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Case Law Database

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

Case No. MISSING
Regular Panel Decision

Smith v. New York State & Local Retirement Systems

Petitioner, a taxpayer services representative, sustained a back injury in March 1981 while lifting forms, leading to a decline in attendance and eventual termination in November 1989. She applied for accidental and ordinary disability retirement benefits, both of which were denied by the Comptroller. The accidental disability claim was denied because the incident was not deemed an 'accident' under Retirement and Security Law § 63. The ordinary disability claim was denied as untimely, having been filed approximately six months after her termination, exceeding the 90-day limit stipulated by Retirement and Social Security Law § 62. The Supreme Court dismissed the challenge to the ordinary disability denial due to untimeliness and transferred the accidental disability challenge to this Court. This Court confirmed the Comptroller's determination on both counts, rejecting the petitioner's estoppel argument regarding the untimely ordinary disability application and finding substantial evidence to support the finding that the injury did not constitute an 'accident' within the meaning of the relevant law, as it resulted from ordinary employment duties without an unexpected event.

Disability Retirement BenefitsAccidental DisabilityOrdinary DisabilityUntimely ApplicationEstoppel Against GovernmentWork-Related InjuryBack InjuryDefinition of AccidentOrdinary Employment DutiesSubstantial Evidence Review
References
16
Case No. MISSING
Regular Panel Decision
May 15, 2012

Hamzik v. Office for People with Developmental Disabilities

Plaintiff John J. Hamzik sued the Office for People with Developmental Disabilities (OPWDD) and several individual employees, alleging discrimination based on sex, age, and disability, as well as equal protection, due process, and retaliation claims under federal and state laws, including Title VII, ADEA, and ADA. Defendants moved to dismiss the amended complaint, and plaintiff cross-moved to file a second amended complaint. The District Court, finding that many claims were barred by Eleventh Amendment immunity or failure to exhaust administrative remedies, and that the remaining claims failed to state a plausible cause of action, granted the defendants' motion to dismiss. All federal claims were dismissed with prejudice, the cross-motion was denied as futile, and the remaining state law claims were dismissed without prejudice.

DiscriminationRetaliationDue ProcessEqual ProtectionTitle VIIADEAADAEleventh Amendment ImmunityAdministrative ExhaustionMotion to Dismiss
References
50
Case No. 2020 NY Slip Op 02301 [182 AD3d 821]
Regular Panel Decision
Apr 16, 2020

Matter of Community, Work, & Independence, Inc. v. New York State Off. for People with Dev. Disabilities

This case involves a CPLR article 78 proceeding initiated by Community, Work, and Independence, Inc. (petitioner) to challenge a determination affirming the objection to its proposed discharge of M.D., an individual with developmental disabilities, from day habilitation services. M.D.'s parents objected to the discharge, and an administrative hearing sustained their objection, a decision later affirmed by the Commissioner of the Office for People with Developmental Disabilities. The Appellate Division, Third Department, confirmed the Commissioner's determination, finding that the burden of proof was appropriately placed on the service provider. The court concluded that substantial evidence supported the finding that discharging M.D. was not reasonable, considering his needs, the lack of suitable alternative programs, and despite the petitioner's financial concerns. The court suggested that financial issues for service providers should be addressed by seeking increased funding rather than by discharging individuals.

Developmental DisabilityHCBS WaiverDischarge ServicesAdministrative HearingBurden of ProofSubstantial EvidenceFinancial ConcernsService ProviderMedicaid FundingAutism Spectrum
References
7
Case No. MISSING
Regular Panel Decision

Jones v. McCall

Petitioner, a food service worker, applied for ordinary disability retirement benefits, claiming permanent incapacitation due to a stroke. The respondent denied the application, finding insufficient evidence that petitioner was permanently incapacitated from her duties. During the subsequent CPLR article 78 proceeding, a neurologist for the State and Local Employees’ Retirement System testified that neither their examination nor review of medical records showed significant objective neurological dysfunction that was permanent or disabling. The court confirmed the respondent's determination, ruling it was supported by substantial evidence and that the respondent had the authority to credit one medical expert's opinion over conflicting views from treating physicians. The petition challenging the determination was dismissed.

Ordinary disability retirement benefitsCPLR Article 78Stroke incapacitationMedical expert testimonyConflicting medical opinionsSubstantial evidence reviewAdministrative determinationJudicial reviewPermanent incapacitationRetirement System benefits
References
1
Case No. ADJ3403193 (RIV 0072531)
Regular
Sep 08, 2009

PERRY NICKLE vs. MESA CONTRACTING CORPORATION, SEABRIGHT INSURANCE

The Appeals Board granted reconsideration, rescinding the original award and substituting a new one. The Board found that the applicant did not sustain a hearing loss injury but did sustain neurological and orthopedic permanent disability. They determined that 60% of the orthopedic disability and 50% of the neurological disability were non-industrial, resulting in a revised permanent disability award of 31%. The Board also confirmed the applicant's entitlement to a cane and further medical treatment based on expert medical opinions.

