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

Case No. 2021 NY Slip Op 01018 [191 AD3d 548]
Regular Panel Decision
Feb 16, 2021

Matter of Tenants United Fighting for the Lower E. Side v. City of New York Dept. of City Planning

The Appellate Division reversed a lower court order that had annulled approvals by the New York City Planning Commission (CPC) for new building constructions. The Supreme Court had initially granted petitions from Tenants United Fighting for the Lower East Side and Lower East Side Organized Neighbors. The appellate court held that the Supreme Court should have deferred to the CPC's reasonable interpretation of the New York City Zoning Resolution (ZR). Specifically, the Appellate Division clarified that ZR § 78-043's requirement for findings as a condition precedent only applies to modifications granted by special permit or authorization, not to other types of modifications to large-scale residential developments. Consequently, the petitions were denied and the proceedings dismissed.

Zoning ResolutionLarge-Scale Residential DevelopmentCity Planning CommissionAdministrative LawAppellate ReviewJudicial DeferenceStatutory InterpretationArticle 78 ProceedingNYC ZoningUrban Planning
References
7
Case No. MISSING
Regular Panel Decision
Aug 04, 1995

Claim of Diliberto v. Hickory Farms, Inc.

The claimant was injured at work on December 30, 1987, sustaining injuries to his neck, shoulder blade, and left arm, with findings later expanded to include the lower back. The employer and its insurer disputed the causal relationship of the lower back injury. Although a Workers’ Compensation Law Judge found the lower back injury causally related, the Workers’ Compensation Board ultimately disallowed this claim due to a lack of credible medical evidence. The Board's decision was affirmed on appeal, as it was within the Board's authority to resolve conflicting expert medical testimony. Supporting the Board's finding, medical experts indicated no causal link, and the claimant did not report lower back pain until 16 months post-accident.

Causality DisputeMedical Expert TestimonyBoard DiscretionAffirmationLower Back PainDelayed SymptomsInjured WorkerEmployer LiabilityInsurance DisputeAppellate Division
References
3
Case No. 527925
Regular Panel Decision
Jul 25, 2019

Matter of Smith v. Rochester-Genesee Regional Transp. Auth.

Claimant George I. Smith appealed a Workers' Compensation Board decision from November 15, 2017. The Board ruled that Smith's lower back injury was not a consequential causally-related injury to his initial work-related right foot and consequential left knee injuries from February 2012. Additionally, the Board found that Smith violated Workers' Compensation Law § 114-a by failing to disclose his complete medical history regarding a prior lower back injury from a 2000 motor vehicle accident. The WCLJ and subsequently the Board denied Smith's request to amend his claim for the lower back injury and imposed penalties, rescinding and disqualifying him from future indemnity benefits. The Appellate Division affirmed the Board's decision, finding substantial evidence supported both the lack of causal relationship for the back injury and the § 114-a violation due to Smith's false representations and omissions.

Workers' Compensation Law § 114-aFraudulent MisrepresentationCausally Related InjuryLower Back InjuryIndependent Medical ExaminationPrior Medical HistoryIndemnity BenefitsAppellate ReviewSubstantial EvidenceCredibility Determination
References
19
Case No. 2019-08-0045
Regular Panel Decision
Sep 14, 2020

Mask, Michael v. Hub Group, Inc.

Employee Michael Mask, a truck driver, suffered a low back injury at work but was subsequently diagnosed with multiple myeloma. The employer, Hub Group, Inc., provided workers' compensation benefits for the back strain but denied further benefits for conditions related to his cancer, asserting it was not work-related. Mask sought additional medical and disability benefits, arguing his ongoing pain was connected to the work injury. The trial court, Judge Allen Phillips presiding, found Mask only established entitlement to benefits for his low back strain and not for temporary or permanent disability or cancer-related treatment, crediting Dr. Wolf's opinion that his pain stemmed from cancer. The Workers' Compensation Appeals Board affirmed the trial court's decision, concluding Mask was only entitled to reasonable and necessary future medical care for his low back strain, thereby denying benefits for cancer or additional disability.

Workers' CompensationBack InjuryMultiple MyelomaCausationMedical BenefitsDisability BenefitsTemporary DisabilityPermanent DisabilityAppeals BoardPro Se Litigant
References
5
Case No. MISSING
Regular Panel Decision

Claim of Gaylord v. Ichabod Crane Central School District

Claimant, a school bus driver, suffered muscle spasms and lower back pain attributed to her work, including lifting a nonambulatory child and enduring kicks from an autistic child. After seeking chiropractic and medical treatment, she was diagnosed with fibromyalgia and permanent disability. The Workers’ Compensation Board, however, only found a minor back strain that had resolved, largely relying on a medical expert who deemed the fibromyalgia a preexisting condition. The claimant appealed for a higher degree of disability, but the Appellate Division affirmed the Board's decision, finding substantial evidence to support the Board's conclusion that the fibromyalgia was not a causally related disability.

Workers' CompensationBack InjuryFibromyalgiaCausationMedical OpinionDisabilityAppellate ReviewPreexisting ConditionSubstantial EvidenceSchool Bus Driver
References
2
Case No. 03-08-00483-CV
Regular Panel Decision
Mar 19, 2010

Texas Property and Casualty Insurance Guaranty Association for Reliance National Insurance Company, an Impaired Company v. Doris J. Toberny

Doris J. Toberny, an exhibit decorator, injured her back on the job in May 2000, leading to spinal-fusion surgery that also corrected pre-existing scoliosis. Initially, her employer's insurer, Texas Property and Casualty Insurance Guaranty Association for Reliance National Insurance Company ('the Company'), paid for the surgery. However, in December 2001, the Company disputed the claim, asserting the injury was only a lower back strain and not the cause of her scoliosis. After a designated doctor assigned Toberny a 25-percent impairment rating in 2002, the Company paid supplemental income benefits for eight quarters. Three years later, in September 2005, the Company sought to dispute her impairment rating and discontinue benefits, claiming her pre-existing conditions were not compensable. The Division of Workers’ Compensation and the district court found that the Company had waived its right to contest the impairment rating under former rule 130.102(g) due to late dispute filing, and affirmed Toberny's 25-percent impairment rating and entitlement to benefits. The Texas Court of Appeals affirmed the trial court's judgment, upholding the validity of rule 130.102(g) and the finding of waiver, thus confirming Toberny's impairment rating and attorney's fees.

Workers' CompensationImpairment Rating DisputeSupplemental Income BenefitsWaiver DoctrineCompensability of InjuryExtent of InjuryJudicial Review of Agency DecisionTexas Appeals CourtAdministrative Rule ValidityMaximum Medical Improvement
References
12
Case No. 2021-08-0966
Regular Panel Decision
Mar 05, 2024

Woods, Lorene V. ST. FRANCIS SENIOR HEALTHCARE CENTER

Lorene Woods sought benefits for a neck condition and permanent disability related to a low-back strain sustained in June 2020 while working for St. Francis Senior Healthcare Center. While the low-back strain was compensable, the employer disputed the work-relatedness of the neck complaints. The Court found that Ms. Woods failed to provide expert medical opinion establishing causation for her neck condition and thus denied related benefits and future medical treatment. For the low-back injury, the Court determined she reached maximum medical improvement with a 0% impairment rating, denying permanent partial disability benefits. However, St. Francis was ordered to continue paying for reasonable and necessary medical treatment for the work-related low-back injury.

Workers' CompensationLow-back injuryNeck conditionCausationMedical treatmentPermanent partial disabilityMaximum Medical ImprovementDegenerative changesExpert medical opinionCredibility of witness
References
0
Case No. MISSING
Regular Panel Decision
Jun 17, 1999

Claim of Sons-Brown v. Oas Hills Dining Hall

Claimant sustained work-related lower back injuries in 1993 and 1994, for which she received workers' compensation benefits. After a non-work-related neck injury in a 1995 car accident, she stopped working. In 1998, her compensation cases were reopened to authorize surgery for her work-related back condition and address further lost time. A Workers’ Compensation Law Judge authorized the surgery and awarded benefits, apportioning them 50% to each prior work-related injury. The employer's workers' compensation carrier appealed, arguing the claimant withdrew from the labor market solely due to the noncompensable car accident. However, the Workers’ Compensation Board affirmed the award, finding evidence that the neck injury had resolved while the work-related lower back problems continued to solely impact her ability to return to the labor market. The Appellate Division affirmed the Board's decision, concluding there was ample support in the record for the Board’s findings.

Workers' CompensationDisability BenefitsCausationApportionment of LiabilityLower Back InjuryNeck InjuryNon-Work-Related InjuryReopened CaseSurgery AuthorizationLabor Market Withdrawal
References
1
Case No. MISSING
Regular Panel Decision

STATE OFFICE OF RISK MANAGEMENT v. Allen

Jerome D. Allen, a juvenile correction officer, was injured in March 2004 during employment. The State Office of Risk Management (SORM), administrator of workers' compensation, accepted head and shoulder injuries but disputed a lower back injury. A contested case hearing and subsequent appeals panel both found Allen's compensable injury extended to his lower back. SORM sought judicial review, and a jury also found in Allen's favor. SORM appealed, arguing the trial court erred in admitting hearsay evidence (a hearing officer's decision and order) and that the verdict was factually insufficient. The appellate court found any error in admitting the decision and order harmless, as the evidence was cumulative and also presented through SORM's own expert witness. The court also found the evidence factually sufficient to support the jury's verdict, noting Allen's testimony about new back pain symptoms post-injury and the compensability of aggravating a pre-existing condition. The trial court's judgment was affirmed.

Workers' CompensationAppellate ReviewHearsay EvidenceFactual SufficiencyJury VerdictCompensable InjuryLower Back InjuryPre-existing ConditionMedical RecordsChiropractor Testimony
References
6
Case No. 2021 NY Slip Op 02252 [195 AD3d 40]
Regular Panel Decision
Apr 13, 2021

Matter of Part 60 RMBS Put - Back Litig.

This case addresses contractual disputes arising from the pooling and securitization of residential mortgages (RMBS). Computershare Trust Company, National Association, acting as a Separate Securities Administrator, sued Natixis Real Estate Holdings LLC (and its predecessor) for breaching a Pooling and Servicing Agreement (PSA) by failing to identify and repurchase nonconforming mortgages. Natixis, in turn, filed counterclaims and a third-party complaint against Wells Fargo Bank, N.A. (the Securities Administrator and Master Servicer), alleging Wells Fargo breached its PSA duties to notify of breaches and supervise the Servicer. The Appellate Division ruled that Natixis's statute of limitations defense, based on the borrowing statute (CPLR 202), was not waived, overturning the lower court's decision on this point. It affirmed the dismissal of Natixis's contractual indemnification claim against Wells Fargo but allowed Natixis's independent breach of contract claims (failure to notify and failure to supervise) against Wells Fargo to proceed.

RMBSPut-Back LitigationContractual ObligationsStatute of LimitationsBorrowing StatuteLaw of the CaseWaiverIndemnificationBreach of ContractSecurities Administrator
References
35
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