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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 06069 [199 AD3d 438]
Regular Panel Decision
Nov 09, 2021

Matter of Ashanti v. New York City Conflicts of Interest Bd.

The Appellate Division, First Department, confirmed the determination of the New York City Conflicts of Interest Board, finding that petitioner Karl J. Ashanti violated New York City Charter and City rule provisions. Ashanti was ordered to pay an aggregate civil penalty of $8,500. The court found substantial evidence supported the determination that Ashanti used his City position to gain personal advantage in negotiations on behalf of his wife and utilized City letterhead to advance a legal position contrary to the City's interests. The court rejected the petitioner's due process and agency bias claims, concluding that the penalty imposed did not shock the conscience.

Conflicts of InterestPublic OfficialsEthical ViolationsCivil PenaltyDue ProcessAgency BiasSubstantial EvidenceAppellate ReviewAdministrative Law JudgeCredibility Determinations
References
4
Case No. MISSING
Regular Panel Decision
Dec 31, 2001

Citrin v. Merkle

The claimant, rendered quadriplegic by a 1972 work accident, was classified as permanently totally disabled. A 1988 Workers’ Compensation Law Judge (WCLJ) decision authorized reimbursement for home-care services, but the carrier subsequently withheld payments, citing a dispute over the claimant's receipt of services. A 1997 WCLJ decision rejected the fraud claim and directed payment of outstanding home-care expenses, which the Workers’ Compensation Board upheld in 1998. The Board then granted the claimant's request for interest and penalties, but determined interest should accrue from December 21, 1998, the date of the Board's direction for payment, rather than September 20, 1988, the initial authorization date. The claimant appealed this calculation, but the court affirmed the Board’s decision, stating that interest under Workers’ Compensation Law § 20 (1) requires an actual 'award' rather than a mere 'authorization' for services.

Workers' CompensationQuadriplegiaPermanent Total DisabilityHome Care ServicesInterest CalculationPenaltiesWorkers' Compensation BoardAppealFraud ClaimAward Date
References
2
Case No. ADJ2529270 (MON0205624)
Regular
Dec 17, 2010

ZOI FOVOS vs. LOS ANGELES UNIFIED SCHOOL DISTRICT permissibly self insured c/o SEDGWICK CLAIMS MANAGEMENT SERVICES

The Workers' Compensation Appeals Board granted reconsideration of a prior decision that found an award was paid timely without penalties. Applicant contended the defendant failed to include interest with the award payment, entitling them to penalties and attorney fees. The Board found the WCJ's decision failed to address the timeliness of interest payment and the applicability of penalties under Labor Code sections 5814 and 5814.5. The case is returned to the WCJ for further proceedings and a new decision regarding potential penalties and attorney fees for the delayed interest payment.

Workers Compensation Appeals BoardPetition for ReconsiderationFindings of FactAwardPenaltyAttorney's FeeInterest on AwardLabor Code Section 4650Labor Code Section 5814Labor Code Section 5814.5
References
6
Case No. ADJ1314529 (LBO 0331102), ADJ2710937 (LBO 0337681), ADJ3736545 (LBO 0334960), ADJ4463186 (LBO 0363045)
Regular
Jan 25, 2018

BELIA FLORES vs. THE KROGER COMPANY, SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves a dispute over lien claimant Dr. Elena Konstat's reimbursement for medical-legal expenses. The Court of Appeal remanded the case, directing the Board to address issues of penalties and interest. The Board affirms its prior decision awarding $4,900 for Dr. Konstat's medical-legal evaluations but defers the penalties and interest issue to the trial level. Further proceedings will occur at the trial level regarding penalties and interest.

Workers Compensation Appeals BoardRemittiturLien ClaimantPetition for Writ of ReviewPenaltiesInterestMedical-Legal CostsAgreed Bill ReviewerOfficial Medical Fee ScheduleLabor Code 4622
References
4
Case No. ADJ7968765
Regular
Mar 22, 2018

DONALD BECHTEL vs. AMZAC ENTERPRISES, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and amended a prior order, finding that lien claimant Med-Legal Photocopy is entitled to penalties and interest under Labor Code section 4622(a). The original order had allowed the lien but denied penalties and interest. The Board found that the employer did not dispute receiving the services or invoices, making them liable for the statutory additions. The parties are directed to adjust the penalty and interest amount, with jurisdiction reserved to the WCJ if they cannot agree.

