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

Case No. 2019 NY Slip Op 05756 [175 AD3d 134]
Regular Panel Decision
Jul 23, 2019

Matter of People Care Inc. v. City of New York Human Resources Admin.

The New York Appellate Division, First Department, affirmed the Supreme Court's decision, which annulled the Human Resources Administration's (HRA) demand to recoup approximately $7 million in Health Care Reform Act (HCRA) funds from People Care Incorporated. The core issue was whether HRA possessed the authority to audit and recover these HCRA funds, established as a distinct Medicaid reimbursement program for worker recruitment and retention, from personal care service providers. The Court found that neither Public Health Law § 2807-v (1) (bb) nor the Memorandum of Understanding between the Department of Health (DOH) and HRA delegated such auditing and recoupment powers to HRA. It rejected HRA's arguments that HCRA funds were merely a subset of general Medicaid funds subject to its existing contractual audit authority, or that DOH's actions constituted ratification of HRA's authority. Consequently, the Court upheld the injunction preventing HRA from recouping the disputed HCRA funds from People Care.

Administrative LawMedicaid ReimbursementAuditing AuthorityStatutory ConstructionInter-agency AgreementsHealthcare Reform ActPersonal Care ServicesGovernment ContractsCPLR Article 78Delegation of Power
References
8
Case No. 2017 NY Slip Op 04184 [150 AD3d 1589]
Regular Panel Decision
May 25, 2017

New York State Workers' Compensation Board v. Program Risk Management, Inc.

The New York State Workers' Compensation Board, acting as administrator and successor to the Community Residence Insurance Savings Plan, initiated legal action against various entities and individuals after the trust became severely underfunded. Defendants include Program Risk Management, Inc. (administrator), PRM Claims Services, Inc. (claims administrator), individual officers of PRM, the Board of Trustees, and Thomas Gosdeck (trust counsel). The plaintiff sought damages for claims such as breach of contract, breach of fiduciary duty, and legal malpractice. The Supreme Court's order partially dismissed some claims and denied others. On cross-appeal, the Appellate Division, Third Department, modified the Supreme Court's order, notably reversing the dismissal of several breach of fiduciary duty claims and common-law indemnification against PRMCS, while affirming denials of motions to dismiss breach of contract, legal malpractice, and unjust enrichment claims. The court's decision was influenced by recent rulings in State of N.Y. Workers' Compensation Bd. v Wang.

Workers' Compensation LawGroup Self-Insured TrustBreach of ContractBreach of Fiduciary DutyLegal MalpracticeUnjust EnrichmentStatute of LimitationsEquitable EstoppelAlter Ego LiabilityCommon-Law Indemnification
References
20
Case No. 2017 NY Slip Op 27428
Regular Panel Decision
Dec 14, 2017

New York State Workers' Compensation Bd. v. Compensation Risk Mgrs., LLC

This action was brought by the New York State Workers' Compensation Board (WCB), as an assignee of former members of the Healthcare Industry Trust of New York (HITNY), against Compensation Risk Managers, LLC (CRM), HITNY trustees, and auditing firm UHY LLP. The WCB alleged mismanagement, breach of fiduciary duty, and negligent auditing, leading to the Trust's insolvency. Defendants moved to dismiss on grounds of standing, statute of limitations, and pleading particularity. The court dismissed certain derivative claims and negligent misrepresentation claims against some trustees due to standing issues and statute of limitations. All claims against UHY LLP were dismissed for lack of a near-privity relationship or prior precedent. An implied indemnity claim against the trustees was sustained. The WCB's cross-motion to consolidate related actions was denied.

Workers' Compensation LawGroup Self-Insured Trust (GSIT)Fiduciary DutyNegligenceNegligent MisrepresentationStatute of LimitationsStandingDerivative ActionImplied IndemnityAuditing Firm Liability
References
46
Case No. MISSING
Regular Panel Decision
Jul 26, 2000

AIU Insurance v. Unicover Managers, Inc.

This case involves plaintiff insurance companies, AIG, seeking a declaration that defendant ReliaStar Life Insurance Company was bound to reinsure AIG for certain workers' compensation risks based on reinsurance slips signed by Unicover Managers, Inc., ReliaStar's managing general underwriter. The Supreme Court, New York County, dismissed AIG's complaint against ReliaStar and Unicover, and ReliaStar's third-party complaint against E.W. Blanch Company. The appellate court affirmed the dismissal, finding that the parties' correspondence and conduct established that reinsurance would only be bound upon ReliaStar's own signature, negating any actual or apparent authority of Unicover or ratification by ReliaStar. Estoppel and misrepresentation claims against both defendants were also dismissed. The judgment was modified to explicitly dismiss all remaining cross claims and counterclaims, and the initial dismissal was otherwise affirmed.

