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

Case No. CV-24-0652
Regular Panel Decision
May 29, 2025

Matter of Cahill v. New York State Dept. of Mental Hygiene

Claimant Lynn Cahill sustained a work-related knee injury in 1992, which led to a total knee replacement in 2012 and subsequent revision surgeries. In October 2020, she was diagnosed with a periprosthetic infection, managed with antibiotics. Her condition acutely worsened in September 2022, leading her orthopedic surgeon, Dr. Frank Lombardo, to recommend and perform immediate cement spacer surgery on October 4, 2022, due to risks of sepsis and amputation. The employer and carrier disputed liability, arguing the surgery lacked prior authorization. However, the Workers' Compensation Board, affirmed by the Appellate Division, Third Department, ruled that the surgery was performed on an emergency basis, thereby waiving the authorization requirement under Workers' Compensation Law § 13-a (5) and holding the carrier responsible for the costs.

Knee InjuryPeriprosthetic InfectionEmergency Medical CareSurgical AuthorizationAppellate DivisionWorkers' Compensation Board ReviewMedical NecessityChronic InfectionSepsisAmputation Risk
References
6
Case No. ADJ4016735 (BAK 0147536)
Regular
Jun 11, 2012

COLLEEN PARHAM vs. KERN RADIOLOGY MEDICAL GROUP, LEGION INSURANCE GROUP

This case involves an applicant seeking bilateral knee replacement surgery due to an admitted industrial back injury. The applicant argues the surgery is necessary to enable further treatment for her back, specifically a spinal cord stimulator. The defendants contested this, claiming the knee condition was independent and unrelated to the industrial injury. The Appeals Board granted reconsideration, finding the knee surgery reasonably required to relieve the industrial back injury, citing *Bolton* and *Rowan*, even if the knee condition itself was not industrial. The Board rescinded prior findings, awarding the knee surgery and deferring issues of permanent disability and temporary disability.

Workers' Compensation Appeals BoardReconsiderationFindings of FactBilateral Knee ReplacementIndustrial InjuryBack InjurySpinal Cord StimulatorTemporary Total DisabilityPermanent and StationaryQualified Medical Evaluator
References
8
Case No. ADJ9179881
Regular
Dec 19, 2014

CURTIS MAUCH vs. CITY OF LODI, YORK RISK SERVICES GROUP, INC.

Here's a summary of the case for a lawyer in four sentences: The Workers' Compensation Appeals Board denied the defendant's Petition for Reconsideration, upholding the prior decision that required liability for necessary medical treatment. This liability is specifically limited to treatment enabling knee replacement surgery, not for subsequent conditions. The Board adopted the WCJ's reasoning, citing *Braewood Convalescent Hospital v. Workers' Comp. Appeals Bd.* to support the decision. The case involved an applicant needing knee replacement surgery, and the defendant argued that a separate cardiac defibrillator issue was unrelated to the industrial injury.

Petition for ReconsiderationWorkers' Compensation Appeals BoardCity of LodiYork Risk Services GroupAdministrative Law JudgeKnee replacement surgeryCardiac defibrillatorBraewood Convalescent HospitalLabor Code Section 5903Myers
References
8
Case No. MISSING
Regular Panel Decision

Claim of Prescott v. Town of Lake Luzerne

A claimant fell off a dump truck at work in February 2008, landing on his right buttock and injuring his hip. The injury led to surgery in May 2008 to remove heterotopic bone and subsequent two-stage hip replacement revision surgeries in November 2008 and February 2009 due to an infection. The Workers’ Compensation Board found the initial surgery and subsequent revisions causally related to the work fall and supported compensation awards. The employer appealed, arguing that an independent medical examination (IME) was improperly precluded and that the initial surgery lacked proper authorization. The Appellate Division affirmed the preclusion of the IME due to untimeliness and upheld the causal relationship findings for the injury and subsequent surgeries. However, the court reversed the Board's determination that the May 2008 surgery was properly authorized, remitting that specific issue for further proceedings, while affirming all other appealed decisions.

Causal RelationshipIndependent Medical Examination (IME)Evidence PreclusionSurgery AuthorizationHip InjuryHeterotopic OssificationMedical Opinion ConflictDue ProcessRemittiturEmployer Liability
References
8
Case No. MISSING
Regular Panel Decision
Jun 02, 2008

Claim of Laezzo v. New York State Thruway Authority

The claimant suffered a work-related slip and fall in 2002, leading to injuries including his head, neck, back, and knees. His morbid obesity contributed to his back and knee issues, prompting him to seek authorization for gastric bypass surgery. The Workers’ Compensation Law Judge approved the surgery, a decision affirmed by the Workers’ Compensation Board, which found the surgery causally related to the compensable injuries. The employer and its carrier appealed, challenging the causal link. The court affirmed the Board's decision, noting substantial evidence that the claimant's weight gain was a result of the sedentary lifestyle imposed by his injuries, and that the surgery would aid in his recovery.

