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Case Law Database

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

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. MISSING
Regular Panel Decision
Sep 18, 1987

Claim of Ferguson v. Fruehauf Corp.

The claimant sustained a left knee injury at work on January 29, 1982, which progressively led to severe disability, including complete paralysis and loss of use of the left leg and hip. The employer's workers' compensation insurance carrier, C.N.A. Insurance Company, initially paid total disability benefits but later objected to their continuation. The Workers’ Compensation Board affirmed the order for the carrier to continue payments, finding substantial evidence to support causal relationship and total disability. The Board also determined that the claimant's refusal to undergo an examination by a specific neurological consultant was reasonable due to a family malpractice claim against that physician.

Medical TestimonyCausal RelationshipDisability BenefitsMedical Examination RefusalAppealsBoard DecisionsNeurological InjuryOrthopedic InjuryEmployer LiabilityInsurance Carrier
References
6
Case No. 2021 NY Slip Op 01456 [192 AD3d 1287]
Regular Panel Decision
Mar 11, 2021

Matter of Brennan (Village of Johnson City)

In 1995, claimant Kevin Brennan sustained a work-related back and hip injury, leading to a workers' compensation claim. He was later disqualified from future wage-replacement benefits under Workers' Compensation Law § 114-a, with liability transferring to the Special Fund for Reopened Cases. After a left hip replacement in 2011, his treating physician annually requested authorization for a gym membership for rehabilitation, which the Special Fund granted until 2019. The 2019 request was denied based on an independent medical examiner's opinion. A Workers' Compensation Law Judge initially authorized the membership and a lump-sum reimbursement, but the Workers' Compensation Board upheld the authorization while modifying the reimbursement to amounts already paid and requiring proof for future monthly payments. Brennan appealed the Board's decision. However, the Appellate Division dismissed the appeal, finding Brennan was not 'aggrieved' by the Board's decision since he received the primary relief sought, thus lacking jurisdiction.

Workers' Compensation BenefitsGym Membership AuthorizationMedical Necessity DisputeSpecial FundAggrievement DoctrineAppellate JurisdictionReimbursement OrderHip Injury ClaimsStatutory InterpretationWCLJ Decision Review
References
10
Case No. ADJ9176582
Regular
Feb 21, 2020

MARIA MORENO vs. GARROUTTE FARMS, ZENITH INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration of a prior award finding applicant sustained industrial injury to her left shoulder, left wrist, left hip, and low back, causing temporary and permanent disability. While the Board denied the defendant's petition regarding the low back injury and temporary disability, it deferred the issue of the permanent disability rating. This deferral includes a potential increase to the whole person impairment for pain, which will be determined at the trial level after further hearing. The Board confirmed an award for additional temporary total disability and further medical treatment.

ADJ9176582Petition for ReconsiderationFindings Award and OrderIndustrial InjuryLeft ShoulderLeft WristLeft HipLow BackTemporary DisabilityPermanent Disability
References
2
Case No. MISSING
Regular Panel Decision
May 23, 2000

Claim of Krebs v. Town of Ithaca

A claimant, who previously underwent a total right hip replacement, sustained a work-related twisting injury to his right hip in March 1996. This injury resulted in a permanent partial disability, leading to his retirement. Despite medical evidence linking his disability to the preexisting hip condition, the Workers’ Compensation Board ruled that apportionment did not apply to his reduced earnings award. The employer and its carrier appealed, arguing for apportionment. The Appellate Division affirmed the Board's decision, concluding that apportionment was not warranted because the claimant had effectively performed his job for approximately one year despite his noncompensable preexisting condition.

Workers' CompensationApportionmentPreexisting ConditionPermanent Partial DisabilityWork-Related InjuryHip InjuryReduced EarningsBoard DecisionAppealNew York Workers' Compensation Law
References
4
Case No. MISSING
Regular Panel Decision
May 20, 1996

Roman v. 1185 Avenue of the Americas Associates

This case involves an appeal from an order granting the plaintiff, Victor Roman, leave to amend his bill of particulars to include additional injuries. Roman filed an action in 1989 for injuries sustained in a 1987 job site accident, initially alleging traumatic degenerative arthritis and torn muscles in his left hip. After undergoing hip replacement surgeries in 1992 and 1994, a stipulation was made in 1994 with defendant A.J. Contracting Co., allowing for further discovery if the hip surgeries were later alleged to be causally related. In 1996, Roman moved to amend his bill of particulars to include these surgeries, supported by proof of workers' compensation coverage due to the causal connection. The court granted this motion, and the appellate court affirmed, citing the policy of freely allowing amendments in the absence of prejudice, which the defendants failed to demonstrate.

