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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

Jeffries v. Pension Trust Fund of the Pension, Hospitalization & Benefit Plan of the Electrical Industry

Plaintiff Claude Jeffries, a retired electrician, sued the Pension Trust Fund of the Electrical Industry under ERISA, seeking to include pension credits from 1969-1975 in his current benefits. He alleged the Plan should have declared a partial termination during a 1975-1979 New York recession, which would have vested his benefits. The defendant moved to dismiss the complaint, arguing lack of standing and statute of limitations, while plaintiff moved for class certification for similarly affected members. The court denied the defendant's motion to dismiss the claim for benefits, finding it timely, but granted dismissal for the breach of fiduciary duty claim as time-barred. The plaintiff's motion for class certification was denied due to insufficient evidence for numerosity, with leave to refile after discovery.

ERISAPension BenefitsClass CertificationMotion to DismissStatute of LimitationsFiduciary DutyPartial TerminationBenefit ForfeitureUnemploymentLabor Union
References
15
Case No. MISSING
Regular Panel Decision

Claim of Frey v. Town of Newstead

This case concerns an appeal from a Workers' Compensation Board decision that awarded benefits to a volunteer firefighter, the claimant, for a causally related loss of earning capacity under the Volunteer Firefighters’ Benefit Law. The claimant was injured in a motor vehicle accident while on duty for the Town of Newstead. A Workers' Compensation Law Judge initially determined a permanent partial disability with a 50% to 75% loss of earning capacity, which the Board affirmed. The employer, Town of Newstead, appealed, arguing a lack of substantial evidence. The appellate court reversed the Board's decision, citing that the claimant's treating physician released her to 'regular duty' with only minor restrictions, and her earnings had increased in the same job since the accident. The matter was remitted to the Workers’ Compensation Board for further proceedings.

Volunteer Firefighters' Benefit LawEarning Capacity AssessmentPermanent Partial DisabilityAppellate Court ReversalRemittal to BoardWorkers' Compensation Board DecisionMedical Opinion EvidenceEmployment RestrictionsWage Increase EffectLine of Duty Injury
References
3
Case No. MISSING
Regular Panel Decision
Aug 08, 2005

Weinstein v. Somers Fire District

Claimant, a volunteer firefighter and self-employed real estate agent, sustained a back injury in July 2001 while performing duties. A Workers’ Compensation Law Judge found he suffered a permanent partial disability and a 50% loss of earning capacity under the Volunteer Firefighters’ Benefit Law, awarding benefits. The Workers’ Compensation Board affirmed this decision. The employer and its carrier appealed the decision. The court affirmed the Board's decision, citing substantial evidence including a neurosurgeon's report indicating chronic low back pain, reduced ability to work, and a moderate permanent disability. The report noted that the claimant's duties as a real estate agent were limited, and his average work hours had significantly decreased.

Volunteer firefighterloss of earning capacitypermanent partial disabilityback injuryreal estate agentneurosurgeon reportsubstantial evidenceWorkers' Compensation Boardappealbenefit law
References
4
Case No. MISSING
Regular Panel Decision
Jun 22, 2011

Griffin v. Town of Dewitt

Claimant, a heavy truck mechanic, sustained a back injury requiring surgery in 2009. Despite returning to work without restrictions, he felt unable to perform his duties and retired in 2010, subsequently seeking lost time benefits. The employer and its third-party administrator argued that he had voluntarily withdrawn from the labor market. A Workers' Compensation Law Judge initially found a permanent partial disability but denied benefits due to voluntary withdrawal. However, the Workers' Compensation Board reversed this, finding an involuntary retirement and awarding continuing benefits. The employer and administrator appealed this decision. The Appellate Division affirmed the Board's decision, citing substantial evidence that the claimant's disability significantly contributed to his decision to retire and his ongoing wage loss, supported by his testimony and medical opinions.

Workers' CompensationInvoluntary RetirementPermanent Partial DisabilityLost Time BenefitsLabor Market WithdrawalBack InjuryDisability BenefitsAppellate ReviewMedical OpinionSocial Security Benefits
References
5
Case No. MISSING
Regular Panel Decision

Schmidt v. Falls Dodge, Inc.

The claimant was awarded a 21.43% schedule loss of use for binaural hearing loss in 2007. The Workers’ Compensation Law Judge and the Workers’ Compensation Board determined that this award was not subject to temporary disability benefits the claimant was already receiving from earlier workers' compensation cases. The employer and State Insurance Fund appealed, contending that a Court of Appeals decision overruled prior holdings regarding the overlap of schedule and nonschedule awards. The appellate court affirmed the Board's decision, distinguishing between schedule awards for future earnings loss and nonschedule awards for temporary disability during a limited time frame, concluding they do not overlap.

