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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

Claim of Evans v. Great Eastern Lumber Co.

This appeal concerns a Workers’ Compensation Board decision regarding a claimant’s schedule loss of use award following a work-related injury. The claimant, who later died from unrelated causes, suffered the amputation of fingers on his right hand. The Board awarded his widow a 40% schedule loss of use of the right hand, relying on a report from Dr. Lawrence Enisman, a plastic surgeon, despite a different assessment by a Board medical examiner. The Workers’ Compensation Law Judge had rejected Enisman’s report due to undisclosed qualifications. The appellate court affirmed the Board’s decision, holding that the Board is authorized to accept or reject medical evidence and assess expert qualifications, and that its resolution of conflicting medical evidence was supported by substantial evidence. The court also found no abuse of discretion in denying a further medical examination.

Schedule Loss of UseMedical Opinion ConflictAdministrative Agency DiscretionExpert Witness QualificationsWorkers' Compensation AppealDisability EvaluationHand Amputation InjurySubstantial Evidence ReviewLegal Residuum RuleAppellate Division Decision
References
7
Case No. MISSING
Regular Panel Decision

Claim of Albano v. Waldbaum's

In 1996, the claimant suffered a compensable injury to his right shoulder and neck. Thirteen years later, in January 2009, he claimed another work-related injury to his neck, right hand, and left leg. The Workers’ Compensation Board established a work-related neck injury from the 2009 incident and denied the employer's application for reconsideration, leading to this appeal. The employer argued that its request to cross-examine the claimant’s physicians was wrongly denied because their initial reports lacked reference to the 2009 accident. The court, however, found that this issue was thoroughly addressed at the hearing, and the physicians' reports, despite the omission, were consistent with the claimant's testimony. Crucially, experts, including the employer's own orthopedic surgeon, concluded that the injuries were causally related to the January 2009 incident. Consequently, the Board's decision to deny the cross-examination request was affirmed.

Workers' CompensationShoulder InjuryNeck InjuryRight Hand InjuryLeft Leg InjuryMedical ReportsCross-ExaminationCausationSpecial Fund for Reopened CasesAppellate Division
References
3
Case No. 2023 NY Slip Op 23398 [81 Misc 3d 21]
Regular Panel Decision
Nov 30, 2023

Associated Plastic Surgeons & Consultants, P.C. v. Global Commodities, Inc.

Plaintiff, Associated Plastic Surgeons & Consultants, P.C., filed a commercial claims action against Global Commodities, Inc. for $5,000 for unpaid medical services provided to an alleged employee. Plaintiff claimed defendant agreed to pay privately. The District Court dismissed the action after excluding a document detailing telephone conversations, which plaintiff argued was admissible under the business records exception or relaxed commercial claims evidence rules. The Appellate Term affirmed the dismissal, ruling that plaintiff failed to prove the patient was injured during employment or that the document was admissible as a business record, thus failing to establish defendant's liability for the medical bill. The court emphasized that while commercial claims courts are not bound by strict evidence rules, judgments cannot rest solely on hearsay.

Commercial claimsMedical servicesUnpaid billsBusiness records exceptionHearsayEvidence rulesEmploymentWorkers' Compensation LawAppellate reviewSubstantial justice
References
10
Case No. MISSING
Regular Panel Decision
Jan 27, 1965

Rivera v. Hellman

This case involves a motion to confirm a Special Referee's report concerning the amounts and priorities of various liens. The Special Referee conducted a hearing and reported on claims from an attorney for the plaintiff ($793.50), Roosevelt Hospital ($846.53), and the Millinery Health Fund ($641.00, later adjusted to $528). The report established the amounts of each lien and recommended priorities, placing the attorney's lien first, followed by the hospital lien (except for a $12 outpatient service), and then the compensation lien. The court concurred with the Special Referee's report and recommendations, granting the motion to confirm.

Lien PriorityAttorney's LienHospital LienDisability BenefitsWorkmen's Compensation LawSpecial Referee ReportMotion GrantedNew York Supreme CourtLien LawMotion Practice
References
2
Case No. MISSING
Regular Panel Decision

Colindres v. Carpenito

Plaintiff Rochelle Colindres sought a protective order to deny defendants' demand for a medical report from her former treating psychologist, Diane Henry, or alternatively, relief from compliance with Uniform Rules for Trial Courts § 202.17(b)(1). Colindres argued that the defendants waived their right to the report as the independent medical examination (IME) already occurred, and that obtaining the report would be an undue hardship since Henry ceased treatment due to Colindres' attendance issues. Defendants Mario Carpenito, Jr., City of White Plains, and White Plains Parking Department opposed, asserting that the report was necessary to clarify alleged injuries, prepare for cross-examination, and facilitate settlement, highlighting Colindres' complex medical history predating the incident. The court denied both branches of Colindres' motion, finding that the rule applies broadly to personal injury actions, defendants did not waive their entitlement, and Colindres failed to prove it was impossible to obtain the report. The court ordered Colindres to exchange a compliant medical report from Diane Henry by March 27, 2017.

