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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

Smith v. New York State & Local Retirement Systems

Petitioner, a taxpayer services representative, sustained a back injury in March 1981 while lifting forms, leading to a decline in attendance and eventual termination in November 1989. She applied for accidental and ordinary disability retirement benefits, both of which were denied by the Comptroller. The accidental disability claim was denied because the incident was not deemed an 'accident' under Retirement and Security Law § 63. The ordinary disability claim was denied as untimely, having been filed approximately six months after her termination, exceeding the 90-day limit stipulated by Retirement and Social Security Law § 62. The Supreme Court dismissed the challenge to the ordinary disability denial due to untimeliness and transferred the accidental disability challenge to this Court. This Court confirmed the Comptroller's determination on both counts, rejecting the petitioner's estoppel argument regarding the untimely ordinary disability application and finding substantial evidence to support the finding that the injury did not constitute an 'accident' within the meaning of the relevant law, as it resulted from ordinary employment duties without an unexpected event.

Disability Retirement BenefitsAccidental DisabilityOrdinary DisabilityUntimely ApplicationEstoppel Against GovernmentWork-Related InjuryBack InjuryDefinition of AccidentOrdinary Employment DutiesSubstantial Evidence Review
References
16
Case No. MISSING
Regular Panel Decision

Claim of McHeffey v. International Talc Co.

A claimant with pneumoconiosis, stemming from two decades of talc dust exposure with his former employer, was denied disability benefits by the board. The board cited that his disability was employment-related and his workers' compensation claim was controverted on multiple grounds, not solely causation. The court affirmed the board's decision regarding the claimant's disqualification from benefits due to the disability's causal link to employment. However, it clarified that under Workmen's Compensation Law § 206(2), disability benefits are payable even when a workers' compensation claim is controverted on additional grounds besides causation, emphasizing the statute's purpose to alleviate economic hardship during litigation of causation.

PneumoconiosisOccupational DiseaseDisability BenefitsCausal RelationStatutory InterpretationEconomic HardshipUnemployment BenefitsLien RightsBoard Decision AppealEmployer Liability
References
3
Case No. MISSING
Regular Panel Decision
May 15, 2012

Hamzik v. Office for People with Developmental Disabilities

Plaintiff John J. Hamzik sued the Office for People with Developmental Disabilities (OPWDD) and several individual employees, alleging discrimination based on sex, age, and disability, as well as equal protection, due process, and retaliation claims under federal and state laws, including Title VII, ADEA, and ADA. Defendants moved to dismiss the amended complaint, and plaintiff cross-moved to file a second amended complaint. The District Court, finding that many claims were barred by Eleventh Amendment immunity or failure to exhaust administrative remedies, and that the remaining claims failed to state a plausible cause of action, granted the defendants' motion to dismiss. All federal claims were dismissed with prejudice, the cross-motion was denied as futile, and the remaining state law claims were dismissed without prejudice.

DiscriminationRetaliationDue ProcessEqual ProtectionTitle VIIADEAADAEleventh Amendment ImmunityAdministrative ExhaustionMotion to Dismiss
References
50
Case No. 2020 NY Slip Op 02301 [182 AD3d 821]
Regular Panel Decision
Apr 16, 2020

Matter of Community, Work, & Independence, Inc. v. New York State Off. for People with Dev. Disabilities

This case involves a CPLR article 78 proceeding initiated by Community, Work, and Independence, Inc. (petitioner) to challenge a determination affirming the objection to its proposed discharge of M.D., an individual with developmental disabilities, from day habilitation services. M.D.'s parents objected to the discharge, and an administrative hearing sustained their objection, a decision later affirmed by the Commissioner of the Office for People with Developmental Disabilities. The Appellate Division, Third Department, confirmed the Commissioner's determination, finding that the burden of proof was appropriately placed on the service provider. The court concluded that substantial evidence supported the finding that discharging M.D. was not reasonable, considering his needs, the lack of suitable alternative programs, and despite the petitioner's financial concerns. The court suggested that financial issues for service providers should be addressed by seeking increased funding rather than by discharging individuals.

Developmental DisabilityHCBS WaiverDischarge ServicesAdministrative HearingBurden of ProofSubstantial EvidenceFinancial ConcernsService ProviderMedicaid FundingAutism Spectrum
References
7
Case No. MISSING
Regular Panel Decision

Cartagena v. City of New York

Haydee Cartagena, a New York City police officer, suffered two line-of-duty injuries in 1987 and 1989, leading to extensive medical treatment and multiple surgeries. She applied four times for accidental disability retirement (ADR) benefits, but the Police Pension Fund's Medical Board repeatedly denied her claims, initially finding no disability, then later acknowledging a disability (Raynaud's Syndrome) but denying its service-related causation. Despite numerous treating physicians' opinions affirming her permanent disability and its work-related origin, the Trustees adopted the Medical Board's recommendation to grant ordinary disability retirement (ODR) but deny ADR. Cartagena challenged this decision via an Article 78 petition. The court found no credible evidence to support the lack of causation and concluded that her disability was the natural and proximate result of her line-of-duty injuries, thereby granting her petition and directing the Pension Fund to award her ADR.

