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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
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

Truly v. Regan

Petitioner, employed by Brooklyn Developmental Center, sustained a lower back and left leg injury in January 1986. After a period of inactivity, she stopped working in March 1987 due to her injuries and began receiving workers' compensation benefits. In February 1988, her applications for ordinary disability retirement benefits (under Retirement and Social Security Law art 14) and article 15 disability retirement benefits (under art 15) were denied by the respondent. The ordinary disability application was denied because she was not 'in service' at the time of filing, having been terminated in May 1987. The article 15 disability application was deemed untimely, as it was filed in February 1988, beyond the three-month window from her last payroll date of March 27, 1987, and she lacked approved medical leave. The court confirmed the denial and dismissed her petition.

Disability RetirementOrdinary Disability BenefitsArticle 15 Disability BenefitsIn Service RequirementTimely FilingCPLR Article 78 ProceedingEmployment TerminationMedical LeaveNew York State Employees' Retirement SystemAlbany County
References
5
Case No. MISSING
Regular Panel Decision
Dec 20, 2000

Sutherland v. Village of Suffern

The petitioner, a police officer, was injured while attempting to open a door at the station house and subsequently applied for benefits under General Municipal Law § 207-c. The Chief of the Village of Suffern Police Department denied these benefits, leading the petitioner to initiate an Article 78 proceeding. The Supreme Court, Rockland County, denied the petition and dismissed the case. On appeal, the judgment was affirmed, with the court citing *Matter of Balcerak v County of Nassau* to underscore that General Municipal Law § 207-c is intended for injuries arising from heightened risks associated with criminal justice duties, concluding the denial was not arbitrary or capricious. The court also clarified that claims for Workers' Compensation benefits should be addressed to the Workers’ Compensation Board.

Police officer injuryGeneral Municipal Law 207-c benefitsDenial of benefitsScope of employmentAdministrative reviewCPLR Article 78Appellate Division decisionWorkers' Compensation jurisdictionMunicipal employee benefitsSuffern Police Department
References
2
Case No. MISSING
Regular Panel Decision
Nov 02, 2001

Claim of Medina v. Building Maintenance Service

Claimant sustained work-related injuries in July 1999. Her physician, Dr. Magdy Elamir, failed to file medical reports with the Workers' Compensation Board after August 1999 and before April 18, 2001, and with the State Insurance Fund until April 18, 2001. This led to a controversy over insurance coverage between Fireman’s Fund and State Fund. Initially, a WCLJ awarded benefits, but the Board rescinded the award for October 4, 1999, to April 18, 2001, citing prejudice to State Fund. On appeal, the court determined that State Fund was not prejudiced from October 4, 1999, to December 21, 2000, and reversed that part of the Board's decision, while affirming the denial of benefits from December 21, 2000, to April 18, 2001.

Workers' CompensationMedical Report FilingPrejudiceInsurance Coverage DisputeDenial of BenefitsAppellate ReviewAdministrative DeterminationSubstantial EvidenceRegulatory ComplianceNeurologist
References
7
Case No. MISSING
Regular Panel Decision
Feb 02, 1984

Krebbeks v. Regan

Petitioner, the widow of a Department of Transportation employee, applied for accidental death benefits after her husband's service-connected death in July 1981. Although her application for accidental death benefits was approved, these benefits were entirely offset by workers' compensation payments, leaving her with no current payments from the State Employees’ Retirement System. Subsequently, petitioner sought a lump-sum ordinary death benefit, which was denied because she was deemed eligible for accidental death benefits, even if offset. This appeal ensued after the denial of her application by a hearing officer and Special Term's concurrence. The court affirmed the denial, citing Retirement and Social Security Law § 60 (a) (3), which states an ordinary death benefit is not payable if an accidental death benefit is payable, with a narrow exception not applicable here.

Accidental Death BenefitsOrdinary Death BenefitsWorkers' Compensation OffsetRetirement and Social Security LawStatutory InterpretationDeath Benefits EligibilityPublic Employee BenefitsAdministrative Law AppealDeath Benefit Offset
References
2
Case No. MISSING
Regular Panel Decision

York v. Comm'r of Soc. Sec.

The plaintiff appealed the Commissioner of Social Security's denial of disability benefits. An Administrative Law Judge (ALJ) initially found the plaintiff not disabled, a decision affirmed by the Appeals Council. The plaintiff subsequently moved for judgment on the pleadings, requesting a remand for benefits or further administrative proceedings. The court found that the ALJ erred in evaluating the plaintiff's spinal impairments under Listing 1.04 and in assessing medical opinion evidence from Dr. Harbinder Toor. Consequently, the court granted the plaintiff's motion, denied the Commissioner's cross-motion, and remanded the case for further proceedings, including a reassessment of Listing 1.04 and reconsideration of Dr. Toor's opinion.

