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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 06800
Regular Panel Decision
Dec 07, 2021

Harris v. Pelham Parkway Nursing Care & Rehabilitation Facility LLC

Plaintiff Mariantha Harris appealed an order from Supreme Court, Bronx County, denying her cross motion for summary judgment dismissing an affirmative defense based on the exclusivity provision of the Workers' Compensation Law. The Appellate Division, First Department, reversed the order, granting Harris's cross motion. Harris successfully established prima facie that she was not an employee of Pelham Parkway Nursing Care and Rehabilitation Facility LLC at the time of her accident, but rather was solely employed by nonparty Clear Choice, P.C. The defendant failed to provide sufficient evidence to support its claim that Harris was its special employee, with its reliance solely on the plaintiff performing duties at its nursing home being insufficient. Additionally, the court found the doctrine of judicial estoppel inapplicable because plaintiff had not secured a judgment in her favor in the prior proceeding, and the defendant's prematurity argument was improperly raised for the first time on appeal.

Summary JudgmentExclusive RemedyEmployment StatusSpecial EmployeeSlip and FallJudicial EstoppelAppellate ProcedureCross MotionAffirmative DefenseClear Choice P.C.
References
6
Case No. MISSING
Regular Panel Decision
Jul 19, 2007

Claim of Torrance v. Loretto Rest Nursing Home

Claimant, a food service worker for Loretto Rest Nursing Home, suffered a work-related injury and received workers' compensation benefits. While receiving partial disability benefits, she took a light duty job with another employer. Loretto subsequently terminated her employment, citing a collective bargaining agreement provision against "moonlighting" while on leave. Claimant filed a discrimination claim under Workers’ Compensation Law § 120. A Workers’ Compensation Law Judge initially found discrimination, but the Workers’ Compensation Board reversed. On appeal, the Board's decision was affirmed, as Loretto's termination was deemed a non-discriminatory application of a neutral company policy.

Discrimination ClaimWorkers' Compensation BenefitsPartial DisabilityLight Duty EmploymentTermination of EmploymentCollective Bargaining AgreementNeutral PolicyCausal NexusAppellate ReviewWorkers' Compensation Law § 120
References
10
Case No. MISSING
Regular Panel Decision
Mar 04, 1988

In re Nurse Care Registry, Inc.

Nurse Care Registry, Inc., an agency providing health care personnel, appealed a decision by the Unemployment Insurance Appeal Board that classified its workers as employees rather than independent contractors, making Nurse Care liable for unemployment insurance contributions. The court affirmed the Board's decision, finding substantial evidence of Nurse Care's control over key aspects of the services provided by the workers. This control included client contact, worker wages, and billing/collection, which were deemed indicative of an employer-employee relationship. The court relied on precedent establishing that such control warrants an employment finding, despite workers having full-time positions elsewhere and the agency not directly supervising daily work.

unemployment insuranceemployer-employee relationshipindependent contractoradministrative lawappellate reviewlabor lawagency staffingcontrol testsubstantial evidencehealth care industry
References
4
Case No. MISSING
Regular Panel Decision

C.N.S., Inc. v. Connecticut General Life Insurance

This case involves cross-motions for summary judgment concerning a dispute over retiree medical benefits provided by AlliedSignal, Inc. The plaintiffs, C.N.S., Inc. d/b/a Community Nursing Services (CNS) and Gloria Steiner, challenged the denial of benefits for nursing services and the hourly rate. The Court dismissed claims against Connecticut General Life Insurance Company (CGLIC) as it had no duty to pay benefits. The Court granted summary judgment to defendants regarding the reduction of nursing service payments from $100 to $55 per hour, finding the administrator's decision reasonable due to plaintiffs' failure to provide justification. However, the Court denied both parties' motions for summary judgment concerning the termination of benefits for around-the-clock nursing care, citing a genuine issue of material fact regarding the reasonableness of that decision.

ERISAEmployee BenefitsRetiree Medical PlanSummary Plan DescriptionPlan Administrator DiscretionBenefit DenialSummary JudgmentArbitrary and Capricious StandardOut-of-Network BenefitsNursing Services
References
7
Case No. MISSING
Regular Panel Decision

Claim of Smith v. Waterview Nursing Home

A 63-year-old nurse’s aide sustained work-related injuries and her workers’ compensation case was established. She was offered a light-duty position by her employer, but her daughter informed the employer that claimant could not work. The Workers’ Compensation Law Judge and the Workers’ Compensation Board subsequently concluded that by rejecting the offer, claimant had voluntarily withdrawn from employment and denied her further benefits. The Appellate Division reversed this decision, finding that the employer failed to provide substantial evidence regarding the specifics of the light-duty position, its requirements, duties, or suitability for the claimant's medical limitations. The court held that without such proof, the Board's finding of voluntary withdrawal was not supported by substantial evidence. The matter was remitted to the Workers’ Compensation Board for further proceedings consistent with the court's decision.

