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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
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. ADJ10168011
Regular
Sep 25, 2017

BELINDA GO vs. SUTTER SOLANO MEDICAL CENTER

This case involved an applicant who self-procured cervical spine surgery after her employer denied authorization, which was upheld by an Independent Medical Review. Despite the denial, the Workers' Compensation Appeals Board (WCAB) denied the employer's petition for reconsideration. The WCAB affirmed that injured workers are entitled to temporary and permanent disability for reasonable, self-procured medical treatment, even if initially unauthorized. The Board found the self-procured surgery was reasonable due to its positive outcome, and the Permanent Qualified Medical Evaluator's findings supported the disability award. The WCAB clarified that utilization review and independent medical review processes do not preclude temporary disability indemnity for self-procured treatment deemed reasonable.

Workers' Compensation Appeals BoardPetition for ReconsiderationUtilization Review (UR)Independent Medical Review (IMR)Self-Procured SurgeryTemporary Disability IndemnityPermanent DisabilityPanel Qualified Medical Evaluator (PQME)Medical Treatment DisputesLabor Code Section 4600
References
14
Case No. 2015 NY Slip Op 00361 [124 AD3d 636]
Regular Panel Decision
Jan 14, 2015

Williams v. Jamaica Hospital Medical Center

The infant plaintiff alleged personal injuries resulting from a delayed transport by the City of New York's Emergency Medical Service during his mother's labor. Approximately four years after the alleged negligence, the plaintiff served a notice of claim and moved to have it deemed timely or for leave to serve a late notice. The Supreme Court granted the plaintiff's motion and denied the City's cross-motion to dismiss. The Appellate Division, Second Department, reversed this order, finding that the City did not acquire actual knowledge of the essential facts of the claim within the statutory 90-day period or a reasonable time thereafter. The court further determined that the plaintiff's delay substantially prejudiced the City's ability to defend the action and that the plaintiff failed to provide a reasonable excuse for the significant delay, noting that infancy alone without a demonstrated nexus to the delay was insufficient.

Late Notice of ClaimGeneral Municipal LawActual Knowledge RequirementPrejudice to MunicipalityReasonable Excuse for DelayInfancyPersonal InjuryMedical Malpractice AllegationAppellate ReviewMunicipal Negligence
References
13
Case No. MISSING
Regular Panel Decision

Lewis v. Erie County Medical Center Corp.

Plaintiff, an HIV-positive, African-American social worker, sued her employer, Erie County Medical Center (ECMC), alleging disability and race discrimination, hostile work environment, retaliation, failure to provide reasonable accommodations, and impermissible medical inquiries under federal and state laws. The claims stemmed from her supervisor's alleged mistreatment, including derogatory comments, denial of schedule changes, negative performance reviews, and inappropriate handling of medical information. Defendant moved for summary judgment, arguing plaintiff failed to establish prima facie cases for her claims and that any adverse actions were not materially adverse or were for legitimate, non-retaliatory reasons. The court granted summary judgment for the defendant, dismissing all claims, finding insufficient evidence of actionable discrimination or a hostile work environment, and that other complaints either resulted in accommodation or were not materially adverse.

Disability discriminationRace discriminationHostile work environmentRetaliation claimsSummary judgmentAmericans with Disabilities ActTitle VIINew York State Human Rights LawEmployment discriminationWorkplace harassment
References
48
Case No. MISSING
Regular Panel Decision
Mar 13, 2006

Taylor v. New York University Medical Center

The court reversed an order and granted judgment to defendants in a sexual orientation discrimination case. Plaintiff's employment was terminated, which he alleged was discriminatory. Defendants, New York University Medical Center (NYUMC) and Ferrara, successfully argued that the termination was due to legitimate budgetary concerns and departmental reorganization, not discrimination. The court found that the plaintiff failed to rebut the defendants' nondiscriminatory reason or prove that discrimination was the real motive, noting that Ferrara was not the decision-maker in the termination. The case was dismissed, with the court also noting improper admission of evidence that would have warranted a new trial.

Sexual Orientation DiscriminationEmployment TerminationBudgetary ConcernsDepartmental ReorganizationPretextMcDonnell Douglas FrameworkSummary JudgmentAppellate ReviewPunitive DamagesMental Anguish
References
14
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

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

King's Medical Supply Inc. v. Travelers Property Casualty Corp.

The plaintiff, a provider of medical supplies, moved for summary judgment seeking $2,522.86 in unpaid no-fault benefits for equipment provided to its assignors. The defendant insurer had made partial payments, asserting 'reasonable and customary fees' or technical denials, contrary to the plaintiff's interpretation of reimbursement based on 150% of documented cost. The court denied the plaintiff's motion, ruling that the plaintiff failed to establish a prima facie case by providing admissible evidence of the actual 'documented cost' of the medical supplies. The court clarified that while the regulation specifies '150 percent of the documented cost,' insurers cannot unilaterally introduce additional 'reasonable or customary cost' requirements, but the plaintiff's inability to sufficiently document their costs was fatal to their motion.

Summary JudgmentNo-Fault BenefitsMedical SuppliesMedical EquipmentInsurance LawDocumented CostPrima Facie CaseReimbursementRegulation InterpretationProvider Costs
References
13
Case No. ADJ344700
Regular
Jan 13, 2011

MARTHA GATLIN BANUELOS vs. LIVHOME, INC., as administered by CRUM FORSTER, CENTRAL ORTHOPEDIC MEDICAL GROUP, RONALD KVITNE, M.D. PHYSICIAN PARTNER

The Workers' Compensation Appeals Board (WCAB) dismissed the lien claimant's petition for reconsideration, finding they were not aggrieved by the decision awarding them full reimbursement for medical services. The defendant's petition for reconsideration was denied as the WCAB adopted the judge's reasoning for upholding the award. The WCAB affirmed the judge's finding that the lien claimant was entitled to $11,508.79 less any penalty or interest, despite an objection to an unsigned bill. This decision resolved disputes regarding the reasonableness of medical charges following an industrial injury.

Workers' Compensation Appeals BoardLien ClaimantPetition for ReconsiderationDefendant's PetitionAmended Findings and AwardOfficial Medical Fee ScheduleLabor Code section 5900Admissibility of EvidenceExhibit 1Itemized Bill
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
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