CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

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

Case No. 2019 NY Slip Op 08951 [178 AD3d 525]
Regular Panel Decision
Dec 12, 2019

Matter of Global Liberty Ins. Co. of N.Y. v. North Shore Family Chiropractic, PC

The Appellate Division, First Department, affirmed the dismissal of a petition by Global Liberty Insurance Company of New York, which sought to vacate an arbitration award denying their claim. Global Liberty had argued that workers' compensation benefits were available to the assignor, Ramon Martinez, and thus their denial of the no-fault insurance claim to North Shore Family Chiropractic, PC (Martinez's assignee) was proper. The court found that Global Liberty failed to prove Martinez was injured in the course of his employment. The order was modified to remand the matter for a determination of attorneys' fees owed to North Shore Family Chiropractic, PC, including those for the appeal.

Insurance DenialNo-Fault BenefitsArbitration AwardAttorneys' FeesWorkers' Compensation CoverageEmployment StatusAppellate ReviewRemandBurden of ProofAssignor
References
4
Case No. ADJ2513573
Regular
Jun 02, 2010

SUSAN PORTER vs. SHERROD CHIROPRACTIC, INC., dba PLACER CHIROPRACTIC

The Workers' Compensation Appeals Board denied Susan Porter's petition for reconsideration of the arbitrator's decision. The Board adopted and incorporated the arbitrator's report as the basis for its denial. The specific reasons for the denial are contained within the arbitrator's report, which was not provided in this excerpt. Therefore, the original decision stands.

Workers' Compensation Appeals BoardReconsideration DeniedArbitrator's ReportApplicantDefendantSherrod ChiropracticPlacer ChiropracticADJ2513573SAC 0369934Petition for Reconsideration
References
0
Case No. 2014-1527 Q C
Regular Panel Decision
Dec 08, 2017

AVM Chiropractic, P.C. v. American Tr. Ins. Co.

This case concerns an appeal from an order of the Civil Court of the City of New York regarding assigned first-party no-fault benefits. Plaintiff, AVM Chiropractic, P.C., sought to recover benefits from American Transit Ins. Co. The Civil Court initially granted some branches of the defendant's motion for summary judgment and reduced claims based on a fee schedule defense. The Appellate Term modified the order, denying summary judgment for the defendant on specific causes of action (second, third, and sixth through eighth) and vacating findings on others (ninth and tenth). The court found that the defendant did not adequately demonstrate appropriate reductions in accordance with workers' compensation Ground Rules for several claims.

No-Fault BenefitsSummary JudgmentWorkers' Compensation Fee ScheduleAppellate ReviewInsurance ClaimsAssigneeFirst-Party BenefitsCivil ProcedureGround RulesNew York Law
References
1
Case No. 2014-1568 S C
Regular Panel Decision
Jul 20, 2016

Chirocare Chiropractic Assoc. v. State Farm Mut. Auto. Ins. Co.

This case involves a provider, Chirocare Chiropractic Associates, as assignee of Antoneta Mertiri, seeking first-party no-fault benefits from State Farm Mutual Automobile Insurance Company. The District Court initially granted State Farm's motion for summary judgment, dismissing the complaint based on a workers' compensation fee schedule defense. The Appellate Term reversed this order, finding that the District Court erred by dismissing the entire complaint on this ground, as the fee schedule defense only applied to amounts in excess of the schedule. Furthermore, the District Court failed to address State Farm's primary defense of lack of medical necessity, which could have been dispositive of the whole action. The matter was remitted to the District Court for a new determination addressing the medical necessity defense first.

No-fault insuranceAutomobile insuranceSummary judgmentAppellate reversalRemittiturMedical necessity defenseWorkers' compensation fee scheduleFirst-party benefitsAssignee claimChiropractic care
References
2
Case No. 2015-1649 Q C
Regular Panel Decision
Jan 20, 2017

Flatbush Chiropractic, P.C. v. American Tr. Ins. Co.

Flatbush Chiropractic, P.C., as assignee of Pierre Luxio, appealed an order that granted American Transit Ins. Co.'s motion to dismiss the complaint and denied plaintiff's cross-motion for leave to renew its prior motion for summary judgment. The Civil Court initially denied plaintiff's summary judgment motion and granted defendant's cross-motion, requiring Workers' Compensation Board resolution within 90 days due to an issue of fact regarding the accident occurring in the course of employment. After 21 months, defendant moved to dismiss for non-compliance, and plaintiff cross-moved to renew, presenting an affidavit indicating no record of a workers' compensation application. The Appellate Term affirmed the Civil Court's decision, stating that the alleged 'new facts' would not change the prior determination and plaintiff failed to show good cause against dismissal.

