed the Board's jurisdiction to remand the case for further proceedings concerning a new diagnosis of bilateral ulnar neuropathy.

Occupational diseaseCarpal tunnel syndromeBilateral ulnar neuropathyData entryMedical recordsNegative inferenceAdjournmentWorkers' Compensation BoardAppellate reviewSubstantial evidence
References
9
Showing 1-10 of 1,211 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational