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

Case No. Motions Nos. 5 and 7
Regular Panel Decision
Jul 27, 1978

Rachlin v. Lewis

This case consolidates two CPLR article 78 proceedings challenging the Insurance Department's regulations on attorneys' fees in no-fault automobile insurance disputes and the constitutionality of certain sections of the Insurance Law. The petitioners sought to rescind 11 NYCRR 65.16 and declare Insurance Law section 671 et seq. unconstitutional. The court ruled that sections 11 NYCRR 65.16 (c) (7) (ix), which prohibited attorneys from charging clients fees in excess of insurer-paid fees, and 11 NYCRR 65.16 (c) (7) (vii), concerning the regulation of disbursements, were invalid as they exceeded the scope of the enabling legislation. However, the court upheld the general fee schedule, finding a rational basis for its establishment by the Insurance Department.

Attorney's FeesNo-Fault InsuranceInsurance LawRegulatory ChallengeCPLR Article 78Administrative LawConstitutional LawDisbursementsArbitrationAutomobile Insurance
References
6
Case No. ADJ1888124 (SAL 0111884) ADJ3322590 (SAL 0079903)
Regular
Oct 20, 2016

MARIA NUNEZ vs. MANN PACKING COMPANY, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION For FREMONT COMPENSATION INSURANCE COMPANY, In Liquidation; STATE OF CALIFORNIA

This case concerns the California Insurance Guarantee Association's (CIGA) liability for an applicant's workers' compensation claims after Fremont Compensation Insurance Company became insolvent. CIGA argued it should be relieved of liability because the State of California, as the applicant's employer through IHSS, constituted "other insurance" under Insurance Code Section 1063.1. The Appeals Board affirmed the WCJ's decision, holding that the State of California does not qualify as "other insurance" under the relevant statutes. This distinction is based on the State not being required to obtain workers' compensation insurance or a certificate of self-insurance like private or other public employers.

CIGAFremont Compensation Insurance Companyliquidationlegally uninsuredother insuranceInsurance Code Section 1063.1covered claimsIn-Home Supportive Services (IHSS)statutory limitationsself-insurance
References
5
Case No. ADJ700106 (SAL 0075388) ADJ4293270 (SAL 0067937) ADJ3847224 (SAL 0067938) ADJ1646200 (SAL 0011386)
Regular
Sep 01, 2015

WILLIE PEARSON vs. STATE OF CALIFORNIA DEPARTMENT OF CORRECTIONS, Chamberlain's Children Center, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, SUPERIOR NATIONAL INSURANCE COMPANY

In this workers' compensation case, CIGA sought to be relieved of liability for applicant's medical treatment, arguing that the State of California Department of Corrections ("the State") constituted "other insurance." The Appeals Board affirmed the WCJ's decision that the State does not qualify as "other insurance" under Insurance Code section 1063.1(c)(9)(A). Unlike private self-insured employers, the State is not required to obtain workers' compensation insurance or a certificate of self-insurance, and thus does not fall within the statutory definition of an "insurer." The Board further clarified that the State Compensation Insurance Fund's role in claim adjustment services for the State does not make it "other insurance" when the State is not otherwise insured with SCIF.

CIGASupernational Insurance Companylegally uninsuredother insurancecovered claimsInsurance Code Section 1063.1State of California Department of Correctionsreimbursementstipulated awardjoint and several liability
References
7
Case No. ADJ9883212
Regular
May 19, 2018

LADONNA PALEGA vs. CALIFORNIA HIGHWAY PATROL, STATE COMPENSATION INSURANCE FUND

This case concerns a California Highway Patrol officer diagnosed with adenocarcinoma in situ of the cervix. The defendant, California Highway Patrol, sought reconsideration of a finding that this condition constituted an industrial injury under Labor Code section 3212.1. The defendant argued that the applicant's condition was not considered "cancer" and therefore the statutory presumption of industrial causation did not apply. The Workers' Compensation Appeals Board denied reconsideration, upholding the finding based on qualified medical evaluator Dr. Ngo's opinion that adenocarcinoma in situ qualifies as cancer under the statute. The Board found the defendant failed to rebut the presumption by providing evidence that the exposure to carcinogens was not linked to the disabling cancer.

Labor Code section 3212.1presumption of injurycervical canceradenocarcinoma in situLoop Electrosurgical Excision Procedure (LEEP)substantial medical evidencepanel qualified medical evaluatordisputable presumptionrebuttal evidencecarcinogen exposure
References
1
Case No. MISSING
Regular Panel Decision

United Derrickmen & Riggers Assoc. Local Union No. 197 of the International Ass'n of Bridge v. Local No. 1 Bricklayers & Allied Craftsman

This action was initiated by Local 197 against Local 1, alleging breach of contract based on violations of the Constitutions of the Building and Construction Trades Department (BCTD) and the Building and Construction Trades Council of Greater New York (BCTC), as well as their respective jurisdictional dispute resolution plans. Local 197 sought partial summary judgment to compel Local 1 to honor its contractual obligations and to rejoin the BCTC, from which Local 1 had withdrawn. Conversely, Local 1 sought summary judgment to dismiss the entire suit, arguing that Local 197 lacked standing as a third-party beneficiary and that the state law tort claims were preempted by the National Labor Relations Act (NLRA). The court determined that Local 197 was an incidental, not intended, beneficiary of the BCTD Constitution and National Plan, and that Local 1's disaffiliation from the BCTC removed its obligations to the New York Plan. Additionally, the court ruled that Local 197's state law claims for tortious interference were preempted by the NLRA. Consequently, the plaintiff's motion for summary judgment was denied, and the defendant's cross-motion for summary judgment was granted, leading to the dismissal of the plaintiff's suit.

