CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

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

Case No. ADJ3685938 (WCK 0066506)
Regular
Dec 02, 2014

EMMETT BOONE vs. DREYER'S GRAND ICE CREAM, FIREMAN'S FUND INSURANCE COMPANY

In this workers' compensation case, the Appeals Board affirmed a prior award finding defendant's utilization review (UR) denials for prescription refills invalid. The Board agreed with the WCJ that the UR denials were untimely because the defendant failed to communicate the decisions to the treating physician within the statutory 24-hour timeframe. Consequently, the Board found the UR invalid, allowing the WCAB to determine medical necessity based on substantial evidence. This decision upholds the applicant's right to ongoing prescription refills.

Workers' Compensation Appeals BoardUtilization ReviewReconsiderationFindings and AwardPrescription RefillsMedical TreatmentDefective DenialTimeliness RequirementsLabor Code § 4610Dubon v. World Restoration
References
8
Case No. MISSING
Regular Panel Decision

People v. Baghai-Kermani

This case concerns an appeal from two Supreme Court orders regarding a defendant's conviction for criminal sale of prescription for a controlled substance. The trial court initially granted the defendant's CPL 440.10 motion to set aside his conviction due to Rosario material violations, but denied his motion on jurisdictional grounds. On appeal, the higher court modified the Rosario order, reinstating most of the convictions, arguing that the Rosario violation for two counts did not necessarily taint the entire indictment. The court affirmed the denial of the jurisdictional motion, holding that the Attorney-General had broad jurisdiction under Executive Law § 63 (3) to prosecute the defendant for offenses connected with Medicaid, despite the defendant no longer being a Medicaid provider.

Criminal Sale of Controlled SubstanceCPL 440.10Rosario MaterialBrady v MarylandJurisdictionExecutive Law § 63 (3)Medicaid FraudAppellate ReviewBench TrialSelf-representation
References
6
Case No. MISSING
Regular Panel Decision
Dec 11, 2002

Claim of Speer v. Wackenhut Corp.

The claimant sought workers' compensation benefits for mental depression, alleging it resulted from being removed from a security guard position by their employer. The Workers' Compensation Board initially ruled the injury non-compensable under Workers' Compensation Law § 2 (7), deeming it a direct consequence of lawful personnel decisions. The claimant subsequently filed applications for full Board review and reconsideration, both of which were denied by the Board. This appeal concerns the denials of those applications. The court dismissed the appeal from the May 1, 2002 denial as untimely and affirmed the December 11, 2002 denial, finding that the Board did not abuse its discretion by not requiring transcription of oral arguments before rendering its decision.

Workers' CompensationMental DepressionStress-related InjuryPersonnel DecisionsReconsideration DenialFull Board ReviewAppellate ProcedureTimeliness of AppealOral Argument TranscriptionAdministrative Discretion
References
3
Case No. MISSING
Regular Panel Decision

Bush v. Mechanicville Warehouse Corp.

This case involves an appeal from the denial of a third-party defendant's (Yankee One Dollar Stores, Inc.) motions for summary judgment against a defendant (Mechanicville Warehouse Corp.). The plaintiff, Bush, was injured at work and sued Mechanicville, who then brought a third-party action against Yankee for indemnification. Yankee argued that plaintiff did not sustain a 'grave injury' under Workers’ Compensation Law § 11 and that there was no written contractual indemnification agreement. The appellate court affirmed the denial of summary judgment regarding the 'grave injury' claim, finding sufficient evidence of permanent total disability due to a traumatic brain injury. However, the court reversed the denial of summary judgment for contractual indemnification, ruling that Workers’ Compensation Law § 11 requires an *express written contract* of indemnification from the employer, which was not present between Yankee and Mechanicville.

Summary JudgmentThird-Party ActionWorkers' Compensation Law § 11Grave InjuryContractual IndemnificationBrain InjuryPermanent Total DisabilityHoldover TenantExpress AgreementAppellate Review
References
18
Case No. MISSING
Regular Panel Decision

Kosakow v. New Rochelle Radiology Associates, P.C.

Nancy Kosakow sued her former employer, New Rochelle Radiology Associates, alleging FMLA violations and wrongful denial of severance pay under ERISA. The court previously found FMLA claims collaterally estopped but remanded the ERISA claim to the Plan Administrator for a determination on severance eligibility. The Administrator denied severance, finding Kosakow not "terminated" and, even if so, not entitled to severance. This court reversed the "not terminated" finding, stating Kosakow was terminated due to a reduction in force. However, the court affirmed the Administrator's denial of severance, concluding that the "where applicable" clause in the Plan gave the Administrator broad discretion and that Kosakow's circumstances did not warrant severance. The court found that the denial was not unreasonable, even when considering a severance payment made to another full-time employee under different circumstances.

