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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
Jan 15, 1988

Pension Benefit Guaranty Corp. v. LTV Corp.

David H. Miller and William W. Shaffer ("Miller and Shaffer") moved to intervene individually and as representatives of participants in the Jones & Laughlin Retirement Plan in an action filed by the Pension Benefit Guaranty Corporation (PBGC) against LTV Corporation and LTV Steel Company ("LTV"). LTV did not object to individual intervention but opposed class action intervention, arguing it would delay the PBGC action. The court granted the motion, allowing Miller and Shaffer to intervene both individually and as class representatives. The decision emphasized that Miller and Shaffer met the minimal burden of showing that PBGC's representation might be inadequate, as their interests, seeking full plan benefits, could diverge from PBGC's role as plan administrator. This opinion allows the class action to proceed under Rule 23(e), preventing dismissal or compromise without court approval.

InterventionERISAPension PlansBankruptcyClass ActionRule 24Rule 23(e)Adequate RepresentationPlan TerminationRestoration
References
6
Case No. MISSING
Regular Panel Decision
Feb 22, 1984

Barnhardt v. Hudson Valley District Council of Carpenters Benefit Funds

The plaintiff, injured in May 1978 during maintenance work, was denied workers' compensation due to the absence of an employer-employee relationship. Subsequently, he sought reimbursement for medical expenses from the Hudson Valley District Council of Carpenters Benefit Funds (Benefit Funds) through a union insurance policy. Continental Assurance Company (Continental), Benefit Funds' insurer, rejected the claim, citing an employment-related injury exclusion in the policy. The plaintiff then initiated an action against Benefit Funds, which in turn filed a third-party action against Continental seeking indemnification. Continental's motion for summary judgment, asserting the exclusion, was denied by the County Court. The appellate court affirmed this denial, ruling that the exclusionary language was ambiguous and applied only in cases where a clear employer-employee relationship existed, a fact still to be determined.

Insurance Policy InterpretationEmployment StatusWorkers' Compensation ExclusionSummary Judgment MotionContractual AmbiguityGroup Health InsuranceMedical Expense ReimbursementThird-Party ActionAppellate ReviewEmployer-Employee Relationship
References
10
Case No. MISSING
Regular Panel Decision

Claim of Newman v. Public Oversight Board

This case addresses the interpretation of Workers’ Compensation Law § 16 (2-a) concerning death benefits for a surviving spouse and children upon the spouse’s remarriage. The Workers’ Compensation Board ruled that the claimant, a surviving spouse, was entitled to a lump-sum payment, and her two children's benefits should increase to 25% each immediately upon her remarriage. The employer and its carrier appealed, contending that the children's increased benefits should be delayed for two years, arguing for a pervasive 66% wage share maximum. The court rejected this argument, affirming the Board's decision, clarifying that the remarriage lump-sum payment is not an advance but a separate entitlement, and thus, the children's benefits increase immediately.

death benefitssurviving spouseremarriage benefitschildren's compensationWorkers' Compensation Lawstatutory interpretationlump-sum paymentwage share maximumWorkers' Compensation Board decisionappellate affirmance
References
2
Case No. MISSING
Regular Panel Decision

Cook v. Pension Benefit Guarantee Corp.

The Trustees of the Local 852 General Warehouseman’s Union Pension Fund sued the Pension Benefit Guarantee Corporation (PBGC) seeking reimbursement for pension benefits paid to retirees of two closed warehouses. The Fund argued for recovery based on equitable estoppel, asserting detrimental reliance on an initial PBGC determination that it would guarantee these benefits. The PBGC moved for summary judgment, contending that estoppel against a federal agency requires a showing of affirmative misconduct or manifest injustice. The Court found no evidence of affirmative misconduct by the PBGC and concluded that its change in determination, made to conform with Congressional intent, did not constitute manifest injustice. Consequently, the Court granted the PBGC's motion for summary judgment, ruling that equitable estoppel was inapplicable.

Equitable EstoppelFederal Agency EstoppelSummary JudgmentERISAPension BenefitsMulti-employer PlanPension Benefit Guarantee Corporation (PBGC)Affirmative MisconductManifest InjusticeDetrimental Reliance
References
10
Case No. MISSING
Regular Panel Decision

Jeffries v. Pension Trust Fund of the Pension, Hospitalization & Benefit Plan of the Electrical Industry

Plaintiff Claude Jeffries, a retired electrician, sued the Pension Trust Fund of the Electrical Industry under ERISA, seeking to include pension credits from 1969-1975 in his current benefits. He alleged the Plan should have declared a partial termination during a 1975-1979 New York recession, which would have vested his benefits. The defendant moved to dismiss the complaint, arguing lack of standing and statute of limitations, while plaintiff moved for class certification for similarly affected members. The court denied the defendant's motion to dismiss the claim for benefits, finding it timely, but granted dismissal for the breach of fiduciary duty claim as time-barred. The plaintiff's motion for class certification was denied due to insufficient evidence for numerosity, with leave to refile after discovery.

ERISAPension BenefitsClass CertificationMotion to DismissStatute of LimitationsFiduciary DutyPartial TerminationBenefit ForfeitureUnemploymentLabor Union
References
15
Case No. ADJ9932467
Regular
Oct 16, 2017

THERESA MCFARLAND vs. REDLANDS UNIFIED SCHOOL DISTRICT

The Workers' Compensation Appeals Board denied an applicant's petition for reconsideration, affirming the WCJ's decision that "Return-To-Work" supplemental payments under Labor Code section 139.48 are not "compensation" as defined by Labor Code section 3207. Therefore, the applicant was not entitled to a second penalty under Labor Code section 5814 for the employer's delay in providing a Supplemental Job Displacement Benefit voucher, as that delay did not cause a delay in a compensable benefit. The Board found that the applicant's penalty claim for the voucher delay was already resolved and that imposing a second penalty for a non-compensable benefit delay would be unfair and against the principle of balancing justice.

Labor Code section 139.48Return-To-Work supplemental paymentscompensation definitionLabor Code section 3207Labor Code section 5814 penaltyLabor Code section 4658.7 voucherSupplemental Job Displacement Benefitcompromise and release agreementGage v. Workers' Comp. Appeals Bd.unreasonable delay
References
1
Case No. MISSING
Regular Panel Decision

Saltares v. Bowen

The plaintiff, Mr. Saltares, sought interim disability insurance benefits and Supplemental Security Income under the Social Security Act after his case was remanded to the Secretary of Health and Human Services for further proceedings. Magistrate Naomi Reice Buchwald recommended denying the request, arguing that courts generally lack the authority to award interim benefits in "original entitlement" cases. Plaintiff objected, citing anticipated delays on remand due to the Administrative Law Judge's initial inadequate processing of his claim. District Judge Kram acknowledged the court's remedial power to grant interim benefits in instances of unreasonable delay caused by the Secretary. However, the Court ultimately denied the application, finding that despite the plaintiff's financial hardship and the reasons for remand, the delays in this particular case did not meet the threshold of "unreasonable delay" established by precedent.

Disability benefitsSocial Security ActInterim benefitsRemandUnreasonable delayJudicial reviewAdministrative Law JudgeOriginal entitlement casesSouthern District of New YorkDistrict Court Decision
References
10
Case No. MISSING
Regular Panel Decision

In re the Estate of Bricker

In an accounting proceeding, the Department of Social Services (DSS) of the City of New York sought summary judgment for the reimbursement of Medicaid benefits totaling $34,913.44 paid to Montefiore Hospital on behalf of the decedent. The central legal question, one of first impression, was whether the decedent's estate or the hospital should bear the cost of hospital care incurred during a period when the decedent's discharge was delayed. This delay was caused by the hospital's unsuccessful petition for conservatorship, alleging the decedent's incompetence. The court, drawing an analogy to Mental Hygiene Law Article 81 guardianship proceedings, determined that such costs could be proportionally allocated. Weighing equitable considerations, the court partially granted DSS's motion for summary judgment, awarding $26,000, and denied the executrix's cross-motion.

Medicaid BenefitsAccounting ProceedingSummary JudgmentConservatorshipDischarge PlanningUnjust EnrichmentEquitable ConsiderationsSocial Services LawMental Hygiene LawHospital Liability
References
3
Case No. 2021 NY Slip Op 04070
Regular Panel Decision
Jun 24, 2021

Matter of Cisnero v. Independent Livery Driver Benefit Fund

Claimant Jeffrey Cisnero, an independent livery driver, sustained injuries when he was shot during a dispatch. He filed a claim for workers' compensation benefits, which was initially disallowed by a WCLJ but later reversed by the Workers' Compensation Board, finding coverage through the Independent Livery Driver Benefit Fund (ILDBF). The carrier appealed, arguing misinterpretation of the relevant statutes, particularly Executive Law § 160-ddd (1). The Appellate Division, Third Department, affirmed the Board's decision, determining that Cisnero's injuries arose out of and in the course of providing covered services as an independent livery driver dispatched by an ILDBF member. The court found that the vehicle's attenuated affiliation with the New York Black Car Operators' Injury Compensation Fund, Inc. did not alter ILDBF's liability.

Workers' CompensationLivery DriverIndependent ContractorBenefit FundAccidental InjuryCourse of EmploymentStatutory InterpretationExecutive LawWorkers' Compensation LawAppellate Review
References
3
Case No. ADJ7989442
Regular
Sep 18, 2015

KATH WALKER vs. GALICHON MACINNES, STATE FARM INSURANCE COMPANY

This case concerns an applicant seeking removal from an order delaying an expedited hearing on temporary disability benefits. The Workers' Compensation Appeals Board (WCAB) granted removal, finding the applicant would suffer significant prejudice from the delay, especially given her two-year period of temporary total disability and lack of benefits. The WCAB rescinded the prior order, mandating an expedited hearing on temporary disability in the accepted case. This decision emphasizes the urgent nature of temporary disability claims and the inappropriable of delaying them for settlement conferences when benefits are overdue.

Petition for RemovalExpedited HearingTemporary DisabilityMandatory Settlement ConferenceIndustrial InjuryApportionmentIrreparable HarmLabor Code Section 5502(b)(4)Total Temporary DisabilityContribution Action
References
8
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