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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

Jones v. New York State & Local Employees Retirement System

Petitioner, a registered nurse, sought ordinary and accidental disability retirement benefits after inhaling noxious fumes at Rome City Hospital. His ordinary disability application was denied as untimely, filed beyond the 90-day post-termination period. The accidental disability claim was also rejected because his prolonged exposure to fumes was not considered a 'sudden, fortuitous mischance' or an accidental injury under Retirement and Social Security Law § 63. The court upheld the respondent's determination, concluding that substantial evidence supported the finding that no accident occurred. Consequently, the petition was dismissed.

Disability RetirementAccidental InjuryTimely FilingCPLR Article 78Noxious FumesOrdinary DisabilityRetirement and Social Security LawRegistered NurseRome City HospitalAlbany County
References
6
Case No. MISSING
Regular Panel Decision

Di Guida v. McCall

Petitioner, a food service worker, sought accidental and ordinary disability retirement benefits after being injured in a fall on milk crates while leaving work. Respondent denied the application for accidental disability benefits, finding the petitioner was not "in service" at the time of the injury, a determination upheld by the court based on substantial evidence and the resolution of a credibility issue. The denial of ordinary disability benefits was also affirmed, supported by a physician's report that found no significant neck or shoulder injury or functional disability. Consequently, the determination was confirmed, and the petition dismissed.

accidental disabilityordinary disabilityretirement benefitsfood service workerfall injuryin servicecredibilitymedical examinationfunctional disabilityCPLR article 78
References
2
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. MISSING
Regular Panel Decision

Kubica v. New York State Employees' Retirement System

The petitioner sought ordinary disability retirement benefits, but the Comptroller denied the application. The case involved conflicting medical opinions regarding the petitioner's ability to return to work as a food service worker due to chronic disc problems. The court upheld the Comptroller's decision, stating that the Comptroller could properly credit the opinion of the respondent's physician, who found the petitioner not permanently disabled. Since the determination was supported by substantial evidence, it was confirmed, and the petition was dismissed.

Disability Retirement BenefitsMedical Opinion ConflictSubstantial Evidence ReviewComptroller DeterminationFood Service WorkerChronic Disc ProblemsAdministrative LawJudicial ReviewArticle 78 Proceeding
References
2
Case No. MISSING
Regular Panel Decision

Truly v. Regan

Petitioner, employed by Brooklyn Developmental Center, sustained a lower back and left leg injury in January 1986. After a period of inactivity, she stopped working in March 1987 due to her injuries and began receiving workers' compensation benefits. In February 1988, her applications for ordinary disability retirement benefits (under Retirement and Social Security Law art 14) and article 15 disability retirement benefits (under art 15) were denied by the respondent. The ordinary disability application was denied because she was not 'in service' at the time of filing, having been terminated in May 1987. The article 15 disability application was deemed untimely, as it was filed in February 1988, beyond the three-month window from her last payroll date of March 27, 1987, and she lacked approved medical leave. The court confirmed the denial and dismissed her petition.

Disability RetirementOrdinary Disability BenefitsArticle 15 Disability BenefitsIn Service RequirementTimely FilingCPLR Article 78 ProceedingEmployment TerminationMedical LeaveNew York State Employees' Retirement SystemAlbany County
References
5
Case No. MISSING
Regular Panel Decision

Donaldson v. Texas Department of Aging & Disability Services

David Donaldson appealed a trial court's summary judgment in favor of the Texas Department of Aging and Disability Services (DADS) on claims of race and disability discrimination, retaliation, and hostile work environment under the TCHRA and Title VII. Donaldson, an African-American employee diagnosed with multiple conditions including prostate cancer and PTSD, alleged DADS failed to accommodate his disabilities and discriminated against him through various adverse actions, culminating in his termination. The appellate court affirmed the summary judgment for DADS on the race discrimination, retaliation, and hostile work environment claims, finding insufficient evidence of discriminatory intent or materially adverse actions in those areas. However, the court reversed and remanded the reasonable accommodation claim, concluding that Donaldson presented a fact issue regarding DADS's failure to provide continued assistance for his disabilities despite initial accommodations. This decision partially reverses the trial court's judgment, necessitating further proceedings on the reasonable accommodation aspect of the disability discrimination claim.

