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

Case No. 2017 NY Slip Op 04184 [150 AD3d 1589]
Regular Panel Decision
May 25, 2017

New York State Workers' Compensation Board v. Program Risk Management, Inc.

The New York State Workers' Compensation Board, acting as administrator and successor to the Community Residence Insurance Savings Plan, initiated legal action against various entities and individuals after the trust became severely underfunded. Defendants include Program Risk Management, Inc. (administrator), PRM Claims Services, Inc. (claims administrator), individual officers of PRM, the Board of Trustees, and Thomas Gosdeck (trust counsel). The plaintiff sought damages for claims such as breach of contract, breach of fiduciary duty, and legal malpractice. The Supreme Court's order partially dismissed some claims and denied others. On cross-appeal, the Appellate Division, Third Department, modified the Supreme Court's order, notably reversing the dismissal of several breach of fiduciary duty claims and common-law indemnification against PRMCS, while affirming denials of motions to dismiss breach of contract, legal malpractice, and unjust enrichment claims. The court's decision was influenced by recent rulings in State of N.Y. Workers' Compensation Bd. v Wang.

Workers' Compensation LawGroup Self-Insured TrustBreach of ContractBreach of Fiduciary DutyLegal MalpracticeUnjust EnrichmentStatute of LimitationsEquitable EstoppelAlter Ego LiabilityCommon-Law Indemnification
References
20
Case No. MISSING
Regular Panel Decision
Dec 23, 1993

Claim of Kroeger v. New York State Workers' Compensation Board

This case involves an appeal from a Workers’ Compensation Board decision awarding death benefits to a claimant, the widow of a Workers' Compensation Board Commissioner. The decedent collapsed and died from an intercranial pontine hemorrhage after work. The Board found his death causally related to job stress, despite his pre-existing conditions (obesity, hypertension, arteriosclerosis). The employer and its insurance carrier appealed, arguing a lack of substantial evidence. The court noted conflicting medical testimony regarding the causal link between work stress and death but upheld the Board’s prerogative to weigh such evidence. Ultimately, the Board's decision to award death benefits was affirmed.

Workers' CompensationCausal RelationshipJob StressIntercranial Pontine HemorrhageMedical Testimony ConflictPre-existing ConditionsDeath BenefitsAppellate ReviewSubstantial EvidenceBoard Decision
References
2
Case No. MISSING
Regular Panel Decision

Yerry v. New York State Workers' Compensation Board

This case involves an appeal from decisions of the Workers’ Compensation Board concerning a claimant, a member of the Board, who sustained a compensable industrial accident on April 21, 1976. The claimant suffered a foot injury which was subsequently aggravated by work activities, leading to thrombophlebitis of the right leg and pulmonary emboli, requiring surgery. The Board, in decisions filed December 7, 1977, and August 10, 1978, found that the claimant's work activities aggravated the condition, establishing a causal relation based on testimony. The appellate court affirmed these decisions, finding substantial evidence to sustain the Board's determination and deemed it unnecessary to consider the personal act doctrine. Costs were awarded to the Workers’ Compensation Board against the appellant State Insurance Fund.

Industrial AccidentAggravated InjuryThrombophlebitisPulmonary EmbolismCausal RelationshipSubstantial EvidencePersonal Act DoctrineAppellate ReviewState Insurance FundBoard Decision Affirmance
References
4
Case No. 17 NY3d 702
Regular Panel Decision

Ovadia v. Office of the Industrial Board of Appeals

The New York Court of Appeals addressed whether a general contractor, HOD Construction Corp., acted as a joint employer of its subcontractor Well Built Construction Corp.'s masonry workers, thereby owing them unpaid wages. The lower courts had found joint employment, but the Court of Appeals reversed, holding that the standard contractor/subcontractor relationship during the bulk of the project did not establish joint employment under the Labor Law. The Court determined that factors relied upon by the Board were common in construction and did not indicate direct control or functional supervision by HOD over Well Built's employees. However, the case was remitted to the Industrial Board of Appeals for a determination on whether HOD's owner made an enforceable promise to pay the workers for a specific six-day period after the subcontractor abandoned the project, which could establish an employment relationship for that limited time.

Joint EmploymentSubcontractor LiabilityUnpaid WagesGeneral Contractor ResponsibilityLabor LawEconomic Reality TestAppellate ReviewRemittalConstruction IndustryWorkers' Rights
References
13
Case No. MISSING
Regular Panel Decision

Transcontinental Refrigerated Lines, Inc. v. Workers' Compensation Board

Transcontinental Refrigerated Lines, Inc. (TRL), a Pennsylvania common carrier, appealed decisions by the New York Workers' Compensation Board that denied its applications for redetermination of civil penalties. The penalties were imposed because TRL allegedly failed to secure New York workers' compensation insurance, despite having coverage in Pennsylvania. TRL contended that its interstate operations and Pennsylvania base exempted it from New York's requirements. The Board had relied on an earlier Workers’ Compensation Law Judge decision concerning an employee, Clarence Edick, which characterized TRL as a 'covered employer in NY.' The Appellate Division reversed the Board's decisions, concluding that TRL was entitled to a hearing to litigate the fundamental jurisdictional issue of its obligation under Workers' Compensation Law § 50, as the Edick proceeding did not definitively resolve this broader question.

