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

Case No. MISSING
Regular Panel Decision

Medoy v. Warnaco Employees' Long Term Disability Insurance Plan

Plaintiff, Audrey Medoy, sued Warnaco Employees’ Long Term Disability Insurance Plan and Warnaco, Inc. (Defendants) under ERISA, alleging wrongful termination of disability benefits, failure to provide requested documents, and failure to retain claims records. Medoy's disability benefits were discontinued in 1987 without notice. After years of requesting information and appealing the decision, which was hampered by the destruction of her claims file, she filed this action in 1997. Defendants moved to dismiss the complaint, arguing that the claims were untimely, that Medoy was not a 'participant' entitled to disclosure, and that ERISA § 1027 did not cover claims records. The court denied Defendants' motion to dismiss on all grounds, finding her claims timely, her status as a 'participant' colorable, and claims records subject to retention under ERISA § 1027.

ERISALong-term Disability BenefitsStatute of LimitationsFailure to DiscloseRecord RetentionFutility ExceptionAccrual of ActionPlan Administrator DutiesParticipant StatusMotion to Dismiss
References
37
Case No. 12 Civ. 5645(KPF)
Regular Panel Decision
Feb 18, 2015

Wedge v. Shawmut Design & Construction Group Long Term Disability Insurance Plan

This case involves Plaintiff William Wedge's challenge under ERISA against the Shawmut Plan and Reliance Standard Life Insurance Company (RSLI) for the termination of his long-term disability benefits. Wedge, a former Senior Project Manager, suffered from Central Serous Chorioretinopathy (CSCR) and had his benefits denied by RSLI, which determined he was not "Totally Disabled" under the "Any Occupation" clause. The court applied an arbitrary and capricious standard of review, considering RSLI's structural conflict of interest but finding it warranted minimal weight. Ultimately, the court concluded that RSLI's decision, supported by comprehensive medical and vocational evidence, including an Independent Medical Examination, was reasonable and not arbitrary or capricious. Therefore, Plaintiff's motion for summary judgment was denied, and Defendants' motion was granted.

ERISA LitigationLong Term DisabilityBenefits DenialArbitrary and Capricious ReviewSummary Judgment MotionDiscretionary AuthorityConflict of InterestCentral Serous ChorioretinopathyMedical EvidenceVocational Assessment
References
46
Case No. 2023 NY Slip Op 01193 [214 AD3d 735]
Regular Panel Decision
Mar 08, 2023

Matter of Long Beach Professional Firefighters Assn. v. City of Long Beach

This case concerns a dispute between the Long Beach Professional Firefighters Association (union) and the City of Long Beach regarding the terms of employment for paramedics. The City had unilaterally set these terms, leading the union to file a grievance and subsequently seek arbitration. The arbitrator found that the City violated the collective bargaining agreement. The Supreme Court confirmed the arbitration award, which the City appealed. The Appellate Division affirmed the Supreme Court's order, ruling that the City failed to provide clear and convincing evidence to vacate the arbitration award on grounds of irrationality, manifest disregard of law, arbitrator misconduct, or violation of public policy.

Collective Bargaining AgreementArbitration AwardCPLR Article 75 ProceedingJudicial Review of ArbitrationPublic Policy ExceptionManifest Disregard of LawAppellate ReviewMunicipal EmploymentParamedicsGrievance
References
20
Case No. 2018 NY Slip Op 03356 [161 AD3d 855]
Regular Panel Decision
May 09, 2018

Matter of City of Long Beach v. Long Beach Professional Fire Fighters Assn., Local 287

The City of Long Beach (petitioner) appealed an order denying its petition to stay arbitration and granting the Long Beach Professional Fire Fighters Association, Local 287's (respondent) cross-motion to compel arbitration. The dispute arose after the City laid off firefighters and hired paramedics, setting the paramedics' terms of employment unilaterally. The union filed a grievance and demand for arbitration. The Supreme Court denied the City's petition and granted the union's cross-motion. On appeal, the Appellate Division, Second Department, held that arbitration of the claim regarding firefighter layoffs violated public policy, citing Civil Service Law § 80 (1) which grants public employers nondelegable discretion over staffing. However, the court found no public policy precluding arbitration of claims related to the paramedics' terms of employment, as permitted by the collective bargaining agreement. Therefore, the order was modified to grant the City's petition to stay arbitration of the layoff claim and deny the union's cross-motion to compel arbitration of that claim, while affirming the rest of the order.

ArbitrationCollective Bargaining AgreementPublic PolicyFirefighter LayoffsParamedics EmploymentCivil Service LawManagement PrerogativeTaylor LawAppellate ReviewLabor Dispute
References
15
Case No. 05-CV-1573
Regular Panel Decision

Magin v. Cellco Partnership

This action was brought under ERISA by David Magin against Verizon Wireless entities and MetLife Corporation after his short-term disability benefits were denied. Plaintiff also implicitly sought long-term disability benefits. The court considered cross-motions for summary judgment. Applying an arbitrary and capricious standard of review, the court found MetLife's denial of short-term disability benefits was not an abuse of discretion, citing a lack of material medical evidence. The claim for long-term disability benefits was dismissed as it was never properly filed. Consequently, the defendants' motion for summary judgment was granted, and the plaintiff's complaint was dismissed.

