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

Case No. 2023 NY Slip Op 23398 [81 Misc 3d 21]
Regular Panel Decision
Nov 30, 2023

What Happened in Felix vs. Weber Metals Reconsideration?

Plaintiff, Associated Plastic Surgeons & Consultants, P.C., filed a commercial claims action against Global Commodities, Inc. for $5,000 for unpaid medical services provided to an alleged employee. Plaintiff claimed defendant agreed to pay privately. The District Court dismissed the action after excluding a document detailing telephone conversations, which plaintiff argued was admissible under the business records exception or relaxed commercial claims evidence rules. The Appellate Term affirmed the dismissal, ruling that plaintiff failed to prove the patient was injured during employment or that the document was admissible as a business record, thus failing to establish defendant's liability for the medical bill. The court emphasized that while commercial claims courts are not bound by strict evidence rules, judgments cannot rest solely on hearsay.

Commercial claimsMedical servicesUnpaid billsBusiness records exceptionHearsayEvidence rulesEmploymentWorkers' Compensation LawAppellate reviewSubstantial justice
References
10
Case No. MISSING
Regular Panel Decision

How Did the WCAB Rule in Hardgrove vs. Intercon Security?

This opinion addresses the sufficiency of an oral contract to satisfy the "purchaser-seller" requirement in a private action under Section 10(b) of the 1934 Exchange Act and Rule 10b-5, where no actual purchase or sale of securities occurred. The court considers whether such an oral agreement, even if potentially unenforceable under the statute of frauds, can support a federal securities claim. Reviewing existing jurisprudence, the court emphasizes a liberal and flexible construction of anti-fraud provisions to protect investors. It concludes that an action under Rule 10b-5 is not deficient merely because the contract relied upon is oral rather than written. Consequently, the defendants' motions for summary judgment are denied, and the case is set to proceed to trial, affirming the court's jurisdiction over the matter.

Securities fraudOral contractsRule 10b-5Purchaser-seller requirementStatute of fraudsPendent jurisdictionSummary judgmentFederal court jurisdictionExchange Act of 1934Investor protection
References
18
Case No. MISSING
Regular Panel Decision
Feb 08, 1984

What Did the WCAB Decide in Cuadra vs. Community Home Care?

This case involves an appeal concerning the enforceability of an alleged oral modification to a written corporate shareholders' agreement. The original agreement, between Jack Klein (decedent), Michael Jacobson, and Jamor Purveyors, Inc., stipulated a $55,000 buy-out price for a deceased shareholder's stock. The plaintiff, as executrix of Klein's estate, claimed an oral agreement increased this buy-out price to $155,000. Special Term dismissed the claims, asserting the oral modification was barred by the Statute of Frauds and a clause in the original agreement requiring written modifications. The Appellate Court affirmed this decision, ruling that the alleged oral agreement fell within the Statute of Frauds and that the plaintiff's arguments regarding memoranda, partial performance, and equitable estoppel were insufficient to satisfy the statute or overcome its provisions. The court also upheld the interpretation that the agreement's modification clause precluded oral changes.

oral agreementStatute of Fraudsshareholders' agreementcorporate buy-outcontract modificationpart performanceequitable estoppelAppellate DivisionCPLRGeneral Obligations Law
References
13
Case No. 2021-02-0655
Regular Panel Decision
Nov 15, 2023

How Were Death Benefits Handled in Bocanegra vs. Sun-Gro Commodities?

Eddie Otey, an employee of Asplundh Tree Expert Company, sought dental care and attorney's fees after sustaining injuries, including a lost tooth, on January 18, 2021. Despite a settlement agreement providing for future dental care, Asplundh failed to provide a panel of oral surgeons. The Court found Mr. Otey was entitled to the requested benefits, ruling that Asplundh must provide the panel and pay reasonable attorney's fees to Michael Large. The Court adjusted the attorney's fees to $1,760.00, including legal staff time, and also taxed the filing fee to Asplundh.

Workers' CompensationDental CareAttorney's FeesPanel of PhysiciansMedical BenefitsSettlement AgreementOral SurgeonsEmployee RightsEmployer ObligationsTennessee Law
References
2
Case No. ADJ1184992
Regular
Feb 10, 2015

Can a WCJ Be Disqualified for Appearance of Bias?

The Workers' Compensation Appeals Board (WCAB) rescinded a penalty against Petsmart, Inc. for allegedly unreasonably delaying dental treatment. The Board found that Petsmart had no obligation to pay for the dental surgery in advance, as dictated by Labor Code section 4603.2, which requires payment within 45 days after services are provided. While the treating oral surgeon requested prepayment due to high costs, the WCAB determined that the defendant's utilization review approval for the treatment did not constitute an agreement to advance payment. Therefore, the WCAB concluded there was no unreasonable delay or refusal of treatment, negating the basis for a Labor Code section 5814 penalty.

Workers' Compensation Appeals BoardPetition for ReconsiderationLabor Code section 5814unreasonable delaydental careoral surgeryutilization reviewpre-authorizationpayment in advancefee schedule
References
2
Case No. MISSING
Regular Panel Decision

What Were the Key Rulings in Torrez vs. SuperShuttle?