Disability BenefitsSocial Security ActALJ Decision ReviewRemandLumbar Spinal StenosisDegenerative Disc DiseaseMedical Opinion EvidenceResidual Functional Capacity (RFC)Vocational Expert TestimonyAppeals Council
References
7
Case No. Dkt. # 6, Dkt. # 7
Regular Panel Decision
Feb 05, 2013

Crayton v. Astrue

Plaintiff appeals the denial of supplemental security income benefits by the Commissioner of Social Security. Plaintiff filed an application for Supplemental Security Income benefits in 2009, alleging inability to work due to various medical conditions. An Administrative Law Judge (ALJ) denied the application, and the Appeals Council denied review, making the ALJ's decision final. The District Court reviews the Commissioner's decision, finding that while the ALJ's assessment of exertional limitations was supported by substantial evidence, the ALJ failed to apply the Psychiatric Review Technique (PRT) in analyzing non-exertional limitations. Consequently, the court remands the matter for further proceedings consistent with its opinion, specifically for proper application of the PRT.

Supplemental Security IncomeSocial Security ActDisability BenefitsAdministrative Law JudgePsychiatric Review TechniqueRFCExertional LimitationsNon-exertional LimitationsDepressionAnxiety
References
15
Case No. MISSING
Regular Panel Decision

Furch v. Bucci

A firefighter for the City of Binghamton sought supplemental wage benefits under General Municipal Law § 207-a, claiming arteriosclerosis and acute myocardial infarction were job-related. After initial denials and an administrative hearing, the application was again denied. The Supreme Court partially dismissed his CPLR article 78 petition but transferred a substantial evidence question to this Court. This Court affirmed due process and the non-binding nature of a workers' compensation decision regarding arteriosclerosis. However, it ruled that respondents were bound by the workers' compensation finding that the myocardial infarction was causally related to employment. Consequently, the matter was remitted to determine the petitioner's entitlement to benefits for any period of disability solely attributable to the myocardial infarction.

Firefighter benefitsGeneral Municipal Law Section 207-aWorkers' Compensation LawCPLR Article 78Myocardial InfarctionArteriosclerosisCausal RelationDue ProcessAdministrative LawRes Judicata
References
7
Case No. 2020 NY Slip Op 02513 [182 AD3d 954]
Regular Panel Decision
Apr 30, 2020

Matter of Colon (Pd 10276, Inc.--Commissioner of Labor)

Nicanor Colon filed for unemployment insurance benefits after ceasing operation of his cleaning business, leading the Department of Labor to assess PD 10276, Inc., doing business as Jan-Pro Cleaning Systems of the Hudson Valley, for additional unemployment insurance contributions. An Administrative Law Judge initially ruled Colon an independent contractor, but the Unemployment Insurance Appeal Board reversed this decision, finding Colon and similarly situated individuals to be employees. PD 10276, Inc. appealed the Board's decision to the Appellate Division, Third Department. The Appellate Division affirmed the Board's determination, concluding that there was substantial evidence of an employment relationship based on the indicia of control exercised by Jan-Pro Cleaning over its unit franchisees, similar to findings in prior cases like Matter of Baez. The court highlighted requirements like certification, provision of supplies, periodic inspections, and noncompetition clauses as supporting the Board's conclusion.

Unemployment InsuranceIndependent Contractor StatusEmployment RelationshipFranchise AgreementAppellate ReviewSubstantial EvidenceJan-Pro Cleaning SystemsDepartment of LaborUnit FranchiseesLabor Law
References
6
Case No. MISSING
Regular Panel Decision
Feb 13, 1998

Castro v. Wing

The petitioner sought review of a determination by the New York State Office of Temporary and Disability Assistance, which upheld the Suffolk County Department of Social Services' decision to deny her application for public assistance and food stamp benefits. The denial was based on her failure to appear at a scheduled front end detection system (FEDS) interview, a requirement for eligibility. The petitioner argued she was misinformed by a case worker and did not see the notices. The court confirmed the determination, ruling that the FEDS review was an essential eligibility requirement and the petitioner failed to demonstrate good cause for her absence. A dissenting judge contended that the respondents did not provide substantial evidence that the petitioner refused to attend the interview, and that the FEDS process, established for fraud prevention, should not inherently preclude benefit application processing.

Public Assistance DenialFood Stamp BenefitsEligibility RequirementsFEDS InterviewAdministrative Due ProcessAgency Determination ReviewGood CauseFraud PreventionSuffolk County DSSNew York Social Services
References
4
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