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

Case No. 2023 NY Slip Op 00139 [212 AD3d 972]
Regular Panel Decision
Jan 12, 2023

Matter of Ceja v. Manetta Enters., Inc.

Claimant Pablo Figueroa Ceja filed for workers' compensation benefits after being injured while working for Manetta Enterprises, Inc. The State Insurance Fund (SIF) disputed coverage, claiming policy cancellation for nonpayment. However, both the Workers' Compensation Law Judge and the Workers' Compensation Board found SIF liable, ruling that SIF failed to strictly adhere to Workers' Compensation Law § 54 (5) by not sending a separate cancellation notice to Manetta, despite sharing an address with a related entity, Manco Enterprises of NY, Inc. The Appellate Division affirmed this decision, emphasizing the statutory requirement for individual notice to each insured entity unless a specific designee is appointed, and rejected SIF's new arguments regarding claimant's employment status as not properly preserved for appeal.

Workers' CompensationInsurance Policy CancellationNotice RequirementsStrict ComplianceAppellate DivisionEmployer LiabilityCarrier LiabilityStatutory InterpretationDual Entity PolicyAdministrative Appeal
References
6
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. 2017 NY Slip Op 27428
Regular Panel Decision
Dec 14, 2017

New York State Workers' Compensation Bd. v. Compensation Risk Mgrs., LLC

This action was brought by the New York State Workers' Compensation Board (WCB), as an assignee of former members of the Healthcare Industry Trust of New York (HITNY), against Compensation Risk Managers, LLC (CRM), HITNY trustees, and auditing firm UHY LLP. The WCB alleged mismanagement, breach of fiduciary duty, and negligent auditing, leading to the Trust's insolvency. Defendants moved to dismiss on grounds of standing, statute of limitations, and pleading particularity. The court dismissed certain derivative claims and negligent misrepresentation claims against some trustees due to standing issues and statute of limitations. All claims against UHY LLP were dismissed for lack of a near-privity relationship or prior precedent. An implied indemnity claim against the trustees was sustained. The WCB's cross-motion to consolidate related actions was denied.

Workers' Compensation LawGroup Self-Insured Trust (GSIT)Fiduciary DutyNegligenceNegligent MisrepresentationStatute of LimitationsStandingDerivative ActionImplied IndemnityAuditing Firm Liability
References
46
Case No. MISSING
Regular Panel Decision

Workers' Compensation Board v. Met-Impro Services, Inc.

This case involves four related actions under Workers' Compensation Law § 26 concerning the enforcement of a Workers' Compensation award. The Supreme Court had erroneously granted defendant Robert San Miguel's motion to vacate judgments against him. San Miguel, identified as the president of the corporate employers, was held personally liable for unpaid benefits under Workers’ Compensation Law § 26-a (1) (a). The court clarified that personal liability for corporate officers does not depend on active management or involvement in the underlying accident. Furthermore, there is no statutory basis to vacate a judgment merely because an officer was not specifically named in the initial administrative determination. Consequently, San Miguel's vague denial of involvement was insufficient, and his motion to vacate the judgments against him was denied.

Workers' CompensationPersonal LiabilityCorporate OfficerJudgment VacationAdministrative LawAppellate ReviewStatutory InterpretationEmployer LiabilityUnpaid BenefitsNew York Law
References
3
Case No. MISSING
Regular Panel Decision
May 23, 2012

Claim of Malave v. Beef & Bourbon, LLC

On June 14, 2008, a claimant suffered catastrophic injuries in an employer-sponsored van crash while returning home from work. A workers' compensation claim was filed, naming Beef & Bourbon, LLC and Tacos Ricos as putative employers. Initially, a Workers' Compensation Law Judge found both entities liable, with the claimant working for Tacos Ricos on the accident night. However, the Workers’ Compensation Board modified this, determining insufficient evidence linked claimant to Tacos Ricos on that night, thus making Beef & Bourbon solely responsible. Beef & Bourbon appealed this amended decision. The Court affirmed the Board's decision, finding substantial evidence supported that the claimant was employed by Beef & Bourbon on the night of the accident.

Workers' CompensationEmployer-Employee RelationshipSubstantial EvidenceMultiple EmployersWork-Related InjuryVan CrashTraumatic Brain InjuryPersistent Vegetative StateHearsay TestimonyBoard Decision Appeal
References
9
Case No. MISSING
Regular Panel Decision

Claim of Mlodozeniec v. Trio Asbestos Removal Corp.

This case concerns an appeal from a Workers’ Compensation Board decision regarding which insurance carrier is liable for workers' compensation benefits for a claimant suffering from an occupational disease. The claimant, an asbestos handler for Trio Asbestos Removal Corporation, developed pleural and hyperactive airway disease. Trio was insured by the State Insurance Fund (SIF) during the claimant's employment, and later by Zurich American Insurance Company. The Workers’ Compensation Law Judge initially held Zurich liable, but the Board reversed, finding SIF liable as the insurer at the time of last exposure. The Court clarified that the carrier on the risk on the date of disablement is responsible, provided a policy is in place at that time. Therefore, the Court reversed the Board’s decision, holding Zurich liable, and remitted the matter for further proceedings. The Court also rejected Zurich's argument for remittal to determine if SIF should be permitted to deny coverage, finding no delay in SIF's disclaimer.

