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

Case No. 2021 NY Slip Op 07401
Regular Panel Decision
Dec 23, 2021

Matter of Carola B.-M. v. New York State Off. of Temporary & Disability Assistance

Petitioners Carola B.-M. and Tiara M. challenged the denial of their supplemental nutrition assistance program (SNAP) benefits by the New York State Office of Temporary and Disability Assistance and the Orleans County Department of Social Services. The benefits were denied because they were deemed ineligible college students. The Appellate Division, Fourth Department, reversed this determination, holding that participation in the Adult Career and Continuing Education Services, Vocational Rehabilitation program (ACCES-VR) qualifies as a Job Training Partnership Act (JTPA) program. This status exempts the students from certain SNAP eligibility requirements. The court found that the original determination was based on an unreasonable interpretation of relevant regulations, annulled the decision, granted the petition, and remitted the case for a calculation of retroactive benefits.

SNAP benefitscollege student eligibilityJob Training Partnership ActACCES-VRvocational rehabilitationCPLR article 78regulatory interpretationpublic assistancefood stampsAppellate Division
References
28
Case No. MISSING
Regular Panel Decision

Claim of Bruzzese v. Guardsman Elevator Co.

In 1994, the claimant sustained head, neck, and back injuries at work, leading to an award for permanent partial disability, which included a wage expectancy adjustment under Workers’ Compensation Law § 14 (5). Following back surgery in 1998, the case was reopened, and the claimant was found to be temporarily totally disabled. Benefits for this temporary total disability were calculated based on the claimant's average weekly wage at the time of injury, without applying the wage expectancy adjustment. The claimant appealed, arguing that since the permanent partial disability preceded the temporary total disability, the wage expectancy adjustment should also apply to the latter period. The court disagreed, affirming the Workers’ Compensation Board's decision, citing established case law that Workers’ Compensation Law § 14 (5) is applicable only to awards for permanent partial disability and not temporary disability.

Wage expectancyTemporary total disabilityPermanent partial disabilityWorkers' Compensation benefitsBack injuryAppellate reviewDisability calculationWorkers' Compensation BoardAverage weekly wage
References
1
Case No. ADJ11672418
Regular
Mar 07, 2023

JOSE MARTIN vs. JORGE PERIBAN, FINISH LINE SELF INSURANCE GROUP

The Workers' Compensation Appeals Board granted reconsideration to correct arithmetic errors in the original award regarding temporary disability indemnity, net temporary disability owed, and attorney's fees. The Board amended the decision to reflect accurate calculations for temporary disability ($17,524.03 total, $5,597.06 net owed) and corresponding attorney's fees ($839.56). However, the Board denied the defendant's request for a credit against temporary disability for a supposed permanent disability overpayment, as the issue was not properly raised and equity did not support the claim.

Temporary disability indemnityNet temporary disabilityAttorney's feesPermanent disability indemnityCredit for overpaymentPetition for ReconsiderationWCJ decisionAmended Findings and AwardPermissibly Self-InsuredExercise rider
References
1
Case No. 5674395Z
Regular Panel Decision
Dec 01, 2011

Baines v. Berlin

Mashon Baines, a homeless and disabled mother of three, initiated a CPLR article 78 proceeding to challenge the New York State Office of Temporary and Disability Assistance's August 31, 2011 decision to discontinue her temporary housing assistance. This decision stemmed from an alleged altercation with a shelter director, Marilyn Gonzalez, during a fire drill, leading to Baines's arrest. Baines argued that her due process rights were violated because the discontinuance notice cited only the assault on Ms. Gonzalez, while the administrative decision was based on multiple uncharged wrongdoings and failed to adequately consider video evidence. The court found that respondents failed to adequately apprise Baines of all charges, thereby violating her due process rights, and consequently annulled the August 31, 2011 fair hearing decision. The court also granted Baines's request for attorneys' fees, costs, and disbursements.

Due ProcessAdministrative HearingHomeless AssistanceShelter BenefitsDiscontinuance of BenefitsNotice RequirementsCPLR Article 78Judicial ReviewAttorneys' FeesSelf-Incrimination
References
8
Case No. MISSING
Regular Panel Decision

Brownley v. Doar

Doris Brownley and Janee Nelson, single mothers receiving Safety Net Assistance (SNA), sought a preliminary injunction to prevent their evictions, arguing the New York State Office of Temporary and Disability Assistance (OTDA) provided inadequate shelter allowances. They contended that Social Services Law § 159 incorporates the adequacy requirements of § 350 (1) (a) for families with children. The court denied OTDA's cross-motion to dismiss, ruling that plaintiffs had standing and were not required to exhaust administrative remedies due to the futility and risk of irreparable harm. Finding a likelihood of success on the merits, irreparable harm including potential homelessness and foster care for children, and a favorable balance of equities, the court granted the preliminary injunction, allowing the plaintiffs and their children to remain in their homes.

