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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
Apr 26, 2004

Claim of Lopresti v. Washington Mills

A claimant appealed an amended decision by the Workers' Compensation Board, which disqualified him from wage replacement benefits for violating Workers' Compensation Law § 114-a. The claimant initially misrepresented how he sustained a knee injury, claiming he slipped on ice, but later admitted it was due to an altercation with a coworker. While a Workers’ Compensation Law Judge initially found the injury compensable and no violation, the Board modified this, concluding the claimant knowingly made a false statement material to his claim. The Appellate Division affirmed the Board's decision, noting that the claimant's motivation to protect a coworker was a credibility issue for the Board to resolve. The court upheld the discretionary penalty of disqualification from wage replacement benefits, finding the Board's determination supported by substantial evidence.

False StatementFraudulent MisrepresentationWage Replacement DisqualificationWorkers' Compensation Board DecisionAppellate AffirmationClaimant CredibilityMateriality of FalsehoodKnee Injury ClaimWorkplace AltercationStatutory Violation § 114-a
References
7
Case No. MISSING
Regular Panel Decision

Dory v. New York State Electric & Gas Corp.

Claimant, receiving workers' compensation for a permanent partial disability from back injuries, was accused by the employer's carrier of violating Workers' Compensation Law § 114-a. This accusation stemmed from an investigator observing claimant using a squat press machine, despite claimant's testimony in November 2006 denying such activity. Both the Workers’ Compensation Law Judge and the Board found that the employer and carrier failed to prove claimant knowingly made a false statement or misrepresentation of a material fact. The Board credited claimant's explanation that he did not understand "squat pressing" to include using the machine he utilized. The appellate court affirmed the Board's determination, concluding that substantial evidence supported the finding that claimant did not knowingly make a false statement.

Workers' CompensationFalse StatementMisrepresentationBenefits DisqualificationSubstantial EvidenceAppellate ReviewCredibilitySquat Press MachineBack InjuryEmployer's Carrier
References
3
Case No. MISSING
Regular Panel Decision

Claim of Engoltz v. Stewart's Ice Cream

The case revolves around a claimant residing in Israel who faced allegations of making false statements to receive workers' compensation benefits. The employer's risk management company issued a questionnaire inquiring solely about "earnings," to which the claimant responded in the negative. This response did not disclose unpaid volunteer activities supporting competitive swimming in Israel, including work for a corporation formed to import swimming gear. However, during a subsequent hearing, the claimant was fully transparent about these activities, affirming no compensation was received and substantiating this with tax returns. The court found no evidence that the claimant knowingly made a false statement or representation regarding a material fact under Workers’ Compensation Law § 114-a (1), emphasizing the claimant's candor at the hearing. Consequently, the lower decision was reversed, and the matter was remitted to the Workers’ Compensation Board for further proceedings.

Workers' CompensationFalse StatementMisrepresentationEarningsQuestionnaireCandorRemittalIsrael ActivitiesUnpaid WorkVolunteer Work
References
3
Case No. MISSING
Regular Panel Decision

Losurdo v. Asbestos Free, Inc.

The New York Court of Appeals addressed whether Workers’ Compensation Law section 114-a (1) authorizes the Workers’ Compensation Board to disqualify a claimant from receiving wage replacement benefits even when the forfeited compensation is not "directly attributable" to a false statement. The court held that while the mandatory penalty requires a direct link, the Board possesses discretionary power to impose disqualification, which can include forfeiture of all or a portion of benefits, regardless of whether the false statement enabled the claimant to receive compensation. The court defined "material fact" broadly as significant or essential to the issue at hand. In the cases of James Losurdo and Florencia Machado, where the Board had imposed disqualifications for misrepresentations, the court reversed and remitted the matters. It directed the Board to clarify whether mandatory or discretionary penalties were applied and to provide an explanation for the proportionality of any disqualification imposed under its discretionary power.

Workers' Compensation LawFraudWage Replacement BenefitsMaterial FactDisqualificationDiscretionary PenaltyMandatory PenaltyApportionmentPreexisting InjurySurveillance
References
11
Case No. G107 435
Regular Panel Decision
Jun 02, 2023

Matter of Marku v. ABM Industries

This case concerns the claim of Denise Perry under the Workers' Compensation Law. The Workers' Compensation Law Judge (WCLJ) previously found that the employer, Adventist Home Care, established a violation of Workers' Compensation Law § 114-a by the claimant for willfully making false statements to obtain benefits. Consequently, the WCLJ disallowed indemnity benefits and imposed both mandatory and discretionary penalties. A Board Panel decision filed on February 17, 2022, affirmed the WCLJ's findings. The claimant subsequently filed an application for reconsideration on March 18, 2022, which the Board Panel reviewed. After considering the claimant’s arguments, the Board Panel determined that the application did not raise new issues or present new material evidence, nor did it demonstrate an erroneous statement of material fact or law in the prior decision. Therefore, the Board Panel, by a majority vote, affirmed its prior decision.

Workers' Compensation FraudFalse RepresentationIndemnity Benefits DisallowanceWCL § 114-a PenaltyApplication for Reconsideration DeniedBoard Panel AffirmationWillful MisrepresentationWorkers' Compensation Law Judge DecisionEmployer Established Violation
References
0
Case No. CA 10-01067
Regular Panel Decision
Apr 01, 2011

TIMMONS, JOSEPH v. BARRETT PAVING MATERIALS, INC.

