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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

Employers Insurance v. General Accident, Fire & Life Assurance Corp.

Employers Insurance of Wausau (Wausau) sought summary judgment for 50% reimbursement of a $500,000 settlement and defense costs. The settlement stemmed from an underlying personal injury action where Frank Rayno, an employee of Sage Garage, was injured on a construction site in 1976. Wausau provided workers' compensation and employer's liability insurance to Sage Garage, while General Accident provided general liability coverage. Wausau paid the full settlement and then pursued General Accident for contribution. General Accident argued for a pro rata contribution based on policy limits. The court granted Wausau's motion for summary judgment, ruling that both insurers should contribute equally up to the limit of the smaller policy, which was General Accident's $500,000 policy, meaning General Accident owed $250,000. The defendants' cross-motion was denied.

Insurance disputeSummary judgmentDeclaratory judgmentContribution among insurersReimbursementPolicy limitsEmployer's liability insuranceGeneral liability insuranceWorkers' compensationPro rata contribution
References
0
Case No. MISSING
Regular Panel Decision

Claim of Lauritano v. Consolidated Edison Co.

This case involves an appeal from a Workers’ Compensation Board decision regarding the transfer of liability to the Special Fund for Reopened Cases under Workers’ Compensation Law § 25-a. The claimant suffered a work-related heart attack in 1992, received benefits, and the case was closed in 1997. After another heart attack and surgery in 1999, the claim was reopened in 2001. A Workers’ Compensation Law Judge initially found it was not a stale claim, but the Board reversed, transferring liability to the Special Fund. The Special Fund argued that employer payments for lost time in 1999-2000 constituted advance payments of compensation, precluding transfer. However, the court affirmed the Board's determination that these payments, made pursuant to a general sick leave plan, did not qualify as advance payments of compensation under § 25-a, thus supporting the transfer of liability to the Special Fund.

Special Fund for Reopened CasesWorkers' Compensation Law Section 25-aStale Claim DoctrineAdvance Payments of CompensationSick Leave BenefitsLiability TransferHeart Attack InjuryReopened CaseAppellate Review of Board DecisionSubstantial Evidence Standard
References
4
Case No. MISSING
Regular Panel Decision

Claim of Smallwood v. Mereda Realty Corp.

This case involves an appeal from a Workers' Compensation Board decision concerning the employment relationship of a building superintendent, the claimant, who sustained injuries. The Board determined that the claimant was both a general employee of Pueblo Nuevo Associates, the building owner, and a special employee of Mereda Realty Corporation, the managing company, holding both entities 50% liable for the claim. The claimant appealed this determination, specifically contesting the employment relationship with Pueblo Nuevo Associates. The appellate court affirmed the Board's decision, concluding that there was substantial evidence in the record to support the finding of a general employment relationship with Pueblo Nuevo Associates, even though other evidence could have supported a different conclusion.

Employment RelationshipGeneral EmployeeSpecial EmployeeDual EmploymentEmployer LiabilitySubstantial EvidenceAppellate ReviewWorkers' Compensation Board DecisionBuilding SuperintendentRent-free Apartment
References
11
Case No. MISSING
Regular Panel Decision

Faison v. City of New York Department of Human Resources

The case concerns an appeal from decisions of the Workers’ Compensation Board regarding liability for a claimant’s reopened case. The claimant sustained a permanent partial disability in 1991 and her case was closed in 1993. In 2001, she applied to reopen it. A Workers’ Compensation Law Judge and subsequently a Board panel found that the employer voluntarily made advance payments of compensation within three years of the application, thereby making the employer, not the Special Fund for Reopened Cases, liable for disability payments. The employer appealed this decision. The appellate court examined whether the employer's payment of wages, deducted from sick leave, constituted an 'advance payment of compensation' with an acknowledgment of liability. The court found that wages paid from sick leave are not advance payments of compensation, and there was no substantial evidence that the employer’s payments were made voluntarily in recognition of continuing liability. Therefore, the Board's decision was reversed, and liability was transferred to the Special Fund for Reopened Cases.

Permanent Partial DisabilityReopened CaseAdvance Payments of CompensationSick LeaveEmployer LiabilitySpecial Fund for Reopened CasesWorkers' Compensation Law § 25-aAppellate ReviewSubstantial EvidenceRemittitur
References
8
Case No. MISSING
Regular Panel Decision

Claim of Martin v. New York Telephone

This case concerns an appeal from a Workers' Compensation Board decision regarding the liability for benefits. The claimant sustained a left knee injury in 1987 and a reinjury in 1995. A 1998 Section 32 settlement agreement released the employer from future claims for a lump sum, but required it to cover medical treatment. In 2004, the claimant developed a consequential right knee injury. The Workers' Compensation Board ultimately shifted liability for benefits to the Special Fund for Reopened Cases under Workers' Compensation Law § 25-a, citing the passage of statutory timeframes. The Special Fund appealed, challenging its statutory liability and the employer's ongoing responsibility for medical expenses per the settlement. The appellate court affirmed the Board's decision, upholding the applicability of Section 25-a and noting the employer's statutory obligation for medical treatment.

Workers' Compensation Law § 25-aSpecial Fund for Reopened CasesSection 32 Settlement AgreementConsequential InjuryMedical Treatment LiabilityStatutory LiabilitySchedule Loss of UseAppellate ReviewTimelinessBoard Review
References
4
Case No. MISSING
Regular Panel Decision

the Claim of Brigandi v. Town & Country Linoleum & Carpet

This case involves an appeal by an employer and its compensation carrier against decisions made by the Workers’ Compensation Board. The decedent, a carpet layer, died from cardiac arrest during work, with an autopsy revealing underlying coronary atherosclerotic disease. His widow was awarded death benefits. The employer’s carrier sought reimbursement from the Special Disability Fund under Workers’ Compensation Law § 15 (8), asserting a preexisting permanent physical impairment. However, the Board determined that there was no evidence that the decedent’s heart condition hindered his job potential before his death, thus releasing the Special Disability Fund from liability and holding the compensation carrier responsible. The employer's subsequent application for reconsideration was denied by the Board, leading to these appeals. The appellate court affirmed the Board's decisions, concluding that the Board rationally found no proof that the decedent's heart disease impaired his job potential, a necessary condition for reimbursement under WCL § 15 (8) (d).

Special Disability FundPreexisting Permanent ImpairmentCardiac ArrestCoronary Atherosclerotic DiseaseDeath Benefits ClaimEmployer ReimbursementCarrier LiabilityBoard Decision ReviewAppellate AffirmationMedical Evidence Interpretation
References
2
Case No. MISSING
Regular Panel Decision

Claim of Fuentes v. New York City Housing Authority

This case concerns an appeal by the Special Fund for Reopened Cases from a Workers’ Compensation Board decision dated November 15, 2006. The Board had transferred liability for a claimant's 1998 work-related back injury to the Special Fund, pursuant to Workers’ Compensation Law § 25-a. The Special Fund argued that certain payments made to the claimant in late 2005, between November 30 and December 17, were advance payments of compensation, which would preclude the transfer of liability. However, the Board found that these payments were charged to the claimant's accumulated sick leave and did not constitute advance payments of compensation. The court affirmed the Board's finding, concluding that the sick leave payments did not prevent the transfer of liability to the Special Fund because they were not made voluntarily in recognition of employer liability, and thus, the criteria for transferring liability to the Special Fund were met.

Special Fund for Reopened CasesWorkers' Compensation Law Section 25-aAdvance Payments of CompensationSick Leave PlanLiability TransferStale ClaimApplication to Reopen ClaimWork-Related InjuryBack InjuryTreating Physician Report
References
7
Case No. MISSING
Regular Panel Decision
Nov 24, 2008

Claim of Clark v. Suny Upstate Medical Center

Claimant injured her back in 1994, leading to a closed case in 1997. Following further work-related injuries in 2001 and 2003, the 1994 claim was reopened in 2004 to address apportionment of liability. The Workers’ Compensation Board determined that the Special Fund for Reopened Cases should assume liability for the 1994 claim under Workers’ Compensation Law § 25-a, a decision which the Special Fund appealed. The Appellate Division affirmed the Board’s decision, finding that the statutory time limits for shifting liability to the Special Fund (more than seven years after injury and more than three years after last payment) were satisfied. The court rejected the Special Fund's contention that the employer's carrier voluntarily paid benefits for the 1994 claim, noting that the carrier had raised the issue of Special Fund liability.

Workers' Compensation LawSpecial Fund for Reopened CasesLiability shiftingCase reopeningApportionmentStatutory time limitsVoluntary paymentsAppellate reviewBack injuryMedical opinion
References
6
Case No. MISSING
Regular Panel Decision
May 24, 1995

Claim of Shoemaker v. Manpower, Inc.

The case concerns an appeal from a Workers' Compensation Board decision regarding the employment status of a claimant who was injured while working at Westwood Pharmaceuticals. The claimant was generally employed by Manpower, Inc., a temporary employee supplier. Westwood contended that it was the claimant's special employer, limiting her remedy to workers' compensation. The Board initially found that Westwood's control was insufficient to establish a special employment relationship, ruling Manpower as the sole employer. Both Westwood and Manpower appealed this decision. The Appellate Division reversed the Board's findings, concluding that the evidence demonstrated Westwood exercised exclusive control and supervision over the claimant's activities, thereby establishing a special employment relationship. The matter was remitted to the Board for further proceedings consistent with this Court's decision.

Special EmploymentTemporary EmployeeWorkers' CompensationEmployer LiabilityControl TestDual EmploymentAppellate ReviewRemittalSubstantial EvidencePersonal Injury
References
8
Case No. MISSING
Regular Panel Decision

Loblaw, Inc. v. Employers' Liability Assurance Corp.

Loblaw, Inc., a self-insured retail chain, sued its excess insurer, Employers’ Liability Assurance Corporation, for reimbursement under a workers’ compensation policy. The dispute centered on whether Loblaw timely notified Employers’ of an employee's escalating injury claim. Loblaw initially believed the claim would not exceed its $25,000 self-retention, delaying notice until June 1972, despite warnings from its agent and mounting costs. The Supreme Court, Erie County, initially sided with Loblaw, but the Appellate Division reversed, ruling Loblaw had an ongoing obligation to notify the insurer and was derelict by May 1969. This court affirmed the Appellate Division's dismissal of Loblaw's complaint, holding that the notice given in June 1972 was too late as a matter of law, given the claim had exceeded $21,000 by December 1970.

Insurance policy interpretationWorkers' compensationExcess insuranceNotice provisionSelf-insurerTimely noticeAppellate reviewContract constructionObjective standardSubjective judgment
References
22
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