Jose Beltran filed a Title VII discrimination and retaliation lawsuit against the University of Texas Health Science Center at Houston (UTHealth) after his termination from an Oral and Maxillofacial Surgery residency program. Beltran, a Hispanic resident, alleged discrimination based on national origin and race, citing incidents such as misidentification, an improper accusation of misdiagnosis, denial of higher rotating pay, and denied vacation time. He also claimed retaliation for complaining about discrimination when UTHealth refused to reconsider his termination. The court granted UTHealth's motion for summary judgment, concluding that Beltran failed to establish a prima facie case for discrimination or retaliation, as he provided insufficient evidence that similarly situated non-Hispanic employees were treated more favorably, and could not rebut UTHealth's legitimate, non-discriminatory reasons for his termination.

Employment DiscriminationTitle VIINational Origin DiscriminationRace DiscriminationRetaliation ClaimSummary JudgmentPrima Facie CasePretextUniversity of TexasFifth Circuit Precedent
References
59
Case No. 2018-01-0006
Regular Panel Decision
Feb 07, 2019

Why Was Removal Denied in Rush vs. California Correctional Institution?

Syvonia Armstrong, a bartender, filed a claim for medical benefits, alleging dental injuries from an electrical shock at work. The employer, Chattanooga Billiard Club, Inc., and its carrier, Eastern Alliance Insurance Co., disputed causation. The court considered conflicting medical opinions from Dr. Drew Shabo, who initially found no way to link the shock to dental issues but later provided letters stating causation was more likely than not, and oral surgeon Dr. Richard L. Johnson, who found no dental disability from the shock. The Court deemed Dr. Shabo's opinions unreliable due to inconsistencies and insufficient prior information, giving greater weight to Dr. Johnson's findings. Consequently, the Court denied Ms. Armstrong's claim for medical benefits related to her dental conditions but ordered the employer to provide care for a left ear canal burn diagnosed by Dr. David Fortune.

Dental InjuriesElectrical ShockCausation DisputeMedical Benefits DenialExpedited HearingExpert Opinion ReliabilityOral Surgeon FindingsBartender AccidentTennessee Workers' Comp LawEar Canal Burn
References
1
Case No. MISSING
Regular Panel Decision

What Did the WCAB Clarify in Ontiveros vs. Savers Stores?

Plaintiff, a subcontractor, initiated an action to recover $209,650 in overtime expenses from U.W. Marx, Inc. and its bonding companies, based on an alleged oral modification to a written subcontract. The Supreme Court initially ruled in favor of the plaintiff, finding an enforceable oral agreement despite a clause prohibiting oral modifications. On appeal, the Appellate Division determined that the plaintiff failed to demonstrate partial performance or equitable estoppel unequivocally referable to the alleged oral agreement for overtime payment, as required by General Obligations Law § 15-301. Consequently, the judgment was modified by reducing the award by $191,870, effectively denying the majority of the overtime claim, while affirming the denial of the defendants' counterclaims.

Oral ModificationSubcontract DisputeConstruction LawOvertime ExpensesGeneral Obligations LawPartial PerformanceEquitable EstoppelContract InterpretationAppellate ReviewJudgment Modification
References
8
Case No. MISSING
Regular Panel Decision

Why Was Reconsideration Denied in Gomez vs. Dorothy Stevens?

Karl Johansson, the appellee, sustained a job-related injury and subsequently filed a worker's compensation claim. He entered into a Compromise Settlement Agreement (CSA) with the Industrial Accident Board but orally attempted to withdraw his consent before the board's approval. Despite the oral notice, the board initially approved the agreement. However, the board later set aside the CSA, citing a timely request from Johansson to withdraw consent. The appellant challenged this decision in District Court, arguing that oral notice was insufficient to void the CSA. The appellate court examined the Industrial Accident Board's explicit rule (28 Tex.Admin.Code § 55.60), which mandates written notice for withdrawal of consent, a provision amended in 1985 to emphasize the written requirement. Furthermore, Texas case law establishes that once the Board approves a settlement, it loses jurisdiction over the case. The court concluded that the oral repudiation was ineffective as it did not comply with Rule 55.60, and therefore, no effective notice of withdrawal was given. Consequently, the court found no evidence to support the trial court's findings and judgment, reversing and rendering the judgment in favor of the appellant.

Workers' CompensationCompromise Settlement AgreementOral vs. Written NoticeIndustrial Accident Board JurisdictionAppellate ProcedureSufficiency of EvidenceAdministrative Rule InterpretationWithdrawal of ConsentTexas Law
References
9
Case No. ADJ3206000 (LAO 0877236)
Regular
Aug 10, 2012

Why Was Reconsideration Dismissed in Sabino vs. Johnson Pump Company?

The applicant sought reconsideration of a decision limiting the defendant's payment for hip surgery to the Official Medical Fee Schedule, which the applicant's surgeon deemed insufficient. The Appeals Board granted reconsideration due to the complex fee dispute, noting that while extraordinary circumstances existed regarding the surgeon's qualifications, the reasonableness of his requested fee was unproven. To resolve this, the Board ordered the appointment of an agreed physician to investigate the surgeon's usual fee and its reasonableness compared to others with similar expertise.

ReconsiderationFindings of FactAgreed PhysicianMedical TreatmentFee ScheduleExtraordinary CircumstancesUsual FeeHip ArthroscopyOsteoplastyChondroplasty
References
1
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