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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

Matter of Strujan v. New York Hospital

The case involves appeals from decisions of the Workers’ Compensation Board regarding a claimant's 1997 work-related injury. A claim for consequential psychiatric injuries was denied in 2010, and the employer sought to transfer liability to the Special Fund for Reopened Cases under Workers’ Compensation Law § 25-a. While a WCLJ initially granted this transfer, the Board reversed, concluding the case was not 'truly closed' due to unresolved issues, including the claimant's alleged migraines. The court affirmed the Board's decision, finding substantial evidence to support that the case was not truly closed, thereby preventing the shift of liability to the Special Fund.

Workers' CompensationSpecial FundReopened CasesTrue ClosureLiability ShiftMigrainesPsychiatric InjuryConsequential InjuryBoard DecisionAppellate Review
References
9
Case No. MISSING
Regular Panel Decision
Jul 15, 1998

Claim of Baldo v. Daily News

This case involves an appeal from a Workers' Compensation Board decision setting the date of disablement for claimant Joseph Baldo, a former newspaper pressman who suffered from work-related lung cancer, as July 29, 1992. Baldo's widow filed for death benefits after his passing in 1994, leading to a dispute between workers' compensation carriers over liability. The appealing carrier contended that the disablement date should be earlier, citing diagnoses in 1990 or 1991. However, the court affirmed the Board's decision, emphasizing the Board's discretion in selecting a disablement date and finding no medical evidence to establish disability prior to July 29, 1992, even though earlier diagnoses existed.

Workers' Compensation LawLung CancerDate of DisablementAppellate ReviewSubstantial EvidenceCarrier ResponsibilityOccupational DiseaseMedical EvidenceClaimant DisabilityBoard Discretion
References
3
Case No. MISSING
Regular Panel Decision
Jul 22, 2002

Claim of Ostuni v. Town of Ramapo

Claimant appealed from a decision of the Workers’ Compensation Board, filed July 22, 2002, which denied her application for reconsideration and/or full Board review of a prior decision. The prior decision had ruled that claimant did not sustain a work-related injury, citing insufficient credible evidence. The appellate court affirmed the Board's denial, finding that the Board fully considered all evidence and no new, previously unavailable evidence was offered to warrant altering its decision. Furthermore, the court found substantial evidence supported the Board’s September 2001 decision that claimant’s injuries were not compensable, as her recurring lower back pain stemmed from injuries predating or following the alleged November 1990 incident, rather than the incident itself. The court also upheld the Board's rejection of contrary testimony as not credible.

Workers' CompensationBack InjuryWork-Related InjuryReconsiderationBoard ReviewAppellate ReviewAbuse of DiscretionArbitrary and CapriciousSubstantial EvidenceMedical Testimony
References
5
Case No. MISSING
Regular Panel Decision
Feb 25, 2009

Claim of Norcross v. Camden Central School

This case involves an appeal by the Special Fund for Reopened Cases from a Workers’ Compensation Board decision. The Board had affirmed a Workers’ Compensation Law Judge's ruling that shifted liability to the Special Fund under WCL § 25-a, regarding a claimant's work-related injury from 2001. The Special Fund contended that the Board's decision deviated from its own precedent by shifting liability without requiring proof that further medical or indemnity benefits were payable, which is a necessary condition for reopening a claim for this purpose. The court determined that the Board failed to provide a rational explanation for departing from its prior decisions, thereby rendering its determination arbitrary and capricious. Consequently, the Board's decision was reversed, and the matter was remitted for further proceedings.

Special Fund for Reopened CasesLiability ShiftAgency PrecedentRational ExplanationArbitrary and CapriciousRFA-2 formMedical BenefitsIndemnity BenefitsAppellate DivisionRemittal
References
7
Case No. MISSING
Regular Panel Decision

Matter of Bank v. Village of Tuckahoe

The Workers' Compensation Board ruled that liability for a claimant's left knee injury shifted to the Special Fund for Reopened Cases under Workers' Compensation Law § 25-a. The claimant sustained a work-related injury in June 2005, and compensation benefits were paid until June 20, 2005. In April 2012, a physician requested an MRI, which was performed and revealed a meniscal tear. Subsequently, surgery was authorized and performed in July 2012. The self-insured employer and its third-party administrator sought to shift liability to the Special Fund, a move initially rejected by a Workers' Compensation Law Judge but later approved by the Board. The Special Fund appealed the Board's decision. The appellate court reversed the Board's decision, finding that the case was not "truly closed" after the MRI request was approved. The court held that the case was reopened in April 2012, within the statutory seven-year period from the date of injury, thus precluding the shifting of liability to the Special Fund. The matter was remitted to the Board for further proceedings.