No-Fault BenefitsWorkers' Compensation IssueSummary Judgment MotionMotion to DismissLeave to RenewAppellate ReviewProcedural ComplianceAssignor-AssigneeCivil CourtAppellate Term
References
1
Case No. MISSING
Regular Panel Decision
Jan 27, 1965

Rivera v. Hellman

This case involves a motion to confirm a Special Referee's report concerning the amounts and priorities of various liens. The Special Referee conducted a hearing and reported on claims from an attorney for the plaintiff ($793.50), Roosevelt Hospital ($846.53), and the Millinery Health Fund ($641.00, later adjusted to $528). The report established the amounts of each lien and recommended priorities, placing the attorney's lien first, followed by the hospital lien (except for a $12 outpatient service), and then the compensation lien. The court concurred with the Special Referee's report and recommendations, granting the motion to confirm.

Lien PriorityAttorney's LienHospital LienDisability BenefitsWorkmen's Compensation LawSpecial Referee ReportMotion GrantedNew York Supreme CourtLien LawMotion Practice
References
2
Case No. 2016-329 S C
Regular Panel Decision
Apr 27, 2017

Spineisland for Chiropractic, P.C. v. 21st Century Advantage Ins. Co.

This case involves an appeal by Spineisland For Chiropractic, P.C., acting as an assignee, against 21st Century Advantage Insurance Company concerning first-party no-fault benefits. The plaintiff sought to recover for services billed under CPT code 95831. The District Court of Suffolk County had previously granted the defendant's motion for summary judgment, asserting that the defendant had appropriately paid the plaintiff based on the workers' compensation fee schedule. On appeal, the Appellate Term affirmed the lower court's decision. The Appellate Term found that the defendant had adequately demonstrated the proper application of CPT code 95833 for the services billed under CPT code 95831, and the plaintiff failed to present a triable issue of fact.

No-fault benefitsSummary judgmentCPT codeWorkers' compensation fee scheduleAppellate TermSuffolk CountyAssigneeInsurance disputeChiropractic servicesMedical billing
References
1
Case No. MISSING
Regular Panel Decision

Colindres v. Carpenito

Plaintiff Rochelle Colindres sought a protective order to deny defendants' demand for a medical report from her former treating psychologist, Diane Henry, or alternatively, relief from compliance with Uniform Rules for Trial Courts § 202.17(b)(1). Colindres argued that the defendants waived their right to the report as the independent medical examination (IME) already occurred, and that obtaining the report would be an undue hardship since Henry ceased treatment due to Colindres' attendance issues. Defendants Mario Carpenito, Jr., City of White Plains, and White Plains Parking Department opposed, asserting that the report was necessary to clarify alleged injuries, prepare for cross-examination, and facilitate settlement, highlighting Colindres' complex medical history predating the incident. The court denied both branches of Colindres' motion, finding that the rule applies broadly to personal injury actions, defendants did not waive their entitlement, and Colindres failed to prove it was impossible to obtain the report. The court ordered Colindres to exchange a compliant medical report from Diane Henry by March 27, 2017.

protective ordermedical report disclosurediscovery disputepsychological treatmentindependent medical examinationCPLR 310322 NYCRR 202.17waiver of discoveryundue hardshippersonal injury damages
References
12
Case No. MISSING
Regular Panel Decision

Chaplin v. Pathmark Supermarkets

This case addresses a motion by defendants, including Supermarkets General Corp., for a protective order to vacate the plaintiff Mimi Chaplin's notice for discovery and inspection of accident reports. Mimi Chaplin sought these reports after sustaining personal injuries from a fall at the defendant's premises. The court, presided over by Justice James F. Niehoff, analyzed the newly enacted CPLR 3101 (g), which mandates full disclosure of accident reports prepared in the regular course of business. The court found that the accident report in question was prepared in Supermarkets General Corp.'s regular course of business, rendering it discoverable regardless of its potential use in litigation, thus denying the defendants' motion.

DiscoveryProtective OrderAccident ReportsCPLR 3101(g)Litigation PreparationRegular Course of BusinessPersonal InjuryNegligenceDisclosureEvidence
References
10
Case No. SAL SJO 252436 (MF); SJO 246192
Regular
Jul 02, 2007

NIHAL HORDAGODA vs. State Compensation Insurance Fund

This case involves an employer's petition for reconsideration of an order authorizing medical treatment and admitting the Qualified Medical Examiner's (QME) reports. The employer argued the QME reports were inadmissible due to an alleged ex parte communication between the applicant and the QME, and that the awarded treatments were improper. The report recommends denying the petition, finding the communication was permissible under LC § 4062.3(h) and that the QME's opinions and awarded treatments for chronic pain were reasonable and not governed by ACOEM guidelines.

Workers' Compensation Appeals BoardPetition for ReconsiderationQualified Medical EvaluatorLabor Code Section 4062.3Ophthalmological evaluationFunctional capacity evaluationUtilization ReviewACOEM GuidelinesChronic spinal conditionTreating physician
References
0
Showing 1-10 of 5,078 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational