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

Case No. ADJ1932035 (ANA 0234626) ADJ2673288 (ANA 0234627) ADJ4019770 (ANA 0234628)
Regular
Jun 15, 2009

Elmer Bourland vs. LONG BEACH MEMORIAL MEDICAL CENTER

The Workers' Compensation Appeals Board denied reconsideration, upholding a prior order for a lifetime annuity of $900 per month. Defendant argued the original compromise and release agreement intended only a 15-year guaranteed payment period, not a lifetime annuity. However, the Board found the 1992 Order approving the settlement explicitly stated "lifetime annuity" and was not timely challenged by defendant. As no good cause such as fraud or mutual mistake was shown, the 1992 Order is now final and binding.

WORKERS' COMPENSATION APPEALS BOARDELMER BOURLANDLONG BEACH MEMORIAL MEDICAL CENTERTRISTAR RISK MANAGEMENTFindings and Orderlifetime annuityCompromise & Releaseindustrial injuryright kneeinternal system
References
14
Case No. MISSING
Regular Panel Decision

LaCroix v. Syracuse Executive Air Service, Inc.

This case concerns whether Workers’ Compensation Law allows for lump-sum payment of "schedule loss of use" awards for permanent partial disability, or if payments must be made periodically. Claimant Marie LaCroix, a baggage handler, fractured her wrist and tore her rotator cuff, leading to a 75% loss of use of her left arm. The Workers’ Compensation Board and Appellate Division affirmed a lump-sum payment. However, the Court of Appeals reversed, holding that the statute's directive for "periodically" payments precludes a lump-sum policy, unless specific commutation procedures for individual cases are followed, requiring actuarial reduction. The court emphasized that any departure from periodic payment must originate from the Legislature.

Permanent Partial DisabilitySchedule Loss of UseLump Sum PaymentPeriodic PaymentWorkers' Compensation LawStatutory InterpretationAppellate ReviewReimbursementEarning CapacityWage Loss
References
8
Case No. MISSING
Regular Panel Decision

Horn & Hardart Co. v. Ross

This Article 78 proceeding reviewed an order from the Industrial Board of Appeals, entered November 17, 1976, which had found petitioners liable for pension payments to certain retired employees. The case originated when Horn & Hardart Company terminated its noncontributory pension plan in 1972 due to financial difficulties, prompting complaints from pensioners and an Industrial Commissioner's order for payment. Petitioners challenged the Commissioner's jurisdiction, but the court affirmed it, citing Labor Law § 198-c(2) and evidence of promised "lifetime pensions." While confirming the order's core, the court modified it to strike a provision that expanded its scope to all similarly situated retirees, noting that such an expansion was not originally contemplated and that the Employee Retirement Income Security Act of 1974 (ERISA) now governs such protections, even if pre-ERISA causes of action remain under state regulation.

Pension Plan TerminationEmployee BenefitsIndustrial Board of AppealsIndustrial Commissioner JurisdictionArticle 78 ProceedingRetirement BenefitsLabor LawERISAAdministrative RemediesJudicial Review
References
4
Case No. MISSING
Regular Panel Decision
Jul 01, 2002

Johnson v. Shelmar Corp.

Claimant suffered work-related injuries in 1993, leading to a settlement approved on September 12, 2001, under Workers’ Compensation Law § 32. The settlement funds were mailed on September 24, 2001. Claimant sought a 20% penalty, arguing the payment was late according to Workers’ Compensation Law § 25 (3) (f) and 12 NYCRR 300.36 (g), as it exceeded the 10-day period post-approval. The Workers’ Compensation Board affirmed this penalty. However, the appellate court reversed the decision, applying General Construction Law § 25-a (1), which extends deadlines falling on a Saturday to the next business day, thus making the September 24th payment timely. The court also noted that the Board could have exercised discretion to waive the deadline due to the operational disruptions caused by the September 11, 2001 attacks on the World Trade Center.

Late Payment PenaltyWorkers' Compensation SettlementStatutory Deadline ExtensionGeneral Construction LawRule DiscretionSeptember 11 Attacks ImpactTimeliness of PaymentAdministrative HearingWorkers' Compensation BoardJudicial Review
References
2
Case No. MISSING
Regular Panel Decision

Claim of Hart v. Pageprint/Dekalb

The case involves an appeal from a Workers' Compensation Board decision that imposed a late payment penalty on an employer's carrier. The claimant, suffering from permanent partial disability due to bilateral carpal tunnel syndrome, entered into a waiver agreement with the carrier for $35,200. Although the Board approved the agreement without a hearing, the carrier paid the claimant 20 days after approval, exceeding the 10-day limit, leading to a $7,040 penalty. The appellate court found the streamlined procedures used for approval invalid because they conflicted with 12 NYCRR 300.36, meaning the agreement was never properly approved and thus the 10-day limitations period for payment never commenced. Consequently, the penalty imposition was reversed, and the matter was remitted to the Board for a proper hearing on the agreement.

Workers' Compensation Law § 32Late Payment PenaltyWaiver AgreementBoard ApprovalStreamlined ProceduresAdministrative LawJudicial ReviewRemandWorkers' Compensation BoardOccupational Disease
References
5
Case No. MISSING
Regular Panel Decision

Claim of Keselman v. New York City Transit Authority

Claimant, injured in 1986, initially established a right shoulder injury. The Workers’ Compensation Board affirmed this but denied a causally related neck injury in 1996. After another application in 1998 alleging a worsened neck condition, the Workers’ Compensation Law Judge found a causally related neck injury and permanent partial disability, awarding benefits from February 5, 1998, which the Board affirmed. Separately, the Board also ruled the employer was entitled to credit schedule payments against disability payments made after February 5, 1998. The court affirmed both decisions, finding substantial evidence supported the deterioration of the neck injury post-1996 and that schedule awards are independent of actual disability periods, thus allowing the employer's credit.

Workers' CompensationPermanent Partial DisabilitySchedule AwardDisability PaymentsNeck InjuryRight Shoulder InjuryCausally Related InjuryReopening CaseMedical EvidenceMRI
References
7
Case No. MISSING
Regular Panel Decision

Garden State Anesthesia Associates, PA v. Progressive Casualty Insurance

Garden State Anesthesia Associates (GSAA) sued Progressive Casualty Insurance Company for unpaid first-party no-fault benefits after providing services to Angela Gowan-Walker. Progressive delayed payment, citing the need for Gowan-Walker's examination under oath (EUO) and extensive medical and workers' compensation records. Although Gowan-Walker completed her EUO, Progressive continued to issue delay letters, requesting information primarily from third parties and Gowan-Walker's attorney, without directly contacting GSAA for verification. The court denied Progressive's motion for summary judgment, ruling that an insurer cannot indefinitely toll the 30-day payment period by requesting verification unrelated to the specific provider's claim or by failing to request verification directly from the provider.

No-fault benefitsSummary JudgmentInsurance LawVerification RequestDelay LetterEUOMedical RecordsInsurance ClaimsTimelinessTolling
References
9
Case No. MISSING
Regular Panel Decision
Dec 04, 1989

Richardson v. Hetelekides

The Workers' Compensation Board imposed a 20% penalty on Insurance Company of North America, the carrier for employer Savos Hetelekides, for late payment of a $1,125 award to the claimant. The carrier argued that the 10-day payment period for compensation awards should commence upon its receipt of the notice of award, not the filing date. However, both a Workers’ Compensation Law Judge and the Board affirmed the penalty, stating that no extra time is allowed for mailing and the period begins from the notice's filing date. The employer and carrier appealed this determination to the appellate court. The appellate court affirmed the Board's decision, reiterating that the 10-day period for payment of a compensation award commences on the date of filing of the notice of award.

Workers' CompensationPenalty for Late PaymentLate Payment of Award10-Day Payment PeriodNotice of AwardFiling Date vs. Receipt DateAppellate ReviewBoard Decision AffirmedInsurance Carrier LiabilityEmployer Appeal
References
2
Case No. MISSING
Regular Panel Decision

Claim of Homan v. Gotham Building Maintenance Corp.

The claimant, a fireman for Gotham Building Maintenance Corporation, suffered an inguinal hernia in 1977 but did not file a workers' compensation claim until 1982 when surgery became necessary. The State Insurance Fund, the carrier, paid for the surgery in September 1983. At a hearing, the employer and carrier argued the claim was time-barred under Workers' Compensation Law § 28, as it was filed more than two years after the accident. However, the Workers' Compensation Board ruled that the carrier's payment for the surgery constituted an advance payment of compensation, thereby waiving the two-year limitation period. The appellate court affirmed the Board's decision, citing established precedent that such advance payments, even if made after the statutory period, waive the limitation, especially when timeliness was not disputed before payment.

Workers' CompensationLimitation PeriodAdvance PaymentWaiverMedical ExpensesHernia InjuryTimeliness of ClaimBoard DecisionAppellate ReviewState Insurance Fund
References
5
Case No. ADJ3619852 (VNO 0395419)
Regular
Apr 05, 2013

JESSIE SHERROD vs. COUNTY OF LOS ANGELES

In this workers' compensation case, the applicant, a physician, claimed temporary total disability (TTD) for a period during which the employer provided long-term disability (LTD) payments. The Workers' Compensation Appeals Board granted reconsideration, amending the original award. The Board found that while the employer is entitled to credit for LTD payments, the TTD indemnity due to the applicant must be calculated at the rate provided by Labor Code section 4661.5, which uses the rate in effect on the date of payment, not the rate at the time of injury. This decision ensures the applicant receives TTD at the statutorily current rate for the retroactive period.

Workers' Compensation Appeals BoardJessie SherrodCounty of Los AngelesPetition for ReconsiderationSupplemental Findings and AwardTemporary Total Disability IndemnityLong Term DisabilityLabor Code section 4661.5Agreed Medical ExaminerAverage Weekly Earnings
References
0
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