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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
Apr 15, 1999

Nunes v. National Union Fire Insurance

Karl Nunes, injured during employment, received workers' compensation benefits from National Union Fire Insurance Company. After settling a third-party action against Tower Elevator, Inc., National Union asserted a lien for the benefits. However, National Union failed to initiate an action to enforce this lien within the three-year Statute of Limitations, which commenced upon the third-party settlement. Consequently, Nunes petitioned the Supreme Court, Queens County, to vacate the lien, a request that was granted. The Appellate Division affirmed this decision, confirming that the lien was appropriately vacated due to the insurer's failure to enforce it within the statutory period.

Workers' CompensationLien VacaturStatute of LimitationsThird-Party ActionInsurance LienAppellate DivisionCPLR 214(2)Workers' Compensation Law § 29(1)Elevator AccidentEmployment Injury
References
2
Case No. MISSING
Regular Panel Decision
Jan 27, 1984

Stedman v. City of New York

This case concerns an appeal regarding a workers' compensation lien. The plaintiff, a cab driver, was injured in an automobile accident and received workers' compensation benefits from the State Insurance Fund and no-fault benefits from Eagle Insurance Co. Plaintiff settled a personal injury action against Walther and the City of New York for $30,000, with Welsbach and Alfo Cab Co. as third-party defendants. The trial court initially granted a motion to vacate the workers' compensation lien but later reversed this decision. The appellate court unanimously reversed the vacatur, denied the motion to vacate the lien, and reinstated the lien, holding that the Fund's lien attaches to recoveries from non-covered persons (City of New York and Welsbach) for both economic and non-economic loss under Insurance Law § 673, subd 2.

Workers' Compensation LienNo-Fault BenefitsAutomobile AccidentThird-Party ActionSubrogationInsurance LawEconomic LossNoneconomic LossSettlement ProceedsStatutory Interpretation
References
2
Case No. MISSING
Regular Panel Decision

Klem v. Special Response Corp.

This case involves an appeal from an order regarding the distribution of settlement proceeds and a workers' compensation lien. The plaintiff sustained an ankle injury during employment and subsequently settled a personal injury action against Special Response Corporation. Zurich Insurance Company, the workers' compensation insurer for the plaintiff's employer, had paid over $114,000 in benefits and claimed a lien against the $70,000 settlement proceeds. The Supreme Court initially ruled that Zurich was not entitled to assert a lien. However, the appellate court reversed this decision, affirming Zurich's right to a lien, but remitted the matter to the Supreme Court for further proceedings to properly calculate the lien amount, taking into account statutory reductions for benefits paid in lieu of first-party benefits and an equitable apportionment of litigation costs, including attorneys' fees.

Workers' CompensationLien RightsSettlement ProceedsPersonal InjuryAppellate ReviewInsurance LawEquitable ApportionmentLitigation CostsFirst-Party BenefitsNo-Fault Law
References
6
Case No. MISSING
Regular Panel Decision

Prentice v. Levy

Plaintiff sustained a work-related cervical spine injury in 1998 and underwent surgery by defendant Dr. Walter J. Levy in 1999. After the first surgery failed and a second surgery in 2002 to remove loosened hardware, plaintiff settled a medical malpractice action against Levy for $400,000. The self-insured employer, Tops, Inc., and its administrator, MAC Risk Management, as "the carrier," asserted a workers' compensation lien against the settlement. The Supreme Court provisionally set the lien at $22,442.91 and appointed a referee to determine the final lien and offset amounts, with the carrier bearing the costs. The appellate court affirmed the order, ruling that the interim lien was "without prejudice" and the referee's hearing scope was sufficient to conduct a comprehensive evidentiary hearing, thus causing no prejudice to the carrier.

Workers' Compensation LienMedical MalpracticeSettlement LienInterim LienWorkers' Compensation LawAppellate ReviewReferee AppointmentLien EstablishmentOffset PaymentsEvidentiary Hearing
References
2
Case No. MISSING
Regular Panel Decision

Kesick v. Ulster County Self Insurance Plan

Paul Kesick, a police officer, was involved in two automobile accidents, leading to workers' compensation claims for knee injuries. Kesick and his wife settled a personal injury action against the drivers for $50,000 and $75,000 without the consent of the Ulster County Self Insurance Plan, their workers' compensation carrier. The Supreme Court granted their application for a nunc pro tunc order approving the settlement but denied the carrier's request for a workers' compensation lien against the settlement proceeds. The carrier appealed, arguing it was entitled to a lien for amounts exceeding $50,000, which are not considered first-party benefits. The appellate court agreed, modifying the order by granting the carrier a lien of $5,969.49 to be held in escrow, preventing an impermissible double recovery for the petitioners.

