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

Case No. MISSING
Regular Panel Decision

Transportation Insurance Co. v. George E. Failing Co.

Transportation Insurance Company (Transportation) appealed a summary judgment in a declaratory judgment action. George E. Failing Company (Failing) sought a declaration that it was an omnibus insured under a motor vehicle liability policy issued by Transportation to Southwestern Laboratories, Inc. An employee of Southwestern was injured by a truck manufactured by Failing and subsequently sued Failing, alleging defects. Failing contended it was covered under the policy's omnibus clause due to the alleged negligence of Southwestern's employees. The court reversed the summary judgment, ruling that Failing's potential liability arose from its own negligence, not that of Southwestern's insured parties, and therefore Failing was not an omnibus insured.

Insurance CoverageOmnibus InsuredMotor Vehicle LiabilitySummary Judgment AppealNegligenceProducts LiabilityDeclaratory JudgmentTexas Law
References
1
Case No. 09-19-00101-CV
Regular Panel Decision
Dec 12, 2019

Brian W. Justice v. Wells Fargo Bank, National Association, on Behalf of the Registered Holders of Bear Stearns Asset Backed Securities I Trust 2007-AC2, Asset-Backed Certificates, Series 2007-AV2

Brian W. Justice appealed the trial court's summary judgment in favor of Wells Fargo Bank, National Association, regarding a breach of contract and judicial foreclosure claim. Justice had defaulted on a promissory note, leading Wells Fargo to seek foreclosure on his property. Following a summary judgment for Wells Fargo, Justice, through an attorney, moved to set aside the judgment and for a new trial, arguing he lacked notice due to being out of state. The appellate court affirmed the trial court's decision, concluding that Justice failed to prove his failure to respond was not due to conscious indifference and that Wells Fargo had adequately demonstrated its status as the note holder. Additionally, the court ruled that Justice waived his objection to attorney's fees by not raising it at the trial level.

Summary Judgment AppealBreach of ContractJudicial ForeclosurePromissory Note DefaultHome EquityDefault JudgmentMotion for New TrialCraddock TestConscious IndifferenceHolder of Note
References
46
Case No. MISSING
Regular Panel Decision
Aug 07, 1984

Murtaugh v. Bankers Trust Co.

In November 1978, claimant Murtaugh filed a discrimination claim against Bankers Trust Company of Albany, N. A. following her 1977 dismissal, citing Workers’ Compensation Law § 241. The Workers’ Compensation Board affirmed a discrimination finding, which was subsequently upheld by the Appellate Division. An administrative law judge directed Murtaugh's reinstatement and awarded back wages from January 1, 1978, to October 19, 1982, with an offset for unemployment benefits. The Bank appealed this decision, contending the back pay award was unauthorized under Workers’ Compensation Law § 120, arguing Murtaugh failed to accept reemployment or mitigate damages. The court found substantial evidence that no bona fide reemployment offer was made and that the issue of mitigation of damages was not properly raised. Consequently, the court affirmed the Board's decision, upholding Murtaugh's entitlement to back pay.

Workers' Compensation LawDiscriminationBack Pay AwardReinstatementMitigation of DamagesUnemployment BenefitsOffer of ReemploymentAppellate DivisionNew York LawEmployer Liability
References
4
Case No. ADJ1088522 (RIV 0015524)
Regular
Jan 03, 2013

SAMANTHA VAN DUINHOVEN vs. SPA HOTEL & CASINO, CALIFORNIA CASUALTY, Administered by GAB ROBINS NORTH AMERICA

This case involved an applicant who claimed industrial injury to her neck, back, left shoulder, psyche, and associated chronic pain syndrome, resulting in a finding of permanent total disability. The defendant sought reconsideration, arguing the medical evidence did not support injury to the low back or a diagnosis of chronic pain syndrome. The Appeals Board reversed the findings on the low back and chronic pain syndrome, finding no substantial evidence to support them. Consequently, the applicant's permanent disability award was amended to 70%, based on ratings for her neck, left shoulder, and psyche.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardPermanent Total DisabilityChronic Pain SyndromeAgreed Medical EvaluatorQualified Medical EvaluatorMedical Record ReviewIndustrial InjuryPermanent Disability Indemnity
References
0
Case No. MISSING
Regular Panel Decision
Oct 21, 2005

Hare v. Champion International

The claimant, a former laborer and millwright, appealed a Workers’ Compensation Board decision ruling he failed to demonstrate attachment to the labor market, despite sustaining multiple work-related injuries, including head, neck, and back trauma. His employment ended in 1999 due to a mill sale, with prior findings attributing his unemployment to economic conditions. Following further hearings and medical examinations, a Workers’ Compensation Law Judge determined he had a moderate, permanent partial disability not prohibiting employment, and lacked labor market attachment. The Board affirmed this determination. The Appellate Division affirmed the Board's decision, rejecting the claimant's arguments for total disability and upholding the finding that he had not sought work since December 2000, thus failing to demonstrate the requisite attachment to the labor market.

