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

Case No. 13-ev-3288; 13-cv-4244
Regular Panel Decision

Alzheimer's Disease Resource Center, Inc. v. Alzheimer's Disease & Related Disorders Ass'n

This case involves two related lawsuits stemming from the disaffiliation of the Alzheimer’s Disease Resource Center, Inc. (ADRC) from the Alzheimer’s Disease and Related Disorders Association (the Association). In case 13-ev-3288, ADRC alleged unfair competition, false advertising, and other claims. The Court denied dismissal for false advertising under the Lanham Act, New York General Business Law § 349, and unjust enrichment, but granted dismissal for trademark infringement, common law unfair competition, UCC violations, conversion, tortious interference, and fraud. In case 13-cv-4244, ADRC alleged breach of contract and misappropriation of trade secrets related to donor lists. The Court granted the Association's motion to dismiss this complaint in its entirety. Punitive damages were stricken for Lanham Act and unjust enrichment claims.

Unfair CompetitionLanham ActFalse AdvertisingTrademark InfringementNew York General Business Law § 349Unjust EnrichmentMotion to DismissBreach of ContractTrade Secret MisappropriationConversion
References
55
Case No. MISSING
Regular Panel Decision

Long Island Neurological Assocs., P.C. v. Highmark Blue Shield & Reed Smith LLP

Plaintiff Long Island Neurological Associates, P.C. sued Highmark Blue Shield and Reed Smith LLP for under-reimbursement of surgical services under ERISA. The case involved a 4-year-old patient who received complex out-of-network surgery from Dr. Schneider due to the unavailability of in-network providers. Highmark significantly under-reimbursed the billed amount and denied multiple appeals, failing to provide requested documentation. The patient's parents assigned their rights to the Plaintiff, leading Defendants to move for dismissal, asserting an anti-assignment provision in their Administrative Service Agreement (ASA). The Court denied the motion, ruling that the ASA is not an ERISA plan document and thus its anti-assignment clause is not binding on plan participants, confirming Plaintiff's standing. The Rule 12(b)(6) motion was also denied as abandoned.

ERISAMotion to DismissAnti-assignment clauseAdministrative Service Agreement (ASA)Plan DocumentSubject Matter JurisdictionStandingUnder-reimbursementOut-of-network providerHealth Insurance
References
27
Case No. MISSING
Regular Panel Decision

Matter of John Z.

This case involves an appeal from an order recommitting the respondent to petitioner's custody due to a dangerous mental disorder. The respondent, with a history of multiple killings and a prior finding of not guilty by reason of mental disease or defect, had his parole revoked after exhibiting aggressive and threatening behavior upon conditional release. The Supreme Court determined he suffered from Antisocial Personality Disorder with narcissistic and paranoid features, which was deemed a dangerous mental disorder justifying civil confinement under CPL 330.20. The appellate court affirmed, rejecting the argument that the diagnosis was legally insufficient and upholding the finding of current dangerousness based on expert testimony, the respondent's history of violence, and his lack of insight into his condition.

dangerous mental disordercivil confinementantisocial personality disordernarcissistic featuresparanoid featuresCPL 330.20recommitmentmental illnessparole revocationexpert testimony
References
10
Case No. MISSING
Regular Panel Decision

In re Anonymous

This case concerns an adoption proceeding in Nassau County for a neurologically handicapped child. The petitioners, an approved adoptive family, sought to finalize the adoption. Former foster parents, the intervenors, challenged this, claiming a statutory preference for adoption due to their long-term care of the child. The court found that the intervenors had previously declined to adopt the child and failed to take affirmative steps to gain statutory preference while the child was in their care. The decision emphasized that intervention rights apply to current foster parents in custody disputes, and ultimately, the court prioritized the child's best interests by granting the petitioners' adoption application.

AdoptionFoster CareChild WelfareNeurological HandicapBest Interests of ChildInterventionStatutory PreferenceSocial Services LawAgency Discretion
References
3
Case No. MISSING
Regular Panel Decision
Jan 17, 1996

Claim of Palevsky v. New York City Board of Education

In 1986, while working as an education associate in the Bronx, the claimant sustained a fractured nose due to a student altercation and filed a timely workers' compensation claim, receiving benefits. The case remained open for a pending nasal surgery issue. Years later, in 1992, the claimant sought compensation for alleged consequential posttraumatic stress disorder. The self-insured employer, the New York City Board of Education, argued that Workers' Compensation Law § 28, a two-year statute of limitations, barred this new claim. However, both the Workers' Compensation Law Judge and the Board affirmed that Section 28 does not apply to consequential injuries. Upon appeal, the Court concurred, holding that a subsequent claim for disability compensation related to injuries in an earlier, timely claim is not barred by the two-year limit for amendment.