Shelter allowanceSafety Net AssistancePreliminary injunctionEviction preventionSocial Services LawHousing inadequacyPublic assistanceFamilies with childrenStandingAdministrative remedies
References
23
Case No. STK 0205488
Regular
May 13, 2008

MICHAEL MONTIEL vs. STOCKTON SCAVENGERS dba WASTE MANAGEMENT, ACE AMERICAN INSURANCE by GALLAGHER BASSETT SERVICES

The Workers' Compensation Appeals Board granted reconsideration to address the employer's claim that the applicant earned income from a trucking business during his temporary total disability. While the original award found temporary disability, the Board amended it to allow credit for applicant's reported net earnings of $1,200 per month from his self-owned trucking business. The case was returned to the trial level for further proceedings and adjustment of temporary disability payments.

Workers' Compensation Appeals BoardStockton ScavengersWaste ManagementMichael MontielACE American InsuranceGallagher Bassett ServicesSTK 0205488Opinion and Order Granting ReconsiderationFindings and Awardindustrial injury
References
0
Case No. ADJ8455911
Regular
Nov 20, 2013

SANDRA VACA vs. CAPISTRANO UNIFIED SCHOOL DIST.,, SCHOOL DIST.,, CORVEL CORP.

This case concerns a dispute over the correct temporary disability indemnity rate for an applicant who worked as both a substitute teacher and a self-employed realtor. The applicant's net income as a realtor, after expenses, was used for the calculation, not her gross receipts. The Board rescinded the original award and found the applicant entitled to $395.93 per week in temporary disability, affirming the use of net income and earnings up to her last day of work. The issue of attorney's fees was deferred.

Workers' Compensation Appeals BoardTemporary Disability RateAverage Weekly EarningsSelf-Employed IncomeGross ReceiptsNet IncomeEarning CapacitySubstitute TeacherIndustrial InjuryGross Income
References
3
Case No. MISSING
Regular Panel Decision

Matter of Brady v. Northeast Riggers & Erectors

In March 2012, the claimant, a union construction laborer, sustained a work-related back and abdomen injury. A Workers' Compensation Law Judge (WCLJ) initially found the claimant attached to the labor market but deemed a total industrial disability finding premature because permanent disability had not yet been classified. The Workers’ Compensation Board upheld this determination. The claimant appealed, arguing the Board erred in declining to classify him with a temporary total industrial disability. The Court affirmed the Board's decision, asserting that a classification of temporary total industrial disability cannot be made without a prior determination of permanency.

Workers' CompensationIndustrial DisabilityPermanent DisabilityTemporary DisabilityLabor MarketAppellate DivisionBoard DecisionPremature DeterminationGainful EmploymentWork History
References
6
Case No. ADJ7620353
Regular
Mar 13, 2013

HECTOR BECERRA vs. CITY OF FRESNO

The applicant sustained an admitted industrial injury to his left shoulder. He was later unable to work due to a psychiatric disability stemming from a separate, denied claim, despite modified work being available for his orthopedic injury. The Board found the applicant not entitled to temporary partial disability for periods he was disabled by the denied psychiatric claim. However, the applicant is entitled to temporary total disability for a specific period following shoulder surgery, subject to credit for net earnings from his self-employment janitorial business.

ReconsiderationTemporary Partial Disability (TPD)Temporary Total Disability (TTD)Self-Employment IncomeCredit for EarningsPsychiatric DisabilityCumulative Stress ClaimIndustrial InjuryLeft Shoulder InjuryPolice Officer
References
12
Case No. ADJ1237800 (AHM0151777)
Regular
Jan 22, 2016

KENNETH ROSENBERG vs. STATE OF CALIFORNIA, CALIFORNIA HIGHWAY PATROL DISABILITY AND RETIREMENT, Legally Uninsured, STATE COMPENSATION INSURANCE FUND/STATE CONTRACT SERVICES, Adjusting Agency

The Workers' Compensation Appeals Board granted reconsideration to clarify clerical errors in a previous award. The Board amended the award to reflect that the defendant, California Highway Patrol, is "legally uninsured" and affirmed the application of the "duty belt" presumption (Labor Code section 3213.2). The Board also affirmed the finding of $43\%$ permanent disability, temporary disability, and the denial of apportionment, finding that the defendant waived any due process claims regarding temporary disability by not objecting at trial.

Workers' Compensation Appeals BoardCalifornia Highway PatrolLegally UninsuredState Compensation Insurance FundPetition for ReconsiderationFindings and AwardAdministrative Law JudgePermissibly Self-InsuredLow Back InjuryLeft Shoulder Injury
References
2
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