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

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. 2016-263 Q C
Regular Panel Decision
May 25, 2018

Mind & Body Acupuncture, P.C. v. Allstate Ins. Co.

Mind & Body Acupuncture, P.C., as assignee, appealed an order denying its summary judgment motion and granting Allstate Insurance Company's cross-motion to dismiss the complaint regarding first-party no-fault benefits. The Appellate Term, Second Department, modified the Civil Court's order, affirming the denial of the plaintiff's motion but reversing the grant of the defendant's cross-motion. The court ruled that Allstate failed to establish timely mailing of its denial of claim forms, thus precluding its defense. However, the plaintiff also failed to prove that the claims were not timely denied or that the denials were without merit, leading to the proper denial of its summary judgment motion.

No-Fault BenefitsSummary Judgment MotionAppellate TermInsurance DefenseDenial of ClaimTimely MailingWorkers' Compensation Fee ScheduleAssignee ClaimCivil Court OrderAffidavit Sufficiency
References
4
Case No. ADJ14297412; ADJ14297399
Regular
Sep 29, 2025

DAVID OLIVAS vs. ECKLES AUTO BODY, INC.; PREFERRED PROFESSIONAL INSURANCE COMPANY

The case involves David Olivas, an auto body worker, who sustained specific and cumulative trauma injuries and settled his claims via a Joint Compromise and Release. The defendant, Eckles Auto Body, Inc. and Preferred Professional Insurance Company, denied payment for interpreting services provided by Marjorie Martinez, citing untimely submission under Labor Code section 4603.2(b). The Workers' Compensation Appeals Board (WCAB) denied the defendant's Petition for Reconsideration. The Board affirmed that Labor Code section 4603.2(b) does not apply to interpreting services for Compromise and Release settlement documents, as it is limited to medical treatment-related services, concluding such services fall under a different regulatory framework for costs which lacks the 12-month billing requirement.

Workers' Compensation Appeals BoardPetition for ReconsiderationLabor Code section 5909Electronic Adjudication Management System (EAMS)transmission date60-day deadlinenotice of transmissionReport and RecommendationState Comp. Ins. Fund v. Workers' Comp. Appeals Bd. (Dorsett)Labor Code section 4663
References
4
Case No. LAO 854789
Regular
Oct 09, 2007

Juana Manriquez vs. KENVIN, INC., dba CORDOVAN & GREY LTD, STATE COMPENSATION INSURANCE FUND

The applicant sought extended temporary disability benefits, claiming a rotator cuff debridement during shoulder arthroscopy constituted an "amputation" under Labor Code section 4656(c)(2)(C). The Board denied reconsideration, affirming the WCJ's finding that "debridement" of an internal body part, like bone, does not meet the statutory definition of amputation. This definition requires the severance or removal of a limb or body appendage, conforming to the common understanding of the term.

Juana ManriquezKenvin IncState Compensation Insurance FundLAO 854789Petition for ReconsiderationAugust 6 2007 Findings and Ordershoulder arthroscopyamputationLabor Code section 4656(c)(2)(C)temporary disability
References
4
Case No. MISSING
Regular Panel Decision

Stromski v. Jefferson Auto Body

The claimant, an auto body repairer for 27 years, sought workers' compensation benefits for stomach cancer, attributing it to occupational exposure to chromium and talc. The Workers’ Compensation Board denied his claim, concluding that his disease was not causally related to his occupation after resolving conflicting expert medical testimony against him. The Board credited the carrier's expert, an internal medicine specialist, who testified that studies only link a specific type of chromium to carcinogenicity in the upper respiratory tract, not stomach cancer. This expert testimony successfully rebutted the statutory presumption of compensability under Workers’ Compensation Law § 21. The appellate court affirmed the Board's decision, emphasizing that resolving conflicts in medical testimony, particularly regarding causation, falls within the Board's province. Additionally, the claimant's appeal from the denial of reconsideration was deemed abandoned.

Occupational DiseaseStomach CancerCausationMedical Expert TestimonyChromium ExposureTalc ExposureBurden of ProofStatutory PresumptionAppellate ReviewBoard Decision Affirmed
References
4
Case No. MISSING
Regular Panel Decision
Apr 13, 1973

Vic's Auto Body & Repair v. Granito

This case concerns an Article 78 proceeding challenging the denial of a special exception permit for an automobile body and fender repair shop. Initially, the Supreme Court, Nassau County, annulled the denial and directed the issuance of the permit. However, the appellate court reversed this judgment, reinstating the appellants' original determination and dismissing the petition. The appellate court found that the appellants' denial was supported by evidence of potential noise, fumes, visual blight from wrecked cars, the residential nature of the vicinity, and the severe negative impact on a neighboring medical practice. The court concluded that the proposed use failed to meet the standards for a special exception permit.

Special Exception PermitZoning DenialAutomobile Repair ShopNuisanceResidential CharacterMedical Practice ImpactCPLR Article 78Abuse of Discretion ReviewProperty ValueAppellate Review
References
1
Case No. ADJ7233668 ADJ7233692 ADJ7941780
Regular
Sep 23, 2014

WALTER MENJIVAR (DECEASED) vs. ABLE BODY LABOR, BROADSPIRE

In *Menjivar (Deceased) v. Able Body Labor; Broadspire*, the Workers' Compensation Appeals Board denied a Petition for Removal. The applicant sought to remove the cases from trial, arguing that an Agreed Medical Evaluator's report indicated a need for psychiatric expertise and that defendants' Declaration of Readiness to Proceed was defective. The Board adopted the WCJ's report, finding that any objections to the DOR were waived due to untimeliness, and that the applicant had prior opportunities to address discovery issues. Defense counsel was also admonished for failing to include her state bar number.

Petition for RemovalWorkers' Compensation Appeals BoardWCJ reportDEIDRA E. LOWEKATHERINE ZALEWSKIMandatory Settlement ConferenceDeclaration of Readiness to ProceedDOR defectsinformal resolutionpsychiatrist opinion
References
0
Case No. ADJ2950403 (POM 0263778)
Regular
Feb 25, 2007

LUIS RIOS vs. HOLMES BODY SHOP, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) has granted a petition for reconsideration filed by the defendant, Holmes Body Shop, Inc. and State Compensation Insurance Fund. This grant is to allow further study of the factual and legal issues presented by the case. The WCAB believes additional review is necessary to ensure a just and reasoned decision. All future communications must be filed with the WCAB's Office of the Commissioners.

Workers' Compensation Appeals BoardPetition for ReconsiderationGranting PetitionStatutory Time ConstraintsFactual and Legal IssuesDecision After ReconsiderationOffice of the CommissionersService by MailOfficial Address Record
References
0
Case No. MISSING
Regular Panel Decision

Garcia v. Pepe

Raul Garcia, an automobile mechanic, suffered severe burns in 1997 while moving a gasoline tank, igniting flammable fumes. He sued his employer, P.N.P. Auto Body, Inc. (PNP), and landlords Peter Pepe, Jr., and Laurie Pepé. The Supreme Court initially denied the defendants' motions for summary judgment and PNP's motion to vacate a default judgment. On appeal, the court dismissed a portion of the Pepes' appeal as premature. The appellate court reversed the orders against the Pepes and PNP, granting their motions for summary judgment and vacating the default judgment against PNP. The court found that the plaintiff's claims were barred by workers' compensation exclusivity, leading to the dismissal of the complaint against all appealing defendants.

Personal InjurySummary JudgmentWorkers' Compensation ExclusivityDefault JudgmentVacate JudgmentAppellate ReviewPremises LiabilityEmployer LiabilityLandlord LiabilityProximate Cause
References
11
Case No. SFO 0501425
En Banc
Sep 05, 2007

Paul Cruz vs. Mercedes-Benz of San Francisco, Auto Dealers Compensation of California

The Appeals Board held that the term 'amputations' in Labor Code section 4656(c)(2)(C) refers to the severance of a limb or external body appendage, not the surgical removal of internal parts like a spinal disk, thus denying the applicant extended temporary disability benefits.

Labor Code section 4656(c)(2)(C)amputation exceptiontemporary disability indemnitytwo-year/104-week capsurgical removaltraumatic losslimbbody appendageen banc decisionWorkers' Compensation Appeals Board
References
14
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