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

Case No. ADJ8765139, ADJ9014068
Regular
Nov 26, 2014

JOEL VARGAS vs. ROMERO'S FOOD PRODUCTS, INC., MITSUI SUMITOMO INSURANCE COMPANY OF AMERICA, MITSUI SUMITOMO MARINE MANAGEMENT

The Workers' Compensation Appeals Board denied the applicant's Petition for Reconsideration, upholding the WCJ's decision that the applicant did not sustain industrial injury. This denial was based on the applicant's lack of credibility and insufficient substantiating medical evidence, compounded by more credible employer witness testimony. The WCJ found the applicant's medical reporting was based on false, inaccurate, or incomplete histories, and the Appeals Board accorded great weight to the WCJ's credibility findings. Therefore, the petition was denied as the applicant failed to prove industrial causation by a preponderance of the evidence.

Petition for ReconsiderationWCJ Credibility FindingSubstantial EvidenceMedical History AccuracyIndustrial Injury CausationLabor Code 3202Developing the RecordPreponderance of EvidenceNon-industrial CausesPrior Injuries
References
9
Case No. MISSING
Regular Panel Decision

People v. Barto

The defendant was convicted after a jury trial in Seneca County Court for insurance fraud in the third degree, falsifying business records in the first degree, defrauding the government, and falsely reporting an incident in the third degree. The charges arose from the defendant, an acting Village Justice, falsely reporting an assault to police, allegedly to obtain prescription pain medication. Medical evidence presented by the prosecution, including the absence of injuries despite extensive testing, contradicted the defendant's account of being strangled and struck. The appellate court unanimously affirmed the judgment, rejecting the defendant's contentions regarding the legal sufficiency and weight of the evidence. The court found that the jury could reasonably conclude the defendant falsely reported the incident and caused a false workers' compensation form to be filed. The appellate court also found no reason to modify the sentence despite improper prosecutorial statements.

Insurance FraudFalsifying Business RecordsDefrauding GovernmentFalse ReportingAssault ClaimMedical EvidenceLegal SufficiencyWeight of EvidenceWorkers' CompensationJury Trial
References
8
Case No. MISSING
Regular Panel Decision

United States v. Carpentieri

The Government sued Frank Carpentieri under the False Claims Act and federal common law, alleging he made false statements regarding his medical history in his employment application to the United States Postal Service and subsequent disability benefit applications. Carpentieri filed cross-motions to dismiss, arguing lack of subject matter jurisdiction under FECA's preclusion-of-review provision (5 U.S.C. § 8128(b)) and failure to state a claim. The District Court denied Carpentieri's 12(b)(1) cross-motion regarding the False Claims Act claims, reserving judgment on federal common law claims, and denied the 12(b)(6) cross-motion. The court ruled that § 8128(b) does not bar the court from hearing the Government’s False Claims Act claims, distinguishing between reviewing the OWCP's benefit determination and inquiring into fraudulent conduct. Consideration of the Government's summary judgment motion was postponed pending supplemental briefs on damages.

False Claims ActFECAFraudDisability BenefitsEmployment ApplicationMedical HistoryJurisdictional DisputeSummary JudgmentFederal Common LawPreclusion of Review
References
16
Case No. 97 Civ. 9770
Regular Panel Decision

Richards v. CITY OF NEW YORK 405

Samantha Richards and her children sued the City of New York, law enforcement personnel, the Administration of Children's Services (ACS), and Little Flower Children's Services (LFCS) for civil rights violations under 42 U.S.C. § 1983, including false arrest, malicious prosecution, and the wrongful removal and failure to protect the children in foster care. Plaintiffs also brought state law claims for breach of contract, social work malpractice, trespass, false arrest, false imprisonment, intentional and negligent infliction of emotional distress, conversion of property, and conspiracy. The court granted summary judgment in part, dismissing § 1983 claims against detectives McCann and Paul for false arrest and child removal based on qualified immunity, all § 1983 claims against ACS and LFCS for lack of deliberate indifference or inadequate training, and various state law claims due to pleading deficiencies or lack of evidence. Claims for malicious prosecution against McCann and Paul, and certain state law claims against the City of New York, remain.

42 U.S.C. § 1983False ArrestMalicious ProsecutionChild Custody DeprivationFailure to ProtectQualified ImmunitySummary JudgmentFoster Care NegligenceDeliberate IndifferenceInadequate Training
References
52
Case No. MISSING
Regular Panel Decision

People v. Starks

Defendant was convicted of grand larceny in the third degree and two counts of offering a false instrument for filing in the first degree, stemming from his failure to report workers' compensation benefits while receiving social services benefits. The appellate court first addressed the defendant's Batson challenge regarding a peremptorily excused black juror, affirming the lower court's finding that the prosecutor's explanation was race-neutral. Next, the court found legally sufficient evidence to support the grand larceny conviction, noting that the defendant's misrepresentations were material and resulted in an overpayment exceeding $3,000. Additionally, the court rejected claims of abridged confrontation rights, prosecutorial misconduct, and ineffective assistance of counsel. Finally, the judgment was modified to impose concurrent, rather than consecutive, sentences for the grand larceny and false instrument for filing convictions, and as modified, affirmed.

