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

Case No. ADJ7821766
Regular
Jan 23, 2014

LUIS ALBERTO AUDELO PARTIDA, dec'd. vs. GO NATIVE, INC., THE HARTFORD

In **Audelo Partida v. Go Native, Inc., et al.**, the Workers' Compensation Appeals Board (WCAB) granted the defendant's petition for reconsideration. This decision allows the Board further time to thoroughly review the factual and legal complexities of the case. The WCAB needs additional study to ensure a complete understanding of the record before issuing a just and reasoned decision. Consequently, all future filings must be submitted directly to the WCAB Commissioners' office, not to any district office or through e-filing, pending the issuance of a Decision After Reconsideration.

Workers' Compensation Appeals BoardPetition for ReconsiderationSan Jose District OfficeGO NATIVEINC.THE HARTFORDADJ7821766LUIS ALBERTO AUDELO PARTIDAdec'dElectronic Adjudication Management System
References
0
Case No. 534656
Regular Panel Decision
Feb 16, 2023

In the Matter of the Claim of Alberto Gomez

Claimant Alberto Gomez, who sustained work-related injuries in 2017, sought payment for medical treatment received in New Jersey from a New Jersey-licensed physician also licensed in New York. The employer's workers' compensation carrier objected to payment, arguing the physician lacked authorization from the Workers' Compensation Board. Both a Workers' Compensation Law Judge and a Board panel affirmed the carrier's position. However, the Appellate Division, Third Judicial Department, reversed these decisions. The court ruled that New York's physician authorization requirements do not apply to out-of-state physicians treating claimants in their home states, even if the physician holds a New York license. The Board's contrary interpretation was found to be irrational and unreasonable, leading to the reversal of the decisions and remittal of the matter to the Board for further proceedings.

Medical Provider AuthorizationInterstate Medical TreatmentRegulatory InterpretationJudicial Review of Administrative DecisionsClaimant ResidenceWorkers' Compensation Carrier LiabilityNew York Workers' Compensation BoardPhysician LicensingBoard Authorization
References
15
Case No. 530563
Regular Panel Decision
Jan 20, 2022

In the Matter of the Claim of Luis Urena

Luis Urena, an employee of Abcal Industries, sustained injuries after falling while working on a residential renovation project in Brooklyn in July 2017 and applied for workers' compensation benefits. The Workers' Compensation Board ruled that Norguard Insurance Company, Abcal's carrier, was liable for Urena's benefits, rejecting Norguard's arguments that its policy did not cover work in New York. Norguard appealed, contending that a policy exclusion applied due to Abcal's failure to notify them of New York work within 30 days. The Supreme Court, Appellate Division, Third Judicial Department, affirmed the Board's decision, finding that Norguard failed to meet its burden of proving the exclusion applied and that the Board's interpretation of the policy language was reasonable.

Workers' Compensation InsurancePolicy ExclusionEmployer LiabilityCarrier LiabilityAppellate ReviewJurisdictionNew York Workers' Compensation LawSubcontract AgreementConstruction InjuryTimeliness
References
7
Case No. No. 13
Regular Panel Decision
Mar 26, 2020

The Matter of the Claim of Luis A. Vega v. Postmates Inc

The New York Court of Appeals addressed whether a Postmates, Inc. courier, Luis A. Vega, and similarly-situated individuals, are employees for unemployment insurance contributions. The Unemployment Insurance Appeals Board (the Board) had determined them to be employees, reversing an Administrative Law Judge's finding of independent contractor status. The Appellate Division then reversed the Board, concluding insufficient evidence of an employer-employee relationship. The Court of Appeals reversed the Appellate Division, reinstating the Board's decision, finding substantial evidence that Postmates exercised control over its couriers, rendering them employees for unemployment insurance purposes. The court highlighted Postmates' control over assignments, compensation, customer complaints, and the inability of couriers to operate as independent businesspersons.

Unemployment InsuranceGig EconomyIndependent ContractorEmployee ClassificationLabor LawApp-based DeliveryControl TestWorkers' RightsNew York Court of AppealsSubstantial Evidence
References
44
Case No. MISSING
Regular Panel Decision
Nov 13, 2002

Zurich American Insurance v. Luis Bastos Construction

Zurich American Insurance Co. initiated an action seeking a declaratory judgment that it was not obligated to defend or indemnify Luis Bastos Construction, Inc. in an underlying personal injury lawsuit filed by Hermilo Cruz. Cruz, an employee of Bastos, sustained injuries in New York while working on a job that was not related to any work being performed in New Jersey. Zurich's insurance policy provided employers' liability coverage specifically for claims arising from accidents in New Jersey or those incidental to New Jersey operations. The Supreme Court, Westchester County, granted Zurich's motion for summary judgment, ruling that Zurich had no obligation to defend or indemnify Bastos. Defendant A.E Roofing & Siding Corp. appealed this decision. The appellate court affirmed the Supreme Court's order and judgment, concluding that the terms of the policy were clear and unambiguous.

Declaratory JudgmentInsurance CoverageEmployers' LiabilityWorkers' CompensationSummary JudgmentPolicy InterpretationPersonal InjuryAppellate ReviewJurisdictionNew York Law
References
2
Case No. ADJ10259451
Regular
Sep 10, 2019

LUIS SILVA vs. CITISTAFF SOLUTIONS, OLD REPUBLIC c/o GALLAGHER BASSETT SERVICES

The Workers' Compensation Appeals Board granted reconsideration of a prior decision. They amended the decision to reflect that Old Republic, not a different insurer, is the liable party for Luis Silva's injury. The Board also admitted Defendant's Exhibit E into evidence. Otherwise, the original decision awarding temporary disability, permanent disability, future medical treatment, and attorney's fees to Luis Silva was affirmed.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ reportExhibit EOld RepublicGallagher Bassettgeneral laborerlumbar spineinternal injurytemporary disability indemnity
References
0
Case No. ADJ9409541
Regular
Aug 23, 2019

LUIS MEDINA BERNAL (Deceased), PATRICIA SOLANO VASQUEZ, MISAEL MEDINA SOLANO, LUCIA MEDINA SOLANO, XIMENA MEDINA SOLANO, I SAI MEDINA SOLANO, LUIS EMANUEL MEDINA SOLANO vs. REBECCA BAUTISTA dba REMAC TIRE SERVICES, UNINSURED EMPLOYERS BENEFITS TRUST FUND

This case involves a fatal industrial injury to Luis Medina Bernal, a tire changer. The Workers' Compensation Appeals Board (WCAB) granted reconsideration to clarify death benefit payment terms. While the WCJ correctly found petitioning applicants failed to prove partial dependency, the WCAB amended the decision. The death benefit for the widow, Patricia Solano Vasquez, is to be paid bi-weekly at $297.29 until the $250,000 total is exhausted. The attorney's fee was recalculated to $34,042.54, representing 15% of the death benefit's present value.

Workers' Compensation Appeals BoardPetition for ReconsiderationDecision After ReconsiderationFatal Industrial InjuryPartial DependencyCredibility DeterminationsNet Financial BenefitDeath BenefitPresent ValueAttorney's Fee
References
4
Case No. 2016 NY Slip Op 02734 [138 AD3d 488]
Regular Panel Decision
Apr 12, 2016

Matter of Lesli R. (Luis R.)

The Family Court's order of disposition, which found that the respondent sexually abused his stepdaughters and derivatively abused his five biological children, was unanimously affirmed. The record supported the court's determination that the respondent was legally responsible for the children and that there was a preponderance of evidence of sexual abuse. The stepdaughters' out-of-court statements were sufficiently corroborated by the respondent's own statements. The court also found that the respondent derivatively abused his own children and properly exercised its discretion in quashing a subpoena to compel one of the stepdaughters to testify due to potential psychological harm.

Child AbuseSexual AbuseDerivative AbuseFamily Court ActAppellate ReviewPreponderance of EvidenceOut-of-court StatementsCorroborationParental ObligationsSubpoena Quash
References
11
Case No. ADJ10083989
Regular
Sep 12, 2016

LUIS PARTIDA vs. ABOVE ALL ROOFING, STATE COMPENSATION INSURANCE FUND

This case concerns a defendant's petition for reconsideration and removal of a WCJ's order deeming a prior stipulation a "continuing award" of temporary disability benefits. The defendant argued this prejudiced their right to present evidence of the applicant's employment and that the stipulation only set the rate and start date, not ongoing benefits. The Board denied both petitions, finding the defendant's subsequent payment of benefits beyond the stipulation date established it as a continuing award. Furthermore, the Board noted that under Labor Code section 4651.1, a rebuttable presumption of continuing disability exists until a petition to terminate liability is properly filed and overcome.

Petition for ReconsiderationPetition for Removalcontinuing awardtemporary disability indemnityStipulations and Awarddue processexpedited trialrebuttable presumptionterminate liabilityLabor Code
References
2
Case No. 2021 NY Slip Op 03276 [194 AD3d 607]
Regular Panel Decision
May 25, 2021

Alberto v. DiSano Demolition Co., Inc.

This case involves an appeal from a Supreme Court order concerning summary judgment motions related to Labor Law §§ 240(1), 241(6), and 200, as well as common-law negligence claims arising from a construction accident. The Appellate Division modified the lower court's order. It dismissed the Labor Law § 241(6) claim against all defendants, granted Niko's Construction's motion for summary judgment on the Labor Law § 241 (6) claim, and partially granted the Sota defendants' motion, while otherwise affirming. The court found issues of fact remaining regarding DiSano, Nick Sota, and Niko's Construction's roles as general contractors or in exercising supervisory control over the work, and Manuela Sota's liability under a dangerous condition theory. Claims against Anna Maria Oppedisano were dismissed entirely.

Labor LawSummary JudgmentAppellate DivisionConstruction SafetyGeneral Contractor LiabilitySupervisory ControlIndustrial CodeHomeowner ExemptionDangerous ConditionPersonal Injury
References
7
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