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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

Burroughs v. Empire State Agricultural Compensation Trust

Claimant, a dairy farmer, sustained work-related injuries in November 2001 when he fell from a ladder. A claim for workers’ compensation benefits was filed, which the carrier controverted, disputing claimant's employee status. A Workers’ Compensation Law Judge (WCLJ) determined that the employer was a limited liability corporation and claimant was an executive officer, thus covered under the Workers' Compensation Law. The Workers’ Compensation Board upheld the WCLJ’s findings. The appellate court reversed the Board's decision, concluding that the record was insufficient to establish the employer’s true status or claimant’s relationship to it, and remitted the matter for further development of the record.

Workers' CompensationEmployment StatusLimited Liability CorporationExecutive OfficerCoverage DisputeAppellate ReviewRemittalRecord DevelopmentNew York Workers' Compensation LawDairy Farmer
References
2
Case No. 2017 NY Slip Op 27428
Regular Panel Decision
Dec 14, 2017

New York State Workers' Compensation Bd. v. Compensation Risk Mgrs., LLC

This action was brought by the New York State Workers' Compensation Board (WCB), as an assignee of former members of the Healthcare Industry Trust of New York (HITNY), against Compensation Risk Managers, LLC (CRM), HITNY trustees, and auditing firm UHY LLP. The WCB alleged mismanagement, breach of fiduciary duty, and negligent auditing, leading to the Trust's insolvency. Defendants moved to dismiss on grounds of standing, statute of limitations, and pleading particularity. The court dismissed certain derivative claims and negligent misrepresentation claims against some trustees due to standing issues and statute of limitations. All claims against UHY LLP were dismissed for lack of a near-privity relationship or prior precedent. An implied indemnity claim against the trustees was sustained. The WCB's cross-motion to consolidate related actions was denied.

Workers' Compensation LawGroup Self-Insured Trust (GSIT)Fiduciary DutyNegligenceNegligent MisrepresentationStatute of LimitationsStandingDerivative ActionImplied IndemnityAuditing Firm Liability
References
46
Case No. MISSING
Regular Panel Decision

Claim of Beder v. Big Apple Circus

Claimant was injured at work in 1987 and was awarded workers’ compensation benefits, continuing until October 2005 when he returned to work. In May 2008, the employer's workers’ compensation carrier disputed medical bills and sought to shift liability to the Special Fund for Reopened Cases under Workers’ Compensation Law § 25-a. The Workers’ Compensation Board affirmed that liability did not shift, finding the C-8.1 forms reopened the claim within three years of the last compensation payment. The court reversed the Board's decision, determining that disputing the timeliness of medical bills does not toll the time limitations for liability transfer under Workers’ Compensation Law § 25-a. The matter was remitted to the Workers’ Compensation Board for further proceedings, and the appeal from the denial of reconsideration was dismissed as academic.

Workers' Compensation Law § 25-aSpecial Fund for Reopened CasesLiability ShiftMedical BillsTimeliness of BillsReopening CaseAppellate ReviewWorkers' Compensation BoardPermanent Total DisabilityLast Payment of Compensation
References
4
Case No. MISSING
Regular Panel Decision
May 14, 1986

Claim of MacMullan v. Associated Press

William Von Stein appealed a Workers’ Compensation Board decision filed May 14, 1986, which denied his application to reopen Philip MacMullan’s previously closed compensation case. The Board determined that any new claim for compensation related to MacMullan's ulcer was barred by the two-year Statute of Limitations under Workers’ Compensation Law § 28. This appeal originated from a medical malpractice action in Supreme Court, where Von Stein, a coemployee and doctor, was accused of failing to inform MacMullan of an ulcer discovered during an employer-conducted medical examination. The Appellate Division affirmed the Board's decision, holding that Von Stein lacked standing to reopen MacMullan’s case and that the requested declaratory ruling on the ulcer's compensability fell outside the Board's authority. Consequently, the court concluded that the judicial forum, not the Workers’ Compensation Board, was the appropriate venue for resolving the dispute concerning MacMullan's injury.

Workers' Compensation Law § 28Statute of LimitationsReopening Closed CaseMedical MalpracticeStanding to SueBoard JurisdictionDeclaratory RulingUlcer ConditionAngina PectorisCoemployee Immunity
References
2
Case No. WCB No. 7990 5338
Regular Panel Decision

In the Matter of Maureen Kigin v. State of New York Workers' Compensation Board

Justice Rivera's dissenting opinion argues that the Workers’ Compensation Board overstepped its authority by implementing regulations that demand preapproval for medical services not listed in its guidelines, thereby presuming such unlisted treatments are not medically necessary. This approach, according to the dissent, obstructs prompt medical care, contradicts the Workers’ Compensation Law's pro-employee stance, and deviates from the legislative intent to ease access to diagnostic and treatment measures. The opinion contends that while the Board can create a pre-authorized list, it cannot use this power to impose a burden on claimants like Kigin to continually prove the medical necessity of treatments not on that list, especially when disputes historically allowed for post-treatment resolution.

Workers' Compensation LawMedical Treatment GuidelinesPre-authorization RegulationsVariance SchemeMedical NecessityBoard AuthorityAdministrative RegulationsClaimant Burden of ProofStatutory InterpretationLegislative Intent
References
13
Case No. MISSING
Regular Panel Decision

L&L Painting Co. v. Contract Dispute Resolution Board

L&L and Odyssey, contractors for lead-based paint removal on the Queensboro Bridge, disputed a contract drawing's interpretation with the Department of Transportation (DOT) concerning scaffolding clearance. Petitioners sought additional compensation after DOT rejected their proposed platform design, claiming a latent ambiguity in the contract. The Contract Dispute Resolution Board (CDRB) denied their claim, finding a patent ambiguity requiring pre-bid clarification. The Supreme Court upheld CDRB's decision, and this appellate court affirmed, concluding that the ambiguity was indeed patent, contrasting 'all roadways' in the note with the drawing's specific references. A dissenting opinion argued against this, stating an engineer would find no ambiguity.

Contract DisputePublic Works ContractQueensboro BridgeConstruction LawContract InterpretationAmbiguityPatent AmbiguityLatent AmbiguityCPLR Article 78Administrative Law
References
0
Case No. 2025 NY Slip Op 04576 [241 AD3d 563]
Regular Panel Decision
Aug 06, 2025

New York Bus Operators Compensation Trust v. American Home Assur. Co.

The New York Bus Operators Compensation Trust (NYBOCT), a self-insured entity, brought an action against its excess-of-loss insurer, American Home Assurance Co., alleging breach of contract and seeking declaratory relief. This dispute arose after American Home denied coverage for a workers' compensation claim due to untimely notice. The Supreme Court granted American Home's motion to dismiss the complaint as time-barred, which NYBOCT appealed. The Appellate Division affirmed the Supreme Court's decision, ruling that the six-year statute of limitations for breach of contract began when American Home disclaimed coverage on May 18, 2012, making NYBOCT's 2020 lawsuit untimely. The court rejected arguments related to the continuing-wrong doctrine and estoppel.

Limitation of ActionsBreach of ContractInsurance ContractDisclaimer of CoverageStatute of LimitationsWorkers' CompensationExcess-of-Loss PolicySelf-Insured TrustUntimely NoticeAppellate Review
References
29
Case No. MISSING
Regular Panel Decision

Claim of Brown v. Hillcrest Heating

In October 1980, the claimant sustained lower back injuries in a work-related automobile accident and received workers’ compensation benefits. In 1986, he reinjured his back in a non-work-related incident, leading to a need for lumbar disc surgery. The claimant contended a causal relationship between the 1986 injury and the 1980 accident, prompting the Workers’ Compensation Board to reopen his case. Medical reports from the carrier’s physician and others supported the causal link, leading the carrier to authorize and fund the surgery. A dispute arose between the carrier’s no-fault and workers’ compensation divisions regarding liability, during which AVMA Group Health and Life Insurance Trust, the claimant’s private insurer, sought reimbursement for medical bills. The carrier’s representative agreed to an order directing reimbursement, which was issued by the Workers’ Compensation Law Judge. Despite this, the carrier sought administrative review, arguing prematurity due to an ongoing dispute over responsibility. The Board affirmed the order, and this appeal ensued. The court affirmed the Board’s decision, citing sufficient evidence from medical reports and the carrier's authorization of surgery and admission of responsibility.

Workers' CompensationMedical ExpensesCausal RelationshipBack InjuryAutomobile AccidentReimbursementInsurance LiabilityNo-Fault BenefitsBoard AffirmationAppellate Review
References
0
Case No. 2022 NY Slip Op 06033
Regular Panel Decision
Oct 27, 2022

Matter of Bernal v. New York Apple Car Serv.

Claimant's spouse, a cab driver dispatched by New York Apple Car Service (NYACS), was fatally stabbed while working. Claimant filed for workers' compensation death benefits. NYACS, a member of the Independent Livery Driver Benefit Fund (ILDBF), disputed liability, contending the decedent was a black car operator, making the New York Black Car Operator's Injury Compensation Fund (NYBCOICF) responsible. The Workers' Compensation Board affirmed a Workers' Compensation Law Judge's decision that the decedent was an independent livery driver, holding the ILDBF carrier liable. The Appellate Division affirmed the Board's determination, rejecting the argument that the vehicle's affiliation with the NYBCOICF was determinative and relying on precedent set in _Matter of Cisnero v Independent Livery Driver Benefit Fund_.

Workers' CompensationDeath BenefitsIndependent Livery DriverBlack Car OperatorFund LiabilityStatutory InterpretationAppellate ReviewDispatch ServiceEmployer ResponsibilityVehicle Affiliation
References
1
Case No. 2018 NY Slip Op 08227
Regular Panel Decision
Nov 29, 2018

Matter of Kelly v. New York State Workers' Compensation Bd.

In 2006, claimant Grace Kelly established a workers' compensation claim for an occupational disease. The State Insurance Fund (SIF) repeatedly sought to transfer liability to the Special Fund for Reopened Cases, which was denied by Workers' Compensation Law Judges. The Workers' Compensation Board affirmed these denials and assessed $500 penalties against both SIF and its counsel, Walsh and Hacker, for filing an application for review without reasonable grounds. Walsh and Hacker appealed the penalty imposed against them to the Appellate Division, Third Department. The Appellate Division found insufficient evidence to support the Board's finding that Walsh and Hacker's application lacked reasonable grounds, and therefore reversed the penalty against them, modifying and affirming the Board's decision.

PenaltiesAppellate ReviewSpecial Fund for Reopened CasesWorkers' Compensation Law § 25-aWorkers' Compensation Law § 114-aAttorney SanctionsAdministrative LawBoard DecisionJudiciary Law § 431
References
4
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