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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

Claim of Bruzzese v. Guardsman Elevator Co.

In 1994, the claimant sustained head, neck, and back injuries at work, leading to an award for permanent partial disability, which included a wage expectancy adjustment under Workers’ Compensation Law § 14 (5). Following back surgery in 1998, the case was reopened, and the claimant was found to be temporarily totally disabled. Benefits for this temporary total disability were calculated based on the claimant's average weekly wage at the time of injury, without applying the wage expectancy adjustment. The claimant appealed, arguing that since the permanent partial disability preceded the temporary total disability, the wage expectancy adjustment should also apply to the latter period. The court disagreed, affirming the Workers’ Compensation Board's decision, citing established case law that Workers’ Compensation Law § 14 (5) is applicable only to awards for permanent partial disability and not temporary disability.

Wage expectancyTemporary total disabilityPermanent partial disabilityWorkers' Compensation benefitsBack injuryAppellate reviewDisability calculationWorkers' Compensation BoardAverage weekly wage
References
1
Case No. MISSING
Regular Panel Decision

Matter of Brady v. Northeast Riggers & Erectors

In March 2012, the claimant, a union construction laborer, sustained a work-related back and abdomen injury. A Workers' Compensation Law Judge (WCLJ) initially found the claimant attached to the labor market but deemed a total industrial disability finding premature because permanent disability had not yet been classified. The Workers’ Compensation Board upheld this determination. The claimant appealed, arguing the Board erred in declining to classify him with a temporary total industrial disability. The Court affirmed the Board's decision, asserting that a classification of temporary total industrial disability cannot be made without a prior determination of permanency.

Workers' CompensationIndustrial DisabilityPermanent DisabilityTemporary DisabilityLabor MarketAppellate DivisionBoard DecisionPremature DeterminationGainful EmploymentWork History
References
6
Case No. 2021 NY Slip Op 07401
Regular Panel Decision
Dec 23, 2021

Matter of Carola B.-M. v. New York State Off. of Temporary & Disability Assistance

Petitioners Carola B.-M. and Tiara M. challenged the denial of their supplemental nutrition assistance program (SNAP) benefits by the New York State Office of Temporary and Disability Assistance and the Orleans County Department of Social Services. The benefits were denied because they were deemed ineligible college students. The Appellate Division, Fourth Department, reversed this determination, holding that participation in the Adult Career and Continuing Education Services, Vocational Rehabilitation program (ACCES-VR) qualifies as a Job Training Partnership Act (JTPA) program. This status exempts the students from certain SNAP eligibility requirements. The court found that the original determination was based on an unreasonable interpretation of relevant regulations, annulled the decision, granted the petition, and remitted the case for a calculation of retroactive benefits.

SNAP benefitscollege student eligibilityJob Training Partnership ActACCES-VRvocational rehabilitationCPLR article 78regulatory interpretationpublic assistancefood stampsAppellate Division
References
28
Case No. MISSING
Regular Panel Decision

Matter of Williams v. Preferred Meal Systems

Claimant, a driver, suffered injuries to his right knee and back in 2009 while making a delivery, leading to an established workers' compensation claim. The claim was later amended to include consequential adjustment disorder, and the Workers' Compensation Board ultimately found that claimant had sustained a permanent total disability from May 2012 onward. The employer, workers’ compensation carrier, and policy administrator appealed this decision, arguing that further proof was needed regarding claimant's vocational and functional capacity. The court affirmed the Board's decision, holding that extensive evidence of vocational and functional capacity is not required when medical proof demonstrates a permanent total disability and inability to engage in any gainful employment, as benefits continue for life in such cases. The court found substantial evidence in the opinions of treating and independent medical examination orthopedists to support the finding of permanent total disability.

Workers' CompensationPermanent Total DisabilityWage-Earning CapacityMedical ProofVocational CapacityFunctional CapacityAppellate ReviewNew York LawDisability BenefitsClaimant Rights
References
4
Case No. MISSING
Regular Panel Decision
Sep 08, 1983

Claim of McNeil v. Geary

The claimant, a groom, injured her left knee in 1979 and was initially found temporarily totally disabled. The Workers' Compensation Board later reclassified her injury as a 15% permanent partial disability of the left leg, dating from the time of injury, and increased her benefits based on wage expectancy due to her being under 25. The employer appealed, arguing that wage expectancy benefits should not apply to the period of temporary total disability and that the record didn't substantiate a permanent partial disability ab initio. The court affirmed the Board's decision, stating that reclassification is a factual determination within the Board's sole province and was based on substantial evidence, and that the Board has continuing jurisdictional power to modify findings.

Permanent Partial DisabilityWage ExpectancyWorkers' Compensation LawInjury ReclassificationBoard JurisdictionSubstantial EvidenceLeft Knee InjuryGroomRiding AcademyTemporary Total Disability
References
4
Case No. MISSING
Regular Panel Decision

Claim of Krausa v. Totales Debevoise Corp.

