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

Case No. MISSING
Regular Panel Decision
Jul 26, 2006

Velez v. Daar

In a medical malpractice action, the plaintiff sought damages for psychological and emotional injuries stemming from a failure to diagnose thyroid cancer. The plaintiff engaged in psychotherapy with Dr. Velma Stade and initially limited the disclosure of related notes. However, during a deposition, the plaintiff disclosed that factors beyond the thyroid cancer, such as work environment and family issues, contributed to his psychological symptoms. Consequently, the defendant sought full disclosure of Dr. Stade's notes, arguing that the plaintiff had waived his psychotherapist-client privilege. The Supreme Court reversed the motion court's protective order, determining that the plaintiff had indeed waived the CPLR 4508 social worker-patient confidentiality privilege by placing his psychological condition in controversy, thereby making the disclosure of the sensitive records warranted.

medical malpracticepsychotherapyconfidentiality privilegewaiver of privilegeCPLR 4508psychological injuriesemotional distressthyroid cancerdisclosure of recordssocial worker-patient privilege
References
2
Case No. ADJ9957492 ADJ9957588 ADJ10160287
Regular
Jul 14, 2017

JULIO NUNEZ vs. BARRETT BUSINESS SERVICES, INC., ACE AMERICAN INSURANCE COMPANY

The Workers' Compensation Appeals Board denied a petition for reconsideration by Barrett Business Services, Inc. and Ace American Insurance Company. The defendants sought to overturn a finding that the applicant, Julio Nunez, was entitled to choose his own psychotherapy provider due to a delay in treatment authorization. The Board agreed with the WCJ that the defendant's failure to authorize treatment with a chosen MPN provider after receiving proper notification established the applicant's right to seek care outside the MPN. This entitlement arose from specific instances of delayed and denied authorization for psychotherapy.

Workers' Compensation Appeals BoardReconsiderationJoint Findings and OrderPsychotherapy treatmentMedical Provider NetworkMPNProvider of choiceAuthorizationDelay of treatmentDenial of treatment
References
0
Case No. 2024 NY Slip Op 24320
Regular Panel Decision
Dec 17, 2024

D.P. v. S.P.

This case involves a custody dispute between D.P. (Plaintiff) and S.P. (Defendant) concerning their two minor children in Westchester County, New York. The defendant sought to compel the plaintiff to release psychotherapy notes and medical records from her former and current mental health professionals (Dr. O.K. and Dr. A.L.). The defendant argued these records were essential for trial preparation, alleging the plaintiff had a personality disorder and received in-patient psychiatric treatment. The plaintiff and the treating professionals' counsel opposed, asserting confidentiality and that substantial medical records had already been disclosed to a court-appointed forensic evaluator. The court affirmed that psychotherapy notes can be discoverable in custody cases but ruled that the defendant failed to demonstrate that the specific information sought was not already available from the extensive records previously provided. Consequently, the defendant's motion for disclosure was denied, and the plaintiff's cross-motion to deny the disclosure was granted.

Custody DisputeChild WelfarePsychotherapy Notes DisclosureMental Health RecordsParental FitnessConfidentiality WaiverProtective OrderIn Camera ReviewBest Interests of the ChildForensic Evaluation
References
15
Case No. 2016-1365 K C
Regular Panel Decision
Nov 16, 2018

New York Infinity Health Care, LCSW, P.C. v. Farmington Cas. Co.

This action involves a healthcare provider, New York Infinity Health Care, seeking assigned first-party no-fault benefits from Farmington Casualty Company. The Civil Court denied the plaintiff's motion for summary judgment and granted the defendant's cross-motion, dismissing the complaint because the amounts sought for services rendered prior to April 1, 2013, exceeded the workers' compensation fee schedule. The Appellate Term affirmed the Civil Court's order, finding the defendant sufficiently established the proper mailing of the denial of claim forms.

No-fault benefitsSummary judgmentDenial of claimWorkers' compensation fee scheduleAppellate reviewMailing proofHealthcare providerInsurance disputeAssigned benefitsCivil Court
References
1
Case No. ADJ3172768 (SRO 0138288)
Regular
Nov 30, 2009

MATTIE WALKER-STRIPLIN vs. SONOMA COUNTY OFFICE OF EDUCATION, REDWOOD EMPIRE SCHOOLS INSURANCE GROUP

The WCAB denied defendant's petition for reconsideration of the WCJ's September 10, 2009 order awarding applicant additional psychotherapy sessions. The board found sufficient evidence that the applicant was still suffering from disabling depression and that the requested treatment was consistent with ACOEM guidelines.

