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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
May 06, 2005

Claim of Fiero v. New York City Department of Housing Preservation & Development

Claimant's decedent, an employee of the New York City Department of Housing Preservation and Development, was struck by a truck and died 16 days later after parking his car across the street from his office. Due to a heart condition, his employer had arranged for him to park in this lot. A Workers’ Compensation Law Judge initially established the case for accident, notice, and causal relationship, awarding benefits. However, the Workers’ Compensation Board reversed, finding the accident did not arise out of and in the course of employment. The appellate court affirmed the Board's decision, concluding there was no special hazard at the off-premises location and the route was not controlled or endorsed by the employer, thus the accident was not a work-related hazard.

Workers CompensationScope of EmploymentGoing and Coming RuleSpecial Hazard ExceptionPublic Highway AccidentOff-Premises InjuryCausal RelationshipDeath BenefitsAppellate ReviewEmployer Liability
References
7
Case No. ADJ8130208
Regular
Jul 21, 2014

GENEVA AGUILAR vs. STAR AUTO PARTS, EMPLOYERS COMPENSATION INSURANCE COMPANY

This case involves a defendant's petition for reconsideration of a Workers' Compensation Appeals Board (WCAB) decision ordering it to pay the Employment Development Department's (EDD) lien. The defendant argued that the applicant declined an offer of modified work, thus discharging their obligation to pay benefits. However, the WCAB denied the petition, finding that the employer failed to prove a concrete offer of modified work was made and refused by the applicant. The WCAB also remanded the case for further proceedings regarding other outstanding liens.

WCABFindings and AwardPetition for ReconsiderationlienEmployment Development Department (EDD)permanent disabilitytemporary disabilitymodified workwork restrictionsprimary treating physician
References
2
Case No. MISSING
Regular Panel Decision
Aug 27, 2013

Matter of McCabe v. Albany County Sheriff's Department

This case involves an appeal by the Albany County Sheriffs Department, a self-insured employer, from a Workers' Compensation Board decision. The claimant, a correction officer, sustained work-related injuries and received full wages under General Municipal Law § 207-c. His workers' compensation claim was established, with awards credited to the employer. Claimant's counsel was awarded fees, which the Board ruled constituted a lien against the compensation awarded as a credit to the employer. The employer appealed, arguing that the statutory provisions granting employers full credit for advanced payments preclude such liens. The court affirmed the Board's determination, clarifying that Workers' Compensation Law § 24 establishes counsel fee liens as taking precedence over employer reimbursement rights and that "compensation" is broadly defined, allowing the lien to attach even if no direct payment is made to the employee. The Board's exercise of discretion in awarding fees was found not to be arbitrary, capricious, or unreasonable.

Counsel Fee LienEmployer CreditGeneral Municipal Law § 207-c BenefitsStatutory ConstructionWorkers' Compensation Board AppealSelf-Insured EntityCorrectional Officer InjuryConsequential Injury ClaimTemporary Disability CompensationLegal Representation Fees
References
13
Case No. MISSING
Regular Panel Decision
Nov 18, 1988

Claim of Valverde v. New York City Department of Housing Preservation & Development

The claimant was injured in a fall while working as a superintendent in a New York City apartment house. The central issue in this appeal was whether the Workers’ Compensation Board erred in finding that the New York City Department of Housing Preservation and Development (HPD) was the claimant's employer, making them responsible for workers' compensation. HPD had successfully initiated a special proceeding to appoint a '7A Administrator' for the premises, who then managed the building and supervised the claimant. Initially, a Workers’ Compensation Law Judge found both the administrator and HPD as employers, but the Board ultimately concluded HPD was the sole employer. The Appellate Division affirmed this decision, finding that the Board had ample basis to conclude HPD utilized the administrator as its agent, thereby qualifying as the claimant’s employer for Workers’ Compensation Law purposes.

Employer-employee relationship7A AdministratorAgencyWorkers' Compensation BoardBuilding managementHousing preservationAppellate DivisionSpecial employerGeneral employerFactual determination
References
5
Case No. LBO 371346, LBO 374443
Regular
Feb 29, 2008

DOROTEO BARRIOS vs. GANGI STUDIOS, EMPLOYERS COMPENSATION INSURANCE CO.

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and amended a prior order. While the WCAB affirmed the finding that applicant Doroteo Barrios did not sustain industrial injury, it modified the order to deny only the Employment Development Department's lien and defer all other liens. This decision acknowledges that liens, including medical-legal ones, should not have been summarily dismissed without proper procedure.

