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Case Law Database

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

Case No. 2023 NY Slip Op 00103 [212 AD3d 644]

Regular Panel Decision

Jan 11, 2023

Pecora v. Fitness Intl., LLC

Michael Pecora appealed from an order granting summary judgment to Fitness International, LLC, in a personal injury action. Pecora alleged he contracted infections, including MRSA, from using a sauna at the defendant's health club. The Appellate Division, Second Department, affirmed the lower court's decision. The court found that the defendants demonstrated the plaintiff could not prove the pathogen originated at their facility, noting MRSA's common transmission, regular cleaning, and lack of prior complaints. The plaintiff failed to raise a triable issue of fact, leading to the affirmation of the dismissal.

Personal InjurySummary JudgmentPremises LiabilityMRSAHealth ClubProximate CauseSpeculationDangerous ConditionInfectious DiseaseAppellate Review

References

Case No. MISSING

Regular Panel Decision

Brennan v. Bally Total Fitness

Kathryn Brennan filed a civil rights action against her former employer, Bally Total Fitness Corp., alleging sexual harassment under Title VII and disability discrimination under the ADA. Bally moved to dismiss the complaint as untimely and to compel arbitration based on its Employee Dispute Resolution Procedure (EDRP). The court denied Bally's motion to dismiss the Title VII claim, applying the 'continuing-violation exception' due to Brennan's allegations of ongoing harassment. The court also denied Bally's motion to compel arbitration, finding Bally's unilateral modifications to the EDRP invalid and raising questions of unconscionability regarding the original EDRP. The case is remanded for jurisdictional discovery and a possible hearing to determine the validity of the arbitration agreement.

Civil RightsSexual HarassmentDisability DiscriminationTitle VIIAmericans with Disabilities Act (ADA)Arbitration AgreementFederal Arbitration Act (FAA)Motion to DismissMotion to Compel ArbitrationContinuing Violation Exception

References

Case No. 2015-2337 Q C

Regular Panel Decision

May 18, 2018

Sama Physical Therapy, P.C. v. Hereford Ins. Co.

This case concerns an action by Sama Physical Therapy, P.C., as assignee, to recover first-party no-fault benefits from Hereford Insurance Co. The defendant argued that the plaintiff's assignor had been injured during the course of employment. The Civil Court conditionally granted defendant's cross-motion for summary judgment, ordering the plaintiff to file an application with the Workers' Compensation Board within 90 days. Plaintiff failed to comply with this order, and upon renewal, the Civil Court adhered to its prior determination. The Appellate Term, Second Department, affirmed the Civil Court's order, finding that the plaintiff did not demonstrate compliance with the order to make a proper application under the Workers' Compensation Law.

No-Fault BenefitsSummary JudgmentWorkers' Compensation BoardAppellate ReviewConditional GrantFailure to ComplyRenewal MotionInsurance LawAssigneeMedical Provider

References

Case No. 2015-608 Q C

Regular Panel Decision

Dec 19, 2017

Adelaida Physical Therapy, P.C. v. 21st Century Ins. Co.

In this case, Adelaida Physical Therapy, P.C., acting as an assignee, appealed an order from the Civil Court of the City of New York, Queens County. The original order had granted 21st Century Insurance Company's motion for summary judgment, dismissing parts of a complaint seeking first-party no-fault benefits for services billed under specific CPT codes (97010, 97110, and 97124). The Appellate Term, Second Department, reversed the lower court's decision. The appellate court found that 21st Century Insurance Company failed to demonstrate that it had used the correct conversion factor to calculate the reimbursement rate, thus not establishing its defense that the charged fees exceeded the workers' compensation fee schedule. As a result, the branches of the defendant's motion for summary judgment related to those CPT codes were denied.

No-Fault BenefitsCPT CodesSummary JudgmentWorkers' Compensation Fee ScheduleReimbursement RateAppellate ReviewInsurance DisputeCivil ProcedureConversion FactorMedical Billing

References

Case No. 2016-198 Q C

Regular Panel Decision

Jun 01, 2018

Comprehensive Care Physical Therapy, P.C. v. Allstate Ins. Co.

This case concerns a provider, Comprehensive Care Physical Therapy, P.C., seeking no-fault benefits from Allstate Insurance Company. The Civil Court initially denied the plaintiff's summary judgment motion and granted the defendant's cross-motion, dismissing the complaint based on the assignor's failure to appear for independent medical examinations (IMEs) and claims exceeding the fee schedule. On appeal, the Appellate Term modified this order, finding that Allstate failed to provide sufficient proof of timely denial form mailing, thereby precluding its defenses regarding IMEs and the fee schedule. Consequently, Allstate's cross-motion for summary judgment was denied, reversing that part of the lower court's decision. However, the Appellate Term affirmed the denial of the plaintiff's summary judgment motion, as the plaintiff also failed to establish their claims.

no-fault insurancesummary judgmentindependent medical examinationstimely denialinsurance defenseappellate reviewmedical billingassignee rightsprocedural requirementsfee schedule

References

Case No. 46885/05, 47943/05, 47945/05

Regular Panel Decision

Robert Physical Therapy, P.C. v. State Farm Mutual Automobile Insurance

This case involves three consolidated claims for first-party no-fault benefits related to physical therapy services. The plaintiff's assignors received physical therapy, and the defendant, an insurer, denied some claims due to disputes over billing codes. The central legal issues concerned whether a physical therapist could utilize billing codes from the medicine fee schedule when such services were not explicitly in the physical medicine schedule, and if range of motion and muscle testing could be billed separately from evaluation and management on the same day. The court determined that physical therapists are not confined to the physical medicine section and can use codes from any section of the medical fee schedule. Furthermore, the defendant failed to provide sufficient evidence to justify its denials regarding separate billing for range of motion and muscle testing. Consequently, the court ruled in favor of the plaintiff, awarding judgment for all disputed amounts.

Physical Therapy BillingNo-Fault BenefitsMedical Fee ScheduleCPT CodesWorkers' Compensation RegulationsEvaluation and Management ServicesRange of Motion TestingMuscle TestingProvider SpecialtyBilling Disputes

References

Case No. MISSING

Regular Panel Decision

Norwood v. Capone

This case involves an appeal from an order of the Otsego County Family Court which modified a prior custody order. The petitioner and respondent, divorced parents of two sons with special needs, Christopher and Anthony, were initially granted joint custody with physical custody to the respondent. The petitioner sought to modify this arrangement due to concerns about the respondent's care for the children, particularly regarding Anthony's behavioral issues and alleged physical violence by the respondent. A family offense petition was also filed. The Family Court transferred physical custody to the petitioner and allowed the children to relocate to Kentucky, while maintaining joint custody. The family offense petition was dismissed. On appeal, the court affirmed the Family Court's decision, finding that the change in circumstances and the children's best interests supported the modification, particularly for Anthony, as Christopher had aged out of Family Court jurisdiction. The appellate court upheld the Family Court's assessment of parental fitness and the decision to allow relocation.

Custody ModificationFamily OffenseChild CustodySpecial Needs ChildrenRelocationParental FitnessBest Interests of the ChildDomestic ViolenceTemporary Order of ProtectionFamily Court Appeal

References

Case No. MISSING

Regular Panel Decision

Perez v. Tru-Fit Manufacturing Co.

Plaintiff, an employee of TFM Industries, was injured in a parking lot in New Jersey and received workers' compensation benefits under New Jersey law. She subsequently filed a common-law tort action against Tru-Fit Manufacturing Co., Inc., a corporation that had merged into TFM in 1981, alleging negligent work in the parking lot. The IAS court initially denied TFM's motion to dismiss, which was based on the exclusivity of workers' compensation as a remedy. The appellate court reversed this decision, granting the motion to dismiss the complaint against Tru-Fit Manufacturing Co., Inc. The court reasoned that New Jersey law should apply, which establishes workers' compensation as the exclusive remedy, and rejected the application of the 'Billy' exception, as the alleged liability was not deemed separate from TFM's role as an employer and operator of the business premises.

Workers' CompensationExclusive RemedyNew Jersey LawCommon-Law TortCorporate LiabilityPremises LiabilityMotion to DismissSummary JudgmentAppellate ReversalEmployer Immunity

References

Case No. MISSING

Regular Panel Decision

Nov 14, 1991

Pellach v. Pellach

The Supreme Court modified an earlier order denying plaintiff's motion to reopen a maintenance and support hearing and compel defendant's physical examination. The record before the Special Referee was reopened, allowing the plaintiff to subpoena defendant's bank account records due to alleged discovery of new information and previous attorney refusal. However, the court affirmed the denial of the physical examination request, noting the defendant's prior adjudication of permanent disability by the Workers’ Compensation Board. The delay in the divorce action, pending since 1988, was largely attributed to the defendant's frequent changes of attorneys.

