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

Case No. 2018 NY Slip Op 00712 [158 AD3d 1114]
Regular Panel Decision
Feb 02, 2018

Bonczar v. American Multi-Cinema, Inc.

Plaintiff David M. Bonczar commenced an action seeking damages for injuries sustained when he fell from a ladder in a movie theater owned by American Multi-Cinema, Inc. He was updating a fire alarm system as a subcontractor. The Supreme Court granted plaintiff's motion for partial summary judgment on liability under Labor Law § 240 (1). The Appellate Division reversed this order, concluding that plaintiff failed to meet his initial burden because he did not know why the ladder malfunctioned and might not have checked its positioning or locking mechanism. The majority found a plausible view that plaintiff's own acts were the sole cause of the accident. A dissenting opinion argued that plaintiff had met his burden and the defendant failed to raise a triable issue of fact.

Ladder AccidentLabor Law § 240(1)Summary Judgment MotionAppellate ReviewProximate CausationSole Proximate Cause DefenseWorkplace SafetyFall from HeightStatutory ViolationDuty to Provide Protection
References
15
Case No. ADJ6947852
Regular
Apr 02, 2012

Claude Brownlee vs. Miami Dolphins; Multi-Line Claims

This case involves a workers' compensation claim by Claude Brownlee against the Miami Dolphins for cumulative trauma. The Appeals Board granted the Defendant's Petition for Removal, allowing discovery to remain open past the Mandatory Settlement Conference. This decision reverses the WCJ's order closing discovery, enabling the Defendant to conduct depositions and medical evaluations. The Board found this necessary for a full and fair resolution of the applicant's claim, despite the Defendant's prior inaction.

Petition for RemovalOrder for Consolidation and StayVacated OrderDiscovery ClosureQualified Medical EvaluatorMandatory Settlement ConferenceLabor Code Section 5502(e)(3)Judicial EconomyTrial on the MeritsDissenting Opinion
References
4
Case No. MISSING
Regular Panel Decision

Star Multi Care Services, Inc. v. Empire Blue Cross Blue Shield

This case involves Star Multi Care Services, Inc. (plaintiff) suing Empire Blue Cross Blue Shield (defendant) and Demetria Sarris and Van Sarris (Sarris defendants) for breach of contract regarding home health care services. Star initially filed the action in New York State Supreme Court, alleging Empire breached a contract to pay for services provided to Ms. Sarris under an ERISA plan. Empire removed the case to federal court, arguing ERISA preemption, and filed a motion to dismiss, while Star moved to remand to state court. The District Court denied Star's motion to remand, finding the claim was preempted by ERISA. The court granted Empire's motion to dismiss, concluding that Empire was not a proper defendant under ERISA and Star failed to exhaust administrative remedies. The remaining state law claims against the Sarris defendants were remanded to the Supreme Court of the State of New York, County of Suffolk, as the federal court declined to exercise supplemental jurisdiction.

ERISA preemptionRemoval jurisdictionMotion to remandMotion to dismissRule of unanimitySubject matter jurisdictionBreach of contractHealth care benefitsEmployee welfare benefit planAdministrative remedies exhaustion
References
73
Case No. ADJ2719991 (VNO 0485134) ADJ1334047 (VNO 0428744)
Regular
Aug 20, 2009

Catalina Barajas vs. WELLPOINT HEALTH NETWORK, INC., ZURICH LOS ANGELES

This case involves an applicant who initially sustained a cumulative trauma injury to her upper extremities during a period covered by one insurer. After returning to work with modified duties, she experienced a recurrence and worsening of symptoms, necessitating further treatment and surgery, which the Board now recognizes as a separate cumulative trauma injury. The Workers' Compensation Appeals Board granted reconsideration, reversing the prior finding of a single cumulative trauma injury. The Board held that distinct periods of compensable temporary or permanent disability, as established by medical evidence and treatment, demarcate separate cumulative trauma injuries, aligning with the *Rodarte* precedent. Consequently, the applicant was found to have sustained two separate cumulative trauma injuries, each attributed to different insurance coverage periods.

cumulative traumaanti-merger doctrineLabor Code sections 3208.25303Rodartecompensable temporary disabilitypermanent disabilitywage lossmodified workbilateral upper extremities
References
3
Case No. ADJ8627409
Regular
Feb 18, 2025

PAUL PIUROWSKI vs. DALLAS COWBOYS, ACE AMERICAN INSURANCE COMPANY, MIAMI DOLPHINS, MULTI-LINE CLAIMS SERVICES, INC., TAMPA BAY BANDITS, ZENITH INSURANCE COMPANY, SUMMIT CONSULTING LLC

The Workers' Compensation Appeals Board granted reconsideration regarding a cumulative trauma injury claim filed by Paul Piuroswki. The Board affirmed the WCJ's finding that defendants Tampa Bay Bandits and Associated Industries of Florida Self-Insurers Fund (AIFSIF) waived their personal jurisdiction defense by failing to timely litigate the issue over nearly two years while participating in the trial on the merits. However, the Board deferred the entry of an award. Further proceedings are required to determine the proper liable entity or entities and resolve issues related to insurance coverage under Labor Code section 5500.5.