Workers' CompensationLight-Duty AssignmentVoluntary WithdrawalLabor MarketMedical LimitationsSubstantial EvidenceReversalRemittiturNurse's AideEmployment Benefits
References
3
Case No. MISSING
Regular Panel Decision

Huntington Hospital v. Huntington Hospital Nurses' Ass'n

Huntington Hospital initiated an action under the Federal Arbitration Act to partially vacate an arbitration award, while the Huntington Hospital Nurses’ Association cross-petitioned to confirm it. The dispute originated from the Hospital unilaterally granting two nurses, Betty Evans and Lynn Meyer, longevity pay credits exceeding the ten-year cap stipulated in their collective bargaining agreement (CBA). The arbitrator found the Hospital violated the CBA's sections on pay and exclusive bargaining rights. The arbitrator mandated the Hospital roll back excess credits and recover overpayments. The District Court denied the Hospital's petition, dismissing arguments regarding public policy, manifest disregard for law, and lack of award finality, ultimately confirming the arbitration award.

Arbitration AwardCollective Bargaining AgreementLabor LawFederal Arbitration ActWage DisputesLongevity PayUnion RightsPublic Policy ExceptionManifest Disregard of LawContract Interpretation
References
22
Case No. MISSING
Regular Panel Decision

Franzese v. United Health Care/Oxford

Plaintiffs Robert and Elizabeth Franzese, parents and legal guardians of disabled adult Robert Franzese Jr. ("Bobby"), sued United Health Care/Oxford under ERISA to recover medical benefits. Bobby, suffering from chronic lung disease, requires 24/7 in-home nursing care. Oxford denied preauthorization for private duty nursing, citing it as an exclusion, and denied home health care services. The court granted Oxford's summary judgment motion regarding private duty nursing and Xopenex preauthorization, finding private duty nursing not covered. However, the court denied Oxford's motion regarding home health care services, deeming Oxford's denial arbitrary and capricious due to lack of substantial evidence. The case is remanded to Oxford for reconsideration of home health care benefits.

Employee Retirement Income Security Act (ERISA)Medical BenefitsHealth Insurance DenialSummary JudgmentArbitrary and Capricious StandardHome Health CarePrivate Duty NursingPreauthorizationMedical NecessityChronic Lung Disease
References
37
Case No. MISSING
Regular Panel Decision

Thomas v. Little Flower for Rehabilitation & Nursing

The plaintiff, Stephanie Thomas, commenced an action against Little Flower for Rehabilitation & Nursing, 1199 SEIU National Benefit Fund, and 1199 SEIU United Healthcare Workers East (Local 1199). She alleged unlawful retaliation and breach of contract by Little Flower, breach of duty of fair representation by Local 1199, and COBRA violations by all three defendants. The COBRA claim against Local 1199 was later dismissed. Local 1199 moved to dismiss the remaining claims against it. The court found that Thomas plausibly alleged a meritorious grievance and that Local 1199 acted arbitrarily by failing to process her grievance or investigate it, thereby breaching its duty of fair representation. Consequently, Local 1199's motion to dismiss the complaint was denied.

Employment TerminationUnlawful RetaliationBreach of ContractDuty of Fair RepresentationMotion to DismissLabor LawUnion GrievanceCollective Bargaining AgreementERISACOBRA Claim
References
26
Case No. MISSING
Regular Panel Decision

George v. Hilaire Farm Nursing Home

This case, an opinion by District Judge Robert L. Carter, addresses motions to dismiss and/or for summary judgment filed by employer defendants Hilaire Farm Nursing Home and Michael Gottsegen, and union defendants Local 1199 and others. The plaintiff, a former nurse's aide, was discharged for alleged patient abuse, reinstated after union intervention, and later resigned. She subsequently sued, alleging breach of collective bargaining agreement, breach of duty of fair representation, intentional infliction of emotional distress, negligence, interference with economic relations, and defamation. The court found that the federal labor claims were time-barred under the six-month statute of limitations and lacked merit. State law claims for intentional infliction of emotional distress and defamation were also dismissed as lacking sufficient egregious conduct or being untimely. Consequently, the court granted summary judgment in favor of all defendants, dismissing all claims.

Summary JudgmentBreach of Collective Bargaining AgreementDuty of Fair RepresentationIntentional Infliction of Emotional DistressDefamationTortious Interference with Economic RelationsStatute of LimitationsFederal PreemptionLabor LawDistrict Court
References
32
Case No. 2019 NY Slip Op 03114 [171 AD3d 1410]
Regular Panel Decision
Apr 25, 2019

Matter of Harry's Nurses Registry, Inc. (Commissioner of Labor)

Harry's Nurses Registry, Inc. (HNR), a staffing agency, appealed a decision from the Unemployment Insurance Appeal Board. The Board had assessed HNR for additional unemployment insurance contributions for health care workers for the years 2008-2010, reversing an Administrative Law Judge's decision. HNR's main contention on appeal was that the Board was bound by a prior unappealed Administrative Law Judge decision from 1999, which had found HNR's health care workers to be independent contractors for an earlier audit period. The Appellate Division, Third Department, affirmed the Board's decision, stating that the Board is not bound by prior unappealed Administrative Law Judge decisions, especially when covering different audit periods and presenting additional factors of control.

Unemployment InsuranceStaffing AgencyHealth Care WorkersIndependent Contractor StatusEmployee StatusUnemployment Insurance Appeal BoardAdministrative Law Judge DecisionStare DecisisAudit PeriodAppellate Review
References
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