Workers' CompensationSchedule Loss of UseTemporary DisabilityBinaural Hearing LossAward OverlapAppellate DecisionInsurance FundEmployer LiabilityMedical BenefitsEarnings Loss
References
3
Case No. MISSING
Regular Panel Decision

State Farm Mutual Automobile Insurance Co. v. Pender

This case involves a subrogation action initiated by an unnamed plaintiff (subrogee) to recover $15,200 in additional personal injury protection (APIP) benefits paid to its subrogor, Darci Plumbing Co., Inc., for an employee, Kareem Atkins. The defendants moved to dismiss the complaint based on documentary evidence, collateral estoppel, and res judicata, arguing that a prior Workers’ Compensation Board decision from November 24, 2008, which awarded Atkins basic economic loss benefits, was determinative. The plaintiff cross-moved for sanctions. The court found that APIP benefits, defined by 11 NYCRR 65-1.3, are distinct from statutory basic economic loss benefits and that an insured's subrogation rights for APIP are equitable, existing under common law. Therefore, the workers' compensation award was not res judicata, and the plaintiff was not precluded from asserting its subrogation rights for amounts paid in addition to the statutory basic economic loss. Consequently, the defendants' motion to dismiss was denied, and the plaintiff's cross-motion for sanctions was also denied.

SubrogationAPIP BenefitsPersonal Injury ProtectionWorkers' CompensationCollateral EstoppelRes JudicataMotion to DismissSanctionsNo-Fault LawInsurance Law
References
1
Case No. MISSING
Regular Panel Decision

Claim of Cerami v. Rochester City School District

This case involves an appeal from a Workers’ Compensation Board decision that found a claimant’s benefit claim untimely. The claim, filed in 1980, stemmed from a mental breakdown in 1966-1967 alleged to be work-related. The Board ruled the claimant was mentally competent to file within the two-year statutory period (WCL § 28), thus rejecting the tolling provision for mental incompetency (WCL § 115). The appellate court reviewed the medical testimony of Dr. Leve and Dr. Pisetzner, concluding the Board misconstrued their findings regarding the claimant’s capacity to comprehend his mental illness as work-related, despite general competence to file other claims. The court found overwhelming medical evidence indicated the claimant was mentally incapable of filing a claim for employment-induced mental illness and therefore deemed the claim timely under WCL § 115 due to continuing mental incapacity. Additionally, the court found substantial, virtually unanimous medical testimony confirming the work-related causation of the claimant’s mental illness, contrary to the Workers’ Compensation Law Judge’s determination. The decision was reversed, compensation benefits granted, and the matter remitted to the Board for further proceedings.

Workers' Compensation ClaimTimeliness of ClaimMental IncompetencyTolling Statute of LimitationsParanoid SchizophreniaEmployment-Induced Psychological InjuryCausal RelationshipMedical Testimony InterpretationAppellate ReviewReversal of Board Decision
References
3
Case No. MISSING
Regular Panel Decision

Claim of Mickelson v. Value Construction

Claimant, a carpenter, sought workers' compensation benefits for a left wrist injury in April 2013. The Workers' Compensation Board initially ruled the claim time-barred but later rescinded that decision, establishing the claim with a disablement date of May 6, 2013, corresponding to the diagnosis of a work-related ligament injury and arthritis. The employer and carrier appealed this decision. The Appellate Division, Third Department, affirmed the Board's finding regarding the timely filing and date of disablement, noting it was supported by substantial evidence, despite the claimant's earlier symptoms. However, the Court found that the Board failed to address a previously raised issue concerning whether the left wrist injury was consequentially related to a 2003 right wrist injury. Consequently, the Court modified the Board's decision by remitting the matter for further proceedings to address this unadjudicated issue.

Workers' CompensationTimeliness of ClaimDate of DisablementOccupational DiseaseLeft Wrist InjuryCarpal Tunnel SyndromeLigament InjuryArthritisMedical DiagnosisRemittal
References
3
Case No. MISSING
Regular Panel Decision

Claim of Elias v. New York City Human Resources Administration

The Workers’ Compensation Board ruled that the claimant’s workers’ compensation benefits claim, filed on March 10, 1987, was timely. This decision came despite the claimant's initial failure to provide timely written notice, which was excused because the employer had actual notice of the injury. The claimant suffered a back injury on October 15, 1985, while at work, pushing a file cabinet. The Board found that the two-year Statute of Limitations under Workers’ Compensation Law § 28 did not bar the claim. The appellate court affirmed the Board's decisions, ruling in favor of the claimant.

Workers' CompensationStatute of LimitationsTimely NoticeActual NoticeBack InjuryEmployer LiabilityBoard DecisionAppealExcused NoticeOccupational Injury
References
0
Case No. MISSING
Regular Panel Decision

Claim of Mott v. ITT Industries

A claimant, who performed clerical duties for the employer for over 27 years, was diagnosed with bilateral carpal tunnel syndrome in 2006 and applied for workers’ compensation benefits. The Workers’ Compensation Board affirmed the disallowance of the claim as time-barred pursuant to Workers’ Compensation Law § 28. The appellate court reversed the Board's decision, noting that despite the claimant's prior awareness of work-related symptoms, the Board failed to establish the crucial date of disablement. Without this finding, the conclusion regarding the claim being time-barred could not be supported. The matter was remitted to the Workers’ Compensation Board for further proceedings.

Occupational DiseaseCarpal Tunnel SyndromeStatute of LimitationsDate of DisablementAppellate ProcedureClaim DisallowanceReversalRemittiturLegal InterpretationCausation
References
5
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