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

Case No. 535717
Regular Panel Decision
Aug 03, 2023

In the Matter of the Claim of Denis Campos

The Appellate Division of the Third Judicial Department affirmed decisions by the Workers' Compensation Board concerning a claim filed by Denis Campos. Claimant Campos, a construction worker, sought benefits after an accident. The Board had ruled that American Zurich Insurance Company was the liable workers' compensation carrier due to an improperly canceled policy, as per Workers' Compensation Law § 54 (5). American Zurich's appeal, including a request for reconsideration and full Board review, was denied because they failed to present crucial evidence to the Workers' Compensation Law Judge despite prior directives. The Appellate Division found no abuse of discretion in the Board's refusal to consider newly submitted evidence on administrative appeal and affirmed the denial of reconsideration.

Workers' CompensationInsurance Carrier LiabilityPolicy CancellationAdministrative ReviewAppellate ProcedureEvidentiary RulesJudicial DiscretionConstruction AccidentLadder FallThird Judicial Department
References
5
Case No. 534352
Regular Panel Decision
Sep 01, 2022

In the Matter of the Claim of Francisco Leon

Claimant Francisco Leon, a construction worker, sought workers' compensation benefits for injuries sustained on January 30, 2020, after falling from a scaffold. The employer, Monadnock Construction Inc., and its carrier disputed the claim, but a Workers' Compensation Law Judge established the claim, a decision subsequently affirmed by the Workers' Compensation Board. The carrier appealed the Board's ruling, contending it lacked substantial evidence. The Appellate Division affirmed the Board's decision, emphasizing that the Board holds broad authority in factual determinations, including witness credibility and drawing reasonable inferences from evidence. The court concluded that substantial evidence supported the Board's finding that Leon's injuries arose out of and in the course of his employment.

Workers' Compensation BenefitsScaffold AccidentWork-related InjuryAccidental Injury ClaimAppellate ReviewFactual DeterminationsSubstantial Evidence ReviewMedical EvidenceCredibility AssessmentEmployer Liability
References
9
Case No. 2017 NY Slip Op 08663
Regular Panel Decision
Dec 13, 2017

Matter of Campo v. City of Mount Vernon

The petitioner, John Campo, initiated a CPLR article 78 proceeding to challenge the Commissioner of the City of Mount Vernon Police Department's denial of his application for benefits under General Municipal Law § 207-c. The Appellate Division, Second Department, reviewed the administrative determination, which was made after a hearing. The court found that the Commissioner's decision to deny benefits was supported by substantial evidence. It emphasized that entitlement to General Municipal Law § 207-c benefits requires proof of a direct causal relationship between job duties and the resulting injury, a relationship the petitioner failed to establish. The court also upheld the administrative factfinder's credibility determinations concerning conflicting medical expert testimony.

CPLR Article 78 ProceedingGeneral Municipal Law § 207-c BenefitsPolice DepartmentSubstantial Evidence ReviewAdministrative DeterminationCausation StandardCredibility of Medical WitnessesJudicial ReviewAppellate DivisionWork-Related Injury
References
12
Case No. 2020 NY Slip Op 01871 [181 AD3d 1118]
Regular Panel Decision
Mar 16, 2020

Matter of Campos v. Federal Express Corp.

Claimant Monserrate Campos filed for workers' compensation benefits in 2014 due to neck and back injuries sustained as a tractor trailer driver. During independent medical examinations, it was revealed that he failed to disclose a prior work-related back injury from 2008, leading the self-insured employer to allege a violation of Workers' Compensation Law § 114-a. Initially, a Workers' Compensation Law Judge ruled that § 114-a did not apply, but a Board panel subsequently modified this decision, finding a violation and imposing a mandatory penalty. Claimant's application for reconsideration and/or full Board review of this decision was denied by the Workers' Compensation Board in May 2018. The Appellate Division, Third Department, affirmed the Board's denial of reconsideration, concluding that review was limited to whether the Board abused its discretion, as the merits of the underlying § 114-a violation were not properly appealed.

MisrepresentationPrior InjuryMandatory PenaltyBoard ReviewAbuse of DiscretionAppellate ReviewProcedural HistoryFactual FindingJudicial DiscretionMedical Disclosure
References
8
Case No. 2023 NY Slip Op 04168 [219 AD3d 1003]
Regular Panel Decision
Aug 03, 2023

Matter of Campos v. Performance Master, Inc.

Claimant Denis Campos, a construction worker, filed for workers' compensation benefits after falling from a ladder. A Workers' Compensation Law Judge (WCLJ) established the claim and put American Zurich Insurance Company on notice regarding a specific workers' compensation policy. American Zurich contested, arguing the policy was canceled or that other policies applied, but failed to provide evidence for the identified policy despite being directed to do so. The WCLJ determined the policy remained in effect, making American Zurich the liable carrier. The Workers' Compensation Board affirmed this decision, declining to consider new evidence submitted by American Zurich on administrative appeal, and subsequently denied their application for reconsideration. The Appellate Division affirmed the Board's decisions, finding no abuse of discretion in refusing new evidence or denying reconsideration.

