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

Case No. ADJ11595561 ADJ11602485
Regular
Jun 27, 2019

CINTIA LEMUS vs. MOTEL 6/G6 HOSPITALITY, LIBERTY MUTUAL

In this case, the applicant sustained work-related injuries to her mid and low back. The defendant disputed the applicant's request for a chiropractic Qualified Medical Evaluator (QME) panel, arguing an orthopedic-spine specialist was more appropriate. The Medical Director initially agreed, citing the use of prescription medication outside a chiropractor's scope. However, the Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, finding that the Medical Director's rationale was insufficient. The Board affirmed the Workers' Compensation Judge's decision to overrule the Medical Director and allow a chiropractic QME, citing precedent that QMEs cannot provide treatment or opine on disputed treatment issues.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalFindings and OrderAdministrative Law Judge (WCJ)Qualified Medical Evaluator (QME)Medical DirectorQME Panel SpecialtyChiropracticOrthopedic-Spine
References
9
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
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
Oct 17, 2012

Douyon v. NY Medical Health Care, P.C.

Plaintiff Gabrielle Douyon sued Seymour Schneider, N.Y. Medical Health Care, P.C., Faraidoon Daniel Golyan, M.D., and Kourosh Golyan, alleging unfair debt collection practices under the FDCPA and NY GBL § 349, along with intentional infliction of emotional distress and negligence. The lawsuit stemmed from attempts to collect an alleged medical debt following Douyon's emergency heart surgery performed by Dr. Golyan. Both parties sought summary judgment. The court granted Plaintiff partial summary judgment on FDCPA violations related to statutory disclosures and a threatening voicemail. However, many other FDCPA and NY GBL claims were denied due to factual disputes, and the intentional infliction of emotional distress claim was dismissed for lack of medical evidence, with negligence claims partially allowed to proceed on the basis of fear for physical safety.

Fair Debt Collections Practices ActNew York General Business Law § 349Debt CollectionSummary JudgmentEmotional DistressNegligenceAgency RelationshipVicarious LiabilityFreelance Debt CollectorUnfair and Deceptive Practices
References
105
Case No. 2020 NY Slip Op 05204 [186 AD3d 1679]
Regular Panel Decision
Sep 30, 2020

Matter of Board of Mgrs. of Half Moon Bay Mar. Condominium v. Board of Directors of Half Moon Bay Homeowners Assn., Inc.

This case concerns a CPLR article 78 proceeding initiated by the Board of Managers of Half Moon Bay Marina Condominium and Maria Elena DiBella against the Board of Directors of Half Moon Bay Homeowners Association, Inc. The dispute arose over the voting rights of Marina directors on the HOA Board, which the HOA Board sought to restrict. The Supreme Court, Westchester County, ruled in favor of the petitioners, compelling the HOA Board to allow unrestricted voting. The Appellate Division affirmed this judgment, determining that the HOA's bylaws regarding voting rights were ambiguous. The court found that extrinsic evidence, including the HOA Board's historical practice, supported the interpretation that all directors had an unrestricted right to vote on all HOA matters.

Bylaws InterpretationVoting RightsCondominium LawHomeowners AssociationCPLR Article 78Contract InterpretationExtrinsic EvidenceBoard of DirectorsAppellate ReviewAmbiguity
References
11
Case No. MISSING
Regular Panel Decision
Aug 10, 2012

Williams v. Woodhull Medical & Mental Health Center

Valerie E. Williams filed an action against Woodhull Medical and Mental Health Center and other defendants, alleging discrimination and retaliation under federal and state laws, including Title VII and 42 U.S.C. §§ 1981, 1983, 1985, and 1986. Magistrate Judge Lois Bloom issued a Report and Recommendation, advising to grant the defendants' motion for summary judgment on all claims. Plaintiff Williams filed objections to the R&R, particularly contesting the recommendation on her Title VII retaliation claim. District Judge Nicholas G. Garaufis, upon de novo review of the contested portions and clear error review of the uncontested, adopted the R&R in its entirety. The court granted summary judgment to the defendants, finding no genuine dispute of material fact regarding Williams's claims, specifically noting a lack of causal connection for retaliation and insufficient evidence for a hostile work environment or due process violations.

