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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

Cortijo v. Ilfin Corp.

A decedent, employed as a building superintendent, was found dead from a 12-gauge shotgun wound on his employer's premises during working hours. The Workers' Compensation Board determined that the unexplained death, occurring on the employer's property and during working hours, raised a presumption of compensability under section 21 of the Workers' Compensation Law. This presumption led to the conclusion that the death arose out of and in the course of employment, justifying an award of death benefits to the claimant. The Board found that police testimony regarding the decedent's prior illegal activities was insufficient to rebut this statutory presumption. The appellate court affirmed the Board's decisions, finding them supported by substantial evidence.

Workers' CompensationDeath BenefitsPresumption of CompensabilityUnexplained DeathEmployment InjuryOn-Premises DeathStatutory PresumptionRebuttal of PresumptionSubstantial EvidenceAppellate Review
References
0
Case No. MISSING
Regular Panel Decision

New York State Public Employment Relations Board v. Board of Education

The concurring opinion, authored by Judge Fuchsberg, affirms the ultimate disposition of the case, upholding the Public Employment Relations Board's (PERB) order. The opinion delves into the critical distinction between an administrative agency exceeding its jurisdiction and merely committing an error of law. It argues that an order issued without statutory power or in excess thereof is inherently void and subject to collateral attack, even if statutory time limits for direct review have passed. Judge Fuchsberg supports this jurisdictional argument by referencing several prior cases, including *Matter of Foy v Schechter* and *Matter of Guardian Life Ins. Co. v Bohlinger*. Ultimately, the opinion concludes that the PERB's remedial orders were fully authorized due to a specific statutory violation, despite the complex jurisdictional challenges raised.

Public Employment Relations BoardAdministrative LawJurisdictionCollateral AttackStatutory InterpretationError of LawBack PayCivil Service LawArticle 78PERB
References
14
Case No. MISSING
Regular Panel Decision

Claim of Martin v. New York Telephone

This case concerns an appeal from a Workers' Compensation Board decision regarding the liability for benefits. The claimant sustained a left knee injury in 1987 and a reinjury in 1995. A 1998 Section 32 settlement agreement released the employer from future claims for a lump sum, but required it to cover medical treatment. In 2004, the claimant developed a consequential right knee injury. The Workers' Compensation Board ultimately shifted liability for benefits to the Special Fund for Reopened Cases under Workers' Compensation Law § 25-a, citing the passage of statutory timeframes. The Special Fund appealed, challenging its statutory liability and the employer's ongoing responsibility for medical expenses per the settlement. The appellate court affirmed the Board's decision, upholding the applicability of Section 25-a and noting the employer's statutory obligation for medical treatment.

Workers' Compensation Law § 25-aSpecial Fund for Reopened CasesSection 32 Settlement AgreementConsequential InjuryMedical Treatment LiabilityStatutory LiabilitySchedule Loss of UseAppellate ReviewTimelinessBoard Review
References
4
Case No. MISSING
Regular Panel Decision

Claim of Rivera v. North Central Bronx Hospital

The employer appealed a decision by the Workers’ Compensation Board, arguing that the Board incorrectly interpreted Workers’ Compensation Law § 13-a (7) by mandating reimbursement to the claimant’s doctor for an EMG test. The employer contended that since the claimant failed to use a specified provider as per statutory notice, it should not be obligated to pay. However, the court found no statutory or historical support for nonpayment as a remedy, noting that the law aims to provide swift benefits to injured employees and prevent providers from collecting directly from workers. The court emphasized that allowing the employer to avoid payment would harm medical providers and deter their participation in the workers’ compensation system. Consequently, the court affirmed the Board’s decision, requiring the employer to pay its in-network rate to the claimant's doctor.

Workers' Compensation LawEMG test reimbursementEmployer appealStatutory interpretationMedical provider paymentClaimant medical expensesSelf-insured employersDiagnostic testsLegislative intentBoard decision affirmed
References
7
Case No. 2022 NY Slip Op 06518 [210 AD3d 1240]
Regular Panel Decision
Nov 17, 2022

Matter of Hoyt (Paul Revere Life Ins. Co.--Commissioner of Labor)

Paul Revere Life Insurance Company appealed decisions by the Unemployment Insurance Appeal Board, which found the company liable for unemployment insurance contributions for claimant William K. Hoyt Jr. and others. The Board determined that Paul Revere's contract with the claimant did not satisfy all seven requirements of Labor Law § 511 (21) and that the parties' conduct was inconsistent with the statutory exclusion, thus establishing an employment relationship under the common-law test. The Appellate Division, Third Department, affirmed the Board's decision, emphasizing that both the written contract and the parties' actual conduct must conform to the statutory provisions for an insurance agent's services to be excluded from the definition of employment. The court found substantial evidence supporting the Board's conclusion of an employment relationship, citing factors such as the claimant's work schedule, reporting requirements, and Paul Revere's training and oversight. The decision clarified that a mere 'verbatim inclusion or rote incantation' of the statutory provisions in a contract is insufficient if actual conduct contradicts them.

Unemployment InsuranceInsurance AgentsEmployment RelationshipCommon Law TestLabor Law § 511Statutory ExclusionAppellate ReviewUnemployment BenefitsInsurance Sales IndustryContractual Provisions
References
6
Case No. MISSING
Regular Panel Decision

McDonald-Besheme v. Verizon Wireless, Inc.

Claimant, an operations specialist, was injured in a fall in March 2003 and subsequently filed a claim for workers’ compensation benefits. The employer failed to file a notice of controversy within the 25-day statutory period after receiving the notice of indexing on August 1, 2003. A Workers’ Compensation Law Judge found the employer's notice untimely, precluding the employer from contesting the employer-employee relationship or that the injury arose out of employment. The Workers’ Compensation Board upheld this determination, as the employer did not demonstrate good cause for the delay. The employer appealed, but the court affirmed the Board’s decision.

Late Notice of ControversyEmployer LiabilityTimeliness of FilingAppeal DecisionAdministrative ReviewStatutory ComplianceDiscretionary PowersAbsence of Good CausePreclusion of DefenseWorkplace Injury Claim
References
4
Case No. MISSING
Regular Panel Decision

City of Rome v. State of New York Public Employment Relations Board

The City of Rome eliminated the position of acting purchasing agent and transferred the duties to non-unit employees. Marilyn McLiesh's bargaining unit, CSEA, filed an improper practice charge, leading PERB to order McLiesh's reinstatement with back pay. The City of Rome initiated a CPLR article 78 proceeding, arguing that McLiesh's prolonged service as an acting agent violated NY Constitution, article V, § 6. The Supreme Court agreed, annulling the reinstatement and back pay order. Upon appeal by CSEA and PERB, the Appellate Division affirmed the Supreme Court's judgment, ruling that McLiesh's employment beyond the statutory temporary period was unconstitutional and therefore PERB exceeded its authority by ordering her reinstatement.

CPLR Article 78Improper Practice ProceedingPublic Employment Relations BoardCivil Service LawConstitutional ViolationReinstatement OrderBack PayProvisional EmployeeBargaining Unit WorkAppellate Division
References
5
Case No. MISSING
Regular Panel Decision

Claim of Hope v. Warren County Board of Elections

This case involves an appeal by a workers' compensation carrier regarding the calculation of a claimant's average weekly wage based on concurrent employment. The claimant, injured on November 3, 2009, had employment as a polling inspector and concurrently with a retail store. A Workers’ Compensation Law Judge (WCLJ) and subsequently the Workers’ Compensation Board calculated the claimant's average weekly wage based on both employments, totaling $80.69, and directed the carrier to continue awards. The carrier appealed, arguing that awards should only be based on the primary employment wage of $3.56 due to the inability to seek reimbursement from the Special Disability Fund for concurrent employment amounts following 2007 amendments to Workers’ Compensation Law § 14 (6). The Appellate Court affirmed the Board's decision, interpreting the statutory language to mean that primary employers are liable for benefits calculated on combined average weekly wages, and the 2007 amendments did not intend to reduce benefits for injured workers.

Concurrent Employment BenefitsAverage Weekly Wage CalculationSpecial Disability Fund ClosureWorkers' Compensation Law § 14(6)Statutory Amendment ImpactEmployer Liability LimitsTemporary Total DisabilityTemporary Partial DisabilityAppellate Review of WCABLegislative Purpose Analysis
References
5
Case No. MISSING
Regular Panel Decision

Place v. Ryder

Claimant, who received workers' compensation benefits from a self-insured employer, settled a third-party action. A dispute arose regarding whether the employer had waived its statutory offset rights against the claimant's net recovery from the third-party action, as there was no written agreement. The Workers' Compensation Board affirmed a Workers' Compensation Law Judge's decision, finding that the self-insured employer had reserved its offset rights. The appellate court affirmed the Board's decision, concluding that the employer's attorney's correspondence provided substantial evidence to support the Board's finding that offset rights were explicitly reserved.

Workers' CompensationOffset RightsThird-Party SettlementEmployer's LienStatutory WaiverAttorney CorrespondenceAppellate ReviewSubstantial EvidenceWorkers' Compensation BoardNew York
References
7
Case No. MISSING
Regular Panel Decision

Claim of Graham v. Life Rollway Corp.

The claimant sustained a leg injury on the employer’s premises and filed for workers’ compensation benefits. The self-insured employer, who had paid disability benefits, controverted the claim. It was later determined that the claimant was entitled to workers’ compensation, and an award was made. A dispute arose regarding the employer's reimbursement for disability benefits paid, specifically whether it should be the full amount or less FICA taxes. The Workers’ Compensation Board ruled the employer was entitled to full reimbursement. The appellate court affirmed this decision, finding the Board's conclusion rational since the full award was effectively paid to the claimant through direct payment and FICA remittances satisfying the claimant's obligations.

Workers' CompensationFICA TaxesDisability Benefits ReimbursementEmployer ReimbursementStatutory InterpretationDue Process ClaimOverpayment RefundAppellate DecisionSocial Security Taxes
References
0
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