Workers' Compensation Appeals BoardReconsiderationApportionmentAgreed Medical EvaluatorQualified Medical EvaluatorPermanent DisabilityNeurological DisabilityOrthopedic DisabilityHearing LossDegenerative Disease
References
2
Case No. MISSING
Regular Panel Decision

Bullard v. St. Mary's Hospital

Claimant, a secretary at St. Mary's Hospital, developed rheumatoid arthritis, resulting in a permanent partial disability. The Workers' Compensation Board ruled it an occupational disease and awarded compensation. Liability was apportioned among three employers: Rochester Savings Bank, Woodward Health Center, and St. Mary's Hospital. The Special Disability Fund (SDF) was deemed liable for benefits after the initial 104-week disability period. SDF appealed, contending its reimbursement should be limited to St. Mary's Hospital's one-third share. The court affirmed the Board's decision, holding that Workers' Compensation Law § 44 makes the last employer (St. Mary's) responsible for total compensation, and Workers' Compensation Law § 15 (8) (d) requires SDF to fully reimburse the employer's carrier, Sedgwick James, for benefits paid after 104 weeks.

Occupational DiseaseRheumatoid ArthritisPermanent Partial DisabilityApportionmentSpecial Disability FundReimbursementWorkers' Compensation LawLast Employer LiabilityInsurance CarrierWorkers' Compensation Board
References
0
Case No. ADJ4018708 (SBA 0079160)
Regular
Apr 23, 2010

KATHY KELLERMANN vs. REGENTS OF UCSB, SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves Kathy Kellermann's claim for workers' compensation benefits, where the administrative law judge initially found a cumulative trauma injury to her psyche but not to her dental, neurological, or internal systems, awarding 8% permanent disability. Ms. Kellermann sought reconsideration, arguing the judge erred by excluding dental, neurological, and internal injuries, acting in excess of powers regarding an independent medical exam, and improperly relying on certain medical reports for disability assessment. The Appeals Board granted reconsideration to clarify the scope of injury, affirming the finding of psyche injury but not other systems as a compensable consequence. The Board also upheld the 8% permanent disability award, citing precedent allowing reliance on a single physician's relevant and considered opinion even if inconsistent with others.

ADJ4018708SBA 0079160Kathy KellermannRegents of UCSBSedgwick Claims Management ServicesOpinion and Order Granting ReconsiderationDecision After Reconsiderationindustrial cumulative trauma injurypsyche injurydental injury
References
2
Case No. MISSING
Regular Panel Decision

Forsyth v. Staten Island Developmental Disabilities Services Office

The claimant, a lifeguard, sustained head and shoulder injuries in an automobile accident while working for the Staten Island Developmental Disabilities Services Office. His workers' compensation benefits were calculated based on concurrent employment, including seasonal work for the City of New York. The Workers’ Compensation Board affirmed the finding of concurrent employment, a decision which was subsequently appealed by the employer and its carrier. The appellate court affirmed the Board's determination, finding substantial evidence to support the finding of concurrent employment under Workers’ Compensation Law § 14 [6], given the claimant's long history of working for both employers during the same periods.

concurrent employmentaverage weekly wageworkers' compensationlifeguard injuryseasonal employmentappellate reviewNew York labor law
References
3
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. 2023 NY Slip Op 02156 [215 AD3d 1201]
Regular Panel Decision
Apr 27, 2023

Matter of Holder v. Office for People with Dev. Disabilities

Claimant's husband, a house manager for the Office for People with Developmental Disabilities, contracted COVID-19 and passed away in March 2020. Claimant filed for workers' compensation death benefits, alleging his death was causally related to his employment. Initially, a Workers' Compensation Law Judge established the death benefits claim. However, the Workers' Compensation Board reversed this decision, concluding there was insufficient evidence to prove COVID-19 was prevalent in the decedent's work environment prior to his symptoms. The Appellate Division, Third Department, affirmed the Board's decision, finding that the claimant failed to meet her burden of establishing that the decedent contracted COVID-19 in the course of his employment.

COVID-19 DeathWorkers' Compensation BenefitsCausal RelationEmployment ExposureHouse ManagerGroup HomeBurden of ProofSubstantial EvidenceAppellate ReviewAdministrative Review
References
13
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