Workers' Compensation Appeals BoardReconsiderationLien ClaimantMedical-Legal LienTake Nothing OrderAmended Findings and OrderIndustrial InjuryWCJ ReportEmployment Development DepartmentDeferred Liens
References
0
Case No. SJO 0254875
Regular
Jun 03, 2008

KIMBERLEY A. TURNER vs. BLOSSOM RIDGE MEDICAL GROUP, PREFERRED EMPLOYERS INSURANCE GROUP

This case involves an employer's petition for reconsideration of an award of additional temporary disability benefits (TDI) for an applicant's low back injury. The Appeals Board granted reconsideration to modify the award, requiring withholding of funds to satisfy a potential Employment Development Department (EDD) lien for overlapping state disability indemnity benefits. The Board affirmed the underlying award of TDI, ruling the employer was liable for 104 weeks of benefits from the date TDI first commenced.

Petition for ReconsiderationTemporary Total DisabilityOrder Terminating Temporary DisabilityPetition to ReopenEmployment Development DepartmentState Disability IndemnityNewly Discovered EvidencePetition for Reconsideration SubstituteBenefit PrintoutHawkins v. Amberwood Products
References
2
Case No. ADJ426447 (RDG 0129495)
Regular
Jul 16, 2010

Shane Guest vs. Barrett Business Services

The Appeals Board dismissed the applicant's petition for reconsideration as he was not aggrieved by a final order. The applicant sought to set aside a settlement concerning the Employment Development Department's (EDD) lien, arguing it was made in error. However, the Board found that the WCJ had not yet made a final determination on the EDD lien, which is a prerequisite for the Board to have jurisdiction to approve or disapprove such a settlement. Therefore, the matter is returned to the trial level for a final determination of the EDD's lien.

WCABPetition for ReconsiderationDismissalEDD LienTrial LevelFinal DeterminationTemporary DisabilityEmployment Development DepartmentStipulationDeferred Lien
References
1
Case No. ADJ8860181
Regular
Jul 16, 2015

GARY GATSON vs. BIMBO BAKERIES USA, INC., ACE AMERICAN INSURANCE COMPANY

This case involves a dispute over the Employment Development Department's (EDD) lien for temporary disability benefits paid to the applicant. The original award found the applicant sustained a cumulative trauma injury and awarded temporary disability benefits, but only allowed partial reimbursement to EDD. Both EDD and the employer sought reconsideration, with EDD arguing for full reimbursement and the employer challenging the EDD lien finding. The Appeals Board granted EDD's petition, denied the employer's, and will allow further proceedings to determine the correct amount of EDD's lien and temporary disability award.

WCABcumulative traumaAchilles tendonpermanent disabilitytemporary disabilityEDD lienreconsiderationsubstantial evidencestandingLabor Code section 4904
References
0
Case No. ADJ7850079, ADJ8339110
Regular
Nov 12, 2014

JUAN PRADO vs. ORIGINAL 22, INC., EMPLOYERS COMPENSATION INSURANCE COMPANY

Defendant sought reconsideration of a workers' compensation award based on a mutual mistake of fact regarding an undisclosed Employment Development Department lien. The Appeals Board granted reconsideration because the electronic record was incomplete, preventing a proper review. The Board rescinded the award and returned the case to the trial level. The WCJ must create a complete record and re-evaluate the issues, including the lien, before issuing a new decision.

Petition for ReconsiderationMutual Mistake of FactEmployment Development Department LienStipulations with Request for AwardElectronic Adjudication Management SystemRescind AwardReturn to Trial LevelWCJ Report and RecommendationProper Record CreationHamilton v. Lockheed
References
2
Case No. ADJ8269580
Regular
Nov 30, 2015

RALPH LARUE vs. SANTA CLARA VTA, permissibly self-insured; administered by TRISTAR RISK MANAGEMENT

The Workers' Compensation Appeals Board (WCAB) granted the defendant's petition for reconsideration, rescinding the prior award that allowed the Employment Development Department (EDD) a $2,300 lien. The WCAB found the record lacked sufficient evidence to establish EDD's lien, as defendant argued EDD failed to prove benefits were for the same industrial injury. The Board clarified that EDD's lien attaches to permanent disability caused solely by the industrial injury, not to the apportionment of disability. The case is remanded for further proceedings to develop the record on EDD's lien claim.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and AwardEmployment Development Department (EDD)Lien ClaimPermanent Disability IndemnityApportionmentLabor Code 4904(b)Causation of InjuryCausation of Disability
References
1
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