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Case Law Database

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

Case No. MISSING
Regular Panel Decision

Cravotta v. New York City Employees' Retirement System

The petitioner, a New York City sanitation worker, sustained a knee injury after allegedly slipping on a sanitation truck step contaminated by a slippery substance from a dump site. His application for accidental disability retirement benefits from the New York City Employees’ Retirement System (NYCERS) was denied, as his injury was not deemed an "accident" under Retirement and Social Security Law § 605-b. The petitioner challenged this determination, but both the Supreme Court and the appellate court affirmed the denial. The courts found that the injury occurred during routine duties and was not so extraordinary or unexpected as to constitute an accidental injury.

Accidental disabilityRetirement benefitsSanitation workerKnee injurySlipping accidentRoutine dutiesNYCERSAdministrative determinationJudicial reviewAnnulment petition
References
7
Case No. MISSING
Regular Panel Decision

Brown v. New York City Employees' Retirement System

A maintenance employee for the New York City Housing Authority sustained a right knee injury in March 1978 during a mugging and reinjured it in May 1979 while moving a refrigerator. His application for accident disability retirement was denied by the New York City Employees’ Retirement System, whose medical board found no causal relationship between the 1978 incident and the disability, and no accident in 1979. Special Term initially vacated this determination, concluding the 1979 event was an accident. However, the Appellate Division reversed Special Term's judgment, holding that an injury occurring without an unexpected event during ordinary employment duties does not constitute an accidental injury. The court found that the petitioner failed to prove an unexpected event, as his knee merely 'gave way' while moving a refrigerator, and therefore dismissed the petition.

Accident Disability RetirementNew York City Employees’ Retirement SystemKnee InjuryPerformance of DutiesCausal RelationshipMedical Board OpinionCPLR Article 78Appellate ReviewAccidental Injury DefinitionBurden of Proof
References
3
Case No. VNO 0365922
Regular
Mar 03, 2008

NANCY COULTER vs. SULPHUR SPRINGS UNION SCHOOL DISTRICT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION

The applicant sought reconsideration of a WCJ's award, arguing injury to her psyche, neck, shoulders, and cardiovascular system, in addition to her teeth. The Appeals Board granted reconsideration to amend the finding of injury to specifically include "teeth (bruxism) resulting in myofascial pain to her jaw and muscle tenderness." Ultimately, the Board affirmed the original award, finding no industrial injury to the psyche, neck, shoulders, or cardiovascular system, relying on the credibility of a witness and substantial medical evidence.

Workers' Compensation Appeals BoardSulphur Springs Union School DistrictCalifornia Insurance Guarantee AssociationFindings and Awardpermanent disabilitypsychiatric injurygood faith personnel action defensePetition for Reconsiderationbruxismmyofascial pain
References
2
Case No. ADJ10733376, ADJ10707736
Regular
Mar 12, 2018

MARILYN BAKER vs. MERCURY INSURANCE COMPANY, TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA

This case concerns an applicant's claim for workers' compensation benefits due to a work-related injury to her cardiovascular system and heart. The defendant sought reconsideration of the initial award, arguing the applicant lacked credibility and the medical evidence was insufficient. The Appeals Board granted reconsideration solely to defer the issue of injury to internal organs for ambiguity. The Board affirmed the original finding of industrial injury to the cardiovascular system and heart, giving great weight to the WCJ's credibility determinations.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardInjury AOE-COECasualty AdjusterCardiovascular SystemHeart InjuryMedical EvidenceCredibility DeterminationTranscript
References
1
Case No. MISSING
Regular Panel Decision

Clarke v. LR SYSTEMS

Walter Clarke, a 74-year-old former employee of Favorite Plastics, Inc., filed a products liability action against LR Systems and Lasits Rohline Service, Inc. for injuries sustained in an industrial accident on August 13, 1996. Clarke's right hand was pulled into an SG Granulator 300 machine, resulting in the loss of part of his thumb and injury to three fingers. He alleged negligence, strict products liability, and breach of warranty, claiming inadequate warnings and a design defect in the grinder. The court granted the defendant's motion for summary judgment on the failure-to-warn claim, finding Clarke was aware of the danger. However, the motion for summary judgment was denied on the defective design claims, ruling that the expert testimony regarding the feasibility of an interlocked guard was admissible.

Products LiabilityIndustrial AccidentGranulator MachineDesign DefectFailure to WarnSummary JudgmentExpert TestimonyNip Point HazardV-belt DriveMachine Safety
References
32
Case No. MISSING
Regular Panel Decision

Protter v. Nathan's Famous Systems, Inc.