Labor LawJurisdictional DisputeBreach of ContractSummary JudgmentThird-Party BeneficiaryNLRA PreemptionUnion AffiliationCollective BargainingAFL-CIO ConstitutionLocal Union Rights
References
26
Case No. MISSING
Regular Panel Decision
May 31, 2012

Windsor v. United States

This case addresses Edie Windsor's constitutional challenge to Section 3 of the Defense of Marriage Act (DOMA), which defined marriage exclusively as between one man and one woman. This definition required Windsor to pay federal estate tax on her late same-sex spouse's estate, a tax from which heterosexual couples were exempt. Windsor contended that Section 3 of DOMA violated the Equal Protection Clause of the Fifth Amendment. The Bipartisan Legal Advisory Group (BLAG) intervened to defend DOMA's constitutionality. The Court denied BLAG's motion to dismiss and granted Windsor's motion for summary judgment, ruling that Section 3 of DOMA is unconstitutional as applied to Windsor and awarded her $353,053.00 plus interest and costs.

Constitutional LawEqual Protection ClauseFifth AmendmentDefense of Marriage ActDOMASame-sex MarriageFederal Estate TaxSummary JudgmentMotion to DismissJudicial Scrutiny
References
62
Case No. MISSING
Regular Panel Decision
Jul 09, 2002

Saunders v. New York City Health & Hospitals Corp.

This case involves an order and judgment from the Supreme Court, New York County, concerning a proceeding under CPLR article 78. The petition was granted to the extent of enjoining the respondent from appointing temporary employees in disregard of Civil Service Law § 64 (1) and directing an amendment to its policy regarding Civil Service Law § 75 (1) (c) to include part-time employees. However, the application for lost wages and benefits on behalf of petitioner Patino was denied. The court unanimously affirmed the decision, stating that the injunctive relief was properly granted as the respondent failed to articulate an important need for open-ended temporary employment consistent with Civil Service Law. The court also rejected the argument that Civil Service Law § 75 (1) (c) applies only to full-time employees, affirming that no hearing was required for Patino's termination under the applicable collective bargaining agreements.

Temporary EmployeesCivil Service LawInjunctive ReliefPart-time EmployeesLost WagesCollective Bargaining AgreementsTerminationPublic PolicyJudicial ReviewAdministrative Law
References
4
Case No. 2023 NY Slip Op 03329
Regular Panel Decision
Jun 21, 2023

Castro v. Wythe Gardens, LLC

The plaintiff, a construction worker, sustained injuries after tripping in a gap between a staircase step and landing. He initiated an action against Express Builders, the general contractor, alleging violations of Labor Law sections 240(1) and 241(6). Express Builders then filed third-party claims seeking contractual indemnification. The Supreme Court initially granted the plaintiff's motion for summary judgment on liability and dismissed a third-party indemnification claim. The Appellate Division modified this ruling, determining that Labor Law section 240(1) and 12 NYCRR 23-1.7(b)(1)(i) were not applicable to the plaintiff's injuries as they did not involve elevation-related risks or a hazardous opening for a complete fall. However, the court affirmed the summary judgment for the plaintiff under Labor Law section 241(6), based on 12 NYCRR 23-1.7(e)(1) pertaining to tripping hazards. The Appellate Division also reinstated the contractual indemnification claim against Bayport Construction Corp., citing triable issues of fact, and upheld the denial of Express Builders' indemnification claims against Urban Precast and Urban Erectors due to unresolved questions regarding Express Builders' own negligence.

Construction AccidentLabor LawIndustrial Code ViolationSummary Judgment MotionContractual IndemnificationTripping HazardElevation-Related RiskAppellate DivisionPersonal InjurySubcontractor Agreement
References
17
Case No. MISSING
Regular Panel Decision

Crosby v. State

This case involves an appeal from a declaratory judgment action challenging the constitutionality of section 24 of the Workers’ Compensation Law. The plaintiff argued that the statute, which limits attorney fees in workers' compensation cases, violated her rights to privacy, freedom to contract, and equal protection. The Supreme Court at Special Term granted summary judgment to the defendant, the Workers’ Compensation Board, dismissing the complaint. On appeal, the court affirmed the constitutionality of section 24, finding no violation of the plaintiff’s rights. The court reasoned that the right to privacy does not extend to attorney contracts, the freedom to contract is subject to reasonable police power limitations, and the fee limitations serve a rational legislative purpose of protecting claimants, thus satisfying equal protection requirements.

Workers' Compensation LawAttorney FeesConstitutional LawRight to PrivacyFreedom to ContractEqual ProtectionSummary JudgmentAppealPolice PowerDeclaratory Judgment
References
6
Case No. SRO 0107686
En Banc
Jul 27, 2004

Jose L. Martinez vs. Jack Neal & Son, Inc., Fremont Compensation Insurance Company, In Liquidation, California Insurance Guarantee Association, Cambridge Integrated Services, Inc.

The Appeals Board held that under Insurance Code section 1063.1(c)(8), as amended effective January 1, 2004, the California Insurance Guarantee Association (CIGA) is not liable for Labor Code section 5814 penalties awarded on or after that date for an insolvent insurer's unreasonable delay of benefits.

CIGAinsolvent insurercovered claimsLabor Code section 5814Insurance Code section 1063.1(c)(8)unreasonable delaymedical benefitsen banc decisionprospective applicationstatutory exclusion
References
20
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