DivorceMaintenanceSupportFinancial DisclosureBank AccountsPhysical ExaminationWorkers' CompensationJudicial DiscretionAppellate ReviewReopening Record

References

Case No. MISSING

Regular Panel Decision

D'Agostino v. LA Fitness International, LLC

Maria D’Agostino (Plaintiff) sued LA Fitness and several related entities and an individual (Defendants) for age and gender discrimination, and retaliation, under the New York State Human Rights Law, Title VII, and the Age Discrimination in Employment Act. Plaintiff, a Training General Manager, alleged discriminatory remarks by her supervisor Michael Sharp and preferential treatment for younger male counterparts. Defendants moved for summary judgment, arguing Plaintiff was demoted due to poor sales performance and staffing issues, not discrimination. The court granted Defendants' motion, finding Plaintiff failed to demonstrate that the legitimate non-discriminatory reasons for her demotion were pretextual, and also failed to establish a prima facie case for retaliation or a hostile work environment.

Age DiscriminationGender DiscriminationRetaliationSummary JudgmentHostile Work EnvironmentMcDonnell Douglas FrameworkPrima Facie CasePretextSales PerformanceEmployee Demotion

References

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Updated Daily

Case Law Database

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

Case No. 2023 NY Slip Op 00103 [212 AD3d 644]

Regular Panel Decision

Jan 11, 2023

Pecora v. Fitness Intl., LLC

Personal InjurySummary JudgmentPremises LiabilityMRSAHealth ClubProximate CauseSpeculationDangerous ConditionInfectious DiseaseAppellate Review

References

Case No. MISSING

Regular Panel Decision

Brennan v. Bally Total Fitness

References

Case No. 2015-2337 Q C

Regular Panel Decision

May 18, 2018

Sama Physical Therapy, P.C. v. Hereford Ins. Co.

No-Fault BenefitsSummary JudgmentWorkers' Compensation BoardAppellate ReviewConditional GrantFailure to ComplyRenewal MotionInsurance LawAssigneeMedical Provider

References

Case No. 2015-608 Q C

Regular Panel Decision

Dec 19, 2017

Adelaida Physical Therapy, P.C. v. 21st Century Ins. Co.

No-Fault BenefitsCPT CodesSummary JudgmentWorkers' Compensation Fee ScheduleReimbursement RateAppellate ReviewInsurance DisputeCivil ProcedureConversion FactorMedical Billing

References

Case No. 2016-198 Q C

Regular Panel Decision

Jun 01, 2018

Comprehensive Care Physical Therapy, P.C. v. Allstate Ins. Co.

no-fault insurancesummary judgmentindependent medical examinationstimely denialinsurance defenseappellate reviewmedical billingassignee rightsprocedural requirementsfee schedule

References

Case No. 46885/05, 47943/05, 47945/05

Regular Panel Decision

Robert Physical Therapy, P.C. v. State Farm Mutual Automobile Insurance

References

Case No. MISSING

Regular Panel Decision

Norwood v. Capone

Custody ModificationFamily OffenseChild CustodySpecial Needs ChildrenRelocationParental FitnessBest Interests of the ChildDomestic ViolenceTemporary Order of ProtectionFamily Court Appeal

References

Case No. MISSING

Regular Panel Decision

Perez v. Tru-Fit Manufacturing Co.

Workers' CompensationExclusive RemedyNew Jersey LawCommon-Law TortCorporate LiabilityPremises LiabilityMotion to DismissSummary JudgmentAppellate ReversalEmployer Immunity

References

Case No. MISSING

Regular Panel Decision

Nov 14, 1991

Pellach v. Pellach

DivorceMaintenanceSupportFinancial DisclosureBank AccountsPhysical ExaminationWorkers' CompensationJudicial DiscretionAppellate ReviewReopening Record

References

Case No. MISSING

Regular Panel Decision

D'Agostino v. LA Fitness International, LLC

Age DiscriminationGender DiscriminationRetaliationSummary JudgmentHostile Work EnvironmentMcDonnell Douglas FrameworkPrima Facie CasePretextSales PerformanceEmployee Demotion

References

Showing 1-10 of 903 results

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