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

Case No. ADJ1438639 (GRO0024593) ADJ3262777 (GRO0025366)
Regular
Jul 06, 2011

DENNIS TIMMONS vs. CALIFORNIA MENS COLONY, STATE COMP. INS. FUND, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Workers' Compensation Appeals Board granted reconsideration to reverse a prior award of Subsequent Injuries Benefits Trust Fund (SIBTF) benefits to the applicant, Dennis Timmons. The applicant sought SIBTF benefits based on a claimed pre-existing disability from a 1991 injury, arguing it imposed a prophylactic restriction from very heavy work that contributed to his 2000 industrial injury. However, the Board found no substantial medical evidence of a ratable pre-existing disability at the time of the 2000 injury, as prior medical reports indicated no residual disability and the applicant returned to work without restrictions. The Board concluded that a retroactive prophylactic restriction, without evidence of actual prior work limitations, is insufficient to establish SIBTF eligibility.

Subsequent Injuries Benefits Trust FundSIBTFpre-existing disabilityindustrial injurypermanent disabilityapportionmentAgreed Medical ExaminerAMEprophylactic restrictionWCJ
References
2
Case No. LBO 0327414
Regular
Jun 12, 2008

GREGORIO PEREZ vs. MSX INTERNATIONAL, CHUBB GROUP OF INSURANCE COMPANIES

The Workers' Compensation Appeals Board granted reconsideration to reduce applicant's permanent disability from 70% to 46% after apportionment. The Board found that while the applicant sustained an industrial injury to his left lower extremity and back, a significant portion of his back disability was attributable to pre-existing degenerative disc disease, as supported by medical evidence. The Board apportioned the back disability by comparing the applicant's current light work restriction to a prophylactic restriction from very heavy work due to his underlying condition.

ApportionmentPermanent DisabilityDegenerative Disc DiseaseIndustrial InjuryNon-Industrial FactorsMedical EvidenceSupplemental ReportDepositionWCJAppeals Board
References
3
Case No. 2018 NY Slip Op 06537 [165 AD3d 667]
Regular Panel Decision
Oct 03, 2018

Matter of Heritage Mech. Servs., Inc. v. Suffolk County Dept. of Pub. Works

This case involves an appeal by Heritage Mechanical Services, Inc. (petitioner) from a judgment denying its petition to annul a determination by the Suffolk County Department of Public Works (DPW). The dispute stemmed from a general construction contract awarded to Posillico/Skanska, JV for a waste water treatment plant upgrade. Heritage was listed as a subcontractor for HVAC work, but a disagreement arose over the agreed-upon amount, with Heritage claiming a higher price for alternates not included in the initial bid figure. DPW approved Posillico's request to perform the HVAC work itself, citing Heritage's refusal as a 'legitimate construction need' under General Municipal Law § 101 (5). The Appellate Division, Second Department, affirmed the Supreme Court's judgment, finding DPW's determination was not arbitrary and capricious, affected by an error of law, or an abuse of discretion, and thus dismissed the proceeding.

Public Works ContractSubcontractor DisputeGeneral Municipal LawCPLR Article 78Administrative ReviewArbitrary and CapriciousProject Labor AgreementHVAC SubcontractBid DisputeContractual Interpretation
References
1
Case No. MISSING
Regular Panel Decision

Claim of Wiltsie v. Owens Corning Fiberglass

Claimant suffered a compensable low back injury in 1995, continuing work with restrictions and ADA accommodations. In 2003, the employer's decision to change his shift caused claimant stress, leading his primary physician to diagnose chest pain syndrome, agoraphobia, and depression, and advise him to stop working. Initially awarded benefits for a period, the Workers’ Compensation Board subsequently denied further benefits, concluding that claimant's departure from work was for reasons unrelated to his back disability. Claimant appealed, contending his back injury prevented him from the new shift, but the Board's determination, supported by other evidence, found he left due to stress from the shift dispute rather than his back condition. The Board's decision, which included an assessment of claimant's testimony and medical evidence, was affirmed, as it was supported by credible evidence.

Low Back InjuryAmericans with Disabilities Act (ADA)Workplace AccommodationShift Schedule ChangeStress-Related IllnessChest Pain SyndromeAgoraphobiaDepression DiagnosisCredibility of Medical OpinionPermanent Partial Disability
References
5
Case No. 2017 NY Slip Op 08382 [155 AD3d 1049]
Regular Panel Decision
Nov 29, 2017

Matter of Soliman v. Suffolk County Dept. of Pub. Works

Nader I. Soliman, a Senior Civil Engineer for Suffolk County Department of Public Works, was terminated after an arbitration award found him guilty of misconduct for accessing unauthorized, sexually explicit websites during work hours. Soliman petitioned the Supreme Court, Suffolk County, to vacate the arbitration award, but the court denied the petition, dismissed the proceeding, and confirmed the award. On appeal, the Appellate Division, Second Department, affirmed the Supreme Court's judgment, finding that Soliman failed to demonstrate by clear and convincing evidence that the arbitration award was irrational or that the arbitrator exceeded their powers.

MisconductArbitration AwardVacaturCPLR Article 75Appellate ReviewPublic EmploymentTerminationEmployee MisconductRationality of AwardArbitrator Powers
References
10
Case No. 533112
Regular Panel Decision
Mar 17, 2022

Matter of Reyes v. H & L Iron Works Corp.

A claimant appealed a Workers' Compensation Board decision which found he violated Workers' Compensation Law § 114-a and permanently disqualified him from future indemnity benefits. The claimant, Leonel Reyes, sustained work-related injuries in 2016 and received benefits. However, he failed to fully disclose his disc jockey activities and the physical nature of this work to the Board, carrier, and examining physicians while collecting benefits. Surveillance videos showed him lifting heavy equipment, contradicting his testimony. The Workers' Compensation Board affirmed the WCLJ's finding of a violation and the imposition of both mandatory and discretionary penalties. The Appellate Division, Third Department, affirmed the Board's decision, concluding that substantial evidence supported the violation and that the permanent forfeiture of indemnity benefits was not a disproportionate penalty given the claimant's multiple egregious misrepresentations.

Workers' Compensation Law § 114-aFalse RepresentationIndemnity BenefitsPermanent DisqualificationUndisclosed EmploymentDisc JockeyMaterial MisrepresentationSubstantial EvidenceWitness CredibilityDiscretionary Penalty
References
7
Case No. ADJ1620559 (ANA 0373462)
Regular
Feb 09, 2015

WAYNE JOHNSON vs. TENNANT COMPANY, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Subsequent Injuries Benefits Trust Fund (SIBTF) sought reconsideration of a workers' compensation award finding the applicant entitled to SIBTF benefits due to a permanent total disability resulting from the combination of two injuries. The SIBTF argued the applicant was not eligible as he claimed to have fully recovered from his prior injury before the second one. The Board denied the petition, holding that medical evidence established prophylactic work restrictions after the first injury which constituted a labor-disabling condition. The applicant's lay opinion of recovery was insufficient to negate the physician-imposed restrictions, which remained valid for SIBTF eligibility purposes.

Subsequent Injuries Benefits Trust FundSIBTFlabor disabling disabilityprophylactic work restrictionpermanent and stationarycompromise and releaseapportionmentratable permanent disabilitylay opinionmedical evidence
References
9
Case No. MISSING
Regular Panel Decision

Claim of Turetzky-Santaniello v. Vassar Bros. Hospital

The claimant, a registered nurse, suffered two work-related back injuries in 1992 and 1996 but continued full-time work. She resigned in March 1998, effective April 24, 1998, to relocate to Massachusetts, undergoing emergency back surgery shortly after. Following her move, she secured a part-time nursing position, but a Workers’ Compensation Law Judge and subsequently the Board denied her reduced earnings benefits post-April 24, 1998, finding a voluntary withdrawal from the labor market. The claimant appealed, arguing the denial was erroneous due to a lack of medical reports restricting her work. The Appellate Division affirmed the Board's decision, concluding that substantial evidence supported the finding that her reduced earnings were attributable to factors unrelated to her work-related injury, given her pre-surgery resignation plans and lack of medical evidence restricting work hours.

Reduced Earnings AwardVoluntary Withdrawal Labor MarketWork-Related InjuryBack SurgeryRegistered Nurse ClaimantMedical Report InsufficiencyCausal Relation DisabilityAppellate Division ReviewEmployment RelocationPart-Time Work
References
6
Case No. MISSING
Regular Panel Decision

Claim of Rosario v. AIG

Claimant, an accountant, ceased working in 1998 and later applied for workers' compensation benefits for repetitive strain injuries, with the claim established in 2001 for bilateral carpal tunnel syndrome. In 2006, the parties stipulated that claimant was permanently partially disabled. The employer's carrier subsequently sought to determine if claimant was actively seeking employment within her medical restrictions. Initially, a Workers’ Compensation Law Judge denied the application to suspend benefits, finding no voluntary withdrawal from the labor market. However, the Workers’ Compensation Board reversed this, concluding claimant had voluntarily withdrawn by failing to search for work within her medical restrictions. The Appellate Division affirmed the Board's decision, citing substantial evidence that the claimant admitted to not searching for work for an extended period, despite being capable of performing sedentary work.

Workers' CompensationVoluntary WithdrawalLabor Market AttachmentPermanent Partial DisabilityCarpal Tunnel SyndromeRepetitive Motion InjurySedentary WorkEmployment SearchBoard DecisionAppeal
References
6
Case No. ADJ11017092
Regular
May 04, 2018

RICHARD CARL vs. DELTA PAINTING & COATING, INC., d/b/a TRU-TECH, STATE COMPENSATION INSURANCE FUND

This case concerns an applicant denied further temporary disability benefits after rejecting a modified work offer. The Appeals Board granted reconsideration due to an illegible medical report relied upon by the judge, which prevented a determination of the work restrictions. The Board rescinded the original award and returned the case for further proceedings, potentially including obtaining a legible report from the physician who set the restrictions. This ensures due process and a proper adjudication of whether the work offer was appropriate.

Petition for ReconsiderationModified Work OfferTemporary Disability IndemnityEmployment RestrictionsBad FaithIllegible Medical ReportDevelop the RecordVocational RehabilitationIndustrial InjuryRight Knee
References
6
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