Workers CompensationPersonal JurisdictionWaiverGeneral AppearanceSpecial AppearanceNotice of AppearancePetition for ReconsiderationFindings and AwardLabor Code Section 5500.5Insurance Coverage
References
11
Case No. 2025 NY Slip Op 03795 [239 AD3d 942]
Regular Panel Decision
Jun 25, 2025

Garcia v. Fed LI, LLC

The injured plaintiff, Jose Garcia, and his wife, suing derivatively, initiated an action after Mr. Garcia fell from an unsecured extension ladder while working on a commercial property. The property was owned by Fed LI, LLC, GSM LI, LLC, ICA LI, LLC, and SAF LI, LLC, and leased by Multi Packaging Solutions, Inc., with Mr. Garcia employed by J.P.S. Electric Co., Inc. (JPS). The plaintiffs moved for summary judgment on the issue of liability under Labor Law § 240 (1), which the Supreme Court denied. The Appellate Division reversed this part of the order, granting summary judgment to the plaintiffs, finding that a violation of Labor Law § 240 (1) was established and was a proximate cause of the injuries, as the defendants failed to provide adequate safety devices or rebut the prima facie showing of negligence. The Appellate Division affirmed the lower court's decision regarding contractual indemnification, ruling that JPS was not contractually obligated to indemnify the MPS entities, as a post-accident purchase order's general reference to 'Terms and Conditions' was insufficient to establish a retroactive indemnification agreement.

Ladder FallConstruction Site InjuryLabor Law ViolationSummary Judgment MotionIndemnification AgreementContract InterpretationRetroactivityThird Party LiabilityAppellate DivisionSuffolk County
References
22
Case No. ADJ8514073 (MF) ADJ9995510 ADJ2721680 (FRE 0187462)
Regular
Sep 24, 2018

VICTOR VILLA vs. JOE CARDOZA DAIRY, PAULA INS. in receivership by CIGA, INSURANCE COMPANY OF THE WEST, SECURITY NATIONAL administered by RISICO, REPUBLIC INDEMNITY administered by SEDGWICK

This case concerns a dispute over the dates of a cumulative trauma injury to the applicant's left knee, following an admitted 1998 specific injury. The Workers' Compensation Appeals Board (WCAB) granted reconsideration to amend the injury period. The WCAB determined the date of cumulative trauma injury under Labor Code § 5412 was September 4, 2012, the date the applicant retained counsel and gained awareness of the cumulative trauma concept. Consequently, liability for the cumulative trauma injury under Labor Code § 5500.5 was established as September 4, 2011, to September 4, 2012.

WORKERS COMPENSATION APPEALS BOARDJOE CARDOZA DAIRYPAULA INSCIGAINSURANCE COMPANY OF THE WESTSECURITY NATIONALREPUBLIC INDEMNITYSEDGWICKVICTOR VILLASUBSEQUENT CUMULATIVE TRAUMA
References
0
Case No. ADJ8680977
Regular
Apr 28, 2014

Albert Johnson vs. Southwest Airlines, ACE USA Insurance

The Workers' Compensation Appeals Board reversed a judge's decision that barred Albert Johnson's cumulative trauma claim due to the statute of limitations. The Board found that the employer's continued provision of medical treatment for Johnson's injuries tolled the one-year statute of limitations under Labor Code section 5405(c). This treatment, provided after an initial specific injury but before the cumulative trauma claim was filed, was deemed to have also addressed the cumulative trauma elements. Therefore, Johnson's claim for cumulative trauma injury ending August 17, 2009, was found to be timely filed.

Cumulative traumaStatute of LimitationsLabor Code section 5405TollingMedical treatmentSpecific injuryRamp agentSouthwest AirlinesWorkers' Compensation Appeals BoardReconsideration
References
1
Case No. ADJ2307991 (VNO 0427797) (MF) ADJ3536405 (VNO 0336819) ADJ487962 (VNO 0533632)
Regular
Jun 14, 2018

JACQUELINE AUSTIN vs. FIRST FOURSQUARE CHURCH OF VAN NUYS, GUIDE ONE MUTUAL INSURANCE COMPANY, FREMONT, CIGA, CYPRESS INSURANCE COMPANY, FOREST LAWN MEMORIAL PARK, SAFECO INSURANCE, TRAVELERS PROPERTY CASUALTY COMPANY

This case involves an applicant who sustained two separate cumulative trauma injuries to her neck, back, and gastrointestinal system, including GERD and fibromyalgia. The Workers' Compensation Appeals Board (WCAB) affirmed the findings that the applicant suffered distinct industrial injuries during employment with First Foursquare Church (insured by Cypress) and Forest Lawn Memorial Park (insured by Travelers). Defendant Cypress contested the dating of the injury and the finding of two separate cumulative trauma periods, while Travelers challenged the sufficiency of medical evidence for one injury. The WCAB found Cypress waived the issue of one versus two cumulative trauma injuries by failing to raise it timely. Ultimately, the WCAB adopted the WCJ's findings, confirming the two separate cumulative trauma periods and the respective carrier liabilities.

Workers' Compensation Appeals BoardReconsiderationCumulative TraumaDate of InjuryLabor Code Section 5412Labor Code Section 5500.5Findings of FactAward and OrderAdministrative Law JudgeCypress Insurance Company
References
9
Case No. GOL 92220, GOL 98213
Regular
Jun 02, 2008

Dave Lucas vs. COMMUNITY WEST BANCSHARES, AARLA by ORION SPECIALTY GROUP

The Workers' Compensation Appeals Board denied a petition for reconsideration, affirming the WCJ's finding that the applicant did not sustain a new cumulative trauma injury to his shoulder and back. The Board found that the defendant's arguments regarding cumulative trauma and apportionment were not supported by substantial medical evidence. Specifically, the Board determined Dr. Hutchinson's findings regarding cumulative trauma were speculative and improperly applied to a previously awarded disability.

New and further disabilityCompensable consequenceIndustrial back injuryPermanent disabilityApportionmentCumulative traumaSpecific injuryQualified Medical EvaluatorPrimary treating physicianPetition to reopen
References
1
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