ERISASeverance PayFMLATerminationSummary JudgmentDe Novo ReviewPlan Administrator DiscretionEmployee BenefitsReduction in ForcePolicy Manual
References
8
Case No. ADJ2172104 (SAC 0326562)
Regular
Jan 15, 2015

THOMAS MEEKER vs. OREGON PACIFIC BUILDING PRODUCTS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for FREMONT COMPENSATION INSURANCE COMPANY

This case involves a dispute over the validity of a utilization review (UR) denial for an applicant's requested prescription medication. Initially, the administrative law judge found the UR denial invalid because the reviewing physician did not examine all relevant medical reports. However, following the en banc decision in *Dubon II*, the Appeals Board reversed this finding. The Board ruled that under *Dubon II*, only untimely UR decisions are invalid; other defects, like incomplete medical review, must be addressed through the Independent Medical Review (IMR) process. Therefore, the UR denial was deemed valid as it was timely.

Utilization ReviewRequest for AuthorizationProvigilDubon IIIndustrial InjuryPermanent DisabilityFuture Medical TreatmentPetition for ReconsiderationAdministrative Law JudgeWorkers' Compensation Appeals Board
References
14
Case No. MISSING
Regular Panel Decision
Jun 25, 1997

Job v. 1133 Building Corp.

The plaintiff appealed the denial of his motion for partial summary judgment on liability under Labor Law § 240 (1) after sustaining injuries from a fall while dismantling a scaffold at a building owned by 1133 Building Corp. The defendant, 1133 Building Corp., and third-party defendants, Big Apple Wrecking and HRH Construction Corporation, opposed the motion. An affidavit from the plaintiff's foreman alleged that a safety belt was provided and the plaintiff was instructed to use it. The Supreme Court denied the motion, finding a triable issue of fact regarding whether the plaintiff was a 'recalcitrant worker.' The appellate court affirmed this denial, citing conflicting evidence on the availability and use of safety devices.

Personal InjuryLabor LawScaffold AccidentSummary JudgmentRecalcitrant WorkerSafety DevicesAppellate ReviewPremises LiabilityConstruction SiteThird-Party Action
References
5
Case No. MISSING
Regular Panel Decision

Claim of Snarski v. New Jersey Manufacturers Insurance Group

The Workers' Compensation Board denied an application by New Jersey Manufacturers Insurance Group for reconsideration of a prior decision finding it liable as the workers' compensation carrier for a claimant's back injury. The claimant, an equipment operator, sustained the injury in October 2000 in Sullivan County, New York, while working for a New Jersey corporation. Initially, the carrier controverted the New York claim, asserting its policy only covered jobs in New Jersey. However, a Workers’ Compensation Law Judge and the Board found the policy vague and ruled the carrier liable. The carrier appealed the Board's denial of reconsideration, but not the underlying liability decision. The court affirmed the Board's denial, finding it was not arbitrary or capricious, and the carrier presented no new evidence to warrant a change.

Workers' Compensation LawInsurance CoverageAppellate ReviewBoard DecisionReconsideration DenialArbitrary and Capricious StandardAbuse of DiscretionPolicy InterpretationJurisdictionBack Injury
References
4
Case No. MISSING
Regular Panel Decision

Ribya BB. v. Wing

Petitioner initiated a CPLR article 78 proceeding to challenge the denial of her request to expunge her name from the State Central Register of Child Abuse and Maltreatment. An indicated report of child maltreatment was filed after she allegedly left her severely disabled and autistic child unsupervised on three occasions in November 1994. Despite her claim that a cousin was watching the child, an administrative review and subsequent hearing found 'some credible evidence as well as a fair preponderance' of evidence supporting maltreatment, leading to the denial of her expungement request. The Appellate Division confirmed the respondent's determination, citing substantial evidence including admissible double hearsay and inconsistencies in testimony, and dismissed the petition.

Child MaltreatmentExpungementState Central RegisterChild AbuseAdministrative LawJudicial ReviewSubstantial EvidenceHearsay AdmissibilityCredibility AssessmentParental Responsibility
References
11
Case No. MISSING
Regular Panel Decision
Jun 25, 2002

Barreiros v. JJR Associates, Inc.

This case concerns an appeal by a third-party defendant following the denial of its motion for summary judgment to dismiss a third-party complaint in a personal injury action. The appellate court reversed the Supreme Court's order, granting the motion and dismissing the complaint. The court found that the third-party defendant successfully demonstrated that the plaintiff's injuries, though serious, did not constitute 'grave' injuries under Workers’ Compensation Law § 11. Additionally, it was established that the third-party defendant had fulfilled the insurance requirements stipulated in the parties' agreement. Therefore, the Supreme Court's initial denial of the summary judgment motion was deemed erroneous.

Personal InjurySummary JudgmentThird-Party ComplaintWorkers' Compensation LawGrave InjuryAppellate ReviewMotion GrantedOrder ReversedInsurance ComplianceSuffolk County
References
6
Showing 1-10 of 3,439 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational