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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

Pension Benefit Guaranty Corp. v. Broadway Maintenance Corp.

This case involves the Pension Benefit Guaranty Corporation (PBGC) and the bankrupt Broadway Maintenance Corporation (Broadway) disputing the termination date of Broadway's non-union employee pension plan. PBGC initiated the lawsuit to become the statutory trustee and sought to establish March 26, 1981, as the termination date. Broadway argued for an earlier, retroactive date. The court, guided by ERISA and the interests of the plan participants, rejected both parties' proposed dates. The judge formulated a test for involuntary terminations and ultimately established December 5, 1980, as the official termination date, citing the date PBGC first formalized its intent to terminate the plan.

ERISAPension Plan TerminationEmployee Retirement Income Security ActInvoluntary TerminationTermination Date DisputeBankruptcyPlan Participants' InterestsStatutory TrusteeFiduciary DutyPension Benefit Guaranty Corporation
References
2
Case No. MISSING
Regular Panel Decision
Jul 13, 2001

A.I. Transport v. New York State Insurance Fund

The Supreme Court, New York County, denied a liability insurer’s application to stay an arbitration initiated by a workers’ compensation insurer. The workers’ compensation insurer sought to recover benefits paid to a bus passenger injured in an accident, where the bus was insured by the liability insurer. The court interpreted Insurance Law § 5105 (a) to allow a workers’ compensation provider, paying benefits in lieu of first party benefits, to recover amounts paid from the insurer of a liable party, even if one of the vehicles involved is a bus. It was determined that an exception for losses arising from the use of a motor vehicle (Insurance Law § 5103 [a] [1]) did not apply, as the respondent was a workers’ compensation insurer and not an automobile insurer. Consequently, the arbitration was allowed to proceed, and the petition to stay it was dismissed and unanimously affirmed.

Arbitration DisputeInsurance Law InterpretationNo-Fault BenefitsWorkers' Compensation SubrogationBus AccidentLiability CoverageStatutory ConstructionAppellate ReviewInsurer Recovery
References
4
Case No. MISSING
Regular Panel Decision

Claim of House v. International Talc Co.

Arthur House suffered a compensable occupational disease in 1973, resulting in permanent total disability and received workers' compensation benefits based on his 1973 average weekly wage. He died in 1995 from lung disease. His widow, the claimant, filed for death benefits, contending the benefits should be calculated based on the average weekly wage of a comparable employee for the year preceding his death (March 17, 1994, to March 17, 1995). The Workers’ Compensation Law Judge and the Board, however, determined that death benefits should be calculated based on House's average weekly wage from the date of his original injury, April 5, 1973. This Appellate Division affirmed the Board's decision, interpreting Workers’ Compensation Law §§ 2, 14, and 38 to establish that the date of the original injury or accident is the basis for computing both disability and death benefits, not the date of death.

Death BenefitsAverage Weekly Wage CalculationOccupational DiseasePermanent Total DisabilityStatutory InterpretationDate of DisablementAppellate DivisionTalcosisClaimant's Widow
References
6
Case No. SAC 349462
Regular
Mar 11, 2008

QAHER MOKDADI vs. HENDRICK AUTOMOTIVE, FEDERAL INSURANCE COMPANY

In this workers' compensation case, the Appeals Board clarified the commencement date for temporary disability payments under Labor Code section 4656(c)(1). Applying its en banc decision in *Hawkins v. Amberwood Products*, the Board held that the two-year period for temporary disability payments begins on the date indemnity is *first paid* to the worker, not when it is first owed or when unemployment benefits are reimbursed. Therefore, the commencement date was established as November 9, 2006, the date the applicant received his first temporary disability indemnity check.

Workers' Compensation Appeals BoardHendrick AutomotiveFederal Insurance CompanyQAHER MOKDADIauto service technicianleft shoulder and spine injuryEmployment Development Department (EDD)temporary disability indemnityLabor Code section 4656(c)(1)date of commencement
References
2
Case No. MISSING
Regular Panel Decision

In re the Arbitration between Williams

Amoco Oil appealed two judgments from the Supreme Court, Nassau County, concerning arbitration for uninsured motorist and no-fault benefits. The first judgment, dated January 6, 1977, granted New Hampshire Insurance Company's application to stay arbitration, deeming Amoco Oil's coverage primary and New Hampshire's secondary for uninsured motorist benefits. The second judgment, dated March 30, 1977, permanently stayed arbitration for no-fault benefits under New Hampshire's policy. The Appellate Division affirmed both judgments, concluding that the claimant was "occupying" the Amoco Oil vehicle, making Amoco Oil primarily liable for uninsured motorist benefits. However, the claimant was precluded from receiving these benefits due to already receiving workers' compensation benefits in excess of the maximum, and was also ineligible for no-fault benefits under the New Hampshire policy.

