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

Case No. ADJ1543435
Regular
Feb 04, 2013

Sergio Cordero vs. Michael Bernier dba Pacific Services, Stellrecht Company, State Compensation Insurance Fund, Uninsured Employers Benefit Trust Fund

The Workers' Compensation Appeals Board denied reconsideration, upholding the finding that the applicant was injured in the course and scope of employment with an unlicensed contractor, Michael Bernier. The Board gave great weight to the Workers' Compensation Judge's credibility determination regarding the employer's testimony. The applicant's injury occurred while he was directed by Bernier to remove solar panels from a property owned by Stellrecht Company. The Board clarified the distinction between "course of employment" and "scope of employment" in workers' compensation law to affirm the decision.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ credibilitycourse and scope of employmentunlicensed contractoruninsured contractorgeneral-special relationshipLabor Code §2750.5B&P §7125.2Blew v. Horner
References
5
Case No. ADJ847031
Regular
Dec 10, 2010

CARLOS REYES vs. EL POLLO LOCO, PACIFIC COMPENSATION INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the Petition for Reconsideration in the case of Carlos Reyes v. El Pollo Loco and Pacific Compensation Insurance Company. The Board adopted the WCJ's report as the basis for the denial. Additionally, the Board corrected a clerical error in the caption of the September 20, 2010 Findings and Order to accurately reflect the defendant's name as "Pacific Compensation Insurance Company." Therefore, the reconsideration is denied, and the caption is corrected.

Workers' Compensation Appeals BoardPetition for ReconsiderationAdministrative Law JudgeFindings and OrderClerical ErrorEAMSCaption CorrectionDefendant Name CorrectionIN-HOUSE LITIGATION DEPARTMENTUNIVERSAL ASSIGNED NAME
References
0
Case No. 2017 NY Slip Op 27428
Regular Panel Decision
Dec 14, 2017

New York State Workers' Compensation Bd. v. Compensation Risk Mgrs., LLC

This action was brought by the New York State Workers' Compensation Board (WCB), as an assignee of former members of the Healthcare Industry Trust of New York (HITNY), against Compensation Risk Managers, LLC (CRM), HITNY trustees, and auditing firm UHY LLP. The WCB alleged mismanagement, breach of fiduciary duty, and negligent auditing, leading to the Trust's insolvency. Defendants moved to dismiss on grounds of standing, statute of limitations, and pleading particularity. The court dismissed certain derivative claims and negligent misrepresentation claims against some trustees due to standing issues and statute of limitations. All claims against UHY LLP were dismissed for lack of a near-privity relationship or prior precedent. An implied indemnity claim against the trustees was sustained. The WCB's cross-motion to consolidate related actions was denied.

Workers' Compensation LawGroup Self-Insured Trust (GSIT)Fiduciary DutyNegligenceNegligent MisrepresentationStatute of LimitationsStandingDerivative ActionImplied IndemnityAuditing Firm Liability
References
46
Case No. ADJ3776662
Regular
Jul 22, 2010

Frederick Deamude vs. Pacific Refrigeration, Inc., State Compensation Insurance Fund

The Workers' Compensation Appeals Board dismissed Pacific Refrigeration, Inc. and State Compensation Insurance Fund's (SCIF) petition for reconsideration. SCIF initially sought to correct alleged clerical errors in temporary disability indemnity rates and dates. However, at a subsequent hearing, the parties mutually agreed to handwritten and initialed amendments to the stipulated findings. These amendments resolved the disputed issues, leading SCIF to withdraw its petition, resulting in its dismissal.

Petition for ReconsiderationStipulated Findings and AwardTemporary Disability IndemnityPermanent Disability IndemnityClerical ErrorWithdrawal of PetitionWorkers' Compensation Appeals BoardStipulationsOrder Dismissing Petition
References
0
Case No. ADJ10786752
Regular
Jun 18, 2018

Marco Urbina vs. Taylor Walk, Inc., Pacific Compensation Insurance Company, Republic Underwriters Insurance Company

The Workers' Compensation Appeals Board (WCAB) granted removal and rescinded an order that denied a petition for joinder of Republic Underwriters Insurance Company. The WCAB found that the Order Denying Petition for Joinder was not a final order, thus dismissing the petition for reconsideration. The Board determined that Pacific Compensation Insurance Company was prejudiced by the denial, as it prevented them from pursuing contribution from Republic. The case was returned to the trial level for further proceedings consistent with the WCAB's decision.

Petition for ReconsiderationPetition for RemovalPetition for JoinderCompromise and ReleaseLabor Code Section 5500.5Supplemental ProceedingsContribution ProceedingsDue ProcessCumulative Trauma InjuryDiscovery Rights
References
20
Case No. 2018 NY Slip Op 08227
Regular Panel Decision
Nov 29, 2018

Matter of Kelly v. New York State Workers' Compensation Bd.

