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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
May 16, 2003

Claim of Isaacs v. Fleet Financial Services

Claimant appealed a Workers’ Compensation Board decision from May 16, 2003, which deemed her application for review untimely. The claimant's initial workers' compensation claim for a compensable back injury was established in 1999, with an average weekly wage set at $258. After the case was reopened in 2000 for further medical treatment and then closed in 2001, claimant sought an explanation for her average weekly wage calculation in March 2003, over three years after the initial decision became final. Her subsequent formal application for Board review of the 1999 administrative decision was denied as untimely because it was filed more than 30 days after the initial decision, as required by 12 NYCRR 313.3 [c] and Workers’ Compensation Law § 23. The court affirmed the Board’s discretionary decision, finding no abuse of discretion given the significant delay and lack of evidence demonstrating erroneous wage computation.

Workers' CompensationAppealTimeliness of ApplicationAdministrative ReviewAverage Weekly WageBoard DiscretionNew York Labor LawJudicial ReviewProcedural IssuesStatutory Interpretation
References
5
Case No. MISSING
Regular Panel Decision

Calabrese v. Astrue

Darlene Calabrese sought judicial review under 42 U.S.C. § 405(g) of a final determination by the Commissioner of Social Security, which found her not disabled. After a prior remand, ALJ Bruce Mazzarella's decision became final, prompting this district court action. Plaintiff moved for judgment on the pleadings, and the Commissioner cross-moved. Presiding District Judge David G. Larimer affirmed the Commissioner's decision, concluding it was supported by substantial evidence from a vocational expert, despite Calabrese's severe impairments including chronic pain, borderline IQ, and depression/anxiety disorder. The court found that the ALJ's hypothetical to the vocational expert adequately accounted for the plaintiff's limitations. Consequently, the plaintiff's complaint was dismissed with prejudice.

Social Security DisabilityMental ImpairmentDepressive DisorderAnxiety DisorderBorderline IQVocational Expert TestimonyResidual Functional CapacitySedentary WorkAppeals CouncilAdministrative Law Judge
References
17
Case No. MISSING
Regular Panel Decision

Claim of Murray v. St. Joseph's Hospital

The State Insurance Fund appealed a decision by the Workers’ Compensation Board, filed March 10, 1995. The Board had denied the Fund’s application to transfer a claimant’s workers’ compensation case to the original Workers’ Compensation Law Judge (WCLJ) after a final determination awarding benefits had already been made. The appellate court affirmed the Board’s decision, citing Workers’ Compensation Law § 20, which states that a continued hearing before the same referee is only required until a final determination is reached. Since a final award had been made, the court found no requirement to assign the matter to the original WCLJ, deferring to the Board's interpretation of the statute.

Workers' CompensationAppealWCLJ AssignmentStatutory InterpretationFinal DeterminationAdministrative LawInsurance CarrierJurisdictionBoard Decision
References
1
Case No. 90-cv-279
Regular Panel Decision
Oct 01, 2013

Deno v. Colvin

Michael Deno sought judicial review under section 205(g) of the Social Security Act of the Commissioner of Social Security's final decision denying him Supplemental Security Income (SSI) benefits. Deno challenged the Administrative Law Judge's (hearing officer) decision, requesting a reversal of the finding that he is not disabled. The Commissioner, in turn, sought affirmation of the hearing officer's decision. This Court previously reversed and remanded Deno's claim in 2009, leading to further administrative proceedings where the hearing officer again denied the claim in 2010. Deno appealed this denial, arguing various errors by the hearing officer, including inadequate consideration of medical evidence, improper weight given to providers, unsupported credibility determinations, and erroneous reliance on vocational expert testimony. The Court, however, found the hearing officer's decision to be supported by substantial evidence, affirming the denial of disability benefits and dismissing Deno's complaint.

Social Security ActSupplemental Security Income (SSI)Disability Benefits AppealJudicial Review StandardALJ Decision ReviewTreating Physician Rule ApplicationResidual Functional Capacity AssessmentVocational Expert ReliabilityClaimant CredibilityChronic Back Pain
References
28
Case No. MISSING
Regular Panel Decision

In re the Claim of Meyerovich

The claimant, a maintenance technician, was discharged for misconduct after his manager observed him loafing on the job and he subsequently filed a workers' compensation claim for a back injury, which the employer alleged was false. The Unemployment Insurance Appeal Board disqualified the claimant from receiving benefits due to misconduct, a decision it adhered to upon reconsideration. The appellate court affirmed the Board's decision, finding substantial evidence in the manager's testimony that she did not observe the claimant using a shovel during her observation, thus supporting the finding of a false workers' compensation claim and misconduct. The court also noted that conflicting testimony presented a credibility issue for the Board to resolve and that prior Workers' Compensation Board decisions were not final regarding the accidental injury issue, thus lacking collateral estoppel effect.

MisconductUnemployment Insurance BenefitsFalse Workers' Compensation ClaimSubstantial EvidenceCredibility IssueDischarge from EmploymentLoafingProbationAppeal Board DecisionAffirmation
References
6
Case No. ADJ3139011 (WCK 0039676) ADJ3737138 (WCK 0039682) ADJ2116694 (WCK 0039685)
Regular
Dec 09, 2008

Diane Pearson vs. Gray C Home Care, Republic Indemnity Company of America

The Workers' Compensation Appeals Board (WCAB) rescinded the original award and remanded the case for further proceedings to allow for full determination of all deferred issues. The WCAB agreed that the applicant is totally permanently disabled and ordered a new final decision addressing all outstanding issues, including potential cardiovascular injuries and medical necessity of mobility equipment, to clarify all injured body parts and potentially issue a non-apportioned award. This decision aims to ensure all relevant evidence is considered before a final determination of the applicant's entitlement to benefits.

Workers' Compensation Appeals BoardReconsiderationFindings Order and AwardAdministrative Law JudgePermanent DisabilityApportionmentLife PensionMedical NecessityDeep Vein ThrombosisStroke
References
0
Case No. ADJ2269231 (OXN 0139900)
Regular
Apr 13, 2008

CAROLE KRAL vs. ST. JOHN'S REGIONAL MEDICAL CENTER, Permissibly Self-Insured OCTAGON RISK SERVICES

This case concerns an applicant challenging a WCJ's denial to reopen a prior finding that the 2005 permanent disability rating schedule applied. The Appeals Board affirmed the WCJ's decision, holding that the April 18, 2007 decision on the rating schedule was a "final order" because it addressed a "threshold issue" fundamental to permanent disability benefits. Applicant's failure to timely seek reconsideration of this final order means the rating schedule issue is now conclusively determined. Therefore, the November 25, 2008 Findings, Award and Orders, which incorporated the 2005 schedule, were properly affirmed.

Workers' Compensation Appeals BoardReconsiderationFindings and OrdersPermanent Disability Rating ScheduleThreshold IssueFinal OrderReopeningSupplemental PleadingsOccupational TherapistIndustrial Injury
References
15
Case No. MISSING
Regular Panel Decision

Joseph v. Barnhart

Ivan Joseph challenged the Commissioner of Social Security's final determination denying him disability insurance benefits. The court reviewed the Administrative Law Judge's (ALJ) decision, finding that the ALJ misapplied the treating physician rule by failing to accord appropriate weight to the opinions of Joseph's treating physicians, Dr. Inserra and Dr. Dragon. The court also noted that the ALJ's assessment of Joseph's credibility might be impacted by additional medical evidence. Consequently, the court denied the Commissioner's motion for judgment on the pleadings, granted Joseph's motion, vacated the Commissioner's final decision, and remanded the case for further administrative proceedings.

Social Security ActDisability BenefitsTreating Physician RuleALJ ErrorRemandChronic Back PainDegenerative Disc DiseaseLumbar SpineSpondylolysisMedical Evidence
References
18
Case No. MISSING
Regular Panel Decision

Caserto v. Barnhart

Paul Caserto appealed the Commissioner of Social Security's final determination denying his disability benefits. The District Court reviewed the Administrative Law Judge's (ALJ) decision, which had been affirmed by the Appeals Council. The court found that the ALJ failed to properly apply the "treating physician rule" by not acknowledging all treating physicians, omitting the weight given to their opinions, and not reconciling conflicting medical evidence. Additionally, the ALJ improperly evaluated Caserto's subjective complaints of pain. Consequently, the District Court granted Caserto's motion, denied the Commissioner's, vacated the final administrative decision, and remanded the case for further administrative proceedings in accordance with its order.

Social Security ActDisability BenefitsDenial of BenefitsALJ Decision ReviewAppeals CouncilTreating Physician RuleSubstantial Evidence ReviewRemand OrderMedical EvidenceChronic Pain Syndrome
References
14
Case No. MISSING
Regular Panel Decision

Banks v. Astrue

Plaintiff Tommy Lee Banks initiated this action to seek judicial review of the final decision by the Commissioner of Social Security, which denied his application for Supplemental Security Income (SSI). Plaintiff argued that Administrative Law Judge (ALJ) John P. Costello's decision was not supported by substantial evidence and was based on erroneous legal standards. The Court, however, found that the Commissioner's decision was supported by substantial evidence and conformed to applicable legal standards. Consequently, the Commissioner's motion for judgment on the pleadings was granted, Plaintiff's motion was denied, and Plaintiff's complaint was dismissed with prejudice.

Social Security ActSupplemental Security IncomeDisability BenefitsALJ DecisionResidual Functional CapacityPTSDDepressionAnxietyBlindnessMedical Evidence
References
14
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