Workers' Compensation LawLienSettlementThird-Party ActionFirst-Party BenefitsNo-Fault Insurance LawDouble RecoveryAutomobile AccidentAppellate CourtStatutory Interpretation
References
3
Case No. ADJ6981750
Regular
Jan 13, 2017

GUMERSINDO DELEON vs. ESPARZA ENTERPRISES, INC.

This case concerns a lien claimant's failure to pay a $100.00 lien activation fee required by Labor Code section 4903.06 by the date of a lien conference. The Workers' Compensation Appeals Board (WCAB) is considering rescinding the order dismissing the lien, but only if the fee is paid within ten days of this notice. The WCAB's intention is based on a court order allowing lien activation fees to be paid between November 9, 2015, and December 31, 2015, and the lien claimant's assertion of computer problems. If payment is received, the lien claim will be returned to the trial level for further proceedings.

Lien activation feeLabor Code Section 4903.06ReconsiderationOrder Dismissing Lien ClaimWCJDWCAngelotti Chiropractic v. BakerPreliminary injunctionNinth CircuitVacating injunction
References
7
Case No. ADJ1035201
Regular
Oct 04, 2016

VICTOR DURAN vs. DONUT INN, STATE FARM INSURANCE COMPANY

The Appeals Board is considering rescinding an order that dismissed Metro Med Shockwave's lien claim for failure to pay a $\$100$ lien activation fee. The WCJ dismissed the lien because the fee was not paid before the lien conference, citing prior precedent. However, the lien claimant argues they had until December 31, 2015, to pay the fee based on a DWC Newsline article referencing a court order. The Board intends to rescind the dismissal if the fee is paid within ten days, allowing further proceedings on the lien claim.

Labor Code section 4903.06Lien activation feeWorkers' Compensation Appeals BoardMetro Med ShockwaveFigueroa v. B.C Doering Co.Angelotti Chiropractic v. BakerPreliminary injunctionDWC NewslineReconsiderationRescind order
References
2
Case No. MISSING
Regular Panel Decision

DeRosa v. Petrylak

This case concerns an appeal and cross-appeal regarding a third-party personal injury settlement and an insurance lien. The plaintiff, DeRosa's widow, initially received workers' compensation death benefits after her husband's work-related automobile accident. She subsequently settled a third-party claim against Petrylak's estate, the driver of the vehicle, without the workers' compensation carrier's (Aetna) prior consent or court approval. This led Aetna to refuse further death benefits. The Supreme Court granted nunc pro tunc approval of the third-party settlement, finding the delay justified by the plaintiff's belief of no lien due to the fellow-employee rule and the initial uncertainty of benefit entitlement. However, the Supreme Court declined to reduce Aetna's insurance lien. The Appellate Division affirmed both orders, concluding that the Supreme Court properly exercised its discretion in granting nunc pro tunc approval.

Workers' Compensation Law § 29Nunc Pro Tunc ApprovalThird-Party SettlementInsurance LienFellow Employee DoctrineAutomobile Accident DeathWorkers' Compensation Death BenefitsAppellate ReviewCarrier ConsentStatutory Interpretation
References
3
Case No. ADJ8 156794
Regular
Jan 12, 2017

NURY PEREZ vs. BLUE RIVER DENIM, THE HARTFORD

The Workers' Compensation Appeals Board (WCAB) is considering rescinding an order that dismissed a lien claim due to a failure to pay a $100 lien activation fee. The lien claimant, Premier Psychological Services (PPS), claims computer issues prevented timely payment. While the WCJ recommended denial of reconsideration, the WCAB may rescind the dismissal if PPS pays the activation fee within ten days of this notice. If paid, the lien claim will be returned to the trial level for further proceedings.

Lien activation feeLabor Code section 4903.06WCABadministrative law judgereconsiderationrescissiondismissallien conferenceCompromise and Releaseindustrial injury
References
1
Case No. ADJ2897340 (VNO 0425114)
Regular
Dec 27, 2013

BLANCHE ALFI vs. DEPARTMENT OF MOTOR VEHICLES, STATE COMPENSATION INSURANCE FUND

This case involves a lien claimant who filed two liens with similar names for the same pharmacy. The WCJ dismissed one lien for failure to pay the activation fee, while the other, correctly paid, was settled. The lien claimant sought reconsideration, arguing the dismissal was moot because they paid the fee for the settled lien and that the dismissal order was invalid. The Board dismissed the petition, finding the lien claimant was not aggrieved by the dismissal and that the separate orders did not invalidate the settlement. The Board also admonished the claimant for wasting judicial resources with their filings.

Workers' Compensation Appeals BoardLien ClaimantReconsiderationOrder Dismissing LienLien Activation FeeLabor Code section 4903.06(a)(4)WCJNegotiated SettlementIndustrial InjuryPetition for Reconsideration
References
1
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