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Case Law Database

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

Case No. 2015-1243 K C
Regular Panel Decision
Feb 08, 2017

Acupuncture Healthcare Plaza I, P.C. v. Metlife Auto & Home

The case involves Acupuncture Healthcare Plaza I, P.C., as assignee of Boris Goldbaum, suing Metlife Auto & Home for first-party no-fault benefits. The defendant had paid a reduced sum, arguing the remaining amount exceeded the workers' compensation fee schedule and that one claim was subject to a policy deductible. During a nonjury trial, the parties stipulated to the plaintiff's prima facie case and timely denials. The defendant sought judicial notice of the workers' compensation fee schedule but failed to provide a witness to testify on its proper utilization or evidence for the deductible reduction. The Civil Court granted judgment to the plaintiff, which was subsequently affirmed by the Appellate Term, Second Department. The Appellate Term noted that while judicial notice of the fee schedule is permissible, the party seeking it must provide sufficient information and notice to the adverse party, and the fee schedule alone doesn't prove proper utilization of codes or reduction due to a deductible without supporting evidence.

No-fault insuranceMedical billing disputeAppellate reviewJudicial noticeBurden of proofFee schedule applicationPolicy deductibleAssigned claimsCivil procedureEvidence admissibility
References
5
Case No. 2019 NY Slip Op 02599 [171 AD3d 1277]
Regular Panel Decision
Apr 04, 2019

New York State Workers' Compensation Bd. v. A&T Healthcare, Inc.

The New York State Workers' Compensation Board assumed administration of the insolvent Healthcare Providers Self-Insurance Trust, which had a deficit of $132.5 million. The Board initiated an action to recover the deficit from former employer-members, including Motherly Love Home Care Services Inc., who were jointly and severally liable. Motherly Love Home Care Services Inc. executed two settlement agreements but subsequently moved to vacate them, claiming a unilateral mistake by believing they had only signed duplicate copies of one agreement. The Supreme Court denied this motion. The Appellate Division, Third Department, affirmed the Supreme Court's decision, finding no basis for vacating the agreements given their distinct terms and the clear clarifications provided by the Board's counsel.

Workers' Compensation TrustInsolvencySettlement AgreementVacate AgreementUnilateral MistakeJoint and Several LiabilityAppellate ReviewContract PrinciplesHome Health CareEmployer Liability
References
5
Case No. No. 95 Civ. 5338 (JGK)
Regular Panel Decision
Dec 11, 1995

Petition of Home Ins. Co.

The Home Insurance Company (Home) filed a petition to compel arbitration against Svedala Industries Inc. (Svedala) under the Federal Arbitration Act concerning disputed retrospective premiums. Svedala cross-moved to dismiss, arguing the dispute arose under an insurance policy without an arbitration clause and that Home had previously invoked federal jurisdiction in a Wisconsin action. The court clarified that only the Southern District of New York could compel arbitration, as specified in the agreement. The court granted Home's petition, concluding that the broad arbitration clause in the Retrospective Premium Agreement covered the dispute, and denied Svedala's cross-motion, thereby ordering the parties to proceed with arbitration.

ArbitrationFederal Arbitration ActRetrospective Premium AgreementWorkers Compensation PolicyMotion to Compel ArbitrationStay of ProceedingsFirst-Filed RuleContract InterpretationScope of Arbitration ClauseBad Faith Claim
References
15
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. MISSING
Regular Panel Decision

Coke v. Long Island Care at Home, Ltd.

Plaintiff Evelyn Coke, a former home healthcare attendant, sued her employers, Long Island Care At Home, Ltd. and Maryann Osborne, for unpaid minimum wages and overtime under the FLSA and New York Labor Law. Defendants moved for judgment on the pleadings, arguing that home healthcare workers like the plaintiff are exempt from FLSA's minimum wage and overtime requirements under DOL regulations 29 C.F.R. §§ 552.6 and 552.109(a) concerning 'companionship services.' The Court, acknowledging compelling arguments against the regulations but bound by strong deference to federal agencies, upheld the validity of these longstanding DOL regulations. Consequently, the Defendants' motion for judgment on the pleadings was granted, and Plaintiff's FLSA claims were dismissed. The Court also declined to exercise pendent jurisdiction over the state law claims, dismissing them without prejudice.

FLSA ExemptionCompanionship ServicesAgency EmployeesRegulatory ValidityChevron DeferenceStatutory InterpretationDomestic Service EmploymentMinimum Wage ClaimsOvertime ClaimsJudgment on Pleadings
References
32
Case No. MISSING
Regular Panel Decision

Diamond v. Reilly Homes Construction Corp.