Workers Compensation Appeals BoardLien ClaimantPetition for ReconsiderationLabor Code Section 4622PenaltiesInterestDuplicative ServicesReasonablenessNecessityCopy Service Fee Schedule
References
0
Case No. ADJ4388600
Regular
Sep 09, 2011

CARLOS CALVILLO vs. ALLIED BUILDING MAINTENANCE, LIBERTY MUTUAL INSURANCE COMPANY

The lien claimant, Joyce Altman Interpreters, sought reconsideration of an award for interpreter services, arguing they were owed the full amount claimed plus penalties and interest. The Workers' Compensation Appeals Board denied the petition, upholding the administrative law judge's decision. The judge found that while some interpreter services were compensable, the claimant's documentation was deficient and charges were unreasonable, precluding full recovery of penalties and interest. The Board agreed that statutory provisions do not expressly allow penalties and interest for interpreter services in this context.

Lien claimantJoyce Altman InterpretersPetition for ReconsiderationSupplemental Findings and AwardCompromise and Releasepenalties and interestLabor Code section 4600reasonably required interpreter servicesReport and Recommendationcustodian of records
References
1
Case No. ADJ8869541, ADJ8869534, ADJ8869536, ADJ8869545
Regular
Apr 09, 2018

IRELA IZAGUIRRE vs. GRIMMAY ENTERPRISES, INC.

This case concerns a lien claimant's entitlement to penalties and interest on unpaid workers' compensation medical-legal expenses. The Workers' Compensation Appeals Board (WCAB) granted reconsideration and amended the original award to include penalties and interest for the lien claimant. The WCAB found that the lien claimant's invoices sufficiently provided the necessary information for the employer to determine payment. Therefore, the WCAB concluded the employer's failure to pay the full amount within the statutory period triggered penalties and interest under Labor Code section 4622.

Workers' Compensation Appeals BoardGrimmsay EnterprisesMed Legal PhotocopyPetition for ReconsiderationFindings Orders and AwardLabor Code Section 4622Penalties and InterestReasonableness and NecessityBurden of ProofMedical-Legal Expenses
References
2
Case No. ADJ4695433 (LAO 0818613) ADJ2060510 (LAO 0818614) ADJ181314 (LAO 0818615)
Regular
Feb 11, 2010

ALFREDO TERCERO vs. DOUGLAS FURNITURE, STATE COMPENSATION INSURANCE FUND

This case concerns a lien claimant's request for penalties and interest on unpaid medical treatment expenses. The Workers' Compensation Appeals Board denied the claimant's petition for reconsideration. The Board affirmed the administrative law judge's decision, finding no legal basis for penalties or interest on the stipulated medical treatment costs. This is because Labor Code section 4603.2, as amended by SB 899 and applied to pending cases, requires pre-established fee schedule rates for such penalties and interest, which did not exist for outpatient surgery centers at the time of service.

Lien claimantReconsiderationFindings and AwardPre-award penaltyInterestLabor Code section 4603.2Medical treatment expensesStipulated amountWCAB Rule 9795.5(f)Industrial injury
References
1
Case No. SAC 0343628
Regular
Feb 25, 2008

LILIAN WILKINSON vs. VETERANS HOME and STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration, striking the finding of unreasonable delay and the penalty awarded by the WCJ. While affirming the allowance of Dr. Pazdel's lien, the Board deferred the issue of penalties and interest under Labor Code section 4603.2. The matter was returned to the trial level for further proceedings on penalties and interest, noting that penalties under Labor Code section 5814 are owed to the applicant, not lien claimants, and that applicant's right to penalties was likely waived in the prior stipulation.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and OrdersIndustrial InjuryCertified Nursing AssistantLow Back InjuryRight Hip InjuryStipulations with Request for AwardUtilization ReviewLabor Code Section 5814
References
3
Case No. MISSING
Regular Panel Decision

Baasch v. United States

Plaintiff Thomas L. Baasch commenced an action to recover interest and penalties paid to the Commissioner of Internal Revenue for the 1981 and 1982 tax years. Plaintiff argued that his employer, TII Corporation, improperly classified him as an independent contractor, which caused a delay in filing and paying his tax returns, and therefore, the IRS should not hold him accountable for the interest and penalties. The defendant, United States of America, conceded the misclassification but contended that the plaintiff still had an obligation to timely file and pay his taxes, regardless of his employment status. The Court found that the employer's misclassification did not relieve the plaintiff of his obligation to comply with tax laws. Furthermore, the Court determined that the plaintiff's explanation did not constitute reasonable cause for the failure to file or pay, and thus he was not entitled to a refund of the interest and penalties. Accordingly, the Court granted summary judgment in favor of the defendant.

Income TaxTax PenaltiesTax InterestSummary JudgmentTax LiabilityIndependent ContractorEmployee MisclassificationInternal Revenue ServiceTax ReturnsFailure to File
References
8
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