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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

Lutheran Medical Center v. Hereford Insurance

Maher Kiswani, a livery car driver, was injured in an automobile accident and received medical treatment from Lutheran Medical Center. Lutheran, as Kiswani's assignee, sought payment from Hereford Insurance Company, the no-fault carrier, which refused to pay. After an initial arbitration where the Workers' Compensation Board determined Kiswani was not injured in the course of employment (without Hereford's notice), a second arbitration awarded Lutheran no-fault benefits. The Supreme Court, Kings County, vacated this arbitration award, ruling that Hereford should have been notified of the Workers' Compensation Board hearing. The appellate court affirmed the Supreme Court's decision, holding that a party not afforded an opportunity to participate in a Board hearing is not bound by its determination.

Arbitration AwardNo-Fault InsuranceWorkers' Compensation BoardDue ProcessNotice RequirementsVacated Arbitration AwardAppellate ReviewLivery Car DriverAutomobile AccidentMedical Benefits
References
3
Case No. MISSING
Regular Panel Decision

ABC Medical Management, Inc. v. GEICO General Insurance

The case addresses whether a plaintiff-assignee medical equipment supplier can recover no-fault first-party benefits when a chiropractor, rather than a physician, issued the prescription. Defendant GEICO General Insurance Company moved for summary judgment, arguing that Education Law § 6551 prohibits chiropractors from prescribing such items. The court denied GEICO's motion, ruling that chiropractors are permitted to prescribe TENS units, thermophore devices, and similar medical supplies, as these do not constitute 'drugs or medicines' under the Education Law. Furthermore, the court found that GEICO failed to properly present its medical necessity defense and that the contested issues should be determined by a trier of fact.

No-Fault BenefitsChiropractic PrescriptionMedical EquipmentEducation Law § 6551Summary JudgmentMedical NecessityTENS UnitThermophoreCervical CollarLumbar Support
References
29
Case No. MISSING
Regular Panel Decision

Perez v. Brookdale University Hospital & Medical Center

Eulalia Perez was admitted to Brookdale University Hospital on November 16, 2010, and treated for various medical conditions before being discharged on December 7. She died two days later. Her family, Ivan and Irma Perez, sued Brookdale and other defendants, alleging a violation of the Emergency Medical Treatment and Active Labor Act (EMTALA) and state-law claims of wrongful death and negligence. The court granted Brookdale's motion for summary judgment on the EMTALA claim, determining that the hospital fulfilled its EMTALA duties once Mrs. Perez was stabilized, and any subsequent issues were outside the statute's scope. Consequently, the court declined to exercise supplemental jurisdiction over the state-law claims, leading to the dismissal of all claims against all parties.

EMTALAEmergency Medical Treatment and Active Labor ActMedical MalpracticeNegligenceWrongful DeathSummary JudgmentSupplemental JurisdictionPatient DumpingHospital DischargeFederal Question Jurisdiction
References
8
Case No. MISSING
Regular Panel Decision

In Re Saint Vincent's Catholic Medical Centers

St. Vincents Catholic Medical Centers of New York, a Chapter 11 debtor, objected to a $48.75 million claim filed by the New York State Department of Labor under the N.Y. WARN Act. The core issue was whether the bankruptcy court or an administrative proceeding by the Department of Labor was the appropriate forum to liquidate this claim. The Department of Labor argued for its administrative proceeding, citing the 'police powers' exception to the automatic stay, and also requested a determination by the Commissioner on certain issues. The Debtors contended the bankruptcy court had jurisdiction due to the proof of claim being filed. The court found it had core jurisdiction to determine the allowance and amount of the claim, declining to defer to another forum, especially given multiple related WARN claims. The court also denied the Debtors' request for an injunction, stating it was not properly brought as an adversary proceeding.

BankruptcyChapter 11WARN ActJurisdictionClaim LiquidationAutomatic StayPolice Powers ExceptionInjunctionCore ProceedingProof of Claim
References
13
Case No. ADJ7436407, ADJ1895040 (FRE 0238028)
Regular
Feb 04, 2015

Colleen Newby vs. Fresno Community Medical Center, St. Agnes Medical Center, State Compensation Insurance Fund

The Workers' Compensation Appeals Board denied Colleen Newby's Petition for Removal, upholding the denial of her petition to quash a Qualified Medical Evaluator (QME) request. The Board found that the prior employer, Fresno Community Medical Center, was authorized to file an application for adjudication of claim for Newby's subsequent employment with St. Agnes Medical Center. Crucially, the Board determined that a claim form is not a prerequisite for St. Agnes to request a QME panel in this specific scenario, where a second injury is claimed by a prior employer. Newby's due process claim was rejected as she had an opportunity to present her arguments on removal.

Petition for RemovalPetition to QuashQME RequestQualified Medical EvaluatorClaim FormDue ProcessAgreed Medical EvaluatorApplication for AdjudicationTemporary DisabilityPermanent Disability
References
1
Case No. MISSING
Regular Panel Decision

Hason v. Department of Health

The petitioner, a physician, sought review of a determination by the Administrative Review Board for Professional Medical Conduct (ARB) which suspended his medical license. The ARB's decision was based on a prior California Board finding that the petitioner's ability to practice medicine was impaired by mental illness (bipolar affective disorder and narcissistic personality disorder). The court upheld the ARB's finding of professional misconduct, applying collateral estoppel to the California determination. However, the court found the penalty imposed by the ARB—a one-year suspension "and thereafter until such time as [petitioner] can demonstrate his fitness to practice medicine"—was not authorized by Public Health Law § 230-a. Consequently, the court modified the determination by annulling the penalty and remitted the matter to the ARB for the imposition of a statutorily appropriate penalty.

Medical License SuspensionProfessional MisconductPsychiatric ImpairmentMental IllnessBipolar Affective DisorderNarcissistic Personality DisorderCollateral EstoppelArticle 78 ProceedingAdministrative ReviewPenalty Annulment
References
26
Case No. MISSING
Regular Panel Decision

Transport Workers Union of America, Local 100 v. New York State Public Employment Relations Board

The New York State Public Employment Relations Board (PERB) determined that a follow-up medical appointment for a union member did not constitute an investigatory interview requiring union representation. This decision reversed a prior ruling by an Administrative Law Judge. The Appellate Court, reviewing PERB's determination under the substantial evidence standard, found that the medical appointment's purpose was to assess the employee's progress in relapse prevention education, not for disciplinary action. Consequently, the court confirmed PERB's determination, denied the petitioner's petition, and dismissed the CPLR article 78 proceeding.

Labour PracticeUnion RepresentationInvestigatory InterviewMedical AppointmentRelapse PreventionPERBCPLR Article 78Substantial EvidenceAdministrative LawEmployee Rights
References
1
Case No. MISSING
Regular Panel Decision

Craftmatic Comfort Manufacturing Corp. v. New York State Tax Commission

Petitioner, a Pennsylvania corporation selling adjustable beds, challenged a sales and use tax assessment for the period of March 1978 to February 1981. The corporation argued that sales of its beds, when prescribed by a physician, should be exempt as medical equipment under Tax Law § 1115 (a) (3). The respondent's determination disallowed this exemption, claiming the beds were not primarily used for medical purposes. The court, however, found the respondent's decision lacked substantial evidence, citing approvals from the Workers’ Compensation Board, Medicare, and the FDA, all of which classified the beds as medical devices or hospital beds. Consequently, the court annulled the portion of the determination denying the exemption for prescription sales and remitted the case for further proceedings.

Sales TaxUse TaxMedical Equipment ExemptionHospital BedsPhysician's PrescriptionSubstantial EvidenceTax LawCPLR Article 78Administrative ReviewTax Assessment
References
5
Case No. MISSING
Regular Panel Decision
Dec 02, 1986

Firestein v. Kingsbrook Jewish Medical Center

Helene Firestein, an employee of Kingsbrook Jewish Medical Center, suffered a work-related hip injury. While hospitalized at Kingsbrook, she sustained an aggravation of her injury due to alleged negligence by a coemployee, Scott. Firestein received workers' compensation benefits for both the initial injury and its aggravation. She then commenced a common-law action against Kingsbrook and Scott for damages from the aggravation. The court determined that her application for and acceptance of workers' compensation benefits do not preclude her from bringing a separate common-law action, as the aggravation of the injury did not arise out of and in the course of her employment, and any recovery would be subject to a workers’ compensation lien. The court affirmed the lower court's denial of motions to dismiss based on the exclusivity of workers' compensation.

Workers' Compensation LawCoemployee NegligenceAggravated InjuryDual Capacity DoctrineExclusivity ProvisionCommon Law ActionMedical MalpracticeEmployer LiabilityThird-Party TortfeasorWorkers' Compensation Lien
References
12
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
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