Disability retirementAccidental disability retirementOrdinary disability retirementPolice Pension FundLine-of-duty injuryCarpal tunnel syndromeRaynaud's phenomenonMedical Board decisionJudicial reviewCausation of disability
References
6
Case No. ADJ9571986
Regular
Feb 22, 2019

ANNE CHOU vs. COUNTY OF RIVERSIDE

The Appeals Board granted reconsideration to address the apportionment of psychiatric permanent disability. The Board clarified that Labor Code section 3208.3(h) pertains to the causation of the injury itself, not the apportionment of permanent disability. Therefore, lawful nondiscriminatory personnel actions, which did not meet the 35% causation threshold for non-compensability, cannot be used to apportion permanent disability under Labor Code section 4663. Accordingly, the applicant's permanent disability was increased from 19% to 22%.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardAdministrative Law JudgeIndustrial InjuryGastrointestinal SystemPsycheHypertensionTemporary DisabilityPermanent Disability
References
0
Case No. MISSING
Regular Panel Decision

Bullard v. St. Mary's Hospital

Claimant, a secretary at St. Mary's Hospital, developed rheumatoid arthritis, resulting in a permanent partial disability. The Workers' Compensation Board ruled it an occupational disease and awarded compensation. Liability was apportioned among three employers: Rochester Savings Bank, Woodward Health Center, and St. Mary's Hospital. The Special Disability Fund (SDF) was deemed liable for benefits after the initial 104-week disability period. SDF appealed, contending its reimbursement should be limited to St. Mary's Hospital's one-third share. The court affirmed the Board's decision, holding that Workers' Compensation Law § 44 makes the last employer (St. Mary's) responsible for total compensation, and Workers' Compensation Law § 15 (8) (d) requires SDF to fully reimburse the employer's carrier, Sedgwick James, for benefits paid after 104 weeks.

Occupational DiseaseRheumatoid ArthritisPermanent Partial DisabilityApportionmentSpecial Disability FundReimbursementWorkers' Compensation LawLast Employer LiabilityInsurance CarrierWorkers' Compensation Board
References
0
Case No. ADJ3817836 (SJO 0250881)
Regular
May 31, 2012

ZUFAN A. REDA vs. FRY'S ELECTRONICS, INC., ZURICH NORTH AMERICAN INSURANCE

This case concerns applicant Zufan A. Reda's claim for permanent total disability due to a psychiatric injury. The Workers' Compensation Appeals Board (WCAB) is ordering the development of the record because neither the applicant's QME, Dr. Sidle, nor the defendant's QME, Dr. Keins, provided substantial evidence regarding the apportionment of psychiatric permanent disability. The WCAB found that Dr. Sidle's report incorrectly addressed causation of injury rather than apportionment of disability, and Dr. Keins' report was rejected as non-substantial due to prior rulings on industrial causation. Therefore, the WCAB has appointed Dr. Roy Curry as a "regular physician" to conduct a new evaluation on the issue of psychiatric permanent disability.

Petition for ReconsiderationDevelopment of RecordLabor Code section 5701Industrial InjuryPsychiatric InjuryCompensable ConsequenceSection 5803Section 5804Section 5410Permanent Total Disability
References
3
Case No. MISSING
Regular Panel Decision

Dudlo v. Plastics

The claimant sustained a left ankle injury in 1973 while working for Polytherm Plastics, receiving workers' compensation benefits. After being discharged for misconduct in 1977, the claimant sought to reopen his 1973 claim, arguing his disability prevented him from securing new employment. The Workers' Compensation Board initially found a causal link between the disability and the inability to find work, awarding benefits. However, the appellate court reversed this decision, finding that the claimant's loss of employment was primarily due to misconduct, not solely the disability. The court ruled that the claimant failed to provide substantial evidence that his disability was a cause of his subsequent inability to obtain employment, thereby defeating the inference of causation. The case was remitted to the Workers' Compensation Board for further proceedings on the issue of causation for the claimant's loss of earnings.

Permanent Partial DisabilityLoss of EarningsCausationMisconduct DischargeEmployment LimitationsAppellate ReviewRemandEvidentiary BurdenWage-Earning CapacityReopened Workers’ Comp Claim
References
9
Case No. ADJ824062 (VNO 0395359) ADJ1729914 (VNO 0452072) ADJ385264 (VNO 0548716) ADJ4506449 (VNO 0548713)
Regular
May 11, 2016

SHARON SPRAGUE vs. BEVERLY FABRICS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, BROADSPIRE, SUPERIOR NATIONAL INSURANCE COMPANY, MIKASA, SOMPO JAPAN INSURANCE COMPANY OF AMERICA

This case involves multiple injury claims for Sharon Sprague against Beverly Fabrics and Mikasa, primarily concerning back, hip, and fibromyalgia injuries. The Workers' Compensation Appeals Board (WCAB) granted reconsideration to address disputes over permanent disability ratings and apportionment of injuries. The WCAB rescinded prior findings, finding insufficient evidence for permanent total disability and the exact causation of fibromyalgia. The matter is remanded for further proceedings to develop the record on fibromyalgia causation, permanent disability, and apportionment.

CIGASompo JapanReconsiderationJoint Findings Award OrdersPermanent DisabilityApportionmentFibromyalgiaScapula/Rhomboid StrainBilateral KneesAgreed Medical Evaluator
References
0
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