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

Case No. ADJ8094646
Regular
Jan 17, 2014

ALEJANDRINA BARRETO vs. OUT OF THE SHELL, SOUTHERN INSURANCE COMPANY, REPUBLIC INDEMNITY COMPANY, PHARMAFINANCE, LLC, HEALTHCARE FINANCE MANAGEMENT, LLC

This case involves lien claimants PharmaFinance and Healthcare Finance Management, and their representatives Landmark Medical Management and Brian Hall, who sought reconsideration of a decision disallowing their liens for medical treatment. The Appeals Board granted reconsideration solely to notice its intention to impose sanctions of up to $2,500 against the lien claimants and their representatives. This action is due to a pattern of allegedly filing petitions containing false statements about not receiving notices, which violates the Board's Rules of Practice and Procedure and Labor Code Section 5813. The Board found these claims not persuasive and indicative of a tactic to avoid responsibility.

Workers' Compensation Appeals BoardPetition for ReconsiderationSanctionsLien ClaimantsHearing RepresentativesIndustrial InjuryFindings and OrderCompromise and ReleaseNotice of IntentionLabor Code section 5813
References
0
Case No. MISSING
Regular Panel Decision

ABC Medical Management, Inc. v. GEICO General Insurance

The case addresses whether a plaintiff-assignee medical equipment supplier can recover no-fault first-party benefits when a chiropractor, rather than a physician, issued the prescription. Defendant GEICO General Insurance Company moved for summary judgment, arguing that Education Law § 6551 prohibits chiropractors from prescribing such items. The court denied GEICO's motion, ruling that chiropractors are permitted to prescribe TENS units, thermophore devices, and similar medical supplies, as these do not constitute 'drugs or medicines' under the Education Law. Furthermore, the court found that GEICO failed to properly present its medical necessity defense and that the contested issues should be determined by a trier of fact.

No-Fault BenefitsChiropractic PrescriptionMedical EquipmentEducation Law § 6551Summary JudgmentMedical NecessityTENS UnitThermophoreCervical CollarLumbar Support
References
29
Case No. MISSING
Regular Panel Decision

Queens Blvd. Medical, P.C. v. Travelers Indemnity Co.

The plaintiff, Queens Blvd. Medical, P.C., sought $950 in first-party no-fault benefits for biofeedback medical services provided to its assignor for lower back and chronic pain syndrome. The central issue at trial was the medical necessity of these services under Insurance Law § 5102 (a) (1). The plaintiff established a prima facie case with expert testimony from a board-certified neurologist affirming the medical appropriateness of biofeedback. The defendant insurance company failed to present admissible evidence to disprove medical necessity, as its expert was deemed incompetent to testify on biofeedback for back pain. Consequently, the court granted the plaintiff's motion for a directed verdict, awarding judgment for $950 along with statutory costs, interest, and attorney's fees.

No-fault benefitsMedical necessityBiofeedback treatmentExpert testimonyDirected verdictInsurance lawChronic pain syndromeBack injuryCPT codesBurden of proof
References
9
Case No. ADJ6722110
Regular
Oct 11, 2013

SERGIO RODRIGUEZ vs. AIR COASTAL FLEET SERVICES, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board affirmed an administrative law judge's order dismissing a lien claim for failure to pay the required activation fee. The lien claimant, Advance Care Specialist Medical Clinic, and its representatives, Innovative Medical Management and Louis Heard, sought reconsideration, which was granted. However, the Board found no good cause to overturn the dismissal. Subsequently, the Board imposed a $1,000 sanction against Innovative Medical Management and Louis Heard for their failure to respond to a notice of intent to impose sanctions.

Lien activation feeSanctionLabor Code section 5813Appeals Board Rule 10561ReconsiderationWCJ Order Dismissing Lien ClaimNotice of Intention to Impose SanctionsWorkers' Compensation Appeals BoardHearing RepresentativeMedical Clinic
References
0
Case No. ADJ757155
Regular
Mar 21, 2013

FRANK KEY vs. TORRANCE MEMORIAL MEDICAL CENTER, MATRIX ABSENCE MANAGEMENT, INC.

The Workers' Compensation Appeals Board denied the Defendant's Petition for Reconsideration. The Defendant argued that the applicant's condition had improved post-surgery, necessitating reevaluation by medical and vocational experts. However, the Board upheld the WCJ's finding that the applicant's testimony was credible and that his chronic pain and unemployability were well-established. The Board agreed with the WCJ that further evaluations were unnecessary as pain management was ongoing and did not alter the applicant's permanent total disability status.

