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

Case No. ADJ1050422 (SAL 0104052) ADJ3107039 (SAL 0114548)
Regular
Jun 30, 2011

ESTELA LUIS vs. COMMUNITY BRIDGES, STATE COMPENSATION INSURANCE FUND

This case concerns Estela Luis's claim for workers' compensation benefits due to injuries sustained from a specific knee/psyche injury and a cumulative trauma knee injury. The WCJ awarded 100% permanent disability and a lifetime pension, which the defendant sought reconsideration of. The defendant argued the wrong disability rating schedule was used, the 100% rating was unsubstantiated, apportionment was incorrect, and the SAWW increase calculation was erroneous. The Board granted reconsideration, affirming the award except for the SAWW increase calculation, which will be deferred for further proceedings.

WCABCommunity BridgesState Compensation Insurance FundEstela Luispermanent disabilityspecific industrial injurycumulative traumaCook Assistantpermanent disability rating schedulevocational rehabilitation experts
References
2
Case No. 530563
Regular Panel Decision
Jan 20, 2022

In the Matter of the Claim of Luis Urena

Luis Urena, an employee of Abcal Industries, sustained injuries after falling while working on a residential renovation project in Brooklyn in July 2017 and applied for workers' compensation benefits. The Workers' Compensation Board ruled that Norguard Insurance Company, Abcal's carrier, was liable for Urena's benefits, rejecting Norguard's arguments that its policy did not cover work in New York. Norguard appealed, contending that a policy exclusion applied due to Abcal's failure to notify them of New York work within 30 days. The Supreme Court, Appellate Division, Third Judicial Department, affirmed the Board's decision, finding that Norguard failed to meet its burden of proving the exclusion applied and that the Board's interpretation of the policy language was reasonable.

Workers' Compensation InsurancePolicy ExclusionEmployer LiabilityCarrier LiabilityAppellate ReviewJurisdictionNew York Workers' Compensation LawSubcontract AgreementConstruction InjuryTimeliness
References
7
Case No. No. 13
Regular Panel Decision
Mar 26, 2020

The Matter of the Claim of Luis A. Vega v. Postmates Inc

The New York Court of Appeals addressed whether a Postmates, Inc. courier, Luis A. Vega, and similarly-situated individuals, are employees for unemployment insurance contributions. The Unemployment Insurance Appeals Board (the Board) had determined them to be employees, reversing an Administrative Law Judge's finding of independent contractor status. The Appellate Division then reversed the Board, concluding insufficient evidence of an employer-employee relationship. The Court of Appeals reversed the Appellate Division, reinstating the Board's decision, finding substantial evidence that Postmates exercised control over its couriers, rendering them employees for unemployment insurance purposes. The court highlighted Postmates' control over assignments, compensation, customer complaints, and the inability of couriers to operate as independent businesspersons.

Unemployment InsuranceGig EconomyIndependent ContractorEmployee ClassificationLabor LawApp-based DeliveryControl TestWorkers' RightsNew York Court of AppealsSubstantial Evidence
References
44
Case No. MISSING
Regular Panel Decision
Nov 13, 2002

Zurich American Insurance v. Luis Bastos Construction

Zurich American Insurance Co. initiated an action seeking a declaratory judgment that it was not obligated to defend or indemnify Luis Bastos Construction, Inc. in an underlying personal injury lawsuit filed by Hermilo Cruz. Cruz, an employee of Bastos, sustained injuries in New York while working on a job that was not related to any work being performed in New Jersey. Zurich's insurance policy provided employers' liability coverage specifically for claims arising from accidents in New Jersey or those incidental to New Jersey operations. The Supreme Court, Westchester County, granted Zurich's motion for summary judgment, ruling that Zurich had no obligation to defend or indemnify Bastos. Defendant A.E Roofing & Siding Corp. appealed this decision. The appellate court affirmed the Supreme Court's order and judgment, concluding that the terms of the policy were clear and unambiguous.

Declaratory JudgmentInsurance CoverageEmployers' LiabilityWorkers' CompensationSummary JudgmentPolicy InterpretationPersonal InjuryAppellate ReviewJurisdictionNew York Law
References
2
Case No. ADJ10477247
Regular
Oct 31, 2017

ESTELA WALLE vs. THE PERMANENTE MEDICAL GROUP

Here's a summary of the two cases for a lawyer, in max four sentences each: **Case 1: Estela Walle vs. The Permanente Medical Group (ADJ10477247)** The Workers' Compensation Appeals Board denied reconsideration, affirming the WCJ's finding that the applicant did not sustain a back injury arising out of and in the course of employment. The Board gave significant weight to the WCJ's credibility determination, finding no substantial evidence to warrant overturning it. Therefore, the applicant was awarded nothing on her claim. **Case 2: Estela Walle vs. The Permanente Medical Group (ADJ8620015, ADJ9183471)** The Appeals Board rescinded the WCJ's award for psychiatric injury and returned the case to the trial level for further proceedings. The Board found the analysis of whether the injury was predominantly caused by employment events, and specifically by lawful, good faith personnel actions, to be inadequate under *Rolda*. Further development of the record is required to clarify the events of May 21, 2012, and to determine the precise causal contribution of employment-related factors versus good faith personnel actions.