Reinsurance AgreementSummary JudgmentContract InterpretationAgency AuthorityApparent AuthorityRatificationEstoppelMisrepresentationWorkers' Compensation RisksCross Claims
References
3
Case No. MISSING
Regular Panel Decision

Uddin v. City of New York

Jamal Uddin, an employee of the New York City Human Resources Administration (HRA), filed a lawsuit against the City of New York, HRA, Director Janice Scott, and Supervisor Roy Francis, alleging retaliation. Uddin claimed the defendants retaliated against him for a prior discrimination lawsuit (Uddin I) by preparing false disciplinary charges, denying him resources like a working telephone, denying promotional opportunities, and unlawfully removing his name from a civil service list. The defendants moved for summary judgment, arguing they lacked knowledge of Uddin's protected activity and that Uddin did not suffer adverse employment actions. The court ultimately granted the defendants' motion for summary judgment, dismissing Uddin's complaint, finding he failed to establish a prima facie case of retaliation.

RetaliationEmployment DiscriminationSummary JudgmentTitle VIISection 1983New York State Executive LawNew York City Human Rights LawAdverse Employment ActionCausationProtected Activity
References
47
Case No. 2019 NY Slip Op 05365
Regular Panel Decision
Jul 03, 2019

Matter of Jones v. Human Resources Admin.

Claimant Laverne Jones appealed a Workers' Compensation Board decision denying her application for administrative review. Jones, a fraud investigator, had sustained work-related injuries and sought to amend her claim for additional consequential injuries, which a WCLJ disallowed. Her counsel's application for Board review was rejected for not being completely filled out, specifically missing information for question 13. The Appellate Division, Third Department, affirmed the Board's decision, ruling that the Board acted within its discretion by enforcing its procedural rules requiring complete applications, citing its broad regulatory powers under the Workers' Compensation Law.

Administrative Review DenialProcedural Non-ComplianceWorkers' Compensation ClaimAppellate Division Third DepartmentBoard Rules EnforcementApplication for Review (Form RB-89)Completeness DoctrineDiscretionary AuthorityWork Injury BenefitsConsequential Injury Claim
References
10
Case No. MISSING
Regular Panel Decision

North Shore University Hospital v. State Human Rights Appeal Board

This proceeding involved a review of an order from the State Human Rights Appeal Board, which affirmed a finding by the State Division of Human Rights that the petitioners had discriminated against complainant Essie Morris. The discrimination stemmed from the petitioners' failure to accommodate Morris's observance of the Sabbath and her subsequent employment termination, violating Executive Law § 296(10). The court found substantial evidence supporting the Division's finding that petitioners improperly placed the burden on Morris to find assignment swaps. It emphasized an employer's affirmative duty to reasonably accommodate religious beliefs. The petitioners also failed to demonstrate exemption from Executive Law § 296(10) under paragraphs (b) and (c). Consequently, the order was confirmed, and the petitioners' appeal was dismissed.

Religious DiscriminationSabbath ObservanceEmployment TerminationReasonable AccommodationExecutive Law § 296State Human Rights LawEmployer ResponsibilitySubstantial Evidence ReviewJudicial Review of Administrative OrderPetition Dismissal
References
3
Case No. MISSING
Regular Panel Decision

Gold-Greenberger v. Human Resources Administration

The petitioner, a candidate for a local school board, was denied access by the Human Resources Administration (HRA) to a homeless shelter to solicit signatures for his nominating petition. The Supreme Court, Kings County, initially granted the petitioner access, ruling that restricting signature solicitation while allowing voter registration would cause no additional disruption. However, the appellate court reversed this judgment, categorizing the homeless shelter as a 'nonpublic forum.' The court concluded that HRA's denial of access for political campaigning was a reasonable restriction, consistent with the shelter's purpose of providing temporary residential care and services, and protected the privacy interests of residents. The court noted that the petitioner could still campaign outside the shelter.

First AmendmentPublic ForumNonpublic ForumFreedom of SpeechHomeless ShelterPolitical CampaigningVoter RegistrationAccess RestrictionGovernment PropertyMootness Exception
References
18
Case No. ADJ158605 (RIV 0028842)
Regular
Nov 14, 2008

CHARLES WEBSTER vs. COUNTY OF RIVERSIDE RISK MANAGEMENT

The Workers' Compensation Appeals Board denied Charles Webster's petition for reconsideration in his case against County of Riverside Risk Management. The Board adopted the findings and reasoning of the workers' compensation administrative law judge in their decision. This order formally denies Webster's request to have the case reconsidered.

Workers' Compensation Appeals BoardOrder Denying ReconsiderationWCJ ReportPetition for ReconsiderationTapia v. Skill Masters StaffingAppeals Board en bancADJ158605RIV 0028842County of Riverside Risk ManagementCharles Webster
References
1
Case No. MISSING
Regular Panel Decision

Rothstein v. Brezenoff

This CPLR article 78 proceeding seeks to challenge a determination by the Human Resources Administration (HRA) to dismiss petitioner Officer Rothstein for using excessive force. The incident involved Officer Rothstein jabbing a client, Floyd Hendricks, with a nightstick after being bitten during an altercation at the Waverly Income Maintenance Center. The hearing officer initially recommended dismissal of charges, but the HRA commissioner ultimately found Rothstein guilty and upheld the dismissal. The dissenting opinion argues that the commissioner's determination was not based on substantial evidence and that the penalty of dismissal for a single infraction, after seven years of unblemished service, was disproportionate.

CPLR Article 78Disciplinary HearingExcessive ForcePolice MisconductAdministrative ReviewHuman Resources AdministrationDismissal PenaltySubstantial EvidenceDisproportionate PunishmentDissenting Opinion
References
2
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