Occupational DiseaseAsbestos ExposureWorkers' Compensation LiabilityInsurance Carrier ResponsibilityDate of DisablementLast Exposure RulePleurisyHyperactive Airway DiseaseStatutory InterpretationAppellate Review
References
7
Case No. MISSING
Regular Panel Decision
Dec 13, 2006

Claim of Aposporos v. NYNEX

Claimant applied for workers' compensation benefits in May 1996 for neck and wrist injuries. A compensable injury for her left wrist was established in February 1997, with other injury sites held in abeyance. In March 2006, claimant requested further action to establish an injury to her right wrist. The employer asserted that the Special Disability Fund was liable pursuant to Workers’ Compensation Law § 25-a due to the time elapsed. Both a Workers’ Compensation Law Judge and the Workers’ Compensation Board determined the Fund was not liable, finding the case was not truly closed because the right wrist injury issue was raised in 1996 and remained unresolved. The appellate court affirmed the Board's decision, stating that substantial evidence supported the finding that the case was not truly closed.

Workers' CompensationSpecial Disability FundCase ReopeningLiabilityUnresolved ClaimWorkers’ Compensation Law § 25-aInjury EstablishmentAppealBoard DecisionSubstantial Evidence
References
3
Case No. 2025 NY Slip Op 04576 [241 AD3d 563]
Regular Panel Decision
Aug 06, 2025

New York Bus Operators Compensation Trust v. American Home Assur. Co.

The New York Bus Operators Compensation Trust (NYBOCT), a self-insured entity, brought an action against its excess-of-loss insurer, American Home Assurance Co., alleging breach of contract and seeking declaratory relief. This dispute arose after American Home denied coverage for a workers' compensation claim due to untimely notice. The Supreme Court granted American Home's motion to dismiss the complaint as time-barred, which NYBOCT appealed. The Appellate Division affirmed the Supreme Court's decision, ruling that the six-year statute of limitations for breach of contract began when American Home disclaimed coverage on May 18, 2012, making NYBOCT's 2020 lawsuit untimely. The court rejected arguments related to the continuing-wrong doctrine and estoppel.

Limitation of ActionsBreach of ContractInsurance ContractDisclaimer of CoverageStatute of LimitationsWorkers' CompensationExcess-of-Loss PolicySelf-Insured TrustUntimely NoticeAppellate Review
References
29
Case No. MISSING
Regular Panel Decision

New York State Workers' Compensation Board v. Fuller & LaFiura, CPAs, P.C.

The OHI Workers' Compensation Trust became insolvent, accumulating an $8.27 million deficit. The New York State Workers’ Compensation Board, as plaintiff and successor in interest, sued several entities including Fuller & LaFiura, CPAs, P.C., Cody Management, and individual trustees for various claims such as breach of contract, breach of fiduciary duty, and negligence. This cross-appeal addresses Supreme Court's partial dismissal of claims and application of statutes of limitations. The Appellate Division reversed the dismissal of the breach of fiduciary duty claim against Fuller, affirmed the dismissal of common-law indemnification and good faith/fair dealing claims, and modified the application of statutes of limitations for other claims, deeming continuous representation and equitable estoppel doctrines inapplicable.

Workers' Compensation TrustInsolvencyBreach of Fiduciary DutyProfessional NegligenceStatute of LimitationsContinuous Representation DoctrineEquitable EstoppelAccountant MalpracticeCross AppealMotion to Dismiss
References
32
Case No. MISSING
Regular Panel Decision

New York State Workers' Compensation Board v. Consolidated Risk Services, Inc.

The New York State Workers’ Compensation Board, acting as a governmental agency and successor in interest to several insolvent workers' compensation self-insured trusts, commenced an action against a third-party administrator (Consolidated Risk Services, Inc.), its employees, related corporate entities, insurance brokers (including Hickey-Finn & Co., Inc.), former trustees of one of the trusts (RITNY), and an actuarial firm (Regnier Consulting Group, Inc.). The plaintiff alleged misconduct and malfeasance by the defendants led to trust insolvencies and sought to recover accumulated deficits. The case involves cross appeals challenging the Supreme Court’s partial dismissal of the complaint, specifically concerning the timeliness of claims for breach of fiduciary duty, fraud, fraudulent inducement, breach of contract, and common-law indemnification, applying the repudiation and discovery rules for statute of limitations. The Appellate Division modified the Supreme Court's order by dismissing specific claims against Hickey-Finn & Co., Inc., broadening the temporal scope of breach of fiduciary duty claims against other defendants, and reinstating common-law indemnification claims against several RITNY trustees, affirming the order as modified and remitting the case.

Workers' CompensationBreach of Fiduciary DutyFraudFraudulent InducementBreach of ContractCommon-Law IndemnificationStatute of LimitationsRepudiation RuleDiscovery RuleTrust Insolvency
References
27
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