Workers' CompensationPosttraumatic Stress DisorderStatute of LimitationsConsequential InjuryWorkers' Compensation Law § 28Time BarBoard DecisionAppealWorkplace InjuryNasal Fracture
References
3
Case No. 10 Civ. 3314; 10 Civ. 5013
Regular Panel Decision
Dec 22, 2010

Alzheimer's Foundation of America, Inc. v. Alzheimer's Disease & Related Disorders Ass'n

This consolidated opinion addresses dueling motions to dismiss in two civil actions involving the Alzheimer’s Foundation of Americas, Inc. (the "Foundation") and the Alzheimer’s Disease and Related Disorders Association (the "Association"). The Foundation initiated a lawsuit alleging misrepresentation, trademark dilution, unfair competition, unjust enrichment, conspiracy, conversion, and UCC violations against the Association and Northern Trust. Conversely, the Association filed its own complaint asserting claims of trademark infringement, libel, injurious falsehood, false designation, dilution, fraud, tortious interference, injury to business reputation, unfair competition, unjust enrichment, and conspiracy against the Foundation and several individuals. The court denied motions to dismiss the Lanham Act, dilution, and unfair competition claims for both parties, but granted motions to dismiss the UCC, conversion, libel, unjust enrichment, and fraud claims, including all claims against Northern Trust. Leave to amend the complaints was granted.

Trademark InfringementUnfair CompetitionLanham ActDilutionUnjust EnrichmentConversionFraudCollateral EstoppelMotion to DismissRule 12(b)(6)
References
59
Case No. ADJ6694033
Regular
Nov 13, 2017

William Swanson vs. COUNTY OF SAN BERNARDINO

This case concerns an applicant's petition for reconsideration of a WCJ's award for psychiatric and neurological injury, specifically a sleep disorder. The applicant argued for permanent total disability, while the defendant opposed the petition. After a settlement conference, the parties submitted stipulations resolving the dispute. The Appeals Board approved these stipulations, finding them in the applicant's best interest, specifically agreeing to a 65% permanent partial disability rating and dismissing the applicant's petition.

Workers' Compensation Appeals BoardSan Bernardino CountyWilliam SwansonAmended Findings and AwardPetition for ReconsiderationPsyche injuryNeurologic system disorderSleep disorderPermanent partial disabilityPermanent total disability
References
0
Case No. ADJ8168988
Regular
Oct 23, 2015

JOSE CEJA vs. YORBA LINDA CAR WASH, PENNSYLVANIA MANUFACTURERS INSURANCE GROUP

This case involves applicant Jose Ceja's petition for reconsideration of a Workers' Compensation Appeals Board decision. The Board denied reconsideration, upholding the finding that while Ceja sustained industrial injuries to his spine and knee, he failed to prove industrial causation for neurological, psychiatric, or sleep disorders. The medical evidence presented was deemed insufficient, lacking reasonable medical probability and proper reasoning for causation. Specifically, expert opinions were criticized for speculation, inadequate history, and reliance on applicant's subjective reporting without sufficient medical analysis.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrdersIndustrial InjuryCervical SpineLumbar SpineRight KneeNeurological SystemPsycheSleep Disorder
References
5
Case No. ADJ9312928
Regular
Sep 11, 2019

Jeffrey DaVanon vs. Oakland Athletics, ACE Insurance Company, Sedgwick Claims Management

The Workers' Compensation Appeals Board granted the applicant's petition for reconsideration. The applicant, a former professional athlete, claimed cumulative trauma injury to multiple body parts, including gastrointestinal issues, neurological problems, and a sleep disorder not initially identified. The Board found that the WCJ erred by excluding medical evidence for these later-identified body parts, as they were included in the parties' stipulations and could have arisen or worsened after the applicant's deposition. The case is returned for further proceedings, allowing admission of relevant medical records and deferring final decisions on disputed body parts and permanent disability.

Mandatory Settlement ConferencePetition for ReconsiderationCumulative TraumaProfessional AthleteStatute of LimitationsLabor Code Section 5405Labor Code Section 5412Discovery CloseBifurcationIndependent Medical Evaluator
References
6
Case No. 532120
Regular Panel Decision
Jun 24, 2021

Matter of Bugianishvili v. Alliance Refrig. Inc.

Archil Bugianishvili, a mechanic, filed for workers' compensation benefits after an April 2016 incident where he was exposed to toxic gas, leading to respiratory, neurological ailments, posttraumatic stress disorder, and major depression. A Workers' Compensation Law Judge determined he had a permanent total disability as of November 2019, which the Workers' Compensation Board affirmed. The employer, Alliance Refrigeration Inc., and its carrier appealed this decision. The Appellate Division, Third Department, affirmed the Board's determination, finding substantial medical evidence from an independent medical examination supported the permanent total disability ruling. The Court also upheld the Board's decision against apportionment for a separate burn incident and declined to allow further development of the record.

Workers' CompensationPermanent Total DisabilityToxic Gas ExposureRespiratory AilmentsNeurological AilmentsPosttraumatic Stress DisorderMajor DepressionIndependent Medical ExaminationMaximum Medical ImprovementApportionment
References
7
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