protective ordermedical report disclosurediscovery disputepsychological treatmentindependent medical examinationCPLR 310322 NYCRR 202.17waiver of discoveryundue hardshippersonal injury damages
References
12
Case No. MISSING
Regular Panel Decision

Chaplin v. Pathmark Supermarkets

This case addresses a motion by defendants, including Supermarkets General Corp., for a protective order to vacate the plaintiff Mimi Chaplin's notice for discovery and inspection of accident reports. Mimi Chaplin sought these reports after sustaining personal injuries from a fall at the defendant's premises. The court, presided over by Justice James F. Niehoff, analyzed the newly enacted CPLR 3101 (g), which mandates full disclosure of accident reports prepared in the regular course of business. The court found that the accident report in question was prepared in Supermarkets General Corp.'s regular course of business, rendering it discoverable regardless of its potential use in litigation, thus denying the defendants' motion.

DiscoveryProtective OrderAccident ReportsCPLR 3101(g)Litigation PreparationRegular Course of BusinessPersonal InjuryNegligenceDisclosureEvidence
References
10
Case No. ADJ2135528 (VNO 0550980)
Regular
May 22, 2015

NUREN KARTAL vs. THREE HANDS CORPORATION, OAK RIVER INSURANCE COMPANY, BERKSHIRE HATHAWAY HOMESTATE COMPANIES

This case involves a petition for reconsideration filed by the defendants, Three Hands Corporation and Oak River Insurance Company. The Workers' Compensation Appeals Board (WCAB) has dismissed the petition. This dismissal is based on the WCJ's report, which found the petition moot because the WCJ issued a corrected award superseding the original one. Therefore, the WCAB adopted the WCJ's reasoning and dismissed the reconsideration.

Petition for ReconsiderationWorkers' Compensation Appeals BoardWCJ reportmootSecond Amended Supplemental FindingsFirst Amended Joint FindingsApplicantDefendantInsurance CompanyAdministrative Law Judge
References
0
Case No. MISSING
Regular Panel Decision

Claim of Quail v. Central New York Psychiatric Center

Claimant appealed a Workers' Compensation Board decision that awarded a 10% schedule loss of use of the right hand. The WCB's decision was based on a September 1998 report from the carrier's consultant, which found a 10% loss. The claimant's treating physician had reportedly found a 20% loss in a July 1998 report, but this report was not properly filed. Despite multiple directives to submit a final medical report from the treating physician, claimant failed to do so before the WCLJ's decision. After the WCLJ's ruling, claimant submitted a newly prepared report from his treating physician indicating a 20% loss. The Board declined to consider this new evidence, citing its discretion to refuse evidence that could have been presented earlier. The appellate court affirmed the Board's decision, finding no abuse of discretion in their refusal to consider the late evidence.

Schedule Loss of UseRight Hand InjuryMedical EvidenceAppellate ReviewBoard DiscretionFailure to Submit EvidenceTreating Physician ReportCarrier Consultant ReportProcedural IssuesPermanency Determination
References
2
Case No. SAL SJO 252436 (MF); SJO 246192
Regular
Jul 02, 2007

NIHAL HORDAGODA vs. State Compensation Insurance Fund

This case involves an employer's petition for reconsideration of an order authorizing medical treatment and admitting the Qualified Medical Examiner's (QME) reports. The employer argued the QME reports were inadmissible due to an alleged ex parte communication between the applicant and the QME, and that the awarded treatments were improper. The report recommends denying the petition, finding the communication was permissible under LC § 4062.3(h) and that the QME's opinions and awarded treatments for chronic pain were reasonable and not governed by ACOEM guidelines.

Workers' Compensation Appeals BoardPetition for ReconsiderationQualified Medical EvaluatorLabor Code Section 4062.3Ophthalmological evaluationFunctional capacity evaluationUtilization ReviewACOEM GuidelinesChronic spinal conditionTreating physician
References
0
Case No. ADJ532181 (SFO 0438716) ADJ250509 (SFO 0242560) ADJ6545137
Regular
Nov 14, 2014

MICHAEL THOMAS, vs. SAFEWAY STORES, INC. Permissibly Self-Insured,

This case involved an applicant seeking treatment from a highly specialized surgeon, Dr. Matsen, located in Seattle, for a complex shoulder revision. The original decision denied authorization for Dr. Matsen, deeming Seattle outside a reasonable geographic area, and excluded a crucial report from the applicant's treating physician, Dr. Osborn. The Appeals Board granted reconsideration, admitting Dr. Osborn's report, which strongly supported Dr. Matsen's expertise and the inadequacy of local Bay Area surgeons for this complex case. Based on the applicant's medical history and the availability of specialized treatment, the Board reversed the original decision, finding Dr. Matsen to be within a reasonable geographic area.

Workers' Compensation Appeals BoardReasonable geographic areaTreating surgeonAdministrative Director Rule 9780Labor Code section 4600Orthopedic surgeonTotal shoulder replacementRevision surgeryMedical historyPhysician competency
References
1
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