The case involves Erwin Protter and his three fast-food franchise corporations suing Nathan's Famous Systems, Inc. and its officers for fraud and Racketeer Influenced and Corrupt Organizations Act (RICO) violations. Protter alleged misrepresentations regarding training, profit margins, and the use of IPO funds, alongside omissions of material facts such as hidden costs and sales declines in other franchises, which he claimed induced him to purchase three Nathan's franchises. Defendants moved to dismiss the Amended Complaint, asserting it was time-barred and failed to state a claim. The Court granted the motion to dismiss the RICO claims with prejudice, citing plaintiffs' failure to plead a distinct enterprise from the persons, acquisition injury under §1962(b), and investment injury under §1962(a). Despite finding the allegations regarding another defrauded franchisee, Steven Lenter, potentially sufficient for an "open-ended scheme" to satisfy the pattern of racketeering requirement at the motion to dismiss stage, the specific deficiencies in the other RICO subsections led to their dismissal. Consequently, the remaining state law claims were dismissed without prejudice due to the lack of federal subject matter jurisdiction.

Franchise FraudRICO ViolationsRacketeering ActivityMotion to DismissFed.R.Civ.P. 12(b)(6)Fed.R.Civ.P. 9(b)Fraudulent MisrepresentationInvestment InjuryAcquisition InjuryEnterprise-Person Distinctness
References
56
Case No. MISSING
Regular Panel Decision
May 12, 1988

Torres v. New York City Employees' Retirement System

The petitioner, a Rikers Island correction officer, sought to annul the New York City Employees’ Retirement System’s denial of his application for accident disability retirement benefits. The Supreme Court affirmed the dismissal of the petition, finding that the Medical Board and Board of Trustees' determination was neither arbitrary nor capricious. The court found that the petitioner's injuries occurred after he completed his tour of duty and signed out, while leaving the premises on a Correction Department bus, not in the actual performance of city service. This decision was based on Administrative Code of the City of New York § 13-168, which requires injury during city service for eligibility. The court also clarified that eligibility for workers’ compensation benefits was not binding on the Medical Board for accident disability benefits, referencing Administrative Code § 13-176 (c).

accident disability retirementRikers Island correction officercity serviceNew York City Employees’ Retirement SystemMedical BoardBoard of TrusteesCPLR Article 78workers' compensationadministrative coderetirement benefits
References
3
Case No. MISSING
Regular Panel Decision

Cassarino v. New York City Employees' Retirement System

The petitioner sought accidental disability retirement benefits, but the Board of Trustees of the New York City Employees’ Retirement System denied the application on December 13, 2007. The Supreme Court reviewed this denial and found that the Board's determination was not arbitrary and capricious. The court reasoned that the petitioner's injuries arose from the performance of usual duties as a sanitation worker, citing prior cases. Furthermore, the court determined that the petitioner's slip or trip on a strap within a sanitation truck was not sufficiently extraordinary or unexpected to qualify as an 'accidental' injury under the law. Consequently, the Supreme Court affirmed the Board's denial of benefits.

Accidental DisabilityRetirement BenefitsSanitation WorkerNew York City Employees’ Retirement SystemJudicial ReviewAdministrative DeterminationInjury CausationOrdinary DutiesAppellate DivisionSocial Security Law
References
3
Case No. ADJ10461936
Regular
Oct 20, 2020

Gary Ross vs. California Highway Patrol, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to amend a prior award for Gary Ross. The WCAB found that Labor Code section 4664(c)(1) limits the total permanent disability awarded for injuries to the "head, face, cardiovascular system, respiratory system, and all other systems or regions of the body" to 100% over an employee's lifetime. Since Mr. Ross had previously received awards totaling 59% permanent disability for injuries to this region, his award for the current cumulative trauma injury is capped at 41%. Consequently, the WCAB modified the award from 32% to 41% permanent disability.

Cumulative traumaCardiovascular systemHypertensionAtrial fibrillationHemorrhoidsLabor Code section 4664(c)(1)(G)Combined Values ChartQualified Medical EvaluatorLifetime capApportionment
References
5
Case No. ADJ2246339 (VNO 0451694), ADJ4352653 (VNO 0487138), ADJ2131157 (VNO 0451693)
Regular
May 06, 2010

JOE DELIA vs. COUNTY OF LOS ANGELES/SHERIFF'S DEPARTMENT, Permissibly Self-Insured, Administered By TRISTAR RISK MANAGEMENT

This case involved a deputy sheriff who sustained multiple industrial injuries, including to his spine, hands, cardiovascular system, and auditory system. The defendant sought reconsideration of a joint award for 99% permanent disability, arguing for separate awards and apportionment. The Appeals Board denied reconsideration, affirming the WCJ's decision. The Board found that the "anti-attribution" statutes precluded apportionment for spinal, cardiovascular, and hernia injuries, and the defendant failed to prove overlap with a prior award, thus justifying a single joint award.

WCABJoint Findings of Fact and Awardreconsiderationpermanent disabilityapportionmentLabor Code § 4664Benson v. Permanente Medical Groupanti-attributionLabor Code § 3212Labor Code § 3212.3
References
10
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