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

Case No. ADJ4680684 (LAO 0878962) ADJ2228561 (LAO 0878963)
Regular
Feb 19, 2016

ARTURO AVILA vs. CARIMEX INTERNATIONAL TRADING, EVEREST NATIONAL INSURANCE CO., SEDGWICK CLAIMS MANAGEMENT SERVICES, INC., STATE COMPENSATION INSURANCE FUND

This case involves a dispute over contribution liability between two insurance carriers for an applicant's cumulative trauma injury. The original Findings and Award determined Everest National Insurance was 68% liable and SCIF 32% liable, ordering Everest to pay SCIF $31,513.97. Everest's petition for reconsideration focuses solely on the monetary calculation, not the proportional liability. The Appeals Board granted reconsideration to rescind the original award, as the WCA's attempt to rescind it was untimely. The matter is returned to the WCA for further proceedings and a proper decision on the monetary calculations.

Petition for ReconsiderationFindings and AwardPetition for ContributionEquitable ContributionCumulative Trauma InjurySpecific InjuryJoint Compromise and ReleaseCredit for PaymentsSupplemental ProceedingsLabor Code Section 5500.5
References
0
Case No. MISSING
Regular Panel Decision

Lyublinsky v. Barnhart

A 73-year-old disabled plaintiff, who has received Social Security Disability (SSD) benefits since 1993, brought this action to review the Commissioner's final determination concerning his benefit rate calculation. The plaintiff argued that his benefit rate was improperly calculated, citing discrepancies in earnings records and claims of discrimination. The case has a lengthy procedural history, including multiple remands from the District Court due to issues like denial of a fair hearing and lack of legal representation. The Court conducted a de novo review of the Social Security Administration's (SSA) benefit calculations, utilizing the Average Indexed Monthly Earnings (AIME) method, and found no mathematical errors. Ultimately, the plaintiff failed to present compelling evidence to disprove the SSA's records, which are considered conclusive after a statutory period. Consequently, the Commissioner's motion for judgment on the pleadings was granted, the complaint was dismissed, and the Administrative Law Judge's (ALJ) decision was affirmed.

Social Security DisabilityBenefit CalculationAIME MethodAdministrative Law JudgePro Se PlaintiffFederal Court ReviewEarnings RecordsBurden of ProofRemandJudgment on the Pleadings
References
3
Case No. MISSING
Regular Panel Decision

Nuara v. State of New York Workers' Compensation Board

Petitioners, two terminated group self-insured trusts (GSITs), challenged monetary assessments levied against them by the New York State Workers' Compensation Board and its chairman. The assessments were imposed pursuant to various sections of the Workers’ Compensation Law, utilizing a "pure premium calculation" method established by 2007 amendments. The court considered new 2008 legislation that further amended the calculation method for ceased self-insurers but declined to apply it retroactively. Ultimately, the court found the Board's interpretation of "the preceding year" in its pure premium calculation for terminated GSITs to be unreasonable and contrary to the clear statutory language. Consequently, the levied assessments were annulled and vacated.

Group Self-Insured TrustsMonetary AssessmentsStatutory InterpretationRetroactive ApplicationPure Premium CalculationAdministrative LawCPLR Article 78Legislative IntentStatutory ConstructionSelf-Insurance Liabilities
References
19
Case No. 2016 NY Slip Op 08012 [144 AD3d 603]
Regular Panel Decision
Nov 29, 2016

Matter of Astoria Gen. Contr. Corp. v. Stringer

The Appellate Division, First Department, reviewed a determination by the Office of the Comptroller of the City of New York, which found Astoria General Contracting Corp. (AGC) falsified payroll records and willfully failed to pay prevailing wages to three employees. The Comptroller imposed significant penalties and a five-year bar from public contracts. While the court agreed that substantial evidence supported the findings of falsified records and willful underpayment, it found the calculated amount of underpaid wages ($735,185.21) to be irrational, given that AGC received a total of $300,000 for the contracts. The court modified the determination, vacating the monetary calculations and remanding the matter for a new calculation of the underpaid wages, interest, and penalty that is supported by substantial evidence, while otherwise confirming the findings.

payroll fraudprevailing wagespublic contractsadministrative determinationsubstantial evidenceirrational calculationunderpaid wageswage theftcontract disputecity comptroller
References
1
Case No. MISSING
Regular Panel Decision

Claim of Reasoner v. New York State Department of Motor Vehicles

This appellate decision addresses whether the Workers' Compensation Board correctly calculated the claimant's average weekly wage. The employer and carrier argued that due to the claimant's limited employment as an MVRSAB member, the compensation rate should be based on actual earnings, not the 200 multiple outlined in Workers’ Compensation Law § 14 (3). The Board determined that neither Workers’ Compensation Law § 14 (1) nor (2) was applicable, thus applying Workers’ Compensation Law § 14 (3). It also found no evidence that the claimant voluntarily limited participation in the labor market, based on testimony of availability and continued business operation. The court affirmed the Board's calculation.