Joseph Timmons sustained injuries while working on property owned by Barrett Paving Materials, Inc., leading to a lawsuit alleging Labor Law violations. Barrett Paving then initiated a third-party action against Timmons' employer, Schneider Brothers Corporation, and a separate action against Colony Insurance Company. The Supreme Court granted Barrett's motion for summary judgment, dismissing the Labor Law claims in Action No. 1, and denied Colony's motion in Action No. 2, declaring Barrett an additional insured. The Appellate Division affirmed the lower court's judgment, concluding that Labor Law §§ 240(1), 241(6), and 200 were inapplicable to the facts of the case. The court also affirmed Schneider's duty to defend Barrett and Colony's obligation to provide coverage to Barrett as an additional insured.

Labor LawSummary JudgmentAppellate DivisionWorkers' Compensation LawIndustrial Code RegulationsCommon-Law NegligenceContractual IndemnificationAdditional Insured EndorsementConstruction Site SafetyGravity-Related Accidents
References
23
Case No. MISSING
Regular Panel Decision

United States v. Raymond & Whitcomb Co.

The United States, on behalf of the Postal Service, sued Raymond & Whitcomb Co. (R&W) for misusing non-profit mail rates, resulting in a $398,960.05 deficiency, bringing claims under the Federal Debt Collection Procedure Act, unjust enrichment, and the False Claims Act. The court found that R&W, a for-profit entity, collaborated with non-profit institutions (Metropolitan Museum of Art and Smithsonian Institution) on travel programs, and its significant financial stake in these ventures made the mailings ineligible for non-profit rates. Consequently, summary judgment was granted to the United States on the Federal Debt Collection Procedure Act and unjust enrichment claims, ordering R&W to pay the deficiency. However, the court denied both parties' motions for summary judgment on the False Claims Act count, determining that a genuine issue of material fact existed regarding R&W's knowledge of the falsity of the mailing statements—specifically, whether their actions constituted reckless disregard or mere negligence. The case will proceed to trial to resolve the scienter element of the False Claims Act claim, while the debt for the misused postage is established.

Mail fraudNon-profit mail rateFalse Claims ActFederal Debt Collection Procedure ActUnjust enrichmentSummary judgmentCooperative mailingsPostal Service regulationsScienterReckless disregard
References
32
Case No. MISSING
Regular Panel Decision

Bub v. Rockstone Capital, LLC

Keith Bub appealed an order from the United States Bankruptcy Court for the Eastern District of New York, which denied his discharge under 11 U.S.C. § 727(a)(4)(A). The Bankruptcy Court found that Bub had made false and fraudulent statements concerning his income, expenses, and his company's assets and liabilities, intending to deceive both creditors and the court. Bub challenged these findings, arguing for reversal or remand, asserting that the evidence was misinterpreted and insufficient to prove falsehoods or intent to deceive. Appellee Rockstone Capital, LLC, countered that Bub had engaged in a prolonged pattern of asset hiding and making false statements under oath. The District Court affirmed the Bankruptcy Court's decision, concluding that the finding of knowingly made material false statements with fraudulent intent, or at least reckless disregard for the truth, was not clearly erroneous.

Bankruptcy DischargeFalse OathFraudulent IntentDebtor-Creditor RelationsFinancial MisrepresentationCorporate FormalityJudicial ReviewChapter 7 BankruptcyAsset ConcealmentIncome Understatement
References
38
Case No. MISSING
Regular Panel Decision

Meyers v. Huschle Bros.

The court affirmed Special Term's decision to strike certain paragraphs from the defendant's answer due to redundancy and failure to comply with Civil Practice Act § 241, which requires plain and concise statements of material facts in pleadings, even in libel actions. Specifically, the court found the material insufficient as a defense of justification if it purported to apply general statements about labor unions to the plaintiff union. The decision further clarified the requirements for pleading justification, stating that particular facts and circumstances constituting the truth must be set forth in detail, rather than merely reiterating libelous words. Additionally, for pleading mitigation, the court mandated that specific mitigating circumstances, including sources of information and grounds for belief, be stated to demonstrate an absence of actual malice, pursuant to Civil Practice Act § 338. Finally, the court addressed the burden of proof for establishing actual malice in cases involving qualified privilege, noting that it generally rests with the plaintiff once a relationship giving rise to qualified privilege is established.

LibelPleading standardsJustification defenseMitigation defenseActual maliceQualified privilegeCivil Practice ActRedundancy in pleadingsMaterial factsBurden of proof
References
6
Case No. MISSING
Regular Panel Decision

People v. Norman

The New York Court of Appeals addresses two larceny cases, People v Norman and People v King, which involve defendants failing to deliver goods after payment. The opinion clarifies the distinction between larceny by false promise and larceny by false pretenses, particularly emphasizing the unique "moral certainty" burden of proof for the former at the fact-finding level, not appellate review. For defendant Norman, accused of larceny by false promise, the Court reversed the Appellate Division's dismissal, finding sufficient evidence of his larcenous intent, and remitted the case. Conversely, in People v King, charged with larceny by false pretenses, the Court affirmed the Appellate Division's judgment, concluding that the prosecution's theory was supported by evidence of a material misrepresentation of fact. This decision reinforces the legal standards for proving criminal intent in such fraud-related offenses.

LarcenyFalse PromiseFalse PretensesCriminal IntentBurden of ProofAppellate ReviewPenal LawCircumstantial EvidenceContract BreachCriminal Possession of Stolen Property
References
38
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