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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
Sep 15, 1997

Mushatt v. Cayuga Medical Center

Plaintiff appealed a judgment favoring defendants Cayuga Medical Center and the estate of her obstetrician, Frank Flacco, in a medical malpractice case. Plaintiff alleged that negligent care during her son Quandale's birth on August 15, 1990, led to his severe spastic cerebral palsy, mental retardation, and seizure disorder, attributing it to oxygen deprivation caused by a delayed Cesarean section. Defendants argued the oxygen deprivation occurred prior to delivery due to an acute event and chronic condition, and their care met standards. The jury sided with defendants. On appeal, plaintiff challenged the verdict's weight, the application of CPLR 4519 (Dead Man's Statute), the admission of testimony regarding her drug and alcohol use, and a missing witness charge. The Supreme Court Appellate Division affirmed the judgment, finding no errors warranting reversal.

Medical MalpracticeBirth InjuryCerebral PalsyOxygen DeprivationCesarean SectionExpert WitnessDead Man's StatuteCPLR 4519Appellate ReviewNegligence
References
4
Case No. 19 Misc 3d 1104(A), 2008 NY Slip Op 50546(U)
Regular Panel Decision

Westchester Medical Center v. American Transit Insurance

This case involves an appeal in an action to recover no-fault medical payments. The plaintiff, Westchester Medical Center (WMC), as assignee of Daphne McPherson, sought summary judgment against American Transit Insurance Company, arguing that the defendant failed to timely pay or deny benefits. The Supreme Court initially granted WMC summary judgment. However, the appellate court reversed this judgment, finding that the defendant had presented a prima facie case for a timely request for additional verification, which effectively tolled the period for denying the claim. The defendant's denial was based on the premise that McPherson might be entitled to workers' compensation benefits. While reversing the summary judgment for WMC, the appellate court declined the defendant's request for summary judgment or referral to the Workers' Compensation Board due to insufficient evidence from the defendant regarding workers' compensation eligibility.

No-fault medical paymentsInsurance disputeSummary judgment reversalTimely denialAdditional verificationWorkers' compensation eligibilityAppellate DivisionAssignee claimMotor vehicle accidentCivil Practice Law and Rules
References
6
Case No. ANA 0290076
Regular
May 28, 2008

CHERI ESTRADA vs. GATEWAY/ANAHEIM HARBOR MEDICAL GROUP, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, FREMONT INDEMNITY INSURANCE COMPANY

This case concerns an applicant who sustained an admitted industrial injury in 1994 resulting in spinal, head, and limb impairments. The applicant sought reconsideration of the Workers' Compensation Appeals Board's (WCAB) denial of 100% permanent disability, arguing her physical limitations and medication rendered her unemployable. The WCAB majority denied reconsideration, adopting the judge's prior findings. However, a dissenting commissioner argued that the applicant's multiple surgeries, medication side effects, failure in vocational rehabilitation, and vocational expert opinions supported a finding of 100% permanent disability.

Workers' Compensation Appeals BoardIndustrial injuryFremont Indemnity Insurance CompanyCalifornia Insurance Guarantee AssociationPermanent disabilityLife pensionVocational rehabilitationAgreed medical evaluatorIndependent vocational expertOpen labor market
References
1
Case No. ADJ1 44848 (GRO 0032874)
Regular
Apr 26, 2016

BILLY BRANHAM vs. ARROYO GRANDE GLASS, STATE COMPENSATION INSURANCE FUND

The Appeals Board rescinded the Workers' Compensation Judge's (WCJ) decision granting a 63% permanent disability award. This was because the WCJ improperly rejected the vocational expert's opinion regarding the impact of industrial medications on the applicant's ability to compete in the labor market. The Board remanded the case for further development of both medical and vocational records, specifically requesting updated opinions on the side effects of the applicant's medications. This is to ensure a more thorough investigation into the cognitive effects of prescribed drugs on the applicant's work capacity.

Workers' Compensation Appeals BoardReconsiderationPetition to ReopenPermanent Disability AwardVocational ExpertCognitive EffectsIndustrially-Prescribed MedicationsMedical Record DevelopmentApportionmentDiminished Future Earning Capacity
References
8
Case No. MISSING
Regular Panel Decision

Rivera v. Lutheran Medical Center

Felix Rivera sued Lutheran Medical Center (LMC) and Myles Davis for retaliatory and discriminatory discharge under New York State and City Human Rights Laws, alleging termination due to his association with a sister-in-law who previously sued LMC. The court granted the defendants' motion to dismiss the claim under the NYSHRL, finding it does not support association discrimination, but denied dismissal for the NYCHRL claim, which explicitly allows such a cause of action. Separately, plaintiff moved to disqualify defendants' law firm, Morgan Lewis & Bockius, LLR, for improperly soliciting non-party witnesses. The court found that Morgan Lewis violated professional conduct rules by soliciting these witnesses to gain a tactical advantage, ordering their disqualification from representing four specific individuals and mandating disclosure of this to the witnesses. The overall decision represents a partial victory for both sides, with motions granted and denied in part.

Retaliatory DischargeDiscriminatory DischargeHuman Rights LawNYSHRLNYCHRLAssociation DiscriminationAttorney DisqualificationProfessional ResponsibilityConflict of InterestWitness Solicitation
References
9
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

Schonholz v. Long Island Jewish Medical Center

Plaintiff Gleniss Schonholz sued her former employer, Long Island Jewish Medical Center (LIJ), and several individual defendants under ERISA, seeking severance benefits. Schonholz alleged that LIJ wrongfully denied her severance benefits after requesting her resignation and promising benefits under a May 1991 plan, which she claims was revoked after her employment termination or not in writing. She also brought a promissory estoppel claim and claims against individual defendants for breach of fiduciary duty, seeking punitive damages. The court denied defendants' motion to dismiss the ERISA claim, finding plaintiff adequately alleged non-payment of benefits under a plan in effect at her termination or an invalid unwritten revocation. However, the court granted the motion to dismiss the promissory estoppel claim with leave to amend, as plaintiff failed to allege actual reliance. Claims against individual defendants for breach of fiduciary duty and for punitive damages were dismissed with prejudice, as fiduciary duties run to the plan, not individuals, and punitive damages are generally unavailable under ERISA. Cross-motions for Rule 11 sanctions were also denied.

ERISAEmployee BenefitsSeverance PayMotion to DismissPromissory EstoppelFiduciary DutyPunitive DamagesRule 11 SanctionsEmployment LawWelfare Plan
References
39
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. 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

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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