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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
Dec 30, 2015

Matter of Curcio v. Sherwood 370 Management LLC

The claimant, a building engineer, sustained a work-related back and neck injury, initially classified as a permanent total disability by a Workers' Compensation Law Judge (WCLJ) with awarded counsel fees. The Workers' Compensation Board (Board) modified this, finding a permanent partial disability with a 90% loss of wage-earning capacity and reduced counsel fees due to an improperly completed application. The appellate court affirmed the Board's decision, citing substantial medical evidence supporting a partial disability and a 90% loss of wage-earning capacity based on the claimant's age, education, work history, and functional abilities. The court also upheld the reduction of counsel fees due to the attorney's failure to accurately complete the required fee application form.

Permanent Partial DisabilityWage-Earning Capacity LossWorkers' Compensation BenefitsCounsel FeesMedical EvidenceVocational FactorsOC-400.1 ApplicationAdministrative AppealAppellate DivisionMedical Impairment Guidelines
References
12
Case No. MISSING
Regular Panel Decision

Guttierez v. Berryhill

Betsy Lee Guttierez applied for disability insurance benefits and Supplemental Security Income, alleging disability due to various mental health impairments. Her applications were denied by an Administrative Law Judge and the Appeals Council. Guttierez sought judicial review, arguing that the ALJ failed to properly assess her residual functional capacity (RFC) by rejecting the only medical opinion on her mental ability to work without providing adequate reasons or a function-by-function analysis. The Court agreed, finding the ALJ's RFC assessment unsupported by substantial evidence, as the ALJ, a non-medical professional, made a determination of Guttierez's mental capacity without relying on a medical opinion. Consequently, the Court granted Guttierez's motion, denied the Commissioner's motion, and remanded the case for further administrative proceedings.

Social Security ActDisability BenefitsSSIALJ Decision ReviewRFC AssessmentMedical EvidenceMental Health ImpairmentsBipolar DisorderAnxiety DisorderTreating Physician Rule
References
13
Case No. MISSING
Regular Panel Decision

Ortiz Torres v. Colvin

Luz Leida Ortiz Torres appealed the denial of her Supplemental Security Income (SSI) benefits by the Commissioner of the Social Security Administration. The District Court found that the Administrative Law Judge (ALJ) improperly discounted the treating physician's opinion regarding Ortiz's physical limitations based on a conservative treatment regimen. Consequently, the court vacated the Commissioner's decision in part and remanded the case for a more comprehensive physical residual functional capacity assessment. However, the court affirmed the ALJ's findings on Ortiz's mental residual functional capacity and credibility, deeming them supported by substantial evidence.

Supplemental Security Income (SSI)Disability BenefitsSocial Security Administration (SSA)Residual Functional Capacity (RFC)Degenerative Disc DiseaseDepressionMedical-Vocational Guidelines (Grid)Treating Physician RuleCredibility DeterminationRemand Order
References
26
Case No. MISSING
Regular Panel Decision
Dec 31, 2015

Drake v. SRC, Inc.

The claimant appealed a Workers’ Compensation Board decision from December 31, 2015, which ruled he sustained a permanent partial disability and a 15% loss of wage-earning capacity after a December 2010 work injury. The claimant argued for a 32% loss of wage-earning capacity, which would extend benefit duration, based on post-injury wages. The court affirmed the Board's decision, distinguishing between calculating loss of wage-earning capacity for benefit duration based on vocational factors and wage-earning capacity based on actual earnings. It found substantial evidence supported the 15% loss of wage-earning capacity, considering the claimant's functional abilities, impairment severity, age, education, and language proficiency.

Permanent Partial DisabilityLoss of Wage-Earning CapacityWorkers' Compensation BenefitsVocational FactorsAppellate ReviewSubstantial EvidenceBenefit DurationWork InjuryNeck InjuryBack Injury
References
10
Case No. MISSING
Regular Panel Decision

Matter of Williams v. Preferred Meal Systems

Claimant, a driver, suffered injuries to his right knee and back in 2009 while making a delivery, leading to an established workers' compensation claim. The claim was later amended to include consequential adjustment disorder, and the Workers' Compensation Board ultimately found that claimant had sustained a permanent total disability from May 2012 onward. The employer, workers’ compensation carrier, and policy administrator appealed this decision, arguing that further proof was needed regarding claimant's vocational and functional capacity. The court affirmed the Board's decision, holding that extensive evidence of vocational and functional capacity is not required when medical proof demonstrates a permanent total disability and inability to engage in any gainful employment, as benefits continue for life in such cases. The court found substantial evidence in the opinions of treating and independent medical examination orthopedists to support the finding of permanent total disability.