Workers' CompensationPermanent Partial DisabilityLabor Market AttachmentMedical EvidenceAppellate ReviewEconomic ConditionsUnemploymentDisability BenefitsJudicial AffirmationConflicting Medical Evidence
References
9
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. 2019-03-1588
Regular Panel Decision
Aug 06, 2020

Justus, Joseph v. Blalock & Sons, Inc.

Joseph Justus claimed medical and temporary disability benefits for a back injury, asserting it was caused by a work accident where a saw struck his face, leading to a fall. The Court denied these benefits because Mr. Justus failed to provide medical evidence demonstrating a causal link between his work injury and his back condition. Despite a pre-existing back issue and subsequent surgery for a disc herniation, no medical expert opinion was presented to establish that the work accident contributed more than fifty percent to the need for treatment. The court concluded that Mr. Justus failed to establish he was likely to prevail at trial.

Workers' CompensationBack InjurySpinal InjuryDisc HerniationRadiculopathyExpedited HearingCausationMedical EvidencePre-existing ConditionTemporary Disability
References
1
Case No. MISSING
Regular Panel Decision

Claim of Torres v. Kaufman's Bakery

A claimant, a machine operator and supervisor, developed bilateral carpal tunnel syndrome and flexor tenosynovitis, and separately, a back injury. His claim for workers’ compensation benefits for the carpal tunnel syndrome was established, and he was classified with a permanent partial disability. The employer and its workers’ compensation carrier sought reimbursement from the Special Disability Fund, arguing the 2004 back injury constituted a preexisting permanent impairment hindering job potential. The Workers’ Compensation Board granted the application for reimbursement, leading the Fund to appeal this decision. The appellate court found substantial evidence to support the Board's determination that the claimant's back injury was indeed a preexisting permanent physical impairment which was likely to hinder employment, thus upholding the Board's decision.

Workers' CompensationSpecial Disability FundReimbursement ClaimPermanent Partial DisabilityPreexisting Permanent ImpairmentCarpal Tunnel SyndromeBack InjuryHindrance to EmploymentMaterially and Substantially Greater DisabilityAppellate Review
References
7
Case No. MISSING
Regular Panel Decision
Feb 14, 2014

Walczyk v. Lewis Tree Service, Inc.

Claimant, a tree service worker, sustained a back injury in 2005 and later bilateral carpel tunnel syndrome in 2007, which was established as an occupational disease. The Workers’ Compensation Law Judge initially determined a 15% schedule loss of use for each hand due to carpel tunnel syndrome, leading to an award of $29,280. However, due to concurrent compensation for the back injury and the statutory weekly cap of $400, the Judge reduced the carpel tunnel award to $2,916, payable weekly. The Workers’ Compensation Board modified this, ruling that the claimant was entitled to the full $29,280 schedule loss of use award for the carpel tunnel syndrome, payable in a lump sum, citing Workers’ Compensation Law §§ 15 (3) (u) and 25 (1) (b) as amended in 2009. The employer's carrier appealed, arguing this violated the maximum disability rate provisions. The appellate court affirmed the Board's decision, stating that the lump-sum payment was an authorized alternative and did not violate the statutory cap, and that prior precedent did not preclude such an award.

schedule loss of uselump sum awardpermanent partial disabilitycarpal tunnel syndromeconcurrent paymentsstatutory capWorkers' Compensation Boardappellate review2009 amendmentsWorkers' Compensation Law
References
6
Case No. 2021 NY Slip Op 02252 [195 AD3d 40]
Regular Panel Decision
Apr 13, 2021

Matter of Part 60 RMBS Put - Back Litig.

This case addresses contractual disputes arising from the pooling and securitization of residential mortgages (RMBS). Computershare Trust Company, National Association, acting as a Separate Securities Administrator, sued Natixis Real Estate Holdings LLC (and its predecessor) for breaching a Pooling and Servicing Agreement (PSA) by failing to identify and repurchase nonconforming mortgages. Natixis, in turn, filed counterclaims and a third-party complaint against Wells Fargo Bank, N.A. (the Securities Administrator and Master Servicer), alleging Wells Fargo breached its PSA duties to notify of breaches and supervise the Servicer. The Appellate Division ruled that Natixis's statute of limitations defense, based on the borrowing statute (CPLR 202), was not waived, overturning the lower court's decision on this point. It affirmed the dismissal of Natixis's contractual indemnification claim against Wells Fargo but allowed Natixis's independent breach of contract claims (failure to notify and failure to supervise) against Wells Fargo to proceed.

RMBSPut-Back LitigationContractual ObligationsStatute of LimitationsBorrowing StatuteLaw of the CaseWaiverIndemnificationBreach of ContractSecurities Administrator
References
35
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