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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 Scheib v. Milton Herman Management

Claimant, injured in the course of employment, received monetary awards. The employer's carrier, Cosmopolitan Mutual Insurance Company, became insolvent, leading to the State Superintendent of Insurance being appointed as liquidator. When the Superintendent defaulted on weekly payments, a penalty was imposed. The Workers’ Compensation Board affirmed this penalty, stating that carrier insolvency does not exempt liquidators from penalties. The court affirmed this decision, holding that the Superintendent assumes the same rights and duties as the insolvent carrier and is thus liable for late payment penalties from the Mutual Workers’ Compensation Security Fund.

Penalties for Late PaymentInsolvent Insurance CarrierSuperintendent of InsuranceLiquidator ResponsibilitiesMutual Workers’ Compensation Security FundStatutory InterpretationAppellate ReviewEmployer LiabilityCompensation Benefits
References
0
Case No. MISSING
Regular Panel Decision
Apr 02, 1985

Landi v. Carrier Corp.

The claimant, a 61-year-old brake press operator, suffered an acute back strain and aggravation of degenerative disc disease, leading to total disability for a period in 1982. He subsequently retired in February 1983, asserting his inability to perform even a light-duty inspector's job offered by his employer due to his ongoing partial disability. Initially, an Administrative Law Judge ruled that the claimant had voluntarily withdrawn from the labor market. However, the Workers’ Compensation Board reversed this decision, finding that the claimant's retirement was directly attributable to his continuing permanent partial disability, a finding supported by his doctor's reports and his own testimony. The employer and its carrier appealed the Board's decision, but the appellate court affirmed the Board's finding, concluding that it was supported by substantial evidence in the record.

Back StrainDegenerative Disc DiseaseTotal DisabilityPartial DisabilityVoluntary WithdrawalLabor MarketWorkers' Compensation BoardMedical EvidenceSubstantial EvidenceOrthopedist
References
3
Case No. MISSING
Regular Panel Decision

Claim of Nebenhaus v. Lydmark Corp.

The claimant, a butcher and president of Lydmark Corporation, allegedly suffered heart attacks and failed to file a timely notice of claim. The Workers’ Compensation Board excused this delay, citing prompt medical attention and no prejudice to the carrier. However, the employer and its carrier appealed. The court found that the carrier did not receive notice within the statutory 30 days, and the Board's finding of no prejudice was unsupported. The claimant had previously indicated no intent to file a compensation claim on disability forms, and the employer corporation disbanded, hindering the carrier's investigation. Consequently, the court reversed the Board's decision, with costs to the carrier against the Workers’ Compensation Board, and remitted the matter for further proceedings on the issue of prejudice.

Workers' Compensation LawNotice of ClaimTimely NoticePrejudice to CarrierHeart AttackEmployer's Report of InjuryEmployee's Claim FormDisability BenefitsCorporate OfficerAppellate Review
References
4
Case No. MISSING
Regular Panel Decision

Claim of Miller v. Arrow Carriers Corp.

This case involves a claimant who received workers' compensation benefits following a 1981 job-related motor vehicle accident. The employer's workers' compensation insurance carrier asserted a lien against the claimant's $100,000 third-party settlement and initially opposed its approval. The Supreme Court approved the settlement, distributing $30,000 to the carrier for its lien and $35,633 to the claimant. Subsequently, through a stipulation, the parties agreed to modify the order, with the carrier compromising its lien for $30,000 while explicitly reserving its right to offset future compensation obligations using the claimant's net recovery. Despite a Workers’ Compensation Law Judge finding the offset right preserved, the Workers’ Compensation Board later reversed this determination, prompting the current appeal. The court ultimately reversed the Board's decision, affirming the carrier's right to offset future compensation benefits, emphasizing that the carrier's explicit reservation during the settlement stipulation was valid under Workers' Compensation Law § 29 (4) and aligned with the legislative intent to prevent double recoveries.

Workers' CompensationThird-Party ActionSettlementLienOffset RightsStatutory InterpretationJudicial ApprovalWorkers’ Compensation Law § 29Double RecoveryStipulation
References
7
Case No. MISSING
Regular Panel Decision
Nov 14, 2000

Claim of Martin v. Levest Electric Corp.

The claimant, having suffered work-related injuries, pursued both workers' compensation benefits and a third-party personal injury action, which was subsequently settled. A contention arose concerning the workers' compensation carrier's entitlement to offset future benefits against the net settlement proceeds, as outlined in Workers' Compensation Law § 29. The Workers’ Compensation Board determined that the carrier had correctly preserved its right to this offset. On appeal, the claimant argued that the carrier had consented to the settlement, thereby waiving its offset right, and that a court possessed the authority to waive such a right. The appellate court upheld the Board's finding, concluding that there was no substantial evidence of carrier consent to the settlement, and reaffirmed that a court cannot override a carrier's explicit reservation of its offset rights.

Workers' CompensationThird-Party ActionSettlementOffset RightsCarrier ConsentFuture BenefitsJudicial ReviewAppellate DecisionBoard RulingReservation of Rights
References
4
Case No. ADJ1034828
Regular
Jan 19, 2000

KELLY JOLLY vs. INPUT 1; CIGA administered by its servicing facility CAMBRIDGE INTEGRATED SERVICES GROUP, INC. for FREMONT COMPENSATION INSURANCE COMPANY; In liquidation; GRANITE STATE INSURANCE COMPANY, by AIG; STATE COMPENSATION INSURANCE FUND; AMERICAN SAFETY CASUALTY, by GALALGHER BASSETT

The Workers' Compensation Appeals Board denied reconsideration in this case. The Board adopted the arbitrator's report, which explained their prior holding. This holding established that CIGA is entitled to pre-litigation benefits from an insolvent carrier but must remit those proceeds to the insolvent carrier's trustee. Therefore, the petition for reconsideration was denied.

CIGAReconsideration DeniedInsolvent CarrierTrusteePre-litigation BenefitsLiquidated Insurance CompanyServicing FacilityWorkers' Compensation Appeals BoardArbitrator ReportAdjudication
References
0
Case No. MISSING
Regular Panel Decision

Claim of Smith v. Specialty Services, Inc.

Claimant, a construction foreman for Specialty Services, Inc., was injured while performing work for a church in Pennsylvania. Although Specialty filed a work-related accident report and its carrier began paying benefits, the carrier filed a notice of controversy over seven months after the Workers' Compensation Board indexed the case, exceeding the 25-day limit. The carrier argued that the late filing was due to surprise, mistake, and newly discovered evidence regarding the church's involvement, which claimant and Specialty allegedly failed to disclose. The Workers' Compensation Board refused to excuse the late filing, finding the carrier failed to demonstrate good cause. The appellate court affirmed the Board's decision, noting that the carrier had ample time to investigate and that belatedly obtained evidence is not a sufficient ground to excuse a late filing.

Workers' CompensationLate Notice of ControversyTimely FilingEmployer-Employee RelationshipInsurance CarrierGood CausePleading BarAppellate ReviewBoard DecisionStatutory Interpretation
References
2
Case No. MISSING
Regular Panel Decision
Apr 12, 2001

Claim of Skippon v. T.M. Kenney's Inc.

The claimant appealed a Workers' Compensation Board decision which ruled that the employer’s workers’ compensation carrier timely raised a Workers’ Compensation Law § 28 defense. The claimant sustained work-related injuries in 1991, and a subsequent claim in 1999 for carpal tunnel syndrome, attributed to the 1991 accident, was challenged by the carrier. The Board concluded that the carrier's general statement of "all issues" at the initial hearing was sufficient to raise the statute of limitations defense. The appellate court affirmed the Board's decision, finding that the parties and the Workers’ Compensation Law Judge understood that the carrier's statement encompassed a timeliness objection.

Statute of LimitationsWorkers' Compensation BoardTimelinessCarpal Tunnel SyndromeWork-related InjuryPermanent Partial DisabilityConsequential InjuryDirect InjuryWorkers' Compensation Law Section 28Appeal
References
1
Case No. MISSING
Regular Panel Decision
Dec 27, 2004

McComber v. Lehrer McGovern Bovis, Inc.

This case involves an appeal of an order from the Supreme Court, New York County, which fixed a nonparty-appellant workers’ compensation carrier’s lien at $23,355.68. The original action was for personal injuries at a work site, resulting in a $14.5 million recovery for the plaintiff through a high-low settlement. The carrier had paid $228,605.18 in past compensation benefits and was assessed to have a present value of $387,143.30 in future compensation benefits that it would have paid. The appellate court affirmed the lower court's decision, which applied the Kelly formula to reduce the carrier's lien by its equitable share of litigation costs, encompassing both past and future benefits. The court also rejected the carrier's argument that the plaintiff violated Workers’ Compensation Law § 29 (5) by not obtaining consent for the settlement, clarifying that such consent is only required for settlements less than the statutory benefits, which was not the case here. Furthermore, any required judicial approval was deemed properly granted nunc pro tunc.

Lien ReductionKelly FormulaFuture Benefits ValuationHigh-Low SettlementJudicial DiscretionNunc Pro Tunc ApprovalWorkers' Compensation Law § 29 (5)Equitable ApportionmentSubrogation RightsPersonal Injury Recovery
References
7
Case No. MISSING
Regular Panel Decision

Claim of Soto v. Chemical Bank

This case concerns an appeal from a Workers' Compensation Board decision dated August 9, 1982. The claimant sustained a back injury in 1973. Initially, the Board ruled in 1981 that the claimant's disability was solely due to the 1973 accident, a decision the carrier did not appeal. Subsequently, the carrier attempted to litigate the application of Workers’ Compensation Law § 15(8). In its 1982 decision, the Board relieved the Special Funds Conservation Committee of any responsibility, leading to this appeal by the carrier. The carrier argued that the Special Funds had conceded liability in 1975. The court affirmed the Board's decision, stating that the unappealed 1981 decision on sole causation was final, thereby providing substantial evidence for the appealed 1982 decision.

Workers' CompensationApportionmentSpecial Disability FundPrior InjuryCausationDisability BenefitsAppellate ReviewFinality of DecisionConcession of LiabilitySubstantial Evidence
References
1
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