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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
Jul 16, 2003

Baez v. New York City Transit Authority

The Supreme Court, Bronx County, entered a judgment on or about July 16, 2003, upholding a jury verdict that awarded the plaintiff $600,000 for past pain and suffering and $380,000 for future pain and suffering. This judgment also brought up for review an order from November 26, 2002, which denied the defendants' motion to deem the damages verdict excessive. The plaintiff, a 56-year-old home-health-aide, sustained a severe comminuted midshaft humeral fracture in her right arm, requiring multiple surgeries including rod and plate placements, and extensive physical therapy. Despite healing, she was left with limited forearm rotation, numbness, hand weakness, and three large keloid scars. The court unanimously affirmed the damages awards, finding them to be reasonable compensation under the circumstances, referencing CPLR 5501 [c] and Martinez v Gouverneur Gardens Hous. Corp.

Humeral fracturePain and sufferingDamages awardJury verdictAppellate affirmationSurgical interventionPhysical therapyKeloid scarsLimited range of motionMedical hardware
References
1
Case No. MISSING
Regular Panel Decision
Jun 10, 2005

Claim of Cucci v. Rexer's Tang Soo Do Karate Academy

Claimant sustained a severe neck laceration in December 2001 while at work, resulting in a significant scar. A Workers’ Compensation Law Judge initially denied an award for facial disfigurement, stating the scar was below the jaw. The Workers’ Compensation Board panel modified this, granting a $10,000 award, finding the scar fell within the compensable region under Workers’ Compensation Law § 15 (3) (t) (2). The employer and its carrier appealed, arguing the Board failed to address the impact of the disfigurement on claimant's present or future earning capacity, a statutory requirement for such an award. The appellate court reversed the Board's decision and remitted the matter for further proceedings, citing the absence of findings or inferences regarding impaired earning capacity.

Facial DisfigurementSerious DisfigurementEarning CapacityWorkers' Compensation Law § 15Scar InjuryAppellate ReviewRemittalStatutory InterpretationCompensable InjuryWorkers' Compensation Board
References
3
Case No. ADJ12305682
Regular
Apr 14, 2023

DAVID REED vs. CSR MANAGEMENT SERVICES, STATE COMPENSATION INSURANCE FUND

This case involves CSR Management Services and their insurer seeking reconsideration of a $71\%$ permanent disability award for David Reed. The defendants argued that the qualified medical evaluator, Dr. Brophy, did not sufficiently explain the applicant's scarring impairment. The Workers' Compensation Appeals Board denied the petition, finding Dr. Brophy adequately explained the scarring impairments as Class 1 under the AMA Guides. The Board noted that defendants could have sought further clarification from the evaluator.

CSR Management ServicesState Compensation Insurance FundADJ12305682Petition for ReconsiderationAmended Findings of FactAward and Orderconstruction laborerindustrial injuryupper extremitiesback
References
2
Case No. 13 NY3d 747
Regular Panel Decision

People v. McKinnon

The case concerns the appeal of a defendant's conviction for first-degree assault, among other crimes, in New York. The core legal issue revolves around whether bite marks inflicted by the defendant on the victim's inner forearm constituted "serious disfigurement" under Penal Law § 120.10 (2). The court, while acknowledging a definition for "disfigurement," found the evidence—consisting of two moderate-sized scars—insufficient to establish serious disfigurement. The court emphasized that the mere existence of scars in that location, without unusually disturbing characteristics, would not make the victim's appearance distressing or objectionable to a reasonable person. Consequently, the first-degree assault conviction and a related second-degree assault count were reversed and dismissed, with the case remitted for further proceedings on a remaining second-degree assault charge.

Criminal LawAssaultFirst Degree AssaultSerious DisfigurementPenal LawSufficiency of EvidenceAppellate ReviewNew York Court of AppealsBite MarksPhysical Injury
References
3
Case No. MISSING
Regular Panel Decision
Feb 15, 1996

Chambers v. City of Ogdensburg

The State Insurance Fund appealed an order from St. Lawrence County Supreme Court denying its request for a full lien on the settlement proceeds received by Timothy J. Cooke, a 12-year-old paperboy. Cooke had received $14,000 from the Fund for permanent facial scars sustained after being struck by a police car, and subsequently settled a third-party personal injury action. The Supreme Court ruled, based on Dietrich v Kemper Ins. Co., that the settlement funds for facial scars constituted compensation for basic economic loss and were therefore exempt from a Workers’ Compensation Law lien. The appellate court affirmed this decision, finding the Fund's appeal timely and agreeing that the compensation for facial disfigurement was equivalent to basic economic loss. Additionally, the court rejected the Fund's argument for a partial lien against amounts exceeding a statutory no-fault cap, determining the lump-sum payment remained within monthly limits when distributed over 36 months.

Workers' CompensationLien EnforcementThird-Party ActionPersonal InjuryFacial ScarsNo-Fault BenefitsBasic Economic LossStatutory InterpretationAppellate AffirmationState Insurance Fund
References
3
Case No. MISSING
Regular Panel Decision

Fleming v. Graham

This case addresses whether plaintiff Cedric Fleming's facial injuries, specifically scars on his forehead and right upper eyelid, constitute a "permanent and severe facial disfigurement" under Workers’ Compensation Law § 11, qualifying as a "grave injury." Fleming, an employee of Pinstripes Garment Services, LLC, sustained these injuries in a collision with a school bus. He sued Evergreen Bus Service, Inc., and its driver, who then initiated a third-party action against Pinstripes for indemnity/contribution, claiming Fleming's injuries were "grave." Supreme Court denied Pinstripes' summary judgment motion, but the Appellate Division affirmed, finding factual questions. The Court of Appeals, however, reversed, establishing a standard for "severe facial disfigurement" which requires the injury to greatly alter the face's appearance and be regarded as "abhorrently distressing, highly objectionable, shocking or extremely unsightly" by a reasonable person. Applying this standard, the Court found that Fleming's injuries, despite numerous scars and some permanency, did not meet the "severe" disfigurement threshold, thereby granting Pinstripes' motion for summary judgment.

Workers' Compensation LawGrave InjuryFacial DisfigurementPermanent InjurySevere InjuryThird-Party ActionCommon-Law IndemnityContributionSummary JudgmentAppellate Review
References
16
Case No. ADJ6704425
Regular
Apr 02, 2012

MANUEL MENDOZA vs. RACKLEY COMPANY, ZURICH AMERICAN INSURANCE CO.

The Workers' Compensation Appeals Board denied reconsideration of a decision awarding permanent disability benefits to Manuel Mendoza. The Board adopted the administrative law judge's report, which found that the primary treating physician's opinion constituted substantial evidence, even if it differed from other medical opinions. The judge's decision to follow the treating physician's rating, which included consideration of a surgical scar and pain, was upheld. The Board noted that a single physician's relevant and considered opinion can be substantial evidence in workers' compensation cases.

Workers' Compensation Appeals BoardReconsideration DeniedSubstantial EvidencePhysician OpinionAMA GuidesGuzman DecisionPermanent DisabilityPrimary Treating PhysicianPQMESurgical Scar
References
1
Case No. ADJ1966949 (GOL 0095232)
Regular
Mar 19, 2012

ARMANDO OROZCO (ARMANDO OROZCO JUAREZ) vs. PACIFIC VINEYARD COMPANY, STATE COMPENSATION INSURANCE FUND

This case involves a defendant employer's petition for reconsideration of a finding that the applicant sustained an injury arising out of and in the course of employment (AOE/COE). The employer contended the AOE/COE finding lacked substantial evidence, particularly questioning the applicant's account of falling off a tractor and being run over. The Workers' Compensation Appeals Board (WCAB) denied the petition, adopting the WCJ's report which found the applicant's testimony persuasive, supported by employer witnesses attesting to his trustworthiness, and contradicted by unreliable defense expert testimony. The WCJ also noted a prior employer letter disputing the *nature* of the injury, not its occurrence, and the fact the applicant showed scarring.

AOE/COEPetition for ReconsiderationFinding of FactCompromise and Releasesubstantial evidenceWCJdefendant employerapplicantState Compensation Insurance Fundinjury
References
1
Case No. ADJ3192115 (SBR 0342658)
Regular
Feb 03, 2014

YONIR ALARCON vs. STELLAR ENTERPRISES, CALIFORNIA INSURANCE COMPANY

This case involves an applicant seeking workers' compensation benefits for injuries stemming from a fall. The WCJ initially awarded benefits for chest pain, right hand, and head injury, but denied claims for sleep apnea, shortness of breath, scarring, right eye, jaw, psyche, and neck. The applicant requested reconsideration, arguing the WCJ erred in denying these additional claims and in failing to further develop the medical record. The Appeals Board affirmed the WCJ's decision, finding applicant failed to properly object to medical findings and that discovery had closed. A dissenting commissioner argued for reconsideration to allow further development of the record, citing inadequate initial medical treatment and potential for more extensive injuries.

Workers' Compensation Appeals BoardIndustrial InjuryPetition for ReconsiderationFindings and AwardMedical DeterminationsLabor CodeMandatory Settlement ConferenceDissenting OpinionOccupational InjuryMedical Provider Network
References
0
Case No. MISSING
Regular Panel Decision

Rosen v. Nygren Dahly Co.

This appeal concerns an order from Supreme Court, Monroe County, which initially denied a third-party defendant's (Flower City Printing, Inc.) motion for summary judgment. The plaintiff, an employee of Flower City, sustained scalp and facial lacerations from a drill press. Flower City sought to dismiss the third-party complaint, arguing the plaintiff did not suffer a grave injury under Workers’ Compensation Law § 11. The appellate court modified the original order. It affirmed the denial of summary judgment regarding an acquired brain injury but granted summary judgment dismissing claims based on permanent and severe facial disfigurement, concluding the plaintiff's scarring did not meet the 'grave injury' threshold.

Workers' CompensationGrave InjurySummary JudgmentFacial DisfigurementBrain InjuryThird-Party ComplaintAppealMonroe CountyAppellate DivisionMedical Evidence
References
1
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