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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

Tahir v. Progressive Casualty Insurance

This case addresses a no-fault health services provider's claims for compensation for current perception threshold (CPT) and sensory nerve conduction threshold (sNCT) testing. The defendant insurer argued these tests were not compensable under Medicare and constituted provider fraud. The court rejected the Medicare defense, clarifying that New York's no-fault statute relies on workers' compensation fee schedules, not Medicare standards. Furthermore, the court categorized the fraud defense as a medical necessity issue, requiring timely assertion with supporting evidence. Finding the insurer failed to meet its burden, the court ruled in favor of the plaintiff, entitling them to attorney fees and statutory interest.

No-fault insuranceCPT testingsNCT testingMedical necessityProvider fraudMedicare compensationWorkers' compensation fee schedulesElectrodiagnostic testSensory neuropathyChiropractic services
References
26
Case No. 2015-03-0506
Regular Panel Decision
Feb 01, 2017

Diana, Annicia v. ABM Industries, Inc.

Ms. Annicia C. Diana sustained a crush injury to her left wrist while working as a sanitation worker for ABM Industries, Inc. The core legal issue revolved around the causal relationship between Ms. Diana's radial nerve palsy and the work injury, along with the medical necessity of additional diagnostic testing, specifically an EMG/NCS. The authorized treating physician, Dr. John M. Ambrosia, could not establish a direct link between Ms. Diana's radial nerve palsy and her work injury, and his opinion was presumed correct under Tennessee law. Ms. Diana failed to provide sufficient evidence to rebut Dr. Ambrosia's findings. Consequently, the Court denied her request for additional medical benefits and the recommended nerve tests.

Workers' Compensation JudgeExpedited HearingMedical Benefits DenialRadial Nerve PalsyCausal RelationshipMedical NecessityDiagnostic TestingTreating Physician OpinionPresumption of CorrectnessBurden of Proof
References
3
Case No. MISSING
Regular Panel Decision

Brian v. Johns

Petitioner Carol Brian initiated an action against respondent Frank T. Johns to establish paternity for her child, Sara, born March 4, 1973, and to secure child support. A court-ordered blood grouping test, conducted at the respondent's expense following an order on January 2, 1974, excluded Mr. Johns as the father. Unsatisfied with these results, the petitioner requested a second blood test, but the court denied this motion after reconsideration, citing respondent's opposition and the lack of statutory authority in Section 532 of the Family Court Act for ordering a second test over objection. The court ruled that the trial should proceed, requiring the respondent to present the performing doctor as a witness to explain the test's basis and procedure, allowing the petitioner to question its accuracy. The decision acknowledged a potential margin of error in such tests and affirmed the petitioner's opportunity to rebut the blood test evidence, as it is not the sole determinant of paternity.

paternityblood testFamily Court Actevidencetrialmotion deniedchild supportmedical examination accuracyserologyhemotology
References
2
Case No. MISSING
Regular Panel Decision
Nov 06, 2003

Nikko Asset Management Co. v. UBS AG, UBS Warburg (Japan), Ltd.

Plaintiffs, Nikko Asset Management Co., Ltd., MMF, and HMMF (collectively 'Nikko'), sued defendants, UBS AG and its subsidiaries ('UBS'), alleging violations of federal securities laws and tort claims. Nikko accused UBS of fraudulently selling credit-linked notes (CLNs) in Japan without disclosing critical information about Enron Corporation's financial instability, knowledge UBS allegedly gained through its U.S. dealings with Enron. The core issue was whether U.S. federal securities laws applied to these predominantly foreign transactions. The court granted UBS's motion to dismiss for lack of subject matter jurisdiction, concluding that the alleged U.S. conduct was merely preparatory and did not directly cause the plaintiffs' losses from the Japanese transactions, thus failing both the 'effects test' and the 'conduct test'.

Securities FraudCredit-Linked NotesSubject Matter JurisdictionForeign TransactionsEnron ScandalConduct TestEffects TestMotion to DismissInvestment BankingInternational Law
References
49
Case No. MISSING
Regular Panel Decision

In Re Morton

Michael Wayne Morton, convicted of his wife's murder in 1987, sought post-conviction forensic DNA testing of various pieces of evidence under chapter 64 of the Texas Code of Criminal Procedure. The district court partially denied his motion, leading to this appeal. The appellate court affirmed the denial of testing for evidence related to a separate murder and for fingerprint evidence, finding these did not meet the statutory requirements of being "secured in relation to the offense" or containing "biological material." However, the court reversed the denial for a blood-stained bandana recovered near the crime scene. The court concluded that if DNA testing on the bandana yielded exculpatory results (Christine's blood and a third party's DNA), there is a greater than 50% likelihood that Morton would not have been convicted, and thus remanded the case for further proceedings concerning the bandana.

forensic DNA testingmurder convictionappealcriminal procedureexculpatory evidenceblood-stained bandanaunidentified fingerprintscircumstantial evidencetime of deathunknown intruder theory
References
12
Case No. MISSING
Regular Panel Decision

Gordon v. Brown

A New York City police officer, referred to as 'Petitioner,' underwent a random drug screening in June 1991, testing positive for cocaine. Subsequently, he was charged with violating department rules and faced an administrative hearing. During the hearing, Dr. William Closson, the Director of Forensic Toxicology at Brunswick Hospital Center, testified regarding the EMIT and GC/MS tests performed on the petitioner's urine specimen. However, the laboratory technicians who conducted the tests were not produced for cross-examination. Petitioner was terminated based on the hearing officer's findings. He challenged his termination through a CPLR article 78 proceeding, alleging a denial of due process due to the inability to cross-examine the technicians. The Appellate Division confirmed the Commissioner's determination, and the Court of Appeals affirmed, holding that due process did not require the production of the laboratory personnel where the general reliability of the procedures was not disputed, the supervisor was subject to cross-examination, and no specific testing defect was claimed. The court also found the termination penalty was not unduly harsh.

due processadministrative lawpolice disciplinedrug screeningurinalysis testcocaine ingestionevidence rulescross-examination rightslaboratory proceduresforensic evidence
References
11
Case No. MISSING
Regular Panel Decision
Jun 01, 2009

People v. Nunn

This case addresses whether a court's discretion to deem a misdemeanor complaint charging a drug offense as an information, without a field test or laboratory analysis, violates a defendant's due process rights. The court distinguishes People v Kalin and Matter of Jahron S., applying the three-factor test from Mathews v Eldridge. It concludes that the substantial private interest in physical liberty and the risk of erroneous deprivation necessitate a laboratory report or field test in most drug-related cases, imposing minimal burden on the prosecution. Specifically, for defendant Mr. Nunn, the misdemeanor complaint was deemed an information on June 1, 2009, after the certified laboratory analysis was filed.

Due ProcessCriminal ProcedureMisdemeanorControlled SubstanceDrug PossessionMisdemeanor InformationMisdemeanor ComplaintPrima Facie CaseLaboratory AnalysisField Test
References
21
Case No. MISSING
Regular Panel Decision
Sep 09, 1980

France v. St. Clare's Hospital & Health Center

The plaintiff, Joe France, sued St. Clare's Hospital for libel, alleging that a letter sent by the hospital to a co-worker falsely stated he had a venereal disease, which led to emotional stress, disruption of his relationship, and sexual impotence. The hospital had conducted routine blood tests after France donated blood, and his sample reacted positively to a VDRL test, leading to the letter informing his co-worker that his blood could not be used. Subsequent tests showed France did not have a venereal disease. The court, applying First Amendment principles from Gertz v. Robert Welch, Inc., found that without proof of malice or actual injury to reputation, claims for presumed damages or emotional distress alone are not compensable in New York. Since malice was conceded to be absent and no actual reputational harm was proven, the court reversed the lower court's denial and granted St. Clare's Hospital's motion for summary judgment, dismissing the complaint.

LibelDefamationVenereal DiseaseVDRL TestSummary JudgmentActual InjuryPresumed DamagesFirst AmendmentReputationEmotional Distress
References
14
Case No. MISSING
Regular Panel Decision

Xue Ming Wang v. Abumi Sushi Inc.

Plaintiff Xue Ming Wang sued Abumi Sushi Inc. and Qing Zhong Li for Fair Labor Standards Act (FLSA), New York Labor Law (NYLL), and New York General Business Law § 349 violations, stemming from his employment as a delivery worker. The core legal dispute centered on whether the defendants, who acquired the restaurant's assets in June 2015, were liable for violations predating the sale under successor liability doctrines. The Court considered both traditional common-law and federal common-law 'substantial continuity' tests. It concluded that the traditional test did not apply due to lack of ownership continuity, and under the 'substantial continuity' test, the plaintiff failed to prove the defendants had notice of the alleged pre-sale violations. Consequently, the Court granted the defendants' motion for partial summary judgment, denied the plaintiff's motion, and dismissed claims related to pre-June 2, 2015 conduct against the appearing defendants.

Successorship LiabilityFair Labor Standards ActNew York Labor LawGeneral Business Law § 349Wage and Hour ViolationsAsset SaleConstructive NoticeSummary JudgmentEmployment LawLabor Dispute
References
45
Case No. 2022 NY Slip Op 06518 [210 AD3d 1240]
Regular Panel Decision
Nov 17, 2022

Matter of Hoyt (Paul Revere Life Ins. Co.--Commissioner of Labor)

Paul Revere Life Insurance Company appealed decisions by the Unemployment Insurance Appeal Board, which found the company liable for unemployment insurance contributions for claimant William K. Hoyt Jr. and others. The Board determined that Paul Revere's contract with the claimant did not satisfy all seven requirements of Labor Law § 511 (21) and that the parties' conduct was inconsistent with the statutory exclusion, thus establishing an employment relationship under the common-law test. The Appellate Division, Third Department, affirmed the Board's decision, emphasizing that both the written contract and the parties' actual conduct must conform to the statutory provisions for an insurance agent's services to be excluded from the definition of employment. The court found substantial evidence supporting the Board's conclusion of an employment relationship, citing factors such as the claimant's work schedule, reporting requirements, and Paul Revere's training and oversight. The decision clarified that a mere 'verbatim inclusion or rote incantation' of the statutory provisions in a contract is insufficient if actual conduct contradicts them.

Unemployment InsuranceInsurance AgentsEmployment RelationshipCommon Law TestLabor Law § 511Statutory ExclusionAppellate ReviewUnemployment BenefitsInsurance Sales IndustryContractual Provisions
References
6
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