Workers' Compensation Appeals BoardReconsiderationFindings and OrderApplicantInjury Arising Out of and In the Course of EmploymentAOE/COEBack InjuryWCJCredibility DeterminationGarza v. Workmen's Comp. Appeals Bd.
References
1
Case No. ADJ10259451
Regular
Sep 10, 2019

LUIS SILVA vs. CITISTAFF SOLUTIONS, OLD REPUBLIC c/o GALLAGHER BASSETT SERVICES

The Workers' Compensation Appeals Board granted reconsideration of a prior decision. They amended the decision to reflect that Old Republic, not a different insurer, is the liable party for Luis Silva's injury. The Board also admitted Defendant's Exhibit E into evidence. Otherwise, the original decision awarding temporary disability, permanent disability, future medical treatment, and attorney's fees to Luis Silva was affirmed.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ reportExhibit EOld RepublicGallagher Bassettgeneral laborerlumbar spineinternal injurytemporary disability indemnity
References
0
Case No. ADJ9409541
Regular
Aug 23, 2019

LUIS MEDINA BERNAL (Deceased), PATRICIA SOLANO VASQUEZ, MISAEL MEDINA SOLANO, LUCIA MEDINA SOLANO, XIMENA MEDINA SOLANO, I SAI MEDINA SOLANO, LUIS EMANUEL MEDINA SOLANO vs. REBECCA BAUTISTA dba REMAC TIRE SERVICES, UNINSURED EMPLOYERS BENEFITS TRUST FUND

This case involves a fatal industrial injury to Luis Medina Bernal, a tire changer. The Workers' Compensation Appeals Board (WCAB) granted reconsideration to clarify death benefit payment terms. While the WCJ correctly found petitioning applicants failed to prove partial dependency, the WCAB amended the decision. The death benefit for the widow, Patricia Solano Vasquez, is to be paid bi-weekly at $297.29 until the $250,000 total is exhausted. The attorney's fee was recalculated to $34,042.54, representing 15% of the death benefit's present value.

Workers' Compensation Appeals BoardPetition for ReconsiderationDecision After ReconsiderationFatal Industrial InjuryPartial DependencyCredibility DeterminationsNet Financial BenefitDeath BenefitPresent ValueAttorney's Fee
References
4
Case No. 2016 NY Slip Op 02734 [138 AD3d 488]
Regular Panel Decision
Apr 12, 2016

Matter of Lesli R. (Luis R.)

The Family Court's order of disposition, which found that the respondent sexually abused his stepdaughters and derivatively abused his five biological children, was unanimously affirmed. The record supported the court's determination that the respondent was legally responsible for the children and that there was a preponderance of evidence of sexual abuse. The stepdaughters' out-of-court statements were sufficiently corroborated by the respondent's own statements. The court also found that the respondent derivatively abused his own children and properly exercised its discretion in quashing a subpoena to compel one of the stepdaughters to testify due to potential psychological harm.

Child AbuseSexual AbuseDerivative AbuseFamily Court ActAppellate ReviewPreponderance of EvidenceOut-of-court StatementsCorroborationParental ObligationsSubpoena Quash
References
11
Case No. ADJ3107039 (SAL 0114548) ADJ1050422 (SAL 0104052)
Regular
Jan 19, 2012

ESTELA LUIS vs. COMMUNITY BRIDGES, STATE COMPENSATION INSURANCE FUND

The Appeals Board denied reconsideration of an Amended Findings and Award, affirming the judge's decision. The Board rejected a request to increase the applicant's attorney's fee due to untimeliness and failure to provide required notice to the applicant. The defendant's petition for reconsideration was denied because they failed to meet their burden to rebut the DEU's use of a 4.6% COLA for calculating permanent disability and attorney fees, as it's a reasonable methodology based on a 50-year average.

Petition for ReconsiderationWorkers' Compensation Appeals BoardAmended Findings and Awardattorney's feeuntimelyWCAB Rule 10778independent counseljurisdictionCost of Living Adjustment (COLA)State Average Weekly Wage (SAWW)
References
5
Case No. ADJ 1050422, ADJ 3107039, SAL 104052, SAL 114548
Regular
Sep 08, 2008

ESTELA LUIS vs. COMMUNITY BRIDGES, STATE COMPENSATION INSURANCE FUND

The WCAB granted reconsideration of a WCJ's decision awarding 100% permanent disability, finding the medical record inadequate to justify the WCJ's determination on cumulative trauma and apportionment. The matter is returned for further development of the medical record and a new decision.

Workers Compensation Appeals BoardEstela LuisCommunity BridgesState Compensation Insurance FundADJ 1050422ADJ 3107039SAL 104052SAL 114548Permanent Disability Rating ScheduleApportionment
References
4
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