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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
Mar 22, 1971

Claim of Pollak v. Robert Day, Inc.

The Workmen’s Compensation Board awarded disability benefits to a waiter under the Disability Benefits Law, finding him to be a 'shape-up worker' concurrently employed by Creative Caterers, Inc. and Robert Day, Inc. The claimant fell ill in February 1970 and was hospitalized, having worked for both employers in the same calendar week. Appellants challenged the board's finding of concurrent employment, citing the claimant's sporadic work record and arguing a lack of substantial evidence. The court affirmed the board's decision, asserting that concurrent employment and eligibility are questions of fact solely within the board's province, and its conclusion was supported by sufficient evidence. The court clarified that regular employment by the *same* employers within the same calendar week is not necessary; only regular and customary employment by more than one covered employer within the same week is required.

disability benefitsconcurrent employmentshape-up workerWorkmen's Compensation LawArticle 9substantial evidencequestion of factapportionmentemployer liabilityappellate review
References
0
Case No. 2023 NY Slip Op 00704 [213 AD3d 1050]
Regular Panel Decision
Feb 09, 2023

Matter of Paka (Same Day Delivery Inc.--Commissioner of Labor)

The case involves Jacques Paka, a delivery driver, who applied for unemployment insurance benefits after working for Same Day Delivery Inc. The Department of Labor initially determined Paka was an employee, making Same Day liable for contributions. The Unemployment Insurance Appeal Board initially overruled this, finding Paka to be an independent contractor. However, upon reconsideration requested by the Commissioner of Labor, the Board rescinded its prior decision and sustained the Department's original determination, finding an employment relationship. The Appellate Division, Third Department, affirmed the Board's decision, rejecting Same Day's arguments against the reopening of the case and finding substantial evidence to support the Board's conclusion that Same Day exercised sufficient control over Paka to establish an employment relationship. The Court also affirmed that these findings apply to similarly situated individuals.

Unemployment InsuranceIndependent ContractorEmployment RelationshipControl TestAppellate ReviewUnemployment Insurance Appeal BoardLabor LawUnemployment BenefitsDelivery DriverSubstantial Evidence
References
11
Case No. 2017 NY Slip Op 04009 [150 AD3d 1507]
Regular Panel Decision
May 18, 2017

Matter of Jie Cao v. Five Star Travel of NY Inc.

Claimant, a bus driver, was involved in a 2007 accident and successfully applied for workers' compensation benefits, naming "Five Stars Travel Bus Inc." as his employer. Five Star Travel of NY Inc. (Five Star) did not appear after being served, leading to a WCLJ finding it liable for awards and assessments. After subsequent awards and medical treatment authorizations, a settlement was approved in 2013. In May 2015, Five Star sought to reopen the claim and challenge the prior decisions and settlement, but the Workers' Compensation Board denied the application due to untimely submission of new material evidence and the non-reviewable nature of an approved waiver agreement. The Appellate Division affirmed the Board's decision.

Workers' CompensationBus AccidentUninsured EmployerClaim ReopeningSettlement AgreementBoard ReviewAppellate DivisionTimelinessContinuing JurisdictionDue Process
References
6
Case No. ADJ12040456
Regular
Dec 16, 2020

ARTURO MONJE vs. FARIA LAND & CATTLE CO., LLC, ZENITH INSURANCE COMPANY

This case concerns a dispute over the timeliness of a defendant's Petition for Automatic Reassignment of a Workers' Compensation Judge. The WCJ initially denied the petition, deeming it untimely as filed more than five days after the Notice of Hearing. However, the Appeals Board granted removal, finding the petition timely because California Code of Regulations, Title 8, section 10605(a)(1) extends the deadline by five days for e-service. Consequently, the WCAB rescinded the WCJ's order and granted the defendant's Petition for Automatic Reassignment.

Petition for RemovalPetition for Automatic ReassignmentWCAB Rule 10605(a)(1)WCAB Rule 10788timely filingservice by emailsubstantial prejudiceirreparable harmreconsiderationAdjudication Number
References
2
Case No. ADJ7232076
Significant
Sep 26, 2011

Tsegay Messele, Applicant vs. Pitco Foods, Inc., California Insurance Company

The Appeals Board, in an en banc decision, held that the timeframe for seeking agreement on an Agreed Medical Evaluator (AME) under Labor Code section 4062.2(b) is extended by five calendar days when the initial proposal is served by mail. Consequently, it found that both the applicant's and the defendant's requests for a Qualified Medical Evaluator (QME) panel were premature and rescinded the prior finding.