Personal injurySlip and fallConstruction accidentHip replacementBill of particularsLeave to amendStipulationCausal connectionWorkers' compensationPrejudice
References
1
Case No. MISSING
Regular Panel Decision

Matter of Riescher v. Central Hudson Gas Electric

A claimant suffered two left knee injuries, first in 1999 and second in 2009, both while working as a lineman for a utility company. The first injury, covered by Alliance National Insurance Co., resulted in a 30% schedule loss of use for the left leg. The second injury, covered by Travelers Indemnity Company of America, led to a total bilateral knee replacement. The cost of left knee surgery was initially apportioned 80% to Alliance and 20% to Travelers. A Workers' Compensation Law Judge (WCLJ) later ruled that this apportionment applied only to the *increase* in the schedule loss of use award, not the overall award. The WCLJ found an overall 50% loss of use, representing a 20% increase, and applied the apportionment to this increase, resulting in Alliance being responsible for 46% and Travelers for 4% of the overall award. Alliance appealed, arguing for apportionment of the overall award, but the Workers’ Compensation Board affirmed the WCLJ's decision. The appellate court further affirmed the Board's decision, declining to reconsider the method of apportionment.

Workers' Compensation AppealSchedule Loss of UseKnee InjuryApportionmentInsurance Carrier LiabilityWCLJ DecisionBoard ReviewJudicial DiscretionLeft Leg InjuryLien
References
2
Case No. ADJ8835660
Regular
Jan 19, 2018

JOE CASILLAS vs. GRAYD A PRECISION METAL FABRICATORS; STATE COMPENSATION INSURANCE FUND

This case concerns a petition for reconsideration by the defendant regarding a permanent total disability award for Joe Casillas. The defendant argued against the total disability finding, questioned injury to the left upper extremity, and contested the basis for vocational rehabilitation findings. The Board granted reconsideration to amend the findings, rescinding the finding of injury to the left upper extremity due to the applicant unilaterally withdrawing that issue. However, the Board affirmed the permanent total disability finding based on substantial medical and vocational evidence, including the applicant's significant limitations in daily living and unsuitability for vocational rehabilitation, despite the absence of left upper extremity injury.

Permanent total disabilityvocational rehabilitationindustrial injurybilateral upper extremitiescervical spinepsychefabricatorState Compensation Insurance Fundpetition for reconsiderationadministrative law judge
References
3
Case No. ADJ1991870
Regular
Sep 07, 2010

TOM DRENNAN vs. SUPERIOR INSPECTION SERVICES, FIREMAN'S FUND INSURANCE COMPANY

This case involves an employer's petition for reconsideration of a WCJ's award finding industrial injury to the applicant's left knee, both hips, and gastrointestinal system as consequential to an admitted right knee injury. The defendant argues that a prior 2005 WCJ decision denying consequential injury to the left knee and hips is res judicata. The Appeals Board granted reconsideration, amending the award to remove the left knee and hip injuries, holding that the 2005 decision was final and the five-year time limit to reopen under Labor Code sections 5410 and 5804 had passed. The finding of consequential injury to the gastrointestinal system and 29% permanent disability remain affirmed.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardCompensable ConsequencesRes JudicataIndustrial InjuryLeft KneeHipsGastrointestinal SystemPermanent Disability
References
2
Case No. MISSING
Regular Panel Decision

Claim of Camby v. System Freight, Inc.

A tractor-trailer driver developed low back, left hip, and left leg pain after extensive clutch use during his employment. His treating orthopedist diagnosed a temporary total disability with disc herniations. The Workers’ Compensation Law Judge and the Workers’ Compensation Board found that the claimant suffered from a work-related occupational disease and awarded benefits. The employer and its carrier appealed, arguing a lack of causal link. The appellate court affirmed the Board's decision, citing substantial evidence supporting the causal relationship and deferring to the Board's credibility determinations regarding conflicting medical evidence.

Occupational DiseaseWorkers' Compensation BenefitsTractor-Trailer DriverClutch InjuryLow Back PainDisc HerniationCausation DisputeMedical EvidenceCredibility DeterminationsAppellate Review
References
5
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