Employment DiscriminationTitle VII RetaliationSummary JudgmentProcedural Due ProcessHostile Work EnvironmentMedical Negligence AllegationsPublic Health LawHospital EmploymentMagistrate Judge ReviewFederal Rules of Civil Procedure 56
References
80
Case No. MISSING
Regular Panel Decision

Martinez v. Downstate Medical Center of State University of New York

The petitioner, an associate professor and director of a Joint Respiratory and Surgical Intensive Care Unit, was reassigned and later terminated following a leave of absence for a heart attack. He initiated a CPLR article 78 proceeding to challenge his reassignment, the transfer of the ICU, and his termination from a tenured position. The Supreme Court's initial judgment was appealed. The appellate court modified the judgment by granting the petitioner's request for reinstatement to a comparable ICU director position. It also remitted the issue of reinstatement as a tenured associate professor to Downstate for review under its medical staff bylaws, displacing a prior referral to the UUP agreement. However, the court affirmed the dismissal of the claim concerning the ICU transfer and found the promotion issue time-barred under the UUP grievance procedure.

ReinstatementTenurePromotion DisputeCPLR Article 78Administrative ReviewMedical Staff BylawsCollective Bargaining AgreementJudicial Review ScopeHospital AdministrationAcademic Appointment
References
6
Case No. MISSING
Regular Panel Decision

Beth Israel Medical Center v. 1199/S.E.I.U. United Healthcare Workers East

Beth Israel Medical Center (BIMC) petitioned to vacate an arbitration award concerning a labor dispute over wage differentials for registered nurses on flex-time schedules at its Kings Highway Division. Local 1199, the nurses' union, moved to confirm the award. The dispute arose when BIMC discontinued pro-rata wage differentials for day shift nurses, arguing a 2002 Memorandum of Agreement (MOA) adopted a different plan. The arbitrator found for Local 1199, concluding the 2002 MOA did not alter the longstanding practice established in prior MOAs. BIMC argued the arbitrator exceeded his power and violated public policy; however, the court denied BIMC's petition and granted Local 1199's motion, affirming the arbitrator's decision that drew its essence from the collective bargaining agreement.

Labor DisputeArbitration AwardWage DifferentialsCollective Bargaining AgreementFlex-Time ScheduleRegistered NursesNew YorkFederal CourtLMRAContract Interpretation
References
14
Case No. MISSING
Regular Panel Decision

Pig Newton, Inc. v. Boards of Directors of the Motion Picture Industry Pension Plan

Plaintiff Pig Newton, Inc. commenced an action against the Boards of Directors of the Motion Picture Industry Pension Plan, Health Plan, and Individual Account Plan, seeking a declaration that certain provisions of the Plans’ Trust Agreements were invalid and unenforceable. The Defendants counterclaimed for delinquent contributions under ERISA. The core dispute revolved around "Controlling Employee Provisions" in the Trust Agreements, which obligated employers to contribute for Controlling Employees for a specified number of hours and weeks regardless of actual hours worked. Pig Newton argued these provisions were invalid, not properly incorporated, or conflicted with collective bargaining agreements (CBAs). The Court, applying federal common law and an arbitrary and capricious standard of review for the Directors' interpretation, found the provisions valid, properly incorporated, and not in conflict with the CBAs, concluding that Szekely (Pig Newton's sole owner) qualified as a Controlling Employee. Consequently, the Court denied Plaintiff's motion for summary judgment and granted Defendants' cross-motion for summary judgment, dismissing Plaintiff's complaint and awarding Defendants the sought-after contributions, interest, auditors’ fees, and liquidated damages.

ERISAMultiemployer PlanPension PlanHealth PlanDeclaratory JudgmentSummary JudgmentTrust AgreementsCollective Bargaining AgreementsControlling Employee ProvisionsDelinquent Contributions
References
44
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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