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

Case No. 2021 NY Slip Op 01219
Regular Panel Decision
Feb 25, 2021

Robinson v. Foremost Glatt Kosher Caterers, Inc.

Plaintiff Barry Robinson initiated a class action against Foremost Glatt Kosher Caterers, Inc., alleging the company withheld mandatory gratuity charges from catering service workers in violation of Labor Law § 196-d. Foremost, in turn, filed a third-party complaint against Kensington Event Staffing, seeking indemnification. The Supreme Court denied Kensington's motion to dismiss the third-party complaint. On appeal, the Appellate Division, First Department, reversed the lower court's decision. The court granted Kensington's motion to dismiss, finding that Foremost failed to state a cause of action for implied indemnification, as there were no allegations that Kensington wrongfully withheld charges or influenced Foremost's decision to retain them.

GratuitiesWage OrderImplied IndemnificationThird-Party ComplaintMotion to DismissLabor LawAppellate ReviewCatering IndustryWorkers' Rights
References
3
Case No. 2014-773 Q C
Regular Panel Decision
Sep 27, 2016

Laga v. Foremost Signature Ins. Co.

In this action, provider Adelaida M. Laga, as assignee of Jenny Jimenez, sought assigned first-party no-fault benefits from Foremost Signature Insurance Company. The Civil Court initially granted the defendant's motion for summary judgment, thereby dismissing the complaint. On appeal, the plaintiff argued that the defendant failed to legally establish that the fees charged exceeded the workers' compensation fee schedule. The Appellate Term, Second Department, reversed the Civil Court's order and denied the defendant's motion for summary judgment, siding with the plaintiff's argument.

No-fault benefitsSummary judgmentWorkers' compensation fee scheduleAppellate reviewInsurance claimMedical providerAssigneeCivil CourtAppellate TermDenial of benefits
References
1
Case No. 2014-1744 K C
Regular Panel Decision
Sep 08, 2017

Lynbrook Pt & Ot, PLLC v. Foremost Ins. Co.

This case concerns an appeal by Lynbrook PT & OT, PLLC, as an assignee of Kelvin Sumper, against Foremost Ins. Co., regarding claims for first-party no-fault benefits. The appeal challenged an order from the Civil Court of the City of New York, Kings County, which had granted the defendant's motion for summary judgment dismissing certain claims and denied the plaintiff's cross-motion for summary judgment on those same claims. The Appellate Term, Second Department, reviewed the lower court's decision, specifically examining the application of Ground Rule 11 of the workers' compensation fee schedule. The court found that a triable issue of fact existed concerning the defendant's application of this rule to the disputed claims. Consequently, the Appellate Term modified the Civil Court's order by denying the branches of the defendant's motion seeking summary judgment dismissal for the claims totaling $174.02 and $116.19, and affirmed the order as so modified.

No-Fault BenefitsSummary JudgmentAppealAppellate TermWorkers' Compensation Fee ScheduleInsurance ClaimAssigneeCivil CourtKings CountyTriable Issue of Fact
References
1
Case No. MISSING
Regular Panel Decision
May 17, 2011

Avrio Group Surveillance Solutions, Inc. v. Essex Insurance

Plaintiff Avrio Group Surveillance Solutions commenced a declaratory judgment action against Defendant Essex Insurance Company, seeking an order to defend and indemnify Avrio in a personal injury action. Essex filed a motion to dismiss, which was converted to a motion for summary judgment. The court addressed two main exclusions: the Completed Operations Exclusion and the Contractual Liability Exclusion. The court found a potentiality of coverage under the Completed Operations Exclusion due to ambiguities in the term "intended use" and unresolved factual issues regarding the completion of work, denying summary judgment on this ground. However, the court granted summary judgment in favor of Essex regarding the Contractual Liability Exclusion, as the subcontract did not qualify as an "insured contract" under the policy's specific definition in effect at the time of the incident, and Avrio was presumed to have agreed to these terms. The case will proceed to an evidentiary hearing on the Completed Operations Exclusion.

Insurance CoverageDeclaratory JudgmentSummary JudgmentContractual Liability ExclusionCompleted Operations ExclusionInsurance Policy InterpretationChoice of LawMaryland Contract LawFederal Civil ProcedureDuty to Defend
References
37
Case No. MISSING
Regular Panel Decision

Durant v. A.C.S. State & Local Solutions Inc.

Plaintiff Sharon Durant filed a lawsuit against A.C.S. State and Local Solutions, Inc. (ACS) alleging sexual harassment and a hostile work environment. Durant, a customer service representative, claimed she received two sexually explicit notes from a co-worker, Terri Simeon. Upon reporting the second note, ACS swiftly responded by moving Durant's workstation and disciplining Simeon, which ended the direct harassment. Despite these actions, Durant resigned, asserting constructive discharge because Simeon was not fired. The court granted summary judgment in favor of ACS, ruling that there was no quid pro quo harassment, the environment was not sufficiently hostile, no constructive discharge occurred, and her state law claims and intentional infliction of emotional distress claim also failed or were time-barred.