Workers' Compensation BenefitsInsurance Coverage DisputePolicy CancellationAdministrative ReviewEvidence SubmissionAppellate DivisionWCLJ DecisionBoard AffirmationReconsideration DenialAbuse of Discretion
References
5
Case No. ADJ9919242
Regular
Apr 04, 2017

JAMES KIRCHER vs. CITY AND COUNTY OF SAN FRANCISCO, SAN FRANCISCO FIRE DEPARTMENT

The Workers' Compensation Appeals Board denied the City and County of San Francisco's petition for reconsideration. The Board affirmed the finding that a firefighter sustained an industrial injury to his heart and circulatory system when he experienced atrial arrhythmias during a mandatory work treadmill test. Although the Agreed Medical Examiner initially stated he wouldn't term the event an "injury," he later opined the arrhythmias were work-related and caused in part by job stress, leading to the applicant being taken off work. The Board concluded this constituted an injury under the Labor Code, resulting in temporary disability.

Atrial arrhythmiasTreadmill stress testAgreed Medical ExaminerWork mandated health checkIndustrial injuryTemporary disabilityPermanent disabilityOccupational medicineCardiologyLabor Code section 3208
References
0
Case No. MISSING
Regular Panel Decision

Campo v. New York City Employees' Retirement System

Helen Campo, widow of a former NYC Department of Sanitation employee, sued the City of New York and the New York City Employees’ Retirement System (NYCERS) after she was denied survivor's benefits following her husband's death. Her husband had retired on disability and allegedly selected a pension option providing survivor's benefits, but NYCERS claimed no such selection was received, defaulting him to a plan without these benefits. Campo contended she was deprived of a property right without due process, challenging the adequacy of NYCERS' administrative procedures and their refusal to grant her a hearing. The court, applying the Mathews v. Eldridge test, determined that a pre-deprivation hearing was not required for pension benefits and that existing post-deprivation state remedies, such as an Article 78 proceeding or breach of contract action, provided adequate due process. Consequently, the defendants' motion to dismiss was granted, and the plaintiff's motion for sanctions was denied.

Due processSurvivor benefitsPension rightsAdministrative lawMotion to dismissConstitutional lawFederal litigationRetirement systemProperty interestPost-deprivation remedies
References
10
Case No. ADJ9298777
Regular
Aug 14, 2017

JUAN FRANCISCO LARIOS vs. VALLEY FLEET CLEAN, SUSSEX INSURANCE, INTERCARE HOLDINGS INSURANCE SERVICES, INC.

The Workers' Compensation Appeals Board (WCAB) granted applicant Juan Francisco Larios' petition for reconsideration of a May 31, 2017 decision. This grant is to allow further study of the factual and legal issues involved to ensure a just decision. All future correspondence regarding the petition must be filed directly with the WCAB Commissioners in San Francisco and not through district offices or e-filing. The WCAB notes that trial-level documents unrelated to the reconsideration should still be filed as usual, but settlement documents require prompt notification to the Appeals Board.

Workers' Compensation Appeals BoardPetition for ReconsiderationGranting ReconsiderationDecision After ReconsiderationStatutory Time ConstraintsFactual and Legal IssuesJust and Reasoned DecisionOffice of the CommissionersElectronic Adjudication Management System (EAMS)Rules of the Administrative Director
References
0
Case No. MISSING
Regular Panel Decision

Campos v. Sarro

The case involves an appeal by New York Central Mutual Fire Insurance Company against orders from the Supreme Court, Nassau County, which denied its motion for summary judgment and mandated it to defend Dominico Sarro in a personal injury claim. The underlying action arose when Humberto Campos sued Dominico Sarro for personal injuries, prompting Sarro to file a third-party complaint against his homeowner's insurer for coverage. The appellate court affirmed the lower court's decision, determining that the insurer's disclaimers, based on policy exclusions regarding residency and business activities, were not issued in a timely manner. These disclaimers were raised too late, specifically 39 days after receiving crucial deposition testimony, despite the insurer having sufficient facts to disclaim earlier. Consequently, the insurer is obligated to defend and indemnify Sarro, and the case was remitted to the Supreme Court for formal judgment entry.

Insurance CoverageDeclaratory JudgmentSummary JudgmentTimely DisclaimerPolicy ExclusionHomeowner's InsurancePersonal InjuryAppellate ReviewDefense and IndemnificationWorkers' Compensation
References
6
Case No. ADJ8540632
Regular
Oct 15, 2013

FRANCISCO MEDINA vs. SCRIPPS HEALTH

The Workers' Compensation Appeals Board denied a petition for reconsideration in the case of Francisco Medina v. Scripps Health. The applicant alleged a psychiatric injury, but the employer successfully argued the defense of good faith personnel actions under Labor Code section 3208.3(h). The Board adopted the WCJ's findings, finding the employer's actions, including performance improvement forms and issues related to English proficiency, were lawful, non-discriminatory, and made in good faith to address job performance deficiencies. Credible employer testimony and evidence supported these findings, leading to the denial of the petition.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJGarza v. Workmen's Comp. Appeals Bd.psychiatric injurygood faith personnel actionslabor code section 3208.3(h)Rolda v Pitney Bowespredominant causelawful
References
4
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