Grand LarcenyFalse Instrument for FilingSocial Services Benefits FraudWorkers' Compensation OverpaymentBatson ChallengeJuror Peremptory ChallengeSufficiency of EvidenceConfrontation Clause RightsProsecutorial MisconductIneffective Assistance of Counsel
References
23
Case No. MISSING
Regular Panel Decision
May 20, 1993

Ray v. Metropolitan Transportation Authority

Larry Ray, a maintenance worker, and Blake Willett, an LIRR Police Officer, were involved in a physical altercation where Willett allegedly beat and handcuffed Ray. Ray was later released by Willett's supervisor. Plaintiffs sued Willett and the Long Island Rail Road (LIRR) for battery, false arrest and imprisonment, negligent retention, and civil rights violations under 42 USC § 1983. The Supreme Court, Kings County, dismissed claims against the LIRR for negligent retention and civil rights violations and dismissed the complaint against Willett due to defective service of process. The jury found Willett liable for battery and false arrest/imprisonment but not for civil rights violation. The appellate court affirmed the judgment, finding no error in the dismissals, concluding that Willett's conduct was not within the scope of employment and he was not acting under color of state law, and that service upon Willett was indeed defective.

BatteryFalse ImprisonmentCivil Rights ViolationNegligent RetentionRespondeat SuperiorPolice MisconductPersonal JurisdictionService of ProcessAppellate LawKings County
References
17
Case No. LAO 801322
Regular
May 23, 2008

O.C. MARSHALL (Deceased) JENNIFER MARSHALL (Widow) vs. ARCO/BRITISH PETROLEUM; ESIS

This case concerns a widow's appeal of a denial of workers' compensation benefits for her husband's death. The Administrative Law Judge (ALJ) denied benefits, finding the death was due to natural causes and not his employment as a pipe fitter for Arco/British Petroleum. The Workers' Compensation Appeals Board affirmed the denial, finding the applicant's medical expert's opinion lacked substantial evidence due to an inaccurate history and incomplete analysis of the decedent's medical records and family history.

Workers Compensation Appeals BoardApplicantDefendantPetition for ReconsiderationFindings of Fact and OrdersAdministrative Law JudgeQualified Medical EvaluatorQMEatherosclerotic diseasehypertension
References
0
Case No. MISSING
Regular Panel Decision

Prevost v. New York State Department of Social Services

The petitioners, maternal grandparents, initiated a CPLR article 78 proceeding to challenge a determination by the State Commissioner of Social Services and the Warren County Department of Social Services. They sought to expunge a report from the State Central Register indicating inadequate guardianship concerning their grandson, Justin. Justin had been placed in foster care, and concerns arose about his behavior after monthly visits with the petitioners, prompting a psychiatrist to recommend discontinuing overnight visits. The psychiatric report detailed Justin's anger towards his grandmother and later allegations of diapering. Despite the petitioners' denials and claims of bias, the agency's decision to indicate inadequate guardianship was upheld after administrative review and a fair hearing. The court ultimately confirmed the determination, citing substantial evidence based on Justin's consistent accounts.

Child protective servicesInadequate guardianshipFoster careAdoption eligibilityCPLR article 78 proceedingAdministrative reviewExpungement of reportHearsay evidenceCredibility determinationSocial Services Law
References
3
Case No. 2021 NY Slip Op 06411 [199 AD3d 1214]
Regular Panel Decision
Nov 18, 2021

Matter of Urdiales v. Durite Concepts Inc/Durite USA

Claimant Jose Urdiales appealed a Workers' Compensation Board decision denying his benefits for respiratory problems allegedly due to an occupational disease from epoxy exposure. The Board affirmed a Workers' Compensation Law Judge's ruling, crediting the employer's testimony over the claimant's regarding his work activities. Medical opinions supporting the claimant's condition were based on his disputed work history. The Appellate Division, Third Department, affirmed the Board's decision, concluding that the Board's findings on witness credibility and rejection of medical evidence based on an inaccurate work history were supported by substantial evidence.

Occupational DiseaseRespiratory IssuesEpoxy ExposureChemical ExposureCausationWitness CredibilitySubstantial EvidenceWorkers' Compensation BenefitsClaim DenialAppellate Review
References
7
Case No. ADJ8189240
Regular
Mar 04, 2013

MARY VAN RYN vs. BEJO SEEDS, INC., INSURANCE COMPANY OF THE WEST/EXPLORER INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded a prior award, finding the medical evidence insufficient. The WCAB determined that the Panel Qualified Medical Evaluator's (PQME) opinion, which formed the basis of the award for industrial injury, lacked substantial evidence. Specifically, the PQME's supplemental report was based on inadequate history and examination, failing to consider crucial factors like job activities and non-work history. The case is returned to the trial level for further development of the record, including potential re-evaluation by the PQME with a job analysis or examination by a regular physician.

WCABReconsiderationFindings and AwardPQMESubstantial EvidenceIndustrial InjuryCumulative TraumaMedical OpinionLabor Code Section 5701EDD Lien
References
6
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