Workers' CompensationPermanent Total DisabilityWage-Earning CapacityMedical ProofVocational CapacityFunctional CapacityAppellate ReviewNew York LawDisability BenefitsClaimant Rights
References
4
Case No. MISSING
Regular Panel Decision
Jun 22, 2015

Claim of Barrett v. New York City Department of Transportation

The case involves an appeal from a Workers’ Compensation Board decision regarding a claimant injured in a 2011 work-related motor vehicle accident. A WCLJ classified the claimant with a permanent partial disability and a 25% loss of wage-earning capacity, ruling that he would be entitled to 250 weeks of benefits if his full wages ceased. The Board affirmed this, leading the employer to appeal, arguing that the claimant's current full wages meant a 100% wage-earning capacity, rendering the 25% loss finding unlawful. The court affirmed the Board’s decision, distinguishing between 'loss of wage-earning capacity' (fixed, for benefit duration) and 'wage-earning capacity' (fluctuating, for weekly rates).

Workers' CompensationPermanent Partial DisabilityWage-Earning CapacityLoss of Wage-Earning CapacityBenefit DurationAppellate ReviewStatutory InterpretationMotor Vehicle AccidentNew York Workers' Compensation BoardDisability Classification
References
2
Case No. MISSING
Regular Panel Decision

Matter of Smith v. New York City Housing Authority

The Workers’ Compensation Board initially ruled that the claimant sustained a permanent partial disability with a 90% loss of wage-earning capacity and awarded $4,300 in counsel fees. Upon review, the Board modified the decision, reducing the loss of wage-earning capacity to 60% and counsel fees to $3,400. This appeal addresses the reduction in wage-earning capacity and counsel fees. The court affirmed the Board's determination of a 60% loss of wage-earning capacity, finding it supported by substantial evidence including medical testimony from Dr. Alan Zimmerman, functional abilities, age, education, and work experience. However, the court reversed the reduction in counsel fees, remitting the matter to the Board for further findings due to the lack of rationale for the modification.

Permanent Partial DisabilityWage-Earning CapacityCounsel FeesWorkers' Compensation LawMedical ImpairmentOrthopedic SurgeonLumbar Spine InjuryLeft Ankle InjurySchedule Loss of UseAppellate Review
References
8
Case No. MISSING
Regular Panel Decision

Homestead Village Assoc., L.P. v. Diamond State Insurance

Plaintiff Homestead Village Associates, LP sued its insurers, Diamond State Insurance Company and Chubb Insurance Company of New Jersey, seeking a declaratory judgment regarding their duty to defend and indemnify Homestead in a personal injury action. Homestead also sued its insurance broker, Capacity Coverage Company of New Jersey, for breach of contract and negligence due to late notification of the accident. All parties cross-moved for summary judgment. The court granted Diamond's motion, finding Homestead's 16-month delay in notification unreasonable. Chubb's motion was granted in part and denied in part, as the court found late notice from Homestead, but a factual dispute remained regarding Chubb's timely disclaimer. The court also clarified that Chubb's excess policy would not 'drop down' to cover primary obligations and it had no duty to defend. Homestead's and Capacity's cross-motions for summary judgment were denied, with factual disputes remaining regarding a special relationship and Capacity's knowledge of the accident's seriousness.

Insurance Coverage DisputeDeclaratory JudgmentSummary Judgment MotionLate Notice DefenseExcess Insurance PolicyInsurance Broker LiabilityBreach of ContractNegligence ClaimChoice of LawNew York Insurance Law
References
41
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. 2017 NY Slip Op 04343
Regular Panel Decision
Jun 01, 2017

Claim of Villalobos v. RNC Industries LLC

The claimant sustained a work-related injury in 2012 after falling from a ladder, affecting his head, neck, and back. A Workers' Compensation Law Judge initially determined a 73.5% loss of wage-earning capacity and found the claimant had reattached to the labor market. However, the Workers' Compensation Board subsequently reversed this decision, concluding that the claimant was not attached to the labor market and reduced his loss of wage-earning capacity to 40%. On appeal, the Appellate Division, Third Department, affirmed the Board's decision, deferring to its assessment of the claimant's credibility regarding his job search efforts. The court also found substantial evidence supported the 40% loss of wage-earning capacity, considering the independent medical examiner's report, claimant's functional abilities, age, work history, education, and language proficiency.

Workers' CompensationLoss of Wage-Earning CapacityAttachment to Labor MarketPermanent Partial DisabilityMedical ImpairmentCredibility AssessmentSubstantial EvidenceAppellate ReviewVocational RehabilitationJob Search
References
8
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