Walter Krausa's 1994 claim for silicosis was established, leading to his classification as permanently totally disabled, and his workers' compensation carrier, the State Insurance Fund, became eligible for reimbursement from the Special Disability Fund. After Krausa's death in 2007, his widow filed for death benefits, which were awarded by a Workers’ Compensation Law Judge, who simultaneously discharged the Special Disability Fund from liability. The carrier appealed this decision, seeking continued reimbursement, but the Workers’ Compensation Board denied their request. This appellate court reversed the Board's decision, clarifying that the statutory language regarding the "date of accident or date of disablement" refers to the original disablement date of September 24, 1992, not the date of death, and that death is considered a consequence of the original injury, not a new accident. Therefore, the court concluded that the carrier was indeed entitled to reimbursement from the Special Disability Fund.

Workers' CompensationSilicosisOccupational DiseaseSpecial Disability FundReimbursementDeath BenefitsStatutory InterpretationDate of DisablementDate of AccidentAppellate Review
References
13
Case No. ADJ11147927
Regular
Oct 23, 2020

RAY SLAUGHTER vs. WALSH SHEA CORRIDOR CONSTRUCTORS, ESIS

The Workers' Compensation Appeals Board denied reconsideration of a decision that halted permanent disability (PD) advances. The applicant argued for continued advances due to ongoing temporary total disability and a lack of a definitive PD estimate, despite exhausting temporary disability benefits. The Board found no legal basis to order further PD advances and stated the applicant could conduct further discovery and present new evidence on the issue. The applicant failed to meet his burden of proof for continuing these advances.

Workers' Compensation Appeals BoardPermanent Disability AdvancesTemporary DisabilityPetition for ReconsiderationWCJ reportAdditional EvidenceLabor CodePermanent Disability IndemnityMedical OpinionPost-Surgical Condition
References
0
Case No. ADJ10616906
Regular
Oct 02, 2018

TASHAY LENZY vs. RALPHS GROCERY COMPANY, SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

This case involves a dispute over temporary total disability benefits and the applicant's primary treating physician. The defendant sought reconsideration of the award finding the applicant temporarily totally disabled and entitled to treatment by Dr. Schmidt, who was not in their Medical Provider Network (MPN). The Board affirmed the temporary disability finding, finding the defendant's MMI argument lacked substantial evidence. However, the Board deferred the issue of treatment outside the MPN, remanding it for further proceedings to determine continuity of care rights under Labor Code section 4616.2 and related regulations.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardTemporary Total DisabilityMaximum Medical ImprovementMedical Provider Network (MPN)Primary Treating Physician (PTP)Qualified Medical Examiner (QME)Continuity of CareLabor Code Section 4062
References
4
Case No. MISSING
Regular Panel Decision

Claim of Kowalchyk v. Wade Lupe Construction Co.

The claimant, a carpenter over 60 with an 11th-grade education, fractured his back and wrist in August 1985 while on a construction jobsite. Initially, his physician, Dr. James Slavin, considered him totally disabled, and he received total disability benefits from his employer's carrier. However, in December 1985, the employer reduced benefits to a partial disability rate, relying on a report from their consultant, Dr. Edward Pasquarella. The claimant subsequently filed for compensation, leading to a determination by the Workers’ Compensation Law Judge and ultimately the Workers’ Compensation Board that he had a total industrial disability. The employer appealed this decision, arguing it lacked substantial evidence. The court affirmed the Board's decision, considering the claimant’s physical limitations, age, work experience, and limited education, concluding he had no marketable skills outside carpentry.

Workers' CompensationTotal Industrial DisabilityPartial DisabilityMedical Testimony ConflictEarning Capacity AssessmentAppellate ReviewVocational RehabilitationAge & Education FactorsCarpenter InjuryScaffold Accident
References
3
Case No. MISSING
Regular Panel Decision

Claim of Harrington v. L.C. Whitford Co.

The claimant, a construction worker, experienced a severe exacerbation of pre-existing asthma after exposure to burning lead paint fumes in June 1996. A certified pulmonologist, Richard Evans, determined the exposure caused a permanent and total disability. A Workers' Compensation Law Judge (WCLJ) found an accidental injury causing permanent and total disability, which the Workers' Compensation Board affirmed in August 2001. The employer and carrier appealed, arguing the condition was pre-existing and only temporarily aggravated. The appellate court affirmed the Board's decision, finding substantial evidence to support that the work-site exposure significantly exacerbated the claimant's stabilized asthma, leading to a permanent and total disability.

Workers' CompensationPermanent Total DisabilityAsthma ExacerbationOccupational ExposureLead Paint FumesPre-existing ConditionMedical Expert TestimonySubstantial EvidenceAppellate ReviewIndustrial Accident
References
14
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