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

Case No. MISSING
Regular Panel Decision

Legal Aid Society v. Association of Legal Aid Attorneys

The Legal Aid Society sought a preliminary injunction against the Association of Legal Aid Attorneys and its officers to prevent the disciplining of striking union members who crossed picket lines. The plaintiff also claimed tortious interference and a civil rights conspiracy under 42 U.S.C. § 1985(3) on behalf of itself, non-striking attorneys, and indigent clients. The District Court denied the injunction, finding several impediments to success on the merits. These included the NLRB's primary jurisdiction, the Norris-LaGuardia Act's prohibitions, and the plaintiff's lack of standing for third-party claims. Furthermore, the court determined that the conspiracy allegations under Section 1985(3) were conclusory and lacked substantial merit.

Labor DisputePreliminary InjunctionUnion DisciplinePicket LinesNational Labor Relations Act (NLRA)Norris-LaGuardia ActStanding (Law)Conspiracy (Law)Civil Rights (42 U.S.C. § 1985(3))Tortious Interference
References
32
Case No. MISSING
Regular Panel Decision

Goldberg v. Edson

The plaintiffs appealed two orders from the Supreme Court, Rockland County. The first order, dated January 5, 2006, granted summary judgment to defendants Page Edson and the County of Rockland, dismissing the complaint against them regarding claims of legal and medical malpractice. The second order, dated January 23, 2006, granted summary judgment to defendant Elizabeth O’Connor, dismissing the complaint against her for legal malpractice. The appellate court affirmed both orders, finding that Edson and the County were immune from liability under Social Services Law § 419 for reporting suspected child abuse and removing a child, and that O’Connor was not negligent in her legal services.

Legal MalpracticeMedical MalpracticeSummary JudgmentChild Abuse ReportingSocial Services LawImmunityMandated ReportersAppellate ReviewGood FaithNegligence
References
6
Case No. ADJ1700793 (SAC 0307437) ADJ3714832 (SAC 0307399)
Regular
Jun 13, 2011

JUANITA BRADLEY (Deceased) vs. COUNTY OF PLACER

This case involves a dispute over liability for a medical-legal report cost. The defendant seeks reconsideration of a prior award holding them responsible for Dr. Adelberg's $4,237.50 report. The defendant argues the judge ignored a prior order for an Agreed Medical Evaluation (AME) and that the applicant's attorney improperly proceeded with Dr. Adelberg's exam. The Board granted reconsideration, preliminarily finding it may be inequitable to place the full cost on the defendant, and intends to split the expense between the defendant and applicant's attorney. A dissenting opinion argues the defendant's own correspondence shows an ongoing dispute regarding the AME, supporting the original award of liability.

Workers' Compensation Appeals BoardReconsiderationMedical-Legal ReportAgreed Medical EvaluationQualified Medical EvaluatorJoint Findings and AwardLabor Code Section 4062(a)Stipulation and OrderEquitable PowersLien Claimant
References
1
Case No. ADJ10183065, ADJ10449030
Regular
Mar 21, 2018

DENNIS MOORE (Dec'd), SHIRLEY MOORE (Wife), ERIC MOORE (Son) vs. WAL-MART, ACE AMERICAN INSURANCE COMPANY, YORK RISK SERVICES GROUP, INC.

In this workers' compensation case, the Appeals Board granted defendant's Petition for Removal, rescinded the WCJ's order, and returned the matter to the trial level. The Board found that setting the case for trial and closing discovery over defendant's objection denied due process. Specifically, it determined that applicant's privately obtained medical report lacked the required review by a Qualified Medical Evaluator (QME) or authorized treating physician. Consequently, the Board ordered that the parties proceed with proper medical-legal discovery, likely through an Agreed Medical Evaluator or QME process, to establish compensability.

Petition for RemovalAOE/COEWCJ OrderDue ProcessRebuttal EvidenceDiscovery ClosureSection 4605 EvaluationMedical-Legal ReportsQME PanelAgreed Medical Evaluator
References
1
Case No. ADJ11408219 ADJ10230973 ADJ8720775 ADJ11048512
Regular
Jul 08, 2019

DAVE PIERSON vs. CITY OF FAIRFIELD FIRE DEPARTMENT

The Appeals Board granted removal and rescinded the WCJ's order allowing further discovery from Dr. McHenry. The Board held that an employee is not required to return to a previous agreed medical evaluator for subsequent injury claims, citing their en banc decision in *Navarro*. Labor Code section 4062.2 exclusively governs medical-legal evaluations, and Dr. McHenry lacked status in the current claims as he was neither an agreed nor panel qualified medical evaluator. The matter was returned to the trial level for discovery consistent with statutory requirements.

Petition for RemovalAgreed Medical EvaluatorPanel Qualified Medical EvaluatorLabor Code section 4062.2Labor Code section 3212Navarro v. City of MontebelloRescind OrderReturn to Trial LevelIndustrial InjuryFire Captain
References
1
Case No. MISSING
Regular Panel Decision

Gartenbaum v. Beth Israel Medical Center

Plaintiff Ilona Gartenbaum, a white employee, filed a Title VII racial discrimination lawsuit against Beth Israel Medical Center and three supervisors, alleging she was denied promotions in favor of less qualified black employees. The court, sua sponte, questioned her counsel, Bart Nason's, pre-filing investigation under Rule 11, noting prior union grievance procedures and an arbitration, where race was not an issue, had not supported Gartenbaum's claims. While Mr. Nason's investigation was found to be inadequate, relying on the client's assertions and an unsupported affidavit from a union representative, the court acknowledged that Gartenbaum could make out a prima facie case for racial discrimination concerning at least two denied promotions. Consequently, the court denied Rule 11 sanctions at this juncture and allowed the Title VII claim to proceed to discovery. Additionally, the court ordered the consolidation of this action with a separate pro se retaliation lawsuit filed by Gartenbaum against the same defendants.

Title VIIRacial DiscriminationEmployment DiscriminationRule 11 SanctionsPre-Filing InvestigationPrima Facie CaseGrievance ProcedureArbitrationEEOC InvestigationNLRB
References
6
Case No. MISSING
Regular Panel Decision

Mental Hygiene Legal Service v. Maul

The Mental Hygiene Legal Service (MHLS), represented by its director Bruce Dix, petitioned the court to compel Thomas Maul, Commissioner of OMRDD, and Joseph Colarusso, Director of Sunmount DDSO, to provide access to investigative files regarding an incident involving resident Lynnette T. MHLS argued its statutory mandate under Mental Hygiene Law § 47.03 required access to safeguard residents from abuse. Respondents contended the records were protected from disclosure under Education Law § 6527 (3) and Mental Hygiene Law § 29.29, which prioritize confidentiality for quality assurance and incident investigations. The court, however, distinguished between CPLR Article 31 discovery and MHLS's specific statutory right of access. The court ruled that the statutes cited by the respondents did not prohibit disclosure to MHLS, granting MHLS access to the requested investigative reports and underlying documentation, with the stipulation that MHLS maintain their confidentiality.

Mental Hygiene LawAccess to RecordsCPLR Article 78Investigative FilesPatient RightsConfidentialityAbuse and MistreatmentState FacilitiesOMRDDSunmount DDSO
References
1
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

Tucker v. Wyckoff Heights Medical Center

Karen Tucker, a pro se plaintiff, sued Wyckoff Heights Medical Center and Dr. Ronald Guberman for breach of contract, Title VII retaliation, defamation, and tortious interference with prospective business relations. The defendants moved to dismiss the complaint, which the court treated as a motion for summary judgment. Plaintiff's claims stemmed from her assertion that she was entitled to a residency completion certificate despite not completing the program, and alleged retaliatory and defamatory actions by defendants regarding her employment. The court granted the defendants' motion for summary judgment, finding that many of Tucker's claims were barred by a prior settlement agreement or failed on the merits, as her factual allegations did not support the legal elements of her claims. The court also denied Tucker's request to amend her complaint as futile, though it allowed her to pursue breach of contract claims in New Jersey.

Employment DiscriminationRetaliationDefamationTortious InterferenceSummary JudgmentPro Se LitigationBreach of ContractSettlement AgreementMedical ResidencyFederal Civil Procedure
References
52
Case No. 25 NY3d 907
Regular Panel Decision
2015-XX-XX

Government Employees Insurance v. Avanguard Medical Group, PLLC

This case addresses whether no-fault insurance carriers are obligated to pay facility fees to New York State-accredited office-based surgery (OBS) centers for the use of their premises and support services. The court concluded that neither existing statutes nor regulations mandate such payments. Plaintiffs, a group of GEICO insurers, successfully sought a declaratory judgment that they are not legally required to reimburse Avanguard Medical Group, PLLC, for OBS facility fees, totaling over $1.3 million. The decision affirmed the Appellate Division's ruling, emphasizing that OBS facility fees are not explicitly covered by statute or fee schedules, nor do they fall under reimbursable "professional health services" as per 11 NYCRR 68.5. The court highlighted the distinct regulatory frameworks for OBS centers compared to hospitals and ambulatory surgery centers, declining to mandate policy changes best left to the legislature.

No-Fault InsuranceOffice-Based Surgery (OBS)Facility FeesInsurance LawBasic Economic LossFee SchedulesWorkers' Compensation BoardDepartment of Financial ServicesStatutory InterpretationRegulatory Framework
References
16
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