Workers' Compensation Appeals BoardPetition for ReconsiderationPsyche InjuryCompensable ConsequencePsychotherapy SessionsACOEM GuidelinesUtilization ReviewIndustrial InjuryPermanent DisabilityAgred Medical Evaluator
References
0
Case No. ADJ4620904 (SRO 0118246)
Regular
Nov 09, 2010

JAMES WESTENBERGER vs. ALL COUNTY MOVING AND STORAGE, STATE COMPENSATION INSURANCE FUND

Defendant sought reconsideration of a WCJ's award to lien claimant Dr. Leonard Schwartzburd for psychotherapy and biofeedback. The primary dispute concerned the reimbursement rate for biofeedback, with defendant arguing it exceeded the Official Medical Fee Schedule. The Appeals Board granted reconsideration, adopting the WCJ's report and affirming the original award. The Board specifically ordered the defendant to pay $924.00 for biofeedback, plus penalty and interest.

WCABADJ4620904SRO 0118246ReconsiderationFindings of FactOrderLien ClaimantPsychotherapyBiofeedbackPenalty
References
0
Case No. ADJ1128183 (AHM 0122447)
Regular
Apr 19, 2010

MANUEL SOLIS vs. THE QUILTING HOUSE, AMERICAN COMMERCIAL CLAIMS ADMINISTRATION FOR EVEREST NATIONAL INSURANCE

The Workers' Compensation Appeals Board granted reconsideration to overturn a prior ruling that awarded over $32,000 to Psychological Assessment Services (PAS) for applicant Manuel Solis's treatment. The Board found that PAS failed to meet its burden of proof by demonstrating that the extensive psychotherapy services provided were reasonably necessary to cure or relieve the applicant's industrial injury. While affirming the finding of psyche injury, the Board concluded that PAS was entitled to no further reimbursement due to inadequate evidence supporting the necessity and reasonableness of the prolonged treatment.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderIndustrial InjuryBack InjuryShoulder InjuryPsyche InjuryAbdomen InjuryHerniaPsychological Assessment Services
References
2
Case No. MISSING
Regular Panel Decision

In re Lakiya S. Onya S.

The mother appealed from two orders of the Family Court, Queens County, which reduced her visitation with her children and extended their foster care placement. The appellate court reversed the orders, finding several errors by the Family Court. Specifically, uncertified psychotherapy summaries were improperly admitted into evidence, and the Family Court exhibited hostility towards the mother. Additionally, the Family Court erred by converting a visitation hearing into an extension of placement hearing without proper notice to the mother and her counsel. The case was remitted to the Family Court for a new hearing before a different judge.

Child Protective ProceedingsFamily Court ActVisitation RightsFoster Care PlacementEvidentiary RulesPsychotherapy SummariesJudicial HostilityDue ProcessNotice RequirementSexual Abuse Allegations
References
0
Case No. MISSING
Regular Panel Decision

Eli v. Eli

The case concerns a father's application for extensive, overnight visitation with his child, which the mother opposed due to allegations of sexual abuse. The court, presided over by Judge Jeffry H. Gallet, reviewed extensive testimony from fourteen witnesses, including psychologists and social workers. Despite the child's behavioral issues and initial reports by the mother and social workers, the court found insufficient evidence to support the sexual abuse allegations against the father. The decision outlines the implementation of a transitional visitation arrangement and recommends psychotherapy for both parents to address the emotional trauma and improve co-parenting.

Child CustodyVisitation RightsChild Sexual Abuse AllegationsExpert Witness TestimonyPsychological EvaluationSocial Worker AssessmentHearsay EvidenceCorroboration RequirementPosttraumatic Stress Disorder (PTSD)Adjustment Disorder
References
33
Case No. MISSING
Regular Panel Decision

Claim of Pratt v. Long Island Jewish Medical

The claimant, who sustained a work-related injury in 1999, was classified with a permanent partial disability and subsequently established a psychotherapy business. The workers’ compensation carrier sought to reduce her earnings award, prompting a dispute over which business expenses were legitimate deductions for calculating her reduced earnings. The Workers’ Compensation Board applied a "necessary/mandatory" versus "optional/elective" expense standard, categorizing various business expenses as optional, thereby decreasing the claimant's award. The court, led by Justice Lahtinen, reviewed this methodology and the Board’s factual determinations. Ultimately, the court affirmed the Board's decision, finding substantial evidence to support its analysis of business expenses for self-employed individuals in workers’ compensation cases.

Workers' CompensationPermanent Partial DisabilityReduced Earnings AwardSelf-Employment IncomeBusiness ExpensesNecessary ExpensesOptional ExpensesWorkers' Compensation BoardIncome CalculationAppellate Review
References
10
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