Insurance DisputeArbitration ProceedingsUninsured Motorist CoverageNo-Fault InsuranceWorkers' CompensationPrimary vs Secondary LiabilityAppellate DivisionNassau County Supreme CourtVehicle OccupancyBenefit Eligibility
References
3
Case No. SAC 0336811
Regular
Aug 31, 2007

Robert McGraw vs. BC STOCKING DISTRIBUTING, INC., STATE COMPENSATION INSURANCE FUND

This case clarifies that the two-year limit for temporary disability payments under Labor Code section 4656(c)(1) begins on the date benefits are *first paid*, not when they are first owed. The Appeals Board found that the applicant was entitled to benefits up to 104 weeks within the two years following the initial payment date of May 19, 2004. The Board also affirmed that it lacks jurisdiction to rule on the constitutionality of statutory provisions.

Labor Code section 4656(c)(1)temporary disability indemnitycompensable weeksperiod of two yearsdate of commencement of temporary disability paymentdate of first paymentindustrial injuryheadneckback
References
4
Case No. MISSING
Regular Panel Decision

Great Wall Acupuncture, P.C. v. GEICO Insurance

This case involves an action brought by a medical provider against an insurer to recover assigned first-party no-fault benefits. The insurer partially paid the claim but denied the remaining portion, arguing that charges for acupuncture treatments exceeded the maximum fees allowed under the applicable fee schedule. Following a nonjury trial, the Civil Court ruled in favor of the defendant, dismissing the complaint. The court held that an insurer may utilize the workers’ compensation fee schedule for acupuncture services rendered by chiropractors, even when the services are performed by a licensed acupuncturist. The appellate court affirmed this judgment, concluding that since the defendant reimbursed the plaintiff according to the workers’ compensation fee schedule for chiropractor-provided acupuncture services, no additional reimbursement was due.

Acupuncture ServicesChiropracticNo-Fault InsuranceFee ScheduleWorkers' Compensation Fee ScheduleLicensure RequirementsFirst-Party BenefitsAppellate ReviewInsurance ReimbursementCivil Court Decision
References
4
Case No. MISSING
Regular Panel Decision

Medina v. Phillips

Plaintiff Philip Medina, an ambulance driver for Shiva Ambulette Service, was injured in a motor vehicle accident in 2007 and subsequently settled a personal injury action for $20,000. He had been receiving workers' compensation benefits from First Cardinal Corporation, LLC. The plaintiff sought a nunc pro tunc order to approve his settlement, which was initially denied by a lower court. This decision reversed the lower court's denial, finding that the plaintiff was not at fault for the delay in seeking approval, as the carrier had misled him. Additionally, the court determined that First Cardinal Corporation, LLC was not prejudiced by the delay, given that the benefits paid were below the statutory cap and the settlement amount was deemed fair and reasonable.

Workers' Compensation BenefitsMotor Vehicle Accident ClaimsSettlement ApprovalNunc Pro Tunc OrderInsurance LawWorkers' Compensation LawCarrier's LienFirst-Party BenefitsPrejudice ArgumentChiropractic Examination
References
4
Case No. MISSING
Regular Panel Decision

In re the Claim of Friedman

This case examines whether claimants are eligible for unemployment benefits for a week in July during which they received vacation pay from their employer. The court references a previous decision, *Matter of Miranda* (Catherwood), which allowed such benefits under certain conditions. However, the court highlights that subdivision 3 of section 591 of the Labor Law was amended in 1963 specifically to correct inequities and prevent employees from receiving both vacation pay and unemployment benefits for the same period. Despite the board's finding that the union agreement did not designate a vacation period, the court interpreted the agreement's clauses as designating the first week in July for vacation. The court concluded that upholding the board's original decision would undermine the legislative intent of the 1963 amendment. Consequently, the court reversed the board's decision and remitted the matter for further proceedings.

Unemployment Insurance BenefitsVacation PayLabor LawStatutory InterpretationLegislative IntentCollective Bargaining AgreementBoard Decision ReversalRemandWorkers' RightsEmployer Obligations
References
3
Case No. MISSING
Regular Panel Decision
Mar 30, 1981

Safeco Insurance Co. of America v. Jamaica Water Supply Co.

An unnamed insurance carrier, as plaintiff, sued an unnamed defendant to recover first-party benefits paid to its insured, Leon Morris, following a 1977 accident. The defendant sought to dismiss the complaint, citing the three-year Statute of Limitations (CPLR 214) from the accident date. Special Term denied this motion, arguing a two-year toll under Insurance Law § 673 (2). The Appellate Division affirmed the denial but on different grounds. The court ruled that Insurance Law § 673 (2) creates an independent cause of action for the insurer, distinct from subrogation. Consequently, the three-year limitation period accrues not from the accident itself, but from the point the insurer became entitled to sue, specifically, two years after the insured failed to sue for first-party benefits. Thus, the insurer's action was deemed timely.

Statute of LimitationsInsurance Law § 673 (2)CPLR 214No-Fault BenefitsCause of Action AccrualStatutory LiabilityInsurance Carrier ActionAppellate ReviewArbitration DecisionPersonal Injury Litigation
References
15
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