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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

Matter of Lichten v. New York City Transit Authority

Claimant, a bus driver, filed for workers' compensation benefits due to an occupational disease stemming from repetitive stress injuries to his legs, including his hips, knees, and feet, caused by his employment. The Workers’ Compensation Law Judge established the case for bilateral hips but disallowed the claim for bilateral knees. This disallowance was upheld by the Workers’ Compensation Board. Claimant appealed this decision. Medical testimony presented conflicting opinions regarding the causal relationship of claimant's knee condition to his work activities. The Board's decision to discredit the treating orthopedist's opinion was found to be supported by substantial evidence and was within its authority concerning credibility determinations. The appellate court affirmed the Board's decision.

Workers' CompensationOccupational DiseaseRepetitive Stress InjuryBilateral KneesCausal RelationshipMedical EvidenceCredibility DeterminationAppellate ReviewAffirmed DecisionBus Driver
References
6
Case No. MISSING
Regular Panel Decision

Nayal v. HIP Network Services IPA, Inc.

Dr. Christine Nayal initiated a class action against HIP Network Services IPA, Inc., alleging breach of contract, unjust enrichment, and a violation of New York General Business Law § 349. As a practicing psychologist, Nayal claimed that HIP, a health maintenance organization, failed to provide timely and adequate reimbursement, including interest, for services rendered under their agreement. HIP responded by filing a motion to compel arbitration, citing a clause in their contract, or, alternatively, seeking dismissal of the claims. The Court, presided over by Judge Victor Marrero, evaluated the enforceability of the arbitration provision. Finding no procedural or substantive unconscionability under New York law, the Court granted HIP's motion to compel arbitration for all claims, subsequently dismissing the entire action without prejudice.

Arbitration AgreementUnconscionabilityClass Action WaiverFederal Arbitration ActNew York General Business LawContract DisputeBreach of ContractUnjust EnrichmentMotion to Compel ArbitrationDismissal Without Prejudice
References
34
Case No. ADJ7741661
Regular
Mar 11, 2020

James E. Lewis vs. County of Riverside

The Workers' Compensation Appeals Board rescinded a prior award and found that the applicant, James Lewis, sustained a cumulative injury to his bilateral hips in addition to previously acknowledged injuries. This finding was based on new evidence, including medical reports and testimony, establishing that Lewis was unaware of his hip condition until February 25, 2014, despite prior medical evaluations. The Board determined that the date of injury for his hip condition was February 25, 2014, making it timely to reopen the claim. Consequently, the award was amended to include the hip injury, and all other issues were deferred.

Workers' Compensation Appeals BoardDeputy SheriffCumulative TraumaNew and Further DisabilityGood Cause to ReopenStipulations with Request for AwardAgreed Medical Evaluator (AME)Primary Treating PhysicianOsteoarthritisDifferential Diagnosis
References
10
Case No. 533203
Regular Panel Decision
Oct 06, 2022

In the Matter of the Claim of Meggan Cotterell

Claimant Meggan Cotterell, a resident assistant, was injured at work on September 13, 2015, sustaining lower back injuries. In 2018, it was determined she also suffered a causally-related right hip labral tear. The employer and carrier objected to amending her claim to include the hip injury, arguing it was untimely under Workers' Compensation Law § 28. A WCLJ credited the testimony of claimant's treating orthopedist, Matthew Stein, who diagnosed the hip injury in June 2017, and amended the claim. The Workers' Compensation Board affirmed, and the Appellate Division, Third Judicial Department, also affirmed, finding that numerous medical reports filed within two years of the accident, establishing bilateral hip pain, were sufficient to provide the Board with facts from which a claim for compensation could be reasonably inferred, thus preventing the claim from being time-barred under Workers' Compensation Law § 28.

Workers' CompensationHip InjuryLabral TearTimeliness of ClaimAmendment of ClaimStatute of LimitationsMedical EvidenceOrthopedist TestimonyCausal RelationshipPreexisting Condition
References
7
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. 2020 NY Slip Op 01879 [181 AD3d 1132]
Regular Panel Decision
Mar 16, 2020

Matter of Abdiyev v. Eagle Container Corp.

