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Case Law Database

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

Case No. MISSING
Regular Panel Decision
Feb 22, 1984

Barnhardt v. Hudson Valley District Council of Carpenters Benefit Funds

The plaintiff, injured in May 1978 during maintenance work, was denied workers' compensation due to the absence of an employer-employee relationship. Subsequently, he sought reimbursement for medical expenses from the Hudson Valley District Council of Carpenters Benefit Funds (Benefit Funds) through a union insurance policy. Continental Assurance Company (Continental), Benefit Funds' insurer, rejected the claim, citing an employment-related injury exclusion in the policy. The plaintiff then initiated an action against Benefit Funds, which in turn filed a third-party action against Continental seeking indemnification. Continental's motion for summary judgment, asserting the exclusion, was denied by the County Court. The appellate court affirmed this denial, ruling that the exclusionary language was ambiguous and applied only in cases where a clear employer-employee relationship existed, a fact still to be determined.

Insurance Policy InterpretationEmployment StatusWorkers' Compensation ExclusionSummary Judgment MotionContractual AmbiguityGroup Health InsuranceMedical Expense ReimbursementThird-Party ActionAppellate ReviewEmployer-Employee Relationship
References
10
Case No. MISSING
Regular Panel Decision

Cook v. Pension Benefit Guarantee Corp.

The Trustees of the Local 852 General Warehouseman’s Union Pension Fund sued the Pension Benefit Guarantee Corporation (PBGC) seeking reimbursement for pension benefits paid to retirees of two closed warehouses. The Fund argued for recovery based on equitable estoppel, asserting detrimental reliance on an initial PBGC determination that it would guarantee these benefits. The PBGC moved for summary judgment, contending that estoppel against a federal agency requires a showing of affirmative misconduct or manifest injustice. The Court found no evidence of affirmative misconduct by the PBGC and concluded that its change in determination, made to conform with Congressional intent, did not constitute manifest injustice. Consequently, the Court granted the PBGC's motion for summary judgment, ruling that equitable estoppel was inapplicable.

Equitable EstoppelFederal Agency EstoppelSummary JudgmentERISAPension BenefitsMulti-employer PlanPension Benefit Guarantee Corporation (PBGC)Affirmative MisconductManifest InjusticeDetrimental Reliance
References
10
Case No. MISSING
Regular Panel Decision

Jeffries v. Pension Trust Fund of the Pension, Hospitalization & Benefit Plan of the Electrical Industry

Plaintiff Claude Jeffries, a retired electrician, sued the Pension Trust Fund of the Electrical Industry under ERISA, seeking to include pension credits from 1969-1975 in his current benefits. He alleged the Plan should have declared a partial termination during a 1975-1979 New York recession, which would have vested his benefits. The defendant moved to dismiss the complaint, arguing lack of standing and statute of limitations, while plaintiff moved for class certification for similarly affected members. The court denied the defendant's motion to dismiss the claim for benefits, finding it timely, but granted dismissal for the breach of fiduciary duty claim as time-barred. The plaintiff's motion for class certification was denied due to insufficient evidence for numerosity, with leave to refile after discovery.

ERISAPension BenefitsClass CertificationMotion to DismissStatute of LimitationsFiduciary DutyPartial TerminationBenefit ForfeitureUnemploymentLabor Union
References
15
Case No. ADJ10387978
Regular
Aug 13, 2019

MELE LATU vs. HEWLETT PACKARD ENTERPRISE SERVICES, SUBSEQUENT INJURIES BENEFITS TRUST FUND

This case involves a denied petition for reconsideration regarding Subsequent Injuries Benefits Trust Fund (SIBTF) benefits. The applicant settled her industrial injury claim for $937,166, then sought SIBTF benefits. The Board denied the petition because the applicant failed to prove a pre-existing "labor disabling" condition, which is a requirement for SIBTF eligibility even after statutory changes. Medical evidence indicated the applicant was asymptomatic and functional prior to her industrial injury, and any apportionment was to asymptomatic pathology, not a labor-disabling condition.

Subsequent Injuries Benefits Trust FundSIBTFLabor Code section 4751labor disablingpermanent partial disabilityapportionmentSenate Bill 899SB 899asymptomatic pathologyEscobedo v. Marshalls
References
2
Case No. MISSING
Regular Panel Decision

Di Guida v. McCall

Petitioner, a food service worker, sought accidental and ordinary disability retirement benefits after being injured in a fall on milk crates while leaving work. Respondent denied the application for accidental disability benefits, finding the petitioner was not "in service" at the time of the injury, a determination upheld by the court based on substantial evidence and the resolution of a credibility issue. The denial of ordinary disability benefits was also affirmed, supported by a physician's report that found no significant neck or shoulder injury or functional disability. Consequently, the determination was confirmed, and the petition dismissed.

accidental disabilityordinary disabilityretirement benefitsfood service workerfall injuryin servicecredibilitymedical examinationfunctional disabilityCPLR article 78
References
2
Case No. MISSING
Regular Panel Decision
Jan 15, 1988

Pension Benefit Guaranty Corp. v. LTV Corp.