DiscriminationRetaliationHostile Work EnvironmentDisability DiscriminationRace DiscriminationReasonable AccommodationSummary JudgmentTexas Commission on Human Rights ActTitle VIIEmployment Law
References
83
Case No. 08-23-00177-CV
Regular Panel Decision
Aug 30, 2024

Texas Department of Aging and Disability Services v. Claudia Gomez

The Texas Department of Aging and Disability Services (DADS) terminated Claudia Gomez, alleging she physically assaulted a coworker; Gomez contended the termination was discriminatory based on age, gender, and disability. The trial court denied DADS's plea to the jurisdiction regarding Gomez's discrimination claims. On appeal, the court found Gomez failed to present evidence of a similarly situated comparator, thus not establishing a prima facie case for age, gender, or disability discrimination. Furthermore, Gomez did not demonstrate that DADS's stated reason for termination was a pretext for discrimination. Consequently, the appellate court reversed the trial court's decision and dismissed Gomez's claims for lack of jurisdiction.

DiscriminationAge DiscriminationGender DiscriminationDisability DiscriminationEmployment LawTerminationPretextPrima Facie CaseSovereign ImmunityTexas Labor Code
References
30
Case No. MISSING
Regular Panel Decision

Smith v. Bayer Corp. Long Term Disability Plan

Plaintiff Terry Smith, a former Diabetes Sales Specialist for Bayer Corporation, filed an action under ERISA to recover long-term disability benefits, claiming wrongful denial due to psychiatric impairments including depression, panic disorder, and bi-polar disorder. The Plan administrator, Bayer, upheld the denial based on reviews by non-examining physicians. However, Smith's treating psychiatrists, Dr. LeBuffe and Dr. McCool, consistently found him disabled. The court found the Plan's reliance on non-examining doctors, who 'cherry-picked' medical records and distorted findings, to be arbitrary and capricious. Consequently, the court granted Smith's motion for benefits, denying Bayer's, and also awarded partial disability benefits, ruling that Smith's failure to seek rehabilitation approval was excused by the prior wrongful denial.

ERISALong-term disabilityDisability benefits denialPsychiatric impairmentDepressionPanic disorderBi-polar disorderAttention Deficit Disorder (ADD)Treating physician ruleArbitrary and capricious standard
References
26
Case No. MISSING
Regular Panel Decision

Lahm v. Bloomberg

The petitioner, a former New York City police officer named Lahm, sought an accident disability retirement (ADR) due to stage III squamous cell carcinoma, claiming it was environmentally induced by his prolonged exposure to toxic debris at the World Trade Center site on September 11, 2001. The Police Department and the Medical Board denied his request for a line-of-duty designation and ADR, asserting no causal relationship, and instead granted him an ordinary disability retirement. The Board of Trustees subsequently denied the ADR application via a tie vote. The court found that the Medical Board failed to consider whether the petitioner's pre-existing condition was aggravated by the WTC exposure. Concluding that the Board of Trustees' denial lacked a rational basis, and noting that the record contained only medical opinions supporting the aggravation claim, the court ruled as a matter of law that the petitioner's cancer was exacerbated by the service-connected September 11, 2001 injury. Consequently, the court granted the petitioner's application, annulled the Board of Trustees' determination, and remanded the matter for recomputation of his retirement allowance with an accident disability retirement.

WTC ExposureCancer AggravationAccident Disability RetirementOrdinary Disability RetirementPolice Pension FundLine-of-Duty InjuryCausation StandardMedical BoardTie Vote AnnulmentExacerbation of Pre-existing Condition
References
7
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