In 2006, claimant Grace Kelly established a workers' compensation claim for an occupational disease. The State Insurance Fund (SIF) repeatedly sought to transfer liability to the Special Fund for Reopened Cases, which was denied by Workers' Compensation Law Judges. The Workers' Compensation Board affirmed these denials and assessed $500 penalties against both SIF and its counsel, Walsh and Hacker, for filing an application for review without reasonable grounds. Walsh and Hacker appealed the penalty imposed against them to the Appellate Division, Third Department. The Appellate Division found insufficient evidence to support the Board's finding that Walsh and Hacker's application lacked reasonable grounds, and therefore reversed the penalty against them, modifying and affirming the Board's decision.

PenaltiesAppellate ReviewSpecial Fund for Reopened CasesWorkers' Compensation Law § 25-aWorkers' Compensation Law § 114-aAttorney SanctionsAdministrative LawBoard DecisionJudiciary Law § 431
References
4
Case No. MISSING
Regular Panel Decision

Claim of McKenzie v. New York Jockey Injury Compensation Fund

Claimant, an exercise rider at Belmont Racetrack, suffered pelvic injuries in December 2003 while working a horse. Despite an expired license, a Workers’ Compensation Law Judge (WCLJ) established his case and determined he was a covered employee of the New York Jockey Injury Compensation Fund, holding the Fund responsible for medical treatment. The Workers’ Compensation Board upheld this decision. The Appellate Division affirmed, referencing *Matter of Adames v New York Jockey Injury Compensation Fund, Inc.* (15 AD3d 696 [2005]), which established that an exercise rider is a covered employee of the Fund under relevant Workers’ Compensation Law and Racing, Pari-Mutuel Wagering and Breeding Law provisions, irrespective of license expiration. The court found the Fund’s remaining contentions lacked merit.

Exercise RiderWorkers' CompensationJockey Injury Compensation FundExpired LicenseCovered EmployeeThoroughbred RacingPelvic InjuryAppellate DecisionBoard DecisionStatutory Interpretation
References
1
Case No. MISSING
Regular Panel Decision

Masotto v. Atlantic & Pacific Tea Co.

The Workers’ Compensation Board discharged the Special Disability Fund from liability under subdivision 8 of section 15 of the Workers’ Compensation Law. This decision stemmed from the carrier's defective Form C-250, a notice of claim for reimbursement, which failed to specify the nature and extent of the claimant's previous physical impairment beyond vague generalities like "permanent disability condition". The employer and its insurance carrier appealed this finding. The appellate court affirmed the Board's decision, holding that the Chairman of the Workers’ Compensation Board is empowered to require specific information on reimbursement claims. The court distinguished reimbursement claims from compensation benefit claims, noting that the former requires more detailed disclosure.

Special Disability FundReimbursement ClaimForm C-250Defective ClaimPrevious Physical ImpairmentWorkers' Compensation BoardAppellate ReviewStatutory InterpretationEmployer LiabilityInsurance Carrier Liability
References
2
Case No. MISSING
Regular Panel Decision

Burroughs v. Empire State Agricultural Compensation Trust

Claimant, a dairy farmer, sustained work-related injuries in November 2001 when he fell from a ladder. A claim for workers’ compensation benefits was filed, which the carrier controverted, disputing claimant's employee status. A Workers’ Compensation Law Judge (WCLJ) determined that the employer was a limited liability corporation and claimant was an executive officer, thus covered under the Workers' Compensation Law. The Workers’ Compensation Board upheld the WCLJ’s findings. The appellate court reversed the Board's decision, concluding that the record was insufficient to establish the employer’s true status or claimant’s relationship to it, and remitted the matter for further development of the record.

Workers' CompensationEmployment StatusLimited Liability CorporationExecutive OfficerCoverage DisputeAppellate ReviewRemittalRecord DevelopmentNew York Workers' Compensation LawDairy Farmer
References
2
Case No. ADJ7790883
Regular
Nov 01, 2012

MACARIO JAIMES vs. FS PRECISION TECH, TRAVELERS, STATE COMPENSATION INSURANCE FUND, PACIFIC COMPENSATION, HOME ASSURANCE

The Workers' Compensation Appeals Board granted reconsideration to obtain a hearing transcript and allow the defendant, Travelers Insurance, to submit correspondence. This correspondence, including a representation letter from applicant's attorney, is relevant to the presumed compensability of the applicant's industrial injury claim under Labor Code section 5402. The Board now intends to admit these documents into evidence unless a written objection with good cause is filed within 10 days. All future communications regarding this case must be submitted in writing to the Board's Commissioners.

Workers' Compensation Appeals BoardMacario JaimesFS Precision TechTravelersState Compensation Insurance FundPacific CompensationHome AssuranceChartisLabor Code section 5402presumption of compensability
References
0
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