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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

NYSA-ILA Medical & Clinical Services Fund Ex Rel. Capo v. Catucci

The NYSA-ILA Medical & Clinical Services Fund, an employee medical services fund, sued Sabato Catucci and his three sons for allegedly withholding payments from Saleo Trucking Corporation to the fund. This action followed a prior judgment against the corporation for delinquent contributions. The plaintiff sought to hold the defendants personally liable under alter ego, breach of ERISA fiduciary duty, and embezzlement theories. The court granted summary judgment to the plaintiff on the breach of ERISA fiduciary duty claim against Sabato Catucci, finding him to be a fiduciary who misused plan assets. However, claims against his sons were dismissed due to lack of sufficient control over the corporation. The alter ego claim against Sabato Catucci will proceed to trial, and the embezzlement claim was dismissed for not supporting a private civil cause of action.

ERISA Fiduciary DutyAlter Ego LiabilityCorporate Veil PiercingDelinquent ContributionsSummary JudgmentEmployee Benefit PlanMultiemployer FundSelf-DealingCorporate ControlLabor Law
References
32
Case No. MISSING
Regular Panel Decision
May 12, 1998

Conway v. Beth Israel Medical Center

Timothy Conway, a construction worker, was injured while stepping on an A-Frame dolly in a storage room owned by Beth Israel Medical Center, causing him to fall. He appealed an order from the Supreme Court, Rockland County, which granted Beth Israel's motion for summary judgment dismissing the complaint. The appellate court affirmed the dismissal of the Labor Law § 200 claim due to insufficient evidence of Beth Israel's direction or control over Conway's work and because the danger was readily apparent. The Labor Law § 240 claim was also dismissed as the injury did not involve an elevation-related risk. Finally, the Labor Law § 241 (6) claim was dismissed because the Industrial Code provisions relied upon (12 NYCRR 23-1.7 [e] [1] and [2]) were not applicable, as the storeroom was not a "passageway" or "working area" and the dolly was not a "scattered tool".

Personal injuryConstruction accidentLabor LawSummary judgmentWorkplace safetyA-Frame dollyElevation riskIndustrial Code violationRockland County Supreme CourtAppellate Division
References
13
Case No. MISSING
Regular Panel Decision

Queens Blvd. Medical, P.C. v. Travelers Indemnity Co.

The plaintiff, Queens Blvd. Medical, P.C., sought $950 in first-party no-fault benefits for biofeedback medical services provided to its assignor for lower back and chronic pain syndrome. The central issue at trial was the medical necessity of these services under Insurance Law § 5102 (a) (1). The plaintiff established a prima facie case with expert testimony from a board-certified neurologist affirming the medical appropriateness of biofeedback. The defendant insurance company failed to present admissible evidence to disprove medical necessity, as its expert was deemed incompetent to testify on biofeedback for back pain. Consequently, the court granted the plaintiff's motion for a directed verdict, awarding judgment for $950 along with statutory costs, interest, and attorney's fees.

No-fault benefitsMedical necessityBiofeedback treatmentExpert testimonyDirected verdictInsurance lawChronic pain syndromeBack injuryCPT codesBurden of proof
References
9
Case No. MISSING
Regular Panel Decision

New York Hospital Medical Center v. Microtech Contracting Corp.

This case addresses whether an employer's protection from third-party claims under Workers' Compensation Law § 11 is lost when its injured employees are undocumented aliens. Plaintiff New York Hospital Medical Center sued defendant Microtech Contracting for common-law and contractual contribution and indemnification, following a judgment paid to Microtech's injured undocumented employees, Luis and Gerardo Lema. The hospital argued that Microtech's alleged violation of the Immigration Reform and Control Act (IRCA) in hiring the Lemas should preclude it from invoking Section 11's shield. Both the Supreme Court and Appellate Division dismissed the hospital's claims, affirming that employee immigration status does not negate an employer's statutory rights. The Court of Appeals affirmed, holding that the illegality of the employment contract under IRCA does not override the employer's protections under Workers' Compensation Law § 11, particularly as the hospital did not pursue conflict preemption on appeal.

Workers' Compensation Law § 11Immigration Reform and Control Act (IRCA)Undocumented AliensThird-Party ClaimsContribution and IndemnificationGrave InjuryPreemptionLabor LawEmployer LiabilityEmployee Rights
References
11
Case No. MISSING
Regular Panel Decision

Claim of Cummins v. North Medical Family Physicians

A claimant sustained a work-related back injury and sought continued medical treatment, which was initially authorized. Disputes over authorization led the claimant to retain an attorney. A Workers’ Compensation Law Judge authorized continued medical treatment but denied counsel fees, stating no "money passing" occurred. The Workers' Compensation Board upheld this decision. The claimant appealed, arguing the Board unconstitutionally applied Workers’ Compensation Law § 24, misinterpreted the statute regarding fee payment from medical benefits, and abused its discretion. The appellate court affirmed the Board's decision, ruling that counsel fees must be paid from "compensation," defined as a money allowance, and medical benefits are not considered "compensation" for this purpose, thus finding no abuse of discretion.

Workers' CompensationCounsel FeesAttorney FeesMedical TreatmentStatutory InterpretationConstitutional LawLienCompensation DefinitionAppellate ReviewBoard Decision
References
3
Case No. MISSING
Regular Panel Decision
Sep 16, 1992

Pica v. Montefiore Medical Group

The Supreme Court, Bronx County, dismissed a personal injury action brought by an employee of Montefiore Hospital and Medical Center against Montefiore Medical Group. The dismissal was based on the affirmative defense of Workers' Compensation. The plaintiff failed to demonstrate that Montefiore Medical Group was a separate legal entity from Montefiore Hospital and Medical Center, whose employee controlled her work. Consequently, the court found recovery barred under Workers' Compensation Law § 11. The appellate court unanimously affirmed the dismissal.

Workers' CompensationPersonal InjuryEmployer LiabilityCorporate VeilExclusive RemedyAffirmative DefenseAppellate DecisionMotion to DismissSummary JudgmentBronx County
References
3
Case No. ADJ6786389
Regular
Aug 14, 2013

LORENZO CASTILLO vs. Controlled Health Management Inc FRONTLINE MEDICAL ASSOCIATES STATE COMPENSATION INSURANCE FUND

This Workers' Compensation Appeals Board case involves a Petition for Reconsideration filed by Controlled Health Management, Inc. for lien claimant Frontline Medical Associates. Frontline's lien was dismissed for failure to pay the lien activation fee. The Board denied the petition, finding that Frontline was properly served with notice of the hearing despite claims of mail delivery issues. The Petitioner's contention that they did not receive notice due to a missing P.O. Box number was also rejected.

Workers' Compensation Appeals BoardPetition for ReconsiderationLien ClaimOrder Dismissing Lien ClaimLien Activation FeeCompromise and ReleaseProof of ServiceDeclarationNotice of HearingService Address
References
0
Case No. MISSING
Regular Panel Decision

Rechenberger v. Nassau County Medical Center

Edward Rechenberger suffered hip fractures and underwent two operations at Nassau County Medical Center in May 1982. Following a re-injury and later diagnosis, he learned the surgical hardware was improperly implanted, leading to further operations. Mr. Rechenberger sought leave to serve a late notice of claim against the medical center. The Supreme Court initially denied the motion, but the Appellate Division reversed this decision, finding that the hospital had actual knowledge of the essential facts of the claim within the statutory 90-day period through its own medical records. The court concluded that the delay in serving the notice of claim was not substantially prejudicial to the hospital, and thus, granted the petitioners leave to serve the late notice of claim.

Medical MalpracticeLate Notice of ClaimNassau CountyHip FractureSurgical ErrorContinuous Treatment DoctrineActual NoticePrejudiceAppellate ReviewMunicipal Corporation
References
11
Case No. MISSING
Regular Panel Decision
Feb 10, 2017

Mitchell v. SUNY Upstate Medical University

Plaintiff Robbie Mitchell sued SUNY Upstate Medical Center for alleged Title VII violations, including race discrimination and retaliation, after experiencing a series of adverse employment actions. These actions included reassignment, disciplinary notices (NODs), a mandatory medical examination, a formal counseling memorandum, a verbal dispute, and eventual termination. The defendant moved for summary judgment, arguing the plaintiff failed to establish a prima facie case for most claims and that their actions were based on legitimate, non-discriminatory reasons. The court granted summary judgment in favor of SUNY Upstate Medical Center, concluding that the plaintiff failed to provide sufficient evidence of discrimination or that retaliation was the but-for cause of the challenged employment actions, and consequently, the case was closed.

Title VIICivil Rights ActEmployment DiscriminationRetaliationSummary JudgmentAdverse Employment ActionMcDonnell Douglas FrameworkWorkplace ConductDisciplinary ActionPaid Administrative Leave
References
49
Case No. MISSING
Regular Panel Decision

Yklik Medical Supply, Inc. v. Allstate Insurance

Plaintiff Yklik Medical Supply, Inc., a medical supply provider, sued Allstate Insurance Company to recover $317 in unpaid medical bills for equipment supplied to its assignor, Tammy Agosto. Yklik moved for summary judgment, asserting proper bill submission and Allstate's failure to timely pay or deny the claim. Allstate argued that the charges exceeded the Workers' Compensation fee schedule and that a partial payment had been made. The court found that Yklik established a prima facie case. The central issue was whether Allstate's fee schedule defense was precluded due to its failure to issue a timely denial within 30 days as mandated by Insurance Law § 5106 (a) and 11 NYCRR 65-3.5. The court ruled that since Allstate waited 56 days to send its denial, it was precluded from raising the fee schedule defense, and therefore, summary judgment was granted to the plaintiff.

No-fault insurancesummary judgmenttimely denialfee schedulepreclusion ruleinsurance lawmedical supplybilling practicespersonal injury protectionassignor
References
19
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