Workers' Compensation Law § 25-aSpecial Fund LiabilityReopened Case DoctrineMedical Treatment AuthorizationCase Closure DeterminationSeven-Year RuleLast Payment of CompensationMeniscal TearMRI AuthorizationSurgery Authorization
References
5
Case No. MISSING
Regular Panel Decision

Claim of Schwartz v. State Insurance Fund

Claimant appealed two Workers' Compensation Board decisions. The first decision, filed April 25, 2012, ruled that her alleged cardiac conditions were not causally related to her established work-related stress claim. The second decision, filed May 2, 2012, denied her payment for intermittent lost time. The court affirmed both decisions, finding that the employer's independent medical examiner complied with Workers' Compensation Law § 137, and the Board's resolution of conflicting medical opinions regarding cardiac conditions was supported by substantial evidence. Additionally, the Board's determination that the claimant's Friday absences were for convenience, not disability, was also upheld by substantial evidence.

Workers' Compensation Board AppealsCausally Related DisabilityCardiac ConditionsHypertensionMitral Valve InsufficiencyTricuspid Valve InsufficiencyEnlarged Left AtriumWork-Related StressAdjustment DisorderIntermittent Lost Time Benefits
References
4
Case No. ADJ7781989; ADJ8262771
Regular
Oct 03, 2013

MIRIAN GARCIA vs. COOPER COLD FOODS, INC., ILLINOIS MIDWEST INSURANCE AGENCY as administrator for STAR INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) is granting reconsideration of its own prior decision and rescinding a July 23, 2013 decision that had overturned a prior finding of 2% permanent disability for applicant's right knee injury. The WCAB determined that its August 9, 2012 order granting reconsideration was improvidently granted because the applicant had already filed a successive and improper petition for reconsideration. Consequently, the prior order and the subsequent rescinded decision are vacated, and the applicant's petition for reconsideration is dismissed.

WCABReconsiderationPetition for ReconsiderationFindings and AwardAdministrative Law JudgePermanent DisabilityIndustrial InjurySuccessive PetitionImprovidently GrantedVacated
References
4
Case No. ADJ1210556 (AGO 0018589)
Regular
Oct 10, 2008

EDWIN MILLER vs. KEEBLER COMPANY

The Workers' Compensation Appeals Board (WCAB) dismissed the defendant's petition for removal and granted reconsideration of the WCJ's prior decisions regarding medical mileage and penalties. The Board found the WCJ failed to properly consider statutory factors in determining a "reasonable geographic area" for the applicant's medical treatment. Consequently, the WCAB rescinded the WCJ's decisions and returned the case to the trial level for further proceedings and a new decision addressing all outstanding issues, including the definition of a reasonable geographic area for treatment.

WCABPetition for RemovalPetition for ReconsiderationMedical MileageReasonable Geographic AreaLabor Code Section 4600Administrative Director Rule 9780(h)WCJBoltonRamirez
References
2
Case No. MISSING
Regular Panel Decision

Claim of Ford v. New York City Transit Authority

Claimant, a public relations director, filed for workers' compensation benefits in April 1994 due to work-related posttraumatic stress disorder, but later withdrew the claim in March 1997 due to a parallel federal civil rights action, leading to its closure without a decision on merits. In March 2003, claimant sought to reopen the case, which the Workers' Compensation Board denied in February 2004, citing Workers' Compensation Law § 123 as a bar. The Board subsequently denied an application for reconsideration and/or full Board review in July 2004, prompting the claimant's appeal. The appellate court affirmed the Board's decision, finding no new evidence was presented for reconsideration and that the Board had properly determined the claim was truly closed and time-barred under Workers' Compensation Law § 123, as over seven years had lapsed since the accident. Consequently, the appellate decision concluded that the Board's denial was not arbitrary, capricious, or an abuse of discretion.

Workers' Compensation AppealReconsideration DenialTime-Barred ClaimPosttraumatic Stress DisorderFederal Civil Rights ActionJurisdictionReopening ClaimMedical EvidenceDue ProcessWorkers' Compensation Law § 123
References
5
Case No. MISSING
Regular Panel Decision

Claim of Oliva v. Albany Cycle Co.

This case concerns a claimant's appeal from two decisions by the Workers’ Compensation Board, filed May 6, 1977, and June 29, 1978, which had denied his application to reopen and reconsider a referee’s decision from March 25, 1976. The referee had previously denied the claimant’s claim for death benefits for his deceased wife, stating that he failed to establish dependency as required by Workers’ Compensation Law § 16. The claimant sought reopening after Matter of Passante v Walden Print. Co. declared section 16 unconstitutional for its gender-based dependency requirements. However, the Board rejected the application due to an untimely appeal. The court affirmed the Board's decision, concluding that the Board did not abuse its discretion as Passante did not expressly mandate retroactive application.

Death BenefitsDependency RequirementConstitutional LawRetroactive ApplicationTimely AppealAbuse of DiscretionBoard ReconsiderationReferee's DecisionAppellate ReviewGender Discrimination
References
3
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