Workers' Compensation Appeals BoardPetition for ReconsiderationAdministrative Law JudgeCredibilityGarza v. Workers' Comp. Appeals Bd.PhlebotomistLumbar spineCervical spineLeft lower extremityPsyche
References
2
Case No. ADJ17937030
Regular
Nov 04, 2025

MARGARET RUSSOTTO vs. PARK MANAGEMENT CORPORATION DBA SIX FLAGS DISCOVERY KINGDOM, PROPERTY AND CASUALTY INSURANCE COMPANY OF HARTFORD

The Workers' Compensation Appeals Board (WCAB) denied the Petition for Reconsideration filed by defendants Park Management Corporation and Property and Casualty Insurance Company of Hartford. The defendants challenged the Findings and Award (F&A) of July 28, 2025, which found applicant Margaret Russotto sustained industrial injuries to her lumbar spine, hips, thigh, and scarring, resulting in 42% disability. The WCAB upheld the F&A, finding that the expert medical opinion of PQME Jagtar Dhesi, D.C., constituted substantial medical evidence supporting the existence and extent of the injuries and impairments. The Board noted the defendants' failure to provide rebuttal medical evidence or undertake further investigation prior to trial, emphasizing the duty to develop the record.

Petition for ReconsiderationFindings and AwardWCJAMA GuidesPermanent ImpairmentSubstantial Medical EvidencePanel Qualified Medical Examiner (PQME)Lumbar SpineHip InjuryScarring
References
10
Case No. MISSING
Regular Panel Decision

Claim of Washington v. Montefiore Hospital

Claimant, a mechanical engineer, sustained a work-related injury and received initial workers' compensation benefits. The employer later contested further disability, leading to a Workers' Compensation Law Judge (WCLJ) order for medical expert depositions, including one from the employer's expert, Robert Orlandi. Claimant's counsel objected to Orlandi's telephone deposition but failed to formally challenge the notice or raise a specific objection to the oath administration during the deposition. Orlandi's testimony, taken via telephone with the court reporter in New York and Orlandi in Connecticut, concluded that the claimant was no longer disabled. Both the WCLJ and the Workers' Compensation Board credited Orlandi's testimony, finding the claimant waived objections to the deposition's procedural irregularities. The Appellate Division affirmed the Board's decision, ruling that the claimant's failure to make a timely and specific objection to the oath's administration during the deposition constituted a waiver, thus allowing the Board to properly rely on Orlandi's evidence.

Workers' CompensationMedical TestimonyDeposition ProcedureWaiver of ObjectionCPLROath AdministrationDisability AssessmentAppellate ReviewExpert WitnessProcedural Irregularities
References
2
Case No. 2020 NY Slip Op 07002 [188 AD3d 1524]
Regular Panel Decision
Nov 25, 2020

Matter of Walczak v. Asplundh Tree Expert Co.

Claimant Marian Walczak, an arborist, appealed a Workers' Compensation Board decision that deemed his claim for occupational hearing loss untimely. Walczak worked for Asplundh Tree Expert Co. from 1998 to 2006 and filed his claim in 2017, listing the onset of hearing loss as December 27, 2006. The Board found the claim time-barred under Workers' Compensation Law § 28, asserting that Walczak knew or should have known of his hearing loss and its probable work-related cause by January 19, 2012, given his testimony and medical records. The Appellate Division affirmed, emphasizing that specialized medical knowledge is not required to trigger the 90-day limitations period under Workers' Compensation Law § 49-bb, and deference is given to the Board's findings of fact and credibility assessments.

Occupational Hearing LossTime-Barred ClaimWorkers' Compensation Law § 28Workers' Compensation Law § 49-bbStatute of LimitationsDate of DisablementKnowledge of DiseaseMedical Diagnosis Not RequiredAppellate ReviewWorkers' Compensation Board
References
2
Case No. MISSING
Regular Panel Decision

Highland Capital Management, L.P. v. Schneider

Plaintiff Highland Capital Management, L.P. initiated an action against Leonard Schneider, Leslie Schneider, Scott Schneider, Susan Schneider (the 'Schneiders'), and Jenkens & Gilchrist Parker Chapin LLP (JGPC) for breach of contract and tortious interference related to a promissory note transaction. The defendants moved in limine to exclude the testimony of Highland's proposed expert witness, Sean F. O’Shea. The court granted the defendants' motion, ruling O’Shea’s testimony inadmissible. The judge found that O'Shea's report contained improper legal conclusions, factual narratives without personal knowledge, speculation on parties' intent, and irrelevant predictions about criminal prosecution. Additionally, Highland's requests to defer the motion or to supplement the expert report were denied.

Breach of ContractTortious InterferencePromissory NotesSecurities FraudInsider TradingExpert TestimonyMotion in LimineAdmissibility of EvidenceFederal Rules of EvidenceDaubert Standard
References
39
Case No. MISSING
Regular Panel Decision

Porcelli v. PMA Associates

Claimant sought workers' compensation death benefits for her husband's death from respiratory failure, alleging it was an occupational disease from toxic chemical exposure during his 30+ years as a printer. A WCLJ initially awarded benefits, but the Workers' Compensation Board later precluded the claimant's medical expert's report and testimony due to untimely filing under 12 NYCRR 300.2 (d) (12). This preclusion led the Board to find no established causal relationship, closing the case without benefits. The appellate court affirmed the Board's decision, finding adequate support for precluding the expert's evidence due to procedural non-compliance.

Workers' CompensationOccupational DiseaseDeath BenefitsMedical ExpertReport PreclusionTimely FilingProcedural RuleCausal RelationshipAppellate ReviewAdministrative Law
References
6
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