Workers' CompensationConsequential InjuryGastric Bypass SurgeryMorbid ObesityMedical Treatment AuthorizationCausationKnee InjuryBack InjurySedentary LifestyleBoard Decision Appeal
References
2
Case No. ADJ2854014 (VNO 0353387) ADJ622083 (VNO 0353389) ADJ2985353 (VNO 0278675) ADJ8101514
Regular
Feb 21, 2012

CAROLYN CHRISTIAN vs. TJ MAXX, AMERICAN CASULATY COMPANY

This case concerns a petition for reconsideration of an approved Compromise and Release (C&R) agreement by the defendant, TJ Maxx. The defendant argues the C&R must be revised because the applicant's knee replacement surgery occurred prior to the approval, potentially rendering the Medicare Set Aside (MSA) provision duplicative. The Appeals Board granted reconsideration and rescinded the Order Approving Compromise and Release. The matter is returned to the trial level to determine if the applicant's pre-approval surgery was consistent with the MSA terms.

Workers' Compensation Appeals BoardTJ MaxxAmerican Casualty CompanyCompromise and Release AgreementMedicare Set Aside (MSA)mutual mistake of factfraudduplicative compensationknee replacement surgeryrescinded order
References
0
Case No. MISSING
Regular Panel Decision

Matter of Dudek v. Victory Markets

This case involves an appeal from a Workers’ Compensation Board decision regarding a claimant’s eligibility to reopen a 1986 work-related knee injury claim. The claimant sustained an initial knee injury in 1986, for which compensation was paid for a brief period. After a subsequent knee injury in 2001 and a knee replacement surgery in 2011, an independent medical examination attributed a majority of the knee replacement to the 1986 injury. The employer argued that liability for the 1986 claim should transfer to the Special Fund for Reopened Cases under Workers’ Compensation Law § 25-a, and further payments were barred by Workers’ Compensation Law § 123, due to the claim being truly closed since 1986. The Workers’ Compensation Board affirmed this position. The Appellate Division affirmed the Board’s decision, finding substantial evidence supported that the 1986 case was truly closed and that the time limits imposed by Workers’ Compensation Law §§ 25-a and 123 applied, thus barring the reopening of the case and further benefits.

Workers' CompensationKnee InjuryReopened CasesSpecial FundStatute of LimitationsAdvance CompensationTrue ClosureLiability TransferMedical CausationIndependent Medical Examination
References
7
Case No. MISSING
Regular Panel Decision
Jan 10, 2005

Bremner v. New Venture Gear

Claimant underwent a right knee replacement in 1991 due to a non-work-related condition. In October 2002, he sustained work-related injuries to his right shoulder and right knee, leading to increased knee pain from loosening knee replacement components, ultimately requiring surgery. A Workers’ Compensation Law Judge found apportionment inapplicable for temporary disability benefits, a decision affirmed by the Workers’ Compensation Board. The Appellate Division affirmed, holding that apportionment does not apply where a pre-existing non-compensable condition did not hinder the claimant's ability to perform job duties at the time of the work-related accident. The court noted that claimant was asymptomatic and fully capable of performing his duties when the accident occurred.

Workers' CompensationApportionmentPre-existing ConditionKnee InjuryWork-related AccidentTemporary Disability BenefitsAppellate ReviewCausationMedical ConditionSurgery
References
4
Case No. 525196
Regular Panel Decision
Apr 26, 2018

Matter of Derouchie v. Massena W. Wc Smelter

Claimant Gerry J. Derouchie sustained injuries on February 18, 2015, including to his right knee and left hip, after stepping into a pothole on his employer's premises. He filed for workers' compensation benefits, and his case was established for multiple injuries. Having prior injuries and surgeries, claimant sought authorization for total right knee and left hip replacement surgeries, which the employer and carrier denied. A Workers' Compensation Law Judge (WCLJ) granted the authorization, and the Workers' Compensation Board affirmed, finding a causal relationship between the February 2015 accident and the need for surgeries. The Appellate Division, Third Department, affirmed the Board's decision, citing substantial evidence and deference to the Board's assessment of medical witness credibility.

Workers' Compensation BenefitsCausal RelationshipKnee Replacement SurgeryHip Replacement SurgeryPreexisting ConditionsAggravation of InjuryMedical AuthorizationSubstantial EvidenceCredibility AssessmentAppellate Review
References
10
Case No. 2022 NY Slip Op 03425
Regular Panel Decision
May 26, 2022

Matter of Hopeck v. Al Tech Specialty Steel Corp.

Claimant Edward Hopeck suffered a left knee injury in 1984, receiving a schedule loss of use award which was later increased. After knee replacement surgery in 2006, awards were made for a temporary disability period, but a new injury claim was canceled and merged with the original, marked for no further action pending new medical evidence. Despite additional knee surgeries in 2017 and 2019, Hopeck did not seek further awards until 2020. Both the Workers' Compensation Law Judge and the Workers' Compensation Board ruled that reopening the claim was barred by Workers' Compensation Law § 123 due to the lapse of time and the claimant's decade-long inaction. The Appellate Division affirmed this decision, concluding that the Board's finding of a truly closed case was not disturbed.

Workers' Compensation Law § 123Schedule Loss of UseClaim ReopeningStatute of LimitationsLachesAppellate ReviewKnee InjurySurgical InterventionBoard Decision AffirmedMedical Evidence Requirement
References
7
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