Sexual HarassmentHostile Work EnvironmentSummary JudgmentQuid Pro QuoConstructive DischargeEmployer LiabilityCorrective ActionCo-worker MisconductEmployment DiscriminationTitle VII
References
21
Case No. 2021 NY Slip Op 07321
Regular Panel Decision
Dec 23, 2021

Matter of Salinas v. Power Servs. Solutions LLC

The case involves a workers' compensation claim by Michel Salinas, which identified Power Services Solutions LLC as the employer and Everest National Insurance Company as the carrier. Everest's appeal to the Workers' Compensation Board was denied as untimely despite concerns about deficient notice and a potentially fraudulent certificate of insurance. The Appellate Division, Third Department, reversed the Board's decision, finding an abuse of discretion given the strong evidence of fraud and the flawed communication to Everest. The matter was remitted to the Board for further proceedings to investigate the fraud allegations. The court emphasized that the Board should not ignore legitimate evidence of fraud.

Workers' Compensation LawAppellate DivisionBoard DiscretionTimeliness of AppealFraudulent Insurance CertificateNotice RequirementsEmployer IdentificationCarrier LiabilityRemittalAbuse of Discretion
References
25
Case No. ADJ3533713
Regular
Nov 07, 2011

JUANA LOPEZ vs. THE MERCHANT OF TENNIS, HARTFORD INSURANCE

The Workers' Compensation Appeals Board (WCAB) removed this matter for the purpose of imposing sanctions. The WCAB found that the petition for reconsideration filed by SIR Practice Solutions, LLC on behalf of several lien claimants was skeletal, unintelligible, and violated multiple WCAB rules regarding evidentiary and legal support. The lien claimants and SIR Practice Solutions, LLC failed to object to the Notice of Intention to Impose Sanctions within the allotted time. Therefore, the WCAB imposed sanctions of $250.00 against each individual lien claimant and found SIR Practice Solutions, LLC jointly and severally liable for these sanctions.

Workers' Compensation Appeals BoardRemovalSanctionsLien ClaimantsSIR Practice SolutionsPetition for ReconsiderationSkeletal PetitionAppeals Board Rule 10846Labor Code Section 5813Notice of Intention to Impose Sanctions
References
6
Case No. ADJ1761179 (LBO 0351115), ADJ3800791, ADJ2478410
Regular
Mar 21, 2013

MARIA MELENDEZ vs. KELERMEYER BUILDING SERVICES, INC.; REHAB SOLUTIONS aka NORTH AMERICAN DISTRIBUTORS

This case involves a lien claimant, Rehab Solutions, whose lien was dismissed by the Workers' Compensation Appeals Board (WCAB) due to non-appearance at a lien conference and failure to respond to a Notice of Intention to Dismiss. Rehab Solutions petitioned for reconsideration, arguing they received neither notice nor an opportunity to be heard. The WCJ's report, adopted by the WCAB, found that Rehab Solutions was properly noticed for the lien conference and later received a Notice of Intention to Dismiss, but failed to appear or respond for approximately 90 days. Consequently, the WCAB denied the Petition for Reconsideration, though they admonished the lien claimant that further frivolous filings would result in sanctions.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJLien ClaimantOrder Dismissing LienDeclaration of Readiness to ProceedLien ConferenceNotice of HearingNotice of Intention to Dismiss LienProof of Service
References
0
Case No. ADJ10954204
Regular
Sep 15, 2022

MARIA FLORES vs. PINNACLE HEALTH CORP., SUMMARY OF EVIDENCE INSURANCE COMPANY OF THE WEST, AFFINITY HOME HEALTH CARE SERVICES, FALLS LAKE FIRE & CASUALTY INSURANCE, SEDGWICK CMS, HOME HEALTH CARE SOLUTIONS, INC.

The Workers' Compensation Appeals Board denied a petition for reconsideration filed by Home Health Care Solutions. The applicant, an LVN, was injured in a car accident while traveling between patients for multiple agencies. The Board adopted the WCJ's report, which found the injury arose out of and occurred in the course of employment for Home Health Care Solutions. This decision was based on the fact that the applicant was required to use her own vehicle, which extended the employer-employee relationship beyond direct service. The WCJ also found the going and coming rule did not bar the claim due to the required use of transportation between patient locations.

Workers' Compensation Appeals BoardPetition for ReconsiderationGoing and Coming RuleAOE/COELVNCar AccidentAutomobile ExceptionTransitEmployment RelationshipRequired Vehicle Use
References
6
Case No. 2024 NY Slip Op 00831 [224 AD3d 1051]
Regular Panel Decision
Feb 15, 2024

Matter of Golisano v. ABX Innovative Packaging Solutions LLC

The claimant, Jason R. Golisano, filed for workers' compensation benefits in August 2021 for injuries to his left wrist and hand. A Workers' Compensation Law Judge (WCLJ) established the claim for a left wrist injury. The employer and its carrier (appellants) sought review of this decision by the Workers' Compensation Board, but their application was filed beyond the 30-day limit. The Board denied the application as untimely, and the carrier appealed. The Appellate Division, Third Department, affirmed the Board's decision, finding no abuse of discretion in denying the untimely application, despite the carrier's arguments regarding a short delay and the COVID-19 pandemic.

Workers' CompensationTimelinessApplication for ReviewBoard DiscretionAppellate ReviewCOVID-19Procedural IssueWCLJ DecisionEmployer-Carrier AppealNew York Law
References
4
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