Civil PenaltiesDue Process RightsJurisdictional DisputesInterstate EmployerInsurance ObligationAdministrative ReviewAppellate ProcedureRemand OrderStatutory ComplianceProcedural Safeguards
References
3
Case No. MISSING
Regular Panel Decision
Jun 11, 1993

Empire Insurance v. Workers' Compensation Board

Empire Insurance Company denied Hugh Wofsy's no-fault benefits claim, alleging he was a Dial-a-Car, Inc. employee requiring Workers' Compensation. An Administrative Law Judge later found Wofsy an independent contractor, denying him Workers' Compensation. Empire sought to reopen the Workers' Compensation claim to participate, which the Board denied. Empire then initiated a CPLR article 78 proceeding, where the IAS Court allowed the reopening and ordered Empire to pay Wofsy, with potential reimbursement. The Appellate Division subsequently reversed this judgment, dismissing Empire's petition, emphasizing that Workers' Compensation Law § 23 vests exclusive appeal jurisdiction with the Third Department and precludes article 78 proceedings for reviewing Board decisions' substance.

No-fault insuranceIndependent contractor disputeEmployee status determinationCPLR Article 78 proceedingAppellate Division jurisdictionWorkers' Compensation Law § 23Judicial review of administrative decisionsInsurance coverage disputeAdministrative Law Judge rulingReimbursement claim
References
2
Case No. 532391
Regular Panel Decision
Nov 18, 2021

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

Claimant, Rebecca Richman, appealed three decisions from the Workers' Compensation Board regarding her claim for a work-related right shoulder injury. She alleged a fall at work on January 19, 2018, but did not seek medical treatment for 19 months. A Workers' Compensation Law Judge initially established the claim, but the Board reversed, finding that Richman failed to submit sufficient, credible medical evidence to demonstrate a causally-related injury and denied her claim. The Board subsequently denied her application for reconsideration and/or full Board review. The Appellate Division affirmed the Board's decisions, concluding that the Board's finding of no causally-related injury was supported by substantial evidence and that the Board did not abuse its discretion in denying reconsideration.

Workers' Compensation ClaimCausation (Medical)Shoulder InjuryMedical Evidence SufficiencyBoard ReversalAppellate Division ReviewBurden of ProofCredibility of EvidenceOsteoarthritis DiagnosisDelayed Medical Treatment
References
8
Case No. 2020 NY Slip Op 07633 [189 AD3d 1831]
Regular Panel Decision
Dec 17, 2020

Matter of Karwowska v. Air Tech Lab, Inc.

Three claimants appealed Workers' Compensation Board (Board) decisions denying their applications for review of Workers' Compensation Law Judge (WCLJ) findings. The Board denied the applications because the claimants failed to fully complete question number 15 on their RB-89 forms, which required specifying the objection or exception made to the WCLJ's ruling and when it was interposed. The Appellate Division affirmed the Board's decisions, stating that the Board has discretion to deny review when parties represented by counsel fail to comply with its procedural requirements. The court found that the claimants' responses were deficient as they only identified when the objection was made, not the specific objection itself, thus violating 12 NYCRR 300.13 (b) (1), (2) (ii).

Workers' Compensation LawBoard ReviewProcedural ComplianceApplication for ReviewRB-89 formAdministrative ReviewWCLJ DecisionAppellate ProcedureRegulatory ComplianceClaim Denied
References
13
Case No. MISSING
Regular Panel Decision

Scott Wetzel Services, Inc. v. New York State Board of Industrial Appeals

The case involves a CPLR article 78 proceeding initiated by a nationwide company, which administers workers’ compensation and general liability claims, against the State Board of Industrial Appeals. The company challenged a Department of Labor determination, later modified by the Board, that its claims examiners were not exempt from Fair Labor Standards Act (FLSA) overtime pay requirements. The core issue was whether the examiners qualified for an administrative capacity exemption under FLSA. Applying the "short test" and the "production/administrative dichotomy," the court concluded that the examiners were "production workers" as their primary duty was to produce the services the employer offered. Consequently, the court found substantial evidence to support the Board's determination, confirmed the Board's decision, and dismissed the petition.

Overtime PayFLSA ExemptionAdministrative CapacityClaims ExaminersLabor Law ViolationCPLR Article 78Production WorkersState Board of Industrial AppealsWage and Hour DisputesDiscretion and Independent Judgment
References
10
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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