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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

Main Evaluations, Inc. v. State

The claimant, Main Medical Evaluations, entered into contracts with the New York State Office of Temporary and Disability Assistance (OTDA) to perform consultative medical evaluations. OTDA terminated these contracts, alleging the claimant failed to disclose professional disciplinary proceedings against its chief medical officer, Arvinder Sachdev, and submitted false information during the bidding process. Following the dismissal of its claim in the Court of Claims, the claimant appealed. The appellate court affirmed the lower court's judgment, concluding that OTDA had legitimate grounds for termination due to the claimant's misrepresentations and failure to report substantial contract-related issues concerning Sachdev's integral role. Additionally, the court rejected the claimant's equal protection argument, finding no evidence of selective enforcement based on impermissible considerations.

Contract TerminationProfessional MisconductFalse RepresentationEqual ProtectionGovernment ContractsAppellate ReviewBreach of ContractMedical LicensingAdministrative ProceedingsDue Diligence
References
5
Case No. MISSING
Regular Panel Decision

Pavilion Central School District v. Pavilion Faculty Ass'n

The Pavilion Central School District initiated a proceeding under CPLR article 75 to vacate an arbitration award, which had directed the District to offer a probationary teacher an additional non-tenure accruing probationary appointment for the 1975-1976 school year. The teacher's services were terminated following legislative changes to the probationary period from five to three years. The arbitrator found the District violated the collective bargaining agreement by failing to provide timely notice of nonrenewal. The court ruled that the arbitrator exceeded his power in ordering reinstatement, reasoning that the grievant, being on maternity leave, suffered no damages from the lack of notice for the immediately subsequent school year, thus making the remedy irrational for that specific breach. However, the court remitted the case back to the arbitrator for a determination on whether the District violated the agreement's teacher evaluation and assistance provisions, suggesting that reinstatement might be a rational remedy if such a substantive breach is established.

Arbitration Award VacaturTeacher EmploymentProbationary TeacherCollective Bargaining AgreementEducation Law AmendmentsArbitrator PowersContract BreachMaternity Leave ImpactNotice RequirementsTeacher Evaluation
References
16
Case No. MISSING
Regular Panel Decision

Davis v. Medical Evaluation Specialists, Inc.

Justice Wilson dissents from the majority's decision on a motion for rehearing, arguing that the majority improperly considered non-evidence and engaged in speculation. The dissent contends that Lennie Davis's controverting affidavit by Dr. Bergeron, which stated a 17% impairment rating compared to the defendants' 0%, was conclusory and insufficient to establish bad faith by Medical Evaluation Specialists, Inc., Dr. DeFrancesco, and Dr. Dozier. Justice Wilson believes that the affidavit failed to meet the objective 'no reasonable doctor' standard for controverting good faith, and therefore, the trial court's summary judgment in favor of the defendants should have been affirmed based on official immunity.

Summary JudgmentOfficial ImmunityGood FaithImpairment RatingMedical AffidavitConclusory StatementsTexas Workers' Compensation ActAppellate ReviewDissenting OpinionPermanent Disability
References
7
Case No. MISSING
Regular Panel Decision

Merrick Union Free School District v. Merrick Faculty Ass'n

This case concerns a dispute between the Merrick Faculty Association and the Merrick Union Free School District over health insurance benefits. The Association challenged the District's denial of dual family health insurance to employees whose spouses had New York State Health Insurance Program (NYSHIP) coverage through other public employers, citing a Civil Service Policy Memo. An arbitrator sustained the grievance, invalidating part of their collective bargaining agreement (CBA). While the Supreme Court initially vacated the award, the appellate court modified this decision, finding the arbitrator did not exceed authority in invalidating the CBA provision, but did exceed it in crafting a prospective remedy that bypassed the CBA's negotiation clause. The case was remitted to direct the arbitrator to devise a prospective remedy consistent with the CBA.

collective bargaining agreementhealth insurancearbitration awardjudicial reviewpublic policyarbitrator authorityprospective remedyretroactive remedyNew York State Health Insurance ProgramCivil Service Policy Memo
References
13
Case No. MISSING
Regular Panel Decision

55th Management Corp. v. Goldman

This case addresses whether an out-of-court statement made to a court evaluator in an Article 81 guardianship proceeding is protected by absolute privilege, thereby defeating a defamation claim. The defendant, a tenant, made allegedly defamatory remarks about a landlord to a court evaluator during the evaluator's investigation for a guardianship proceeding. The court considered if the remarks were pertinent, if a statement to a court evaluator is considered part of a judicial proceeding, and if the speaker had standing. The court found the remarks pertinent, extended the absolute privilege to statements made to court evaluators given their role as court agents, and affirmed the defendant's standing as a potential witness. Consequently, the defendant's motion to dismiss the defamation complaint was granted.

DefamationAbsolute PrivilegeJudicial ProceedingsCourt EvaluatorGuardianshipMental Hygiene Law Article 81Tenant-Landlord DisputeMotion to DismissCPLR 3211 (a) (7)Scope of Privilege
References
44
Case No. 2016-03-0413
Regular Panel Decision
Oct 05, 2017

Dodson, Deborah v. LHC Group

Deborah Dodson, an employee of LHC Group, injured her left ankle and right knee in May 2015. She underwent knee surgery and was placed at maximum medical improvement by Dr. Johnson. She later developed small fiber neuropathy, and despite a referral, faced difficulties obtaining a neurologic impairment evaluation. The Court granted Ms. Dodson's request for a neurologic impairment evaluation, either by Dr. Butler or another neurologist, referring Dr. Butler to the Penalty Program for failure to provide an impairment opinion. However, the Court denied her claim for additional temporary total disability benefits, finding she reached MMI on March 23, 2017, when Dr. Butler ceased active treatment.

Workers' CompensationNeurologic Impairment EvaluationTemporary Total Disability BenefitsMaximum Medical ImprovementSmall Fiber NeuropathyPain ManagementExpedited HearingMedical TreatmentImpairment RatingPenalty Program
References
3
Case No. MISSING
Regular Panel Decision

Claim of Peterson v. Faculty Student Ass'n

The claimant, a food service worker, injured her left knee in April 2005, exacerbating prior injuries from a 1992 car accident and two 1995 work-related accidents. Her treating physician requested a total left knee replacement, but the carrier argued for apportionment of costs, suggesting the 2005 injury was only 15% responsible. Both the Workers’ Compensation Law Judge and the Workers’ Compensation Board rejected the apportionment claim, holding the carrier fully responsible, aligning with the rule against apportionment for non-compensable prior conditions where the claimant was fully employed. The Court affirmed the Board's decision, emphasizing that the claimant was not disabled by the 1992 car accident at the time of the 2005 injury and that the Board's credibility determinations regarding conflicting medical opinions were entitled to deference.

ApportionmentPreexisting ConditionKnee InjuryKnee Replacement SurgeryWorkers' Compensation Board DecisionCompensable InjuryNon-compensable InjuryFull EmploymentMedical Opinion DiscrepancyEmployer Responsibility
References
6
Case No. MISSING
Regular Panel Decision

In re Carew

The court considered two child abuse petitions filed by the Suffolk County Department of Social Services against a father, based on unsworn statements from his three and five-year-old children. The respondent father moved for psychiatric evaluations of the children and their mother to defend against the allegations, citing the need for expert assessment of the children's credibility. The court balanced the children's welfare against the father's right to a fair trial, noting the unique challenges of corroborating out-of-court statements in Article 10 proceedings. The court granted the father's request to the extent of ordering a validation interview for both children, stipulating a court-designated examiner if parties could not agree. The request for the mother's examination was denied due to insufficient justification.

Child AbuseFamily Court ActPsychiatric EvaluationChild CredibilityHearsay TestimonyCorroboration RequirementDue ProcessParental RightsSuffolk CountyUnsworn Statements
References
5
Case No. 2016-07-0378
Regular Panel Decision
Oct 19, 2016

King, Richard v, Big Binder Express, LLC

Richard King, an employee, suffered a work injury in March 2015, leading to a nasal fracture, blurred vision, and headaches. His treating ophthalmologist, Dr. Jason Sullivan, assessed a 34% visual impairment, which the employer, Big Binder Express, LLC, considered "skewed" and sought an Independent Medical Evaluation (IME). Mr. King opposed this, arguing Dr. Sullivan was an employer-approved physician and the request was solely to obtain a lower rating, not to ascertain recovery or work-relatedness. The Workers' Compensation Judge denied Big Binder's request, finding it unreasonable because Dr. Sullivan was already the approved physician and the IME's true purpose was to seek another impairment rating, contrary to statutory intent. The court cited precedents emphasizing that employers do not have an unlimited right to repeated examinations merely due to dissatisfaction with results.

IME DenialEmployer RequestMedical EvaluationImpairment Rating DisputeOphthalmological InjuryNeurological ImpairmentWorkers' Compensation LawTennessee LawReasonableness StandardTreating Physician
References
7
Case No. ADJ519728
Regular
Aug 08, 2011

LOWELL BAPTISTE vs. METROPOLITAN TRANSIT AUTHORITY

The Workers' Compensation Appeals Board granted reconsideration of a prior award finding industrial injury and temporary total disability dating back to 2000. The Board found that the medical opinion relied upon by the workers' compensation judge was not substantial evidence due to staleness, lack of complete records, and insufficient specialization. To ensure a fair resolution, the Board ordered new evaluations by independent orthopedic and psychiatric physicians, who will report on all outstanding medical issues.

Workers' Compensation Appeals BoardReconsiderationCompelling Medical EvaluationsTemporary Total DisabilityIndustrial InjuryOrthopedicsPsychiatrySubstantial EvidenceMedical OpinionWCJ
References
2
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