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

Case No. ADJ8522603
Regular
Jun 05, 2017

RUSSELL GARY vs. PHILADELPHIA EAGLES, GULF/TRAVELERS, NEW ORLEANS SAINTS, ACE USA

This case concerns a former professional football player seeking workers' compensation benefits for cumulative injuries. The applicant was found to have sustained industrial injuries to several body parts while playing for the New Orleans Saints and Philadelphia Eagles. While the award for permanent disability and future medical treatment was affirmed, the Board rescinded the finding of one year of temporary total disability. The Board found that the applicant's testimony indicated retirement due to failure to secure further employment, not physical inability to work, and that medical opinions relied upon by the judge were based on incorrect assumptions regarding the applicant's ability to continue playing.

Workers' Compensation Appeals BoardPhiladelphia EaglesGulf TravelersNew Orleans SaintsACE USAADJ8522603Opinion and Decision After Reconsiderationtemporary disability indemnitypermanent disabilityfuture medical treatment
References
2
Case No. ADJ7598160
Regular
Nov 19, 2014

MAURICE JOHNSON vs. PHILADELPHIA EAGLES, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for RELIANCE INSURANCE COMPANY, in liquidation, FAIRMONT PREMIER INSURANCE COMPANY

The Workers' Compensation Appeals Board reversed a lower decision, finding California lacked jurisdiction over a professional football player's cumulative trauma claim against the Philadelphia Eagles. The Board held that playing only two games in California did not create a sufficient connection to the injury to warrant applying California law, citing *Federal Insurance Co. v. Workers' Comp. Appeals Bd. (Johnson)*. The applicant's limited physical presence and routine pre/post-game treatment in California were deemed de minimis. Therefore, the applicant took nothing on his California WCAB claim.

CIGAPhiladelphia EaglesReliance Insurance Companycumulative traumaprofessional football playerjurisdictionFederal Insurance Co. v. Workers' Comp. Appeals Bd. (Johnson)administrative law judgepermanent disabilityapportionment
References
16
Case No. MISSING
Regular Panel Decision
Jun 18, 2003

Local 8A-28A Welfare and 401 (K) Retirement Funds v. Golden Eagles Architectural Metal Cleaning and Refinishing

The plaintiffs, Local 8A-28A Welfare and 401(k) Retirement Funds, sued defendant Golden Eagles Architectural Metal Cleaning and Refinishing, alleging violations of ERISA Section 515 and a collective bargaining agreement for failing to submit to an audit. Golden Eagles moved to dismiss the complaint, asserting lack of personal jurisdiction, improper venue, and the requirement for arbitration. The District Court, presided over by Judge Sweet, denied the motion, finding that personal jurisdiction existed over Golden Eagles due to ERISA's nationwide service of process provision, and venue was proper in the Southern District of New York as the Funds are administered there. Furthermore, the court determined that the Local 8A-28A Funds, as independent non-signatory entities, were not bound by the arbitration clause present in the collective bargaining agreement between the union and the employer. Consequently, Golden Eagles' motion to dismiss was denied.

ERISAPersonal JurisdictionVenueArbitrationCollective Bargaining AgreementEmployee BenefitsTrust FundsMotion to DismissNationwide Service of ProcessMinimum Contacts
References
26
Case No. MISSING
Regular Panel Decision

Claim of Blanchard v. Eagle Nest Tenancy In Common

Claimant's decedent, a superintendent for Eagle Nest Tenancy In Common, died in an unwitnessed one-car motor vehicle accident on the employer's premises. His widow filed a claim for workers' compensation benefits, arguing his death was causally related to his employment. Both the Workers' Compensation Law Judge and the Board affirmed this finding, prompting an appeal by the employer's insurance carrier. The carrier contested that the accident occurred "in the course of employment," despite testimony suggesting the decedent intended to address maintenance issues after returning home. The Appellate Division affirmed the Board's amended decision, finding sufficient evidence to support that the accident occurred in the course of employment, especially given the presumption afforded to unwitnessed accidents within the scope of employment under Workers' Compensation Law § 21.

Workers' Compensation BenefitsEmployment CausalityMotor Vehicle FatalityOn-Premises AccidentWorkers' Compensation Board AppealScope of EmploymentUnwitnessed Accident PresumptionJudicial ReviewAppellate Division AffirmationInsurance Carrier Appeal
References
6
Case No. 2017 NY Slip Op 06496
Regular Panel Decision
Sep 14, 2017

Matter of Cortes v. Eagle Sys., Inc.

Patricio Cortes, a truck driver, was injured in a motor vehicle accident and sought workers' compensation benefits from his employer, Eagle Systems, Inc. Although XL Specialty Insurance was the proper workers' compensation carrier, it failed to appear at hearings. Zurich American Insurance Company, despite not being the carrier and not on notice, participated, arguing Cortes was an independent contractor. The Workers' Compensation Law Judge (WCLJ) found Cortes to be an employee and his injuries compensable. Zurich appealed, asserting standing based on a contingency liability policy, but both the Workers' Compensation Board and the Appellate Division, Third Department, affirmed that Zurich lacked standing as it was not a direct party to the claim and its liability was a contractual issue beyond the Board's jurisdiction.

Workers' CompensationAppellate ReviewStandingInsurance LiabilityIndependent ContractorEmployer-Employee RelationshipJurisdictionMotor Vehicle AccidentContingency Policy
References
4
Case No. ADJ1009271 (AHM 0055424)
Regular
Apr 27, 2009

MYRNA PEREZ vs. FIDELITY FEDERAL BANK, TIG SPECIALTY INSURANCE CO., REM, LTD, GOLDEN EAGLE

This case concerns a contribution dispute between two insurance carriers, TIG and Golden Eagle, for a cumulative trauma injury claim. Golden Eagle sought reconsideration of an order compelling it to pay over $\$101,000$ in contribution to TIG. Golden Eagle argued it was never properly served with a notice of intention and that Labor Code section 5275 mandates arbitration for contribution disputes. The Appeals Board agreed that mandatory arbitration applies, rescinded the order, and remanded the case for either informal resolution or arbitration.

Workers' Compensation Appeals BoardOrder of ContributionPetition for ReconsiderationLabor Code section 5275mandatory arbitrationContributionCumulative Trauma InjuryCompromise and Release AgreementPetition for ContributionNotice of Intention
References
0
Case No. MISSING
Regular Panel Decision

Claim of Seo v. UTOG 2-Way Radio, Inc.

The claimant, a limousine driver for UTOG 2-Way Radio, Inc., was injured in an automobile accident while driving home from work. Initially, a Workers’ Compensation Law Judge (WCLJ) denied benefits, ruling the injuries did not arise from employment. Eagle Insurance Company, the no-fault carrier, appealed to the Workers’ Compensation Board, which initially reversed the WCLJ, deeming the claimant an 'outside worker' eligible for 'portal to portal' coverage. UTOG appealed this reversal, but the full Board rescinded the decision and referred it back. Upon reconsideration, the Board panel determined that Eagle lacked standing as it was not a party in interest under Workers’ Compensation Law § 23 and affirmed the WCLJ's denial of benefits. Eagle then appealed to the Appellate Division, which reversed the Board's decision, citing prior cases, and remitted the matter for further proceedings.

Automobile AccidentLimousine DriverWorkers' Compensation BenefitsStanding to AppealNo-Fault Insurance CarrierOutside WorkerPortal to Portal CoverageAppellate ReviewBoard ReconsiderationRemittal
References
2
Case No. CA 13-01535
Regular Panel Decision
Aug 08, 2014

HAUBER-MALOTA, MICHELLE T. v. PHILADELPHIA INSURANCE CO.

The plaintiff, Michelle T. Hauber-Malota, was injured as a passenger in a vehicle operated by a coemployee and owned by their common employer, JMFSC, when it was rear-ended by another vehicle also operated by a coemployee. Her initial personal injury action against the coemployee and the vehicle owner was dismissed based on the Workers' Compensation Law's exclusivity provisions. Subsequently, she sought supplementary uninsured/underinsured motorist (SUM) benefits from her employer's insurers, Philadelphia Insurance Companies, Tokio Marine Group, and Philadelphia Consolidated Holding Corp. The Supreme Court denied the defendants' motion for summary judgment, but the Appellate Division reversed this decision. The court concluded that because the plaintiff was not "legally entitled to recover damages" from the coemployee due to Workers' Compensation Law § 29 (6), she was also not entitled to SUM benefits under her employer's policy.

SUM BenefitsUninsured Motorist CoverageUnderinsured Motorist CoverageWorkers Compensation LawExclusive RemedyCoemployee LiabilityAutomobile Liability InsuranceContractual ObligationTort LiabilitySummary Judgment
References
13
Case No. ADJ7529761
Regular
Sep 02, 2018

MARIA GARCIA vs. GREEN CUISINE, INC., GOLDEN EAGLE INSURANCE COMPANY, SOUTHERN INSURANCE COMPANY

This case involves Southern Insurance Company seeking reconsideration of an arbitrator's award of contribution to Golden Eagle Insurance Company. Southern argued a contribution petition filed before a Compromise and Release (C&R) approval was void, and Golden Eagle missed the subsequent one-year limitations period. The Board denied reconsideration, adopting the arbitrator's report and finding the initial petition timely filed under Labor Code Section 5500.5(e). The Board clarified that filing before award approval does not void a contribution petition, especially when the C&R doesn't require a refiling.

Petition for ReconsiderationCompromise and ReleasePetition for ContributionLabor Code section 5500.5(e)ContributionArbitratorFindings and AwardGolden Eagle Insurance CompanySouthern Insurance CompanyIndustrial Injury
References
0
Case No. ADJ1322165 (OAK 0234515) ADJ4051294 (OAK 0239085) ADJ590376 (OAK 0240882)
Regular
Apr 08, 2010

VICTORIA GOMEZ vs. CASA SANDOVAL, THE CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for CALIFORNIA COMPENSATION in liquidation, by its servicing facility SEDGWICK CMS and GOLDEN EAGLE INSURANCE CORPORATION, as administered by LIBERTY MUTUAL INSURANCE COMPANY

This case involves Golden Eagle Insurance Corporation seeking reconsideration of an arbitrator's decision that CIGA's reimbursement claim was not barred by prior rulings, statutes of limitations, or laches. Golden Eagle argued that a previous en banc decision established CIGA's sole liability, thus precluding relitigation. The Appeals Board denied reconsideration, affirming the arbitrator's finding that the prior decision only established shared liability and reserved apportionment for further proceedings. The Board clarified that the arbitrator's ruling determined threshold issues, making it a final order subject to review, and that CIGA's right to reimbursement had not been definitively determined.

CIGAGolden Eagle Insurance CorporationPetition for ReconsiderationArbitratorEn banc decisionLaw of the caseStatute of limitationsLachesThreshold issueFinal order
References
12
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