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

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. 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
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. 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. MISSING
Regular Panel Decision

Concerned Home Care Providers, Inc. v. State

The case concerns a challenge by home care service agencies and a trade association (petitioners) to New York's Wage Parity Law (Public Health Law § 3614-c). This law conditions Medicaid reimbursement for home health care services in the metropolitan New York area on agencies paying home care aides a minimum wage, determined by reference to New York City's Living Wage Law. Petitioners argued the law was unconstitutional due to improper delegation of legislative authority, violation of the "incorporation by reference" clause, and violation of home rule provisions. They also challenged the Department of Health's (DOH) interpretation of "total compensation." The Supreme Court granted summary judgment to the respondents (DOH), and the appellate court affirmed, finding no improper delegation, no violation of the incorporation by reference clause, home rule provisions inapplicable as Medicaid is a state concern, and DOH's interpretation of "total compensation" to be rational.

Wage Parity LawHome Health Care ServicesMedicaid ReimbursementConstitutional LawLegislative AuthorityNew York City Living Wage LawHome RuleDue ProcessDepartment of HealthStatutory Interpretation
References
27
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

Hypolite v. Health Care Services of New York Inc.

The plaintiff, Allison Hypolite, on behalf of a putative class of home health aides, moved for conditional certification and notice to a proposed class under the FLSA. The defendants, HCS Healthcare and Agnes Shemia, opposed and moved to strike portions of the plaintiff's reply. The court denied the motion to strike. The court granted conditional certification for the period between January 1, 2015, and October 13, 2015, finding that the defendants failed to comply with revised FLSA regulations concerning the Home Health Aide Exemption during this time. However, the motion was denied for the period before January 1, 2015, as the plaintiff did not sufficiently demonstrate that other potential opt-in plaintiffs were similarly situated, given the fact-specific nature of the prior exemption rules. The plaintiff's request to extend the notice period to six years for state law claims was also denied.

FLSAConditional CertificationCollective ActionHome Health AidesOvertime PayWage and HourThird Party EmployerCompanionship Services ExemptionDepartment of Labor RegulationsRetroactive Effect
References
36
Case No. 2020 NY Slip Op 02696 [183 AD3d 983]
Regular Panel Decision
May 07, 2020

Matter of Zuniga v. Aliah Home Care Inc.

Zulma Zuniga, a home health care aide, filed a workers' compensation claim listing Aliah Home Care Inc. as her employer. A Workers' Compensation Law Judge (WCLJ) found Aliah to be Zuniga's employer and 100% liable for awards. Aliah later filed an application with the Workers' Compensation Board seeking review, asserting that Zuniga was actually employed by County Agency. The Board denied Aliah's application as untimely, as it was filed well beyond the 30-day window. Aliah's subsequent request for reconsideration was also denied. The Appellate Division, Third Department, affirmed the Board's decision, finding no abuse of discretion in denying the untimely application for review.

Workers' CompensationTimelinessApplication for ReviewAdministrative DiscretionEmployer LiabilityPermanent Partial DisabilityHome Health CareAppellate ReviewUntimely FilingBoard Decision
References
5
Case No. 2020 NY Slip Op 04473 [186 AD3d 594]
Regular Panel Decision
Aug 12, 2020

Moreno v. Future Health Care Servs., Inc.

The Appellate Division, Second Department, affirmed the denial of class certification for a putative class action brought by former home health care aides against Future Health Care Services, Inc. Plaintiffs alleged violations of Labor Law article 19, specifically concerning minimum wage payments for 24-hour shifts. The court, upon remittitur from the Court of Appeals, considered the Department of Labor's interpretation of Minimum Wage Order Number 11, which permits exclusion of up to 11 hours for sleep and meal breaks in 24-hour shifts. Consequently, the plaintiffs failed to demonstrate commonality, as they did not allege a lack of prescribed breaks or provide sufficient evidentiary basis for systemwide wage violations, thus failing to meet the requirements of CPLR article 9. Therefore, the Supreme Court's decision to deny class certification was upheld.

Class ActionLabor LawMinimum Wage24-hour ShiftsHome Health Care AidesClass CertificationWage OrderAppellate ReviewJudicial InterpretationNew York Department of Labor
References
7
Case No. MISSING
Regular Panel Decision

League of Voluntary Hospitals & Homes v. Local 1199, Drug, Hospital & Health Care Workers Union

The court addresses an application for a preliminary injunction against Local 1199, a union planning a three-day strike. The League of Voluntary Hospitals and Homes of N. Y. sought the injunction following a previous temporary restraining order concerning a one-day strike. The union argued that each planned strike required a new legal proceeding, but the court deemed the strikes "episodic and organically connected." Citing concerns about blocked ingress/egress to hospitals and the union president's threats to "shut down" facilities, the judge found a preliminary injunction necessary under Labor Law § 807 to protect public health and safety. The injunction restrains the union from unlawfully interfering with hospital operations, blocking access, and picketing within certain distances of hospital entrances and emergency rooms.

Labor DisputePreliminary InjunctionStrike ActionUnion ActivityHospital AccessPicketing RegulationsCollective BargainingCivil Disobedience ThreatPublic Health and SafetyIngress Egress Interference
References
1
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