Claimant, David Abdiyev, appealed a decision by the Workers' Compensation Board. The Board had denied his application for administrative review of a Workers' Compensation Law Judge's (WCLJ) decision disallowing his claim for work-related injuries, specifically to bilateral shoulders, left elbow, left hand, bilateral knees, left hip, neck, head, and back. The denial was based on Abdiyev's failure to interpose an objection to the WCLJ's decision on the record, as required by 12 NYCRR 300.13 (b) (4) (v). The Appellate Division, Third Department, affirmed the Board's decision, ruling that the regulation was consistent with Workers' Compensation Law § 23 and that the Board did not abuse its discretion in declining review.

Workers' Compensation LawAdministrative ReviewWCLJ DecisionObjection RequirementAppellate ProcedureBoard RegulationsCredibility FindingMedical EvidenceClaim DisallowanceJudiciary Law
References
5
Case No. 533203
Regular Panel Decision
Oct 06, 2022

Matter of Cotterell v. Trinity Health Corp.

Claimant, Meggan Cotterell, sustained a lower back injury in 2015 while working for Trinity Health Corporation. Later, a right hip injury was found to be causally-related to the original work injury. The employer and carrier argued the hip injury claim was untimely under Workers' Compensation Law § 28, which mandates claims be filed within two years of the accident. The Workers' Compensation Board affirmed the claim amendment, crediting the treating orthopedist's testimony that initial hip pain was confused with low back symptoms and the hip labral tear was diagnosed later. The Appellate Division affirmed the Board's decision, finding that medical reports indicating hip pain filed within two years, coupled with the delayed diagnosis, provided substantial evidence to support the Board's determination that the amendment was not time-barred.

Workers' CompensationHip InjuryLabral TearTimelinessWorkers' Compensation Law § 28CausationMedical EvidenceOrthopedist TestimonyAppellate ReviewBoard Decision
References
7
Case No. ADJ7649680, ADJ7650589
Regular
Apr 20, 2015

MIGUEL VEGA vs. COLLIGERE FARM MANAGEMENT, INC.

The Workers' Compensation Appeals Board (WCAB) affirmed a prior award finding applicant sustained industrial injury to his bilateral hips and back. Defendant argued the award was unsupported by medical evidence and their petition for reconsideration was timely. The WCAB found the initial service of the award was defective, thus the petition was timely filed based on defendant's claimed receipt in "late September." Ultimately, the WCAB affirmed the award, incorporating the WCJ's reasoning by reference.

WCABPetition for ReconsiderationFindings of Fact Award and OrderPermanent DisabilityApportionmentFurther Medical CareIndustrial InjuryTimelinessProof of ServiceService Defects
References
0
Case No. ADJ128523 (GOL 0095636) ADJ1378031 (GOL 0095637)
Regular
Oct 10, 2016

MARIA PADILLA vs. DONALD AND LINDA FAREED, ALLSTATE INSURANCE COMPANY c/o SEDGWICK CMS

The Workers' Compensation Appeals Board rescinded a prior award, finding applicant did not sustain industrial injury to her left hip, left knee, right shoulder, or bilateral upper and lower extremities, based on Agreed Medical Examiner opinions. The Board deferred issues of temporary disability, permanent disability, apportionment, and attorney fees for further development of the record. Industrial injury was affirmed for the psyche and previously stipulated body parts, along with medical treatment and reimbursement for expenses. The case is returned to the trial level for further proceedings and a new decision.

Workers' Compensation Appeals BoardReconsiderationJoint Findings of Fact and AwardPermanent Total DisabilityApportionmentAgreed Medical Examiner (AME)Independent Medical Examiner (IME)Injury Arising Out of and Occurring in the Course of Employment (AOE/COE)Cumulative Trauma (CT)Temporary Disability
References
9
Case No. ADJ8042940
Regular
May 15, 2015

, Victor Moran, vs. , J.B. Hunt Transportation Services; Liberty Mutual Insurance Company,

The Workers' Compensation Appeals Board granted reconsideration to amend the temporary disability end date to May 9, 2013, and to remove findings of injury to the applicant's bilateral knees due to insufficient medical evidence. The Board affirmed the original award for injury to the applicant's left shoulder, low back, neck, and left hip. Defendant's claim for credit for overpaid temporary disability benefits was denied as it was not raised during the original proceedings. A dissenting opinion argued for retaining the finding of injury to the knees, noting applicant's complaints, despite lack of permanent disability.

WCABPetition for ReconsiderationFindings and AwardTemporary DisabilityPermanent DisabilityCredit for OverpaymentSubstantial EvidenceTreating PhysicianSubpoenaed RecordsDissenting Opinion
References
6
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