QME panelagreed medical evaluatorLabor Code 4062.2Code of Civil Procedure 1013WCAB Rule 10507service by mailtime computationremovalen banc decisionmedical evaluation
References
24
Case No. ADJ1871643 (SDO 0291759)
Regular
Oct 23, 2017

JOSE GOMEZ vs. DEPARTMENT OF CORRECTIONS, REHABILITATION PAROLE & COMMUNITY SERVICES, Legally Uninsured, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, affirming the WCJ's award of medical treatment. The defendant's Utilization Review denial was deemed untimely because their Request for Information was served more than five business days after the initial request, excluding the day after Thanksgiving. The Board clarified that the day after Thanksgiving is considered a normal business day for UR purposes under Labor Code section 4600.4. Therefore, the defendant's untimely RFI did not extend the UR deadline, and the requested medical treatment was properly authorized.

Workers' Compensation Appeals BoardUtilization ReviewRequest for AuthorizationRequest for InformationTimelinessBusiness DayLabor Code Section 4600.4Petition for ReconsiderationFindings and AwardPrimary Treating Physician
References
0
Case No. MISSING
Regular Panel Decision
May 06, 1998

Nieves v. Five Boro Air Conditioning & Refrigeration Corp.

Reding Nieves, an employee of United Fire Protection, was injured while installing fire sprinklers at a New York Hall of Science site, which was subcontracted by Five Boro Air Conditioning & Refrigeration Corp. He allegedly tripped over a concealed drop light after stepping off an eight-foot ladder, sustaining an ankle injury. Nieves sued Five Boro under Labor Law § 240 (1), and Five Boro filed a third-party action against United, with the motion court initially granting Nieves summary judgment. However, the appellate court modified this order, denying summary judgment for all parties due to unresolved questions of fact surrounding the accident's cause, including conflicting testimonies. Consequently, the case requires a trial to determine liability and facts, as neither side was entitled to summary judgment.

Elevation-related riskTripping hazardSummary judgmentLabor Law § 240(1)Construction site accidentLadder fallContributory negligenceQuestions of factAppellate DivisionSubcontractor liability
References
11
Case No. ADJ7231344 ADJ7231347 ADJ7231403
Regular
Feb 22, 2011

, Applicant, vs. 99 CENT ONLY STORES, INC.; SEDGWICK CLAIMS MANAGEMENT SERVICES, vs. , Defendant(s).

The Workers' Compensation Appeals Board dismissed the petition for reconsideration as untimely, as it was filed over 25 days after the Administrative Law Judge's decision. The Board emphasized that the 20-day filing deadline, extended by five days for mailing, is jurisdictional. Furthermore, the petition was not taken from a final order, and the request for removal was denied for failure to demonstrate substantial prejudice or irreparable harm.

ADJ7231344ADJ7231347ADJ7231403Petition for ReconsiderationDismissedUntimelyLabor Code section 5903JurisdictionalFinal OrderInterlocutory
References
12
Case No. ADJ7020366
Regular
Aug 22, 2013

OCTAVIO GONZALEZ vs. BODEGA LATHE CORPORATION, PACIFIC COMP INSURANCE

The Workers' Compensation Appeals Board dismissed Octavio Gonzalez's petition for reconsideration because it was untimely filed. The petition was submitted more than 25 days after the administrative law judge's decision, exceeding the 20-day statutory limit, which can be extended by five days for mail. Because the deadline for filing a petition for reconsideration is jurisdictional, the Board lacked the authority to consider it. Had the petition been timely, it would have been denied on the merits as well.

Workers' Compensation Appeals BoardPetition for ReconsiderationUntimely filingJurisdictional time limitLabor Code section 5903Administrative Law JudgeWCJ's Report and RecommendationMaranian v. Workers' Comp. Appeals Bd.Rymer v. HaglerScott v. Workers' Comp. Appeals Bd.
References
3
Case No. ADJ3357951
Regular
Jul 02, 2013

BENNY ANDRADE vs. KELLY SERVICES, ESIS

The Workers' Compensation Appeals Board dismissed Benny Andrade's petition for reconsideration as untimely. The petition was filed on May 15, 2013, which was over 25 days after the WCJ's decision was served on May 23, 2008. Labor Code section 5903 sets a strict 20-day deadline for reconsideration petitions, extendable by five days for mailing. As the deadline is jurisdictional, the Board lacked the power to grant the untimely petition.

Petition for ReconsiderationTimelinessLabor Code 5903JurisdictionalWCJ DecisionAppeals BoardDismissedService of OrderFiling DateMail Extension
References
0
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