Plaintiffs Dale A. Diamond and James Panek sustained injuries at a construction site in East Fishkill while assembling a modular home. The accident occurred when a suspended roof section, being hoisted to allow for 'knee wall' installation, fell on them due to bracket failure. Plaintiffs subsequently filed a claim under Labor Law § 240 (1) against defendants Reilly Homes Construction Corporation, Chelsea Homes, Inc., and Royal Crane, Inc. The Supreme Court initially denied plaintiffs' motion for partial summary judgment and granted summary judgment to Reilly Homes and Chelsea Homes, while also granting summary judgment to Royal Crane. The appellate court modified the orders, reversing the denials against Reilly Homes and Chelsea Homes and granting partial summary judgment to plaintiffs, but affirmed the summary judgment in favor of Royal Crane.

Labor Law § 240 (1)Construction Site AccidentFalling ObjectSummary JudgmentAppellate ReviewHoist ApparatusElevation DifferentialWorker SafetyContractor LiabilityStatutory Interpretation
References
6
Case No. MISSING
Regular Panel Decision
Oct 17, 2001

Vanderwerff v. Home

This case concerns an appeal by a plaintiff and defendant Otis Elevator, Inc., from an order of the Supreme Court, Westchester County. The order granted summary judgment to Victoria Home, dismissing the plaintiff's personal injury complaint against it, and also granted judgment dismissing Otis Elevator's cross claim. The Appellate Division affirmed the order, holding that the plaintiff, having received Workers’ Compensation benefits from her general employer, was a special employee of Victoria Home. Consequently, the plaintiff's action against Victoria Home was barred by the Workers’ Compensation Law. The court found that Victoria Home exclusively controlled the manner and details of the plaintiff's work while she was employed there, thus establishing a special employment relationship.

Personal InjuryWorkers' CompensationSpecial EmployerGeneral EmployerSummary JudgmentAppellate ReviewPremises LiabilityNegligenceTort LawNew York Law
References
6
Case No. MISSING
Regular Panel Decision

Mafia v. Creekview Homes Ltd.

The plaintiffs appealed an order from the Supreme Court, Dutchess County, which had granted summary judgment to the defendant Creekview Homes, Ltd., and dismissed the complaint against all defendants in a personal injury action. The appellate court found that Creekview Homes, Ltd. failed to demonstrate a prima facie entitlement to judgment as a matter of law. Affidavits submitted by Creekview Homes regarding the injured plaintiff's workers' compensation claim did not definitively rule out the accident occurring on their property. A triable issue of fact exists concerning the accident location. Therefore, the appellate court reversed the lower court's order and denied Creekview Homes' motion for summary judgment.

personal injurysummary judgmentappealDutchess Countypremises liabilityworkers' compensation claimprima facie showingtriable issue of factaccident locationappellate court
References
1
Case No. MISSING
Regular Panel Decision

Home Depot U.S.A., Inc. v. National Fire & Marine Insurance

Home Depot U.S.A., Inc., the general contractor, commenced an action against its subcontractor's insurer, National Fire & Marine Insurance Company, seeking a declaration of coverage. Home Depot, individually and as assignee of Westward Contracting, Inc., sought to compel National Fire to defend and indemnify it as an an additional insured in an underlying action, and to indemnify Westward. The Supreme Court denied Home Depot's discovery motion, granted National Fire summary judgment declaring Home Depot was not an additional insured, and denied National Fire's motion to dismiss Home Depot's claims as Westward's assignee for lack of standing and for summary judgment on the indemnification obligation to Westward. The appellate court affirmed the Supreme Court's order, finding Home Depot was not an additional insured and that the assignment to Home Depot was valid and did not relieve National Fire of its indemnification obligation to Westward.

Insurance CoverageAdditional InsuredIndemnificationSummary JudgmentStandingAssignment of ClaimsSubcontractor LiabilityGeneral ContractorCommercial General Liability PolicyAppellate Review
References
13
Case No. MISSING
Regular Panel Decision

In re Harmon Funeral Home, Inc.

Judge Mikoll dissents from a Workers' Compensation Board decision that found an employer-employee relationship between Harmon Funeral Home, Inc. and its pallbearers. The dissent argues that there is not substantial evidence to support this conclusion, citing a lack of control and direction by the funeral home over the pallbearers. Pallbearers are sourced from a livery service, not instructed by the funeral home, and receive no employee benefits. Although a union agreement designated pallbearers as employees, the dissent states this factor alone should not be determinative given the overall circumstances indicating an independent contractor relationship. The dissent concludes that the Board's decision should be reversed.

Employer-employee relationshipPallbearersIndependent contractorWorkers' compensationUnion agreementControl and directionLivery serviceDissentFuneral homeLabor law
References
1
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