David H. Miller and William W. Shaffer ("Miller and Shaffer") moved to intervene individually and as representatives of participants in the Jones & Laughlin Retirement Plan in an action filed by the Pension Benefit Guaranty Corporation (PBGC) against LTV Corporation and LTV Steel Company ("LTV"). LTV did not object to individual intervention but opposed class action intervention, arguing it would delay the PBGC action. The court granted the motion, allowing Miller and Shaffer to intervene both individually and as class representatives. The decision emphasized that Miller and Shaffer met the minimal burden of showing that PBGC's representation might be inadequate, as their interests, seeking full plan benefits, could diverge from PBGC's role as plan administrator. This opinion allows the class action to proceed under Rule 23(e), preventing dismissal or compromise without court approval.

InterventionERISAPension PlansBankruptcyClass ActionRule 24Rule 23(e)Adequate RepresentationPlan TerminationRestoration
References
6
Case No. 2021 NY Slip Op 04070
Regular Panel Decision
Jun 24, 2021

Matter of Cisnero v. Independent Livery Driver Benefit Fund

Claimant Jeffrey Cisnero, an independent livery driver, sustained injuries when he was shot during a dispatch. He filed a claim for workers' compensation benefits, which was initially disallowed by a WCLJ but later reversed by the Workers' Compensation Board, finding coverage through the Independent Livery Driver Benefit Fund (ILDBF). The carrier appealed, arguing misinterpretation of the relevant statutes, particularly Executive Law § 160-ddd (1). The Appellate Division, Third Department, affirmed the Board's decision, determining that Cisnero's injuries arose out of and in the course of providing covered services as an independent livery driver dispatched by an ILDBF member. The court found that the vehicle's attenuated affiliation with the New York Black Car Operators' Injury Compensation Fund, Inc. did not alter ILDBF's liability.

Workers' CompensationLivery DriverIndependent ContractorBenefit FundAccidental InjuryCourse of EmploymentStatutory InterpretationExecutive LawWorkers' Compensation LawAppellate Review
References
3
Case No. ADJ1220987 (SJO 0262634)
Regular
Nov 17, 2010

RICHARD GILLISPIE vs. PLASTECH, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Subsequent Injuries Benefits Trust Fund (SIBTF) appealed an award of benefits to an applicant with a pre-existing disability, arguing a subsequent industrial back injury did not cause pathology in the opposite leg as required by statute. The Appeals Board affirmed the award, finding that Labor Code section 4751 only requires the subsequent injury to "affect" the opposite member, not necessarily cause direct pathology. Evidence showed the applicant's low back injury caused verified radiculopathy and impaired leg function, meeting the statutory requirement. The Board found SIBTF's legal arguments unpersuasive and the WCJ's findings supported by substantial evidence.

Subsequent Injuries Benefits Trust FundLabor Code section 4751industrial injurylow backradiculopathypermanent disabilityopposite and corresponding memberpathologyAMA GuidesDRE category III
References
2
Case No. MISSING
Regular Panel Decision
Jun 27, 2013

Karabinas v. Colvin

Dimitrios N. Karabinas challenged the Commissioner of Social Security's denial of his Disability Insurance Benefits application, arguing the Administrative Law Judge (ALJ) committed several legal errors. The court identified flaws in the ALJ's Residual Functional Capacity (RFC) assessment, including failure to accommodate Karabinas's moderate difficulties in concentration, persistence, and pace, and an incomplete function-by-function analysis of his work abilities. Furthermore, the court found the ALJ improperly weighed medical opinions, specifically downplaying the detailed report from Karabinas's chiropractor, and based its credibility determination on a circular logic. Concluding that the ALJ's errors led to an unsupported denial of benefits, the District Court reversed the Commissioner's decision. The case was remanded for the sole purpose of calculating and providing benefits to Karabinas for the specified period.

Disability Insurance BenefitsSocial Security ActRFC AssessmentMedical OpinionCredibility AssessmentVocational ExpertCervical Disc ProblemsPain ManagementChiropractic TreatmentWork Limitations
References
34
Case No. MISSING
Regular Panel Decision
May 18, 2000

Ertner v. County of Chenango

Petitioner, a correction officer employed by the Chenango County Sheriff's Department, sustained injuries after falling downstairs while inspecting cells at the County Jail. She was awarded workers' compensation benefits but subsequently denied General Municipal Law § 207-c benefits, with the denial based on the injury not being incurred during a job function "peculiar to a correction officer." Petitioner's challenge to this determination was dismissed by the Supreme Court. On appeal, the Court affirmed the dismissal, distinguishing between Workers' Compensation Law and General Municipal Law § 207-c, stating the latter applies to injuries incurred from "heightened risks and duties" peculiar to specialized employment, which a fall down stairs is not considered.

Correction Officer InjuryGeneral Municipal LawWorkers CompensationPublic Safety Officer BenefitsLine of DutyHeightened RiskJob FunctionAppellate DecisionMunicipal EmployeeInjury Classification
References
1
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