CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

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

Case No. 2021 NY Slip Op 00133 [190 AD3d 505]
Regular Panel Decision
Jan 12, 2021

Santana v. MMF 1212 Assoc L.L.C.

Plaintiff, Juan C. Santana, was injured during demolition work when a ceiling fell and struck him. He brought claims under Labor Law §§ 241 (6) and 200, alleging violations of Industrial Code (12 NYCRR) §§ 23-1.8 (c) and 23-3.3 (c). The Appellate Division affirmed the denial of Richard Mishkin Contracting Inc.'s motion for summary judgment on the Labor Law § 241 (6) claim, finding issues of fact regarding the provision of safety hats and ongoing inspections. The court also affirmed the dismissal of the Labor Law § 200 claim against MMF 1212 Assoc L.L.C. and Finkelstein Timberger East Real Estate LLC, as plaintiff did not oppose and they lacked control over the work. Finally, Mishkin's cross-claims for common-law contribution and indemnification were not dismissed due to conflicting expert opinions on the gravity of plaintiff's brain injury under Workers' Compensation Law § 11.

Demolition AccidentFalling ObjectsConstruction SafetyLabor LawIndustrial CodeSummary JudgmentContribution ClaimIndemnification ClaimWorkers' CompensationAppellate Review
References
4
Case No. 2025 NY Slip Op 05500 [242 AD3d 829]
Regular Panel Decision
Oct 08, 2025

DeMarco v. C.A.C. Indus., Inc.

The plaintiff, Peter DeMarco, suffered personal injuries when excavation walls collapsed at a Queens work site. He sued C.A.C. Industries, Inc., a contractor that provided a backhoe and operating engineer to his employer, the City of New York Department of Environmental Protection (DEP). The Supreme Court, Queens County, partially granted the defendant's motion for summary judgment, dismissing claims under Labor Law § 200 and certain Labor Law § 241 (6) violations, while denying dismissal of the common-law negligence claim. The plaintiff's cross-motion for summary judgment was denied. On appeal, the Appellate Division, Second Department, affirmed the Supreme Court's order, finding that the defendant lacked authority to supervise for the Labor Law claims but failed to demonstrate a special employment relationship, leaving triable issues of fact regarding the common-law negligence claim and whether the defendant's excavation created or exacerbated the dangerous condition.

Excavation CollapseTrench SafetyLabor Law 200Labor Law 241(6)Industrial Code ViolationsSpecial EmploymentContractor NegligencePremises LiabilitySummary Judgment AppealDuty of Care
References
21
Case No. ADJ3328008 (VNO 0517608)
Regular
May 20, 2011

ELIODORO LOPEZ vs. VIRGIL CONVALESCENT HOSPITAL, HEALTHCARE SERVICES GROUP, ZURICH NORTH AMERICA

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The defendant argued they were denied due process when the Workers' Compensation Judge (WCJ) amended a prior decision to correct a Labor Code section reference concerning temporary disability indemnity. The Board found that the original reference to Labor Code § 4656(c)(2) was a clerical error, as the WCJ clearly intended to apply Labor Code § 4656(c)(1) based on the date of injury. The Board affirmed the WCJ's authority to correct such clerical errors.

Workers' Compensation Appeals BoardPetition for ReconsiderationTemporary Disability Indemnity104 week capLabor Code section 4656(c)(1)Labor Code section 4656(c)(2)Industrial InjuryNeck InjuryShoulder InjuryCardiovascular System Injury
References
4
Case No. 2016-119 K C
Regular Panel Decision
Jul 06, 2018

Jing Luo Acupuncture, P.C. v. NY City Tr. Auth.

This case involves an appeal from an order and judgment concerning a claim for first-party no-fault benefits for acupuncture services. The plaintiff, Jing Luo Acupuncture, P.C., as assignee of Sarah Adams, sought to recover unpaid balances from the NY City Transit Authority. The Civil Court initially granted the plaintiff's motion for summary judgment and denied the defendant's cross-motion. On appeal, the Appellate Term reversed the judgment, finding that the plaintiff failed to establish prima facie entitlement to summary judgment. The court also held that the defendant was not precluded from interposing its fee schedule defense, as it had fully paid for services billed under CPT codes 97811, 97813, and 97814 according to the workers' compensation fee schedule. Consequently, the plaintiff's motion for summary judgment was denied, and the defendant's cross-motion was granted in part for those specific CPT codes, while denied for CPT code 99262 and the seventh cause of action.

Acupuncture ServicesNo-Fault BenefitsSummary JudgmentFee Schedule DefenseWorkers' Compensation Fee ScheduleCPT CodesAppellate ReviewInsurance LawTimely DenialFirst-Party Benefits
References
14
Case No. 2016-329 S C
Regular Panel Decision
Apr 27, 2017

Spineisland for Chiropractic, P.C. v. 21st Century Advantage Ins. Co.

This case involves an appeal by Spineisland For Chiropractic, P.C., acting as an assignee, against 21st Century Advantage Insurance Company concerning first-party no-fault benefits. The plaintiff sought to recover for services billed under CPT code 95831. The District Court of Suffolk County had previously granted the defendant's motion for summary judgment, asserting that the defendant had appropriately paid the plaintiff based on the workers' compensation fee schedule. On appeal, the Appellate Term affirmed the lower court's decision. The Appellate Term found that the defendant had adequately demonstrated the proper application of CPT code 95833 for the services billed under CPT code 95831, and the plaintiff failed to present a triable issue of fact.

No-fault benefitsSummary judgmentCPT codeWorkers' compensation fee scheduleAppellate TermSuffolk CountyAssigneeInsurance disputeChiropractic servicesMedical billing
References
1
Case No. MISSING
Regular Panel Decision

Burgio & Campofelice, Inc. v. New York State Department of Labor

Burgio & Campofelice, Inc. (B&C), a general contractor, sought to prevent the New York State Department of Labor (DOL) from enforcing state prevailing benefit supplement laws. This action stemmed from B&C's subcontractor, Shared Management Group, Ltd., allegedly failing to pay union-related benefit funds, leading the DOL to order the withholding of payments to B&C. B&C argued that New York Labor Law §§ 220 and 223, which impose liability on general contractors for subcontractor non-compliance with prevailing wage laws, are preempted by the Employee Retirement Income Security Act (ERISA). The court reviewed various precedents on ERISA preemption, including GE I and GE II, and concluded that New York Labor Law § 223 is fundamentally linked to § 220, which directly relates to ERISA plans. Therefore, the court found § 223 also preempted by ERISA, granting B&C's motion for summary judgment and denying the DOL's cross-motion.

ERISA preemptionLabor LawPrevailing Wage ActBenefit supplementsGeneral contractor liabilitySubcontractor defaultPublic works contractSummary judgmentFederal preemptionEmployee benefit plans
References
13
Case No. 2015-976 K C
Regular Panel Decision
Dec 22, 2017

Acuhealth Acupuncture, P.C. v. Hereford Ins. Co.

This case concerns an appeal from an order of the Civil Court regarding a dispute between Acuhealth Acupuncture, P.C. (applicant) and Hereford Ins. Co. (defendant) over first-party no-fault benefits. The applicant sought recovery for services billed under CPT code 97039, which has a 'By Report' designation in the workers' compensation fee schedule requiring additional documentation. The Civil Court initially granted the defendant's motion for summary judgment and denied the applicant's cross-motion. On appeal, the Appellate Term modified the order, denying the branch of the defendant's motion seeking summary judgment on the CPT code 97039 claims, as the defendant failed to demonstrate it requested the required additional verification. However, the applicant's cross-motion for summary judgment was still denied as it failed to establish its prima facie entitlement to judgment.

No-fault insuranceSummary judgment motionCPT codeWorkers' compensation fee scheduleVerification of claimAppellate reviewMedical billing disputeInsurance benefitsAssignee claimCivil procedure
References
5
Case No. MISSING
Regular Panel Decision
Jul 10, 2013

Christopher C. v. Bonnie C.

This divorce action between Christopher C. and Bonnie C. addresses equitable distribution, spousal maintenance, and counsel fees. The defendant, Bonnie C., who has a court-appointed guardian due to mental and emotional difficulties, had separated from the plaintiff in 2003 and informally divided marital assets. The court ratified this prior asset division, noting the defendant had dissipated her share. Finding the defendant unable to work and self-support, and the plaintiff capable of employment despite his claims of disability, the court awarded the defendant non-durational permanent maintenance of $2,500 per month and substantial attorney's fees. The plaintiff's motion to suspend or refund temporary maintenance was denied.

DivorceSpousal MaintenanceEquitable DistributionGuardianshipMental Health IssuesAsset DissipationAttorney's FeesFinancial CapacityPermanent MaintenanceMarital Property
References
12
Case No. 2015-608 Q C
Regular Panel Decision
Dec 19, 2017

Adelaida Physical Therapy, P.C. v. 21st Century Ins. Co.

In this case, Adelaida Physical Therapy, P.C., acting as an assignee, appealed an order from the Civil Court of the City of New York, Queens County. The original order had granted 21st Century Insurance Company's motion for summary judgment, dismissing parts of a complaint seeking first-party no-fault benefits for services billed under specific CPT codes (97010, 97110, and 97124). The Appellate Term, Second Department, reversed the lower court's decision. The appellate court found that 21st Century Insurance Company failed to demonstrate that it had used the correct conversion factor to calculate the reimbursement rate, thus not establishing its defense that the charged fees exceeded the workers' compensation fee schedule. As a result, the branches of the defendant's motion for summary judgment related to those CPT codes were denied.

No-Fault BenefitsCPT CodesSummary JudgmentWorkers' Compensation Fee ScheduleReimbursement RateAppellate ReviewInsurance DisputeCivil ProcedureConversion FactorMedical Billing
References
2
Case No. 2016-334 S C
Regular Panel Decision
Apr 27, 2017

2 & 9 Acupuncture, P.C. v. 21st Century Advantage Ins. Co.

This case concerns an appeal by 2 & 9 Acupuncture, P.C. from an amended order that granted summary judgment to 21st Century Advantage Insurance Company, dismissing a complaint to recover assigned first-party no-fault benefits. The defendant argued it had paid the plaintiff in accordance with the workers' compensation fee schedule. The Appellate Term, Second Department, reversed the lower court's decision, finding that the defendant failed to prima facie demonstrate proper denial of payment for services billed under CPT codes 97026 and 97016. Consequently, the defendant's motion for summary judgment regarding these specific CPT codes was denied.

No-Fault BenefitsSummary JudgmentCPT CodesWorkers' CompensationAppellate ReviewInsurance LawMedical BillingAcupunctureSuffolk CountyPayment Dispute
References
3
Showing 1-10 of 10,059 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational