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

Case No. 2018 NY Slip Op 08737
Regular Panel Decision
Dec 20, 2018

NYAHSA Servs., Inc., Self-Insurance Trust v. Recco Home Care Servs., Inc.

This case concerns an appeal from an order of the Supreme Court in Albany County. Plaintiff NYAHSA Services, Inc., Self-Insurance Trust, a self-insured trust providing workers' compensation coverage, sued defendant Recco Home Care Services, Inc. for unpaid adjustments after the defendant terminated its membership. Following an amendment to the complaint adding individual trustees as plaintiffs, the defendant asserted counterclaims for fraud, breach of fiduciary duty, and negligence against these trustees, which the Supreme Court dismissed as time-barred. The defendant also sought to amend its answer to include a counterclaim under General Business Law, which was denied. The Appellate Division, Third Department, found that the Supreme Court erred in dismissing the counterclaims for fraud and breach of fiduciary duty and in denying the cross-motion to amend for the General Business Law claim. Consequently, the Appellate Division modified the Supreme Court's order, reversing parts of the dismissal and denial, and affirmed the order as modified.

Workers' Compensation CoverageSelf-Insurance TrustFraud AllegationsBreach of Fiduciary DutyGeneral Business LawStatute of LimitationsAmended PleadingsCounterclaimsAppellate ReviewMotion to Dismiss
References
2
Case No. MISSING
Regular Panel Decision

NYAHSA Servs., Inc., Self-Insurance Trust v. People Care Inc.

This case involves an appeal from an order of the Supreme Court, which granted the plaintiff's motions for leave to amend complaints. The plaintiff, a group self-insured trust, initiated collection actions against former member employers, People Care Incorporated and Recco Home Care Services, Inc., for unpaid workers' compensation adjustment bills. The plaintiff sought to add its trustees as party plaintiffs and to update allegations to include subsequently accrued unpaid bills. The appellate court affirmed the Supreme Court's decision, clarifying that an evidentiary showing of merit is not required for leave to amend pleadings under CPLR 3025 (b) unless there is prejudice, surprise, palpable insufficiency, or patent lack of merit. The court found no such grounds for denial and also rejected the defendants' statute of limitations arguments, affirming that for contracts requiring continuing performance, each breach can restart the limitations period.

Workers' Compensation CoverageSelf-Insured TrustBreach of ContractUnjust EnrichmentPleading AmendmentCPLR 3025 (b)Statute of LimitationsPrejudiceAppellate ReviewSupreme Court Order
References
18
Case No. 2023 NY Slip Op 01170
Regular Panel Decision
Mar 07, 2023

Teshabaeva v. Family Home Care Servs. of Brooklyn & Queens, Inc.

Maktumma Teshabaeva and Jian Hua Deng, former home health aids, initiated a wage-and-hour class action against Family Home Care Services of Brooklyn and Queens, Inc., alleging underpayment for 24-hour shifts and overtime. Defendants sought to compel arbitration based on a 2015 memorandum of agreement (MOA) with the plaintiffs' union, which established a mandatory alternative dispute resolution procedure. The Supreme Court initially denied the defendants' motion to compel, ruling the MOA did not apply to plaintiffs who terminated employment before its effective date. After a federal court confirmed an arbitration interim award, defendants moved to renew their arbitration motion, which the Supreme Court denied, also granting plaintiffs legal fees for opposing the motion. Separately, the Supreme Court granted plaintiffs' motion to strike defendants' answer due to persistent discovery non-compliance. The Appellate Division, First Department, affirmed both Supreme Court orders, finding the federal court's confirmation did not constitute new facts for renewal, and reiterated that lower federal court decisions are not binding precedent in state courts. The court also upheld the sanctions against defendants for frivolous conduct and their willful failure to comply with discovery demands.

Wage-and-hour disputeLabor Law claimsBreach of contractClass actionArbitrationAlternative Dispute Resolution (ADR)Motion to renewDiscovery sanctionsFrivolous conductRes judicata
References
15
Case No. 2025 NY Slip Op 06107 [243 AD3d 986]
Regular Panel Decision
Nov 06, 2025

Matter of Dunkez Private Home Care, Inc. v. McDonald

The case involves Dunkez Private Home Care, Inc., a licensed home care services agency, challenging the Commissioner of Health's determination to revoke its license and impose a monetary penalty. The revocation stemmed from multiple deficiencies found during DOH surveys in 2019 and 2021, a substantiated patient complaint, and the agency's failure to comply with a temporary suspension order. The Appellate Division, Third Department, confirmed the Commissioner's determination, finding it supported by substantial evidence. The Court also found the penalty, license revocation and a monetary fine, was not disproportionate or shocking to one's sense of fairness, considering the serious danger posed to vulnerable patients.

Home Care Services AgencyLicense RevocationAdministrative LawJudicial ReviewSubstantial EvidenceDepartment of HealthCPLR Article 78Monetary PenaltyTemporary Suspension OrderPatient Care Deficiencies
References
12
Case No. No. 11, No. 12
Regular Panel Decision
Mar 26, 2019

Lilya Andryeyeva v. New York Health Care , Adriana Moreno v. Future Care Health Services

The New York Court of Appeals addressed a common issue in two joint appeals: whether home health care aides on 24-hour shifts must be paid for each hour. The Department of Labor (DOL) interpreted its Wage Order (12 NYCRR part 142) to allow payment for at least 13 hours if the employee receives at least 8 hours for sleep (with 5 uninterrupted) and 3 hours for meals. The Appellate Division rejected this, but the Court of Appeals reversed, deferring to DOL's interpretation as rational and consistent with the Wage Order's plain language. The cases were remitted for lower courts to evaluate class certification issues in accordance with DOL's interpretation.

Home Health Care24-Hour ShiftsMinimum Wage ActWage OrderDepartment of Labor InterpretationClass CertificationAppellate ReviewLabor Law ViolationsSleep BreaksMeal Breaks
References
49
Case No. ADJ10954204
Regular
Sep 15, 2022

MARIA FLORES vs. PINNACLE HEALTH CORP., SUMMARY OF EVIDENCE INSURANCE COMPANY OF THE WEST, AFFINITY HOME HEALTH CARE SERVICES, FALLS LAKE FIRE & CASUALTY INSURANCE, SEDGWICK CMS, HOME HEALTH CARE SOLUTIONS, INC.

The Workers' Compensation Appeals Board denied a petition for reconsideration filed by Home Health Care Solutions. The applicant, an LVN, was injured in a car accident while traveling between patients for multiple agencies. The Board adopted the WCJ's report, which found the injury arose out of and occurred in the course of employment for Home Health Care Solutions. This decision was based on the fact that the applicant was required to use her own vehicle, which extended the employer-employee relationship beyond direct service. The WCJ also found the going and coming rule did not bar the claim due to the required use of transportation between patient locations.

Workers' Compensation Appeals BoardPetition for ReconsiderationGoing and Coming RuleAOE/COELVNCar AccidentAutomobile ExceptionTransitEmployment RelationshipRequired Vehicle Use
References
6
Case No. MISSING
Regular Panel Decision
Feb 24, 1988

Settlement Home Care, Inc. v. Industrial Board of Appeals of the Department of Labor

Four related CPLR article 78 proceedings were brought by nonmunicipal petitioners (Settlement Home Care, Inc., Christian Community in Action, Inc., and CABS Home Attendants Service, Inc.) along with the City of New York and the Human Resources Administration, challenging determinations by the Industrial Board of Appeals of the Department of Labor. The determinations affirmed that the Commissioner of Labor had jurisdiction to issue labor violation notices against the nonmunicipal petitioners for failing to meet minimum wage requirements for sleep-in home attendants. The core issue was whether these home attendants were exempt from the State Minimum Wage Act under Labor Law § 651 (5) (a) as 'companions.' The court confirmed the board's finding that the attendants were not exempt because the clients were not considered employers, the principal purpose of the attendants was not companionship, and their principal duties included housekeeping. Consequently, the court confirmed the Industrial Board of Appeals' determinations and dismissed the proceedings on the merits.

Minimum Wage ActHome AttendantsLabor Law ExemptionCPLR Article 78Industrial Board of AppealsSleep-in EmployeesEmployer DefinitionCompanionship ExemptionHousekeeping DutiesAgency Determination Review
References
4
Case No. MISSING
Regular Panel Decision

Claim of Enriquez v. Home Lawn Care & Landscaping, Inc.

The claimant filed for workers' compensation benefits after sustaining an injury from falling off a ladder while working for Home Lawn Care and Landscaping, Inc. A Workers' Compensation Law Judge initially determined an employer-employee relationship existed and that the injury arose out of and in the course of employment. The Workers' Compensation Board affirmed these findings and found Home Lawn Care had violated Workers’ Compensation Law § 25 (2) (b) due to an untimely notice of controversy. Home Lawn Care appealed. The appellate court agreed that the Board erred in finding a violation of Workers’ Compensation Law § 25 (2) (b) but upheld the Board's determination of an employer-employee relationship and that the injury arose from employment, thus modifying and affirming the Board's decisions.

Workers' CompensationEmployer-Employee RelationshipScope of EmploymentAccidental InjuryNotice of ControversySubstantial EvidenceCredibility DeterminationAppellate ReviewLadder FallGutter Cleaning
References
12
Case No. 2022 NY Slip Op 00289
Regular Panel Decision
Jan 18, 2022

Matter of Personal-Touch Home Care of N.Y., Inc. v. City of N.Y. Human Resources Admin.

The Appellate Division affirmed the Supreme Court's judgment, which denied a petition to overturn a decision by the Office of Administrative Trials and Hearings Contract Dispute Resolution Board (CDRB). The CDRB had found that Personal-Touch Home Care's claim to use unspent Medicaid funds for fiscal year 2007 to offset workers' compensation assessment expenses from 2009-2010 was foreclosed. The court agreed that the State Department of Health (DOH) rationally interpreted its regulations, concluding that these retroactive assessments, levied due to financial mismanagement of a self-insurance trust, were not

Workers' CompensationMedicaid FundsSelf-Insurance TrustFiscal YearRetroactive AssessmentAdministrative LawAgency DeferenceContract DisputeHealth Care AgenciesFinancial Mismanagement
References
4
Case No. MISSING
Regular Panel Decision

Franzese v. United Health Care/Oxford

Plaintiffs Robert and Elizabeth Franzese, parents and legal guardians of disabled adult Robert Franzese Jr. ("Bobby"), sued United Health Care/Oxford under ERISA to recover medical benefits. Bobby, suffering from chronic lung disease, requires 24/7 in-home nursing care. Oxford denied preauthorization for private duty nursing, citing it as an exclusion, and denied home health care services. The court granted Oxford's summary judgment motion regarding private duty nursing and Xopenex preauthorization, finding private duty nursing not covered. However, the court denied Oxford's motion regarding home health care services, deeming Oxford's denial arbitrary and capricious due to lack of substantial evidence. The case is remanded to Oxford for reconsideration of home health care benefits.

Employee Retirement Income Security Act (ERISA)Medical BenefitsHealth Insurance DenialSummary JudgmentArbitrary and Capricious StandardHome Health CarePrivate Duty NursingPreauthorizationMedical NecessityChronic Lung Disease
References
37
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