ERISADisability BenefitsShort Term DisabilityLong Term DisabilitySummary JudgmentAbuse of DiscretionDe Novo ReviewFiduciary DutyClaims DenialMedical Evidence
References
38
Case No. MISSING
Regular Panel Decision

Rector v. Sylvania

Plaintiff Sylvia Rector sued her former employer, Osram Sylvania, alleging disability discrimination under the Americans with Disabilities Act (ADA) after her termination. Rector suffered a shoulder injury requiring surgery and received short-term and long-term disability benefits. She was eventually cleared to return to work without restrictions, but Sylvania was undergoing a reduction in force and had no available position. The court granted Sylvania's motion for summary judgment, concluding that Rector's temporary shoulder injury did not constitute a disability under the ADA as it lacked the required permanent or long-term impact on a major life activity.

ADADisability DiscriminationSummary JudgmentEmployment LawShoulder InjuryTendonitisImpingement SyndromeTemporary DisabilityMajor Life ActivityReduction in Force
References
15
Case No. MISSING
Regular Panel Decision

In Re Dana Corp.

Dana Corporation, as the debtor, sought court approval for its Executive Compensation Motion, which included the assumption of employment agreements and the establishment of a long-term incentive plan (LTIP) for its CEO and Senior Executives. This was Dana’s second attempt after an earlier, less incentivizing proposal was denied. The motion faced opposition from the U.S. Trustee, unions, and a non-union retiree committee, who raised concerns under Bankruptcy Code section 503(c) regarding retention and severance payments to insiders. The Court, treating the motion de novo, determined that the revised plan was a legitimate incentive program, not primarily retentive, and generally permissible under the Debtors’ sound business judgment. However, the Court expressed concern over the potential cumulative generosity of both the annual and long-term incentive plans for 2007-2008 without a clear ceiling. Consequently, the Executive Compensation Motion was granted, but conditioned on the submission of an order establishing an appropriate annual compensation cap for the CEO and Senior Executives.

Bankruptcy LawExecutive CompensationIncentive PlansEmployment AgreementsChapter 11 ReorganizationCreditors' RightsBusiness Judgment RuleKey Employee Retention Programs (KERPs)Severance PayNon-compete Clauses
References
28
Case No. 2016 NY Slip Op 00977 [136 AD3d 824]
Regular Panel Decision
Feb 10, 2016

Matter of Long Beach Professional Firefighters Assn., Local 287 v. City of Long Beach

Jay Gusler, a lieutenant in the City of Long Beach Fire Department and a member of Long Beach Professional Firefighters Association, Local 287, was demoted to firefighter. This demotion followed a disciplinary proceeding presided over by Robert L. Douglas, as per a settlement agreement between the City and the Association. The appellants (Gusler and the Association) initiated a CPLR article 78 proceeding to challenge the demotion, arguing Douglas lacked authority under the City Code. The Supreme Court, Nassau County, dismissed the proceeding. The Appellate Division, Second Department, affirmed this decision, finding that the City and Association could negotiate a collective bargaining agreement allowing demotion, and Douglas acted within the authority granted by their settlement agreement.

DemotionFirefightersCollective Bargaining AgreementSettlement AgreementDisciplinary ProceedingsArticle 78 ProceedingArbitrator AuthorityCity CodePublic EmploymentAppellate Review
References
6
Case No. MISSING
Regular Panel Decision

Lampo v. Eastman Kodak Co.

The claimant appealed three decisions by the Workers' Compensation Board that denied additional disability benefits and rejected an application for reconsideration of a discrimination claim. The court found substantial evidence in Dr. David Smith's testimony, which indicated normal visual performance, supporting the Board's conclusion that the claimant had no loss of visual acuity. It was also noted that the claimant received 26 weeks of disability payments, and the employer's long-term disability plan, which exceeds state requirements, is governed solely by ERISA. The Board's decision to deny reconsideration of the discrimination claim was deemed neither an abuse of discretion nor arbitrary, as no new evidence was presented. Consequently, the court affirmed the Board's decisions.

Workers' Compensation BoardDisability BenefitsVisual AcuityERISADiscrimination ClaimReconsideration DenialSubstantial EvidenceCredibility IssueAppellate ReviewAffirmed Decision
References
3
Case No. ADJ1429155 (LAO 0862514) ADJ2655171 (LAO 0886561)
Regular
Mar 06, 2013

GUILLERMO HERNANDEZ vs. MCKESSON CORPORATION, ATHENS ADMINISTRATORS

The Appeals Board rescinded prior decisions and issued a Joint Findings and Award, apportioning applicant's permanent disability between two industrial injuries (March 1, 2005, and June 29, 2005) based on Agreed Medical Evaluator opinions. The Board also granted applicant a 15% "bump up" in permanent disability payments due to the employer's failure to offer long-term work. The issue of the EDD lien and attorney fee division was deferred to the trial level.

Workers' Compensation Appeals BoardReconsiderationIndustrial InjuryPermanent DisabilityApportionmentAgreed Medical EvaluatorDRE Category IIIActivities of Daily LivingSleep DisorderLabor Code Section 4658(d)
References
0
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