average weekly wageworkers' compensation lawcompensation rateemployment limitationlabor marketstatutory interpretationappellate reviewMVRSAB member
References
8
Case No. No. 95
Regular Panel Decision
Dec 15, 2022

The Matter of John Borelli v. City of Yonkers

This case addresses a dispute between the City of Yonkers and 39 of its permanently disabled, retired firefighters regarding the calculation of their General Municipal Law § 207-a (2) supplement. The core issue is whether certain compensation, specifically holiday pay, check-in pay, and night differential, constitutes “regular salary or wages” for the purpose of this supplement. The Court concluded that “regular salary or wages” includes monetary compensation to which current firefighters are contractually entitled based on the performance of their regular job duties, thus requiring the inclusion of holiday pay and check-in pay. However, it excludes monetary compensation based on the performance of additional responsibilities beyond their regular job duties, and therefore, night differential should not be included. The lower court's decision was modified to reflect this interpretation.

General Municipal Law 207-aDisabled Firefighters' BenefitsRegular Salary CalculationCollective Bargaining Agreement InterpretationHoliday Pay EntitlementCheck-in Pay DisputesNight Differential ExclusionMunicipal Financial BurdenStatutory Remedial PurposePublic Sector Employment
References
22
Case No. MISSING
Regular Panel Decision

Romero v. Albany Medical Center Hospital

The case involves an appeal from a Workers' Compensation Board decision concerning a claimant's wage expectancy calculation. The employer challenged the Board's consideration of the claimant's potential earnings as a physician, rather than a part-time nursing aide, given her age and career aspirations. The court affirmed the Board's decision, emphasizing that the rule limiting wage expectancy to similar employment does not apply in atypical situations, especially when a claimant is actively pursuing a higher-earning career path like medicine, with their current job being secondary.

Wage ExpectancyFuture EarningsWorkers' Compensation BoardAppellate ReviewCareer ProgressionAtypical EmploymentAverage Weekly WageMedical CareerPart-time WorkUnder 25 Claimant
References
3
Case No. MISSING
Regular Panel Decision

Claim of Whittaker v. Central Square Central School District

The claimant appealed the Workers’ Compensation Board's calculation of his average weekly wage following a work-related injury to his right elbow and hand. The Board used a 200 multiplier under Workers’ Compensation Law § 14 (3), which the claimant contended did not accurately reflect his annual salary as a school bus driver working 10 months a year. The court found that applying a 200 multiplier, although a minimum, was erroneous as it did not rationally correspond to the claimant's actual work days and resulted in an average weekly wage that was not fair or reasonable. Therefore, the court reversed the Board's decision and remitted the case back to the Workers’ Compensation Board for further proceedings consistent with its ruling.

Average Weekly WageWorkers' Compensation Law200 MultiplierAnnual Salary CalculationSchool Bus DriverWork-Related InjuryJudicial ReviewError in CalculationRemittal
References
1
Case No.
Regular
Oct 29, 2009

TONY PACHECO, ANDREW ARMIJO, MARTHA MARIN, JOSE CONTRERAS, PERRY LOFTON, VITALINO AJVIX, MARTHA HERNANDEZ vs. GLOBAL WIRELESS, INC.; and STATE COMPENSATION INSURANCE FUND, CUTTING EDGE SUPPLY COMPANY; and STATE COMPENSATION INSURANCE FUND, AVEC SERVEALL; and STATE COMPENSATION INSURANCE FUND, GEHR INDUSTRIES, INC.; and STATE COMPENSATION INSURANCE FUND, AMERICAN METAL RECYCLING; and STATE COMPENSATION INSURANCE FUND, STRICTLY WHOLESALE ADA KENDALL SIGN; and STATE COMPENSATION INSURANCE FUND, MARRIOTT INTERNATIONAL, INC.

The Appeals Board issued an Order consolidating cases and a notice of intention (NIT) to impose monetary sanctions on CMS Network, Inc. and its representatives for misstatements of law. A hearing is set for November 18, 2009.

Workers Compensation Appeals BoardMonetary SanctionsNotice of Intention (NIT)Petitions for ReconsiderationMisstatements of LawGood CauseHearingObjectionAttorney ServiceRecusal
References
2
Case No. MISSING
Regular Panel Decision
Mar 20, 2000

Claim of Hamm v. USF Red Star

A truck driver, referred to as 'claimant', was injured while crossing a street to get a meal before starting a new assignment. The Workers’ Compensation Board found the injury compensable, categorizing the claimant as an 'outside employee' entitled to expanded coverage. The employer and its insurance carrier appealed, arguing the accident occurred during a deviation from employment. The court affirmed the Board's decision, ruling that the activity was reasonable and within the course of employment. The court also dismissed an appeal concerning the calculation of benefits due to abandonment by the claimant.

Traveling EmployeePortal-to-Portal CoverageCourse of EmploymentDeviation from EmploymentCompensable InjuryAccidentTruck DriverMeal BreakOff-Duty InjuryBoard Resolution
References
7
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