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Case Law Database

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

Case No. MISSING
Regular Panel Decision

Clear Water Psychological Services PC v. American Transit Insurance Co.

Plaintiff Clear Water Psychological Services PC sought no-fault benefits from defendant American Transit Insurance Company. The plaintiff moved for summary judgment, while the defendant cross-moved for a 90-day stay, arguing that the assignor, Oshane Crooks, was acting as an employee at the time of the November 10, 2014 automobile accident, falling under Workers’ Compensation Board jurisdiction. A key issue was the admissibility of an uncertified police accident report (MV-104AN) which suggested the assignor was driving a taxi. The court ruled the uncertified report inadmissible under CPLR 4518 (c) for authentication reasons, despite the officer's personal observations. However, acknowledging the unresolved factual question of the assignor’s employment status and the Workers’ Compensation Board's primary jurisdiction, the court granted the defendant’s motion, staying the action for 90 days for a Workers’ Compensation Law applicability determination.

No-fault benefitsSummary judgmentStay of actionWorkers' CompensationPolice accident reportAdmissibility of evidenceCPLR 4518Vehicle and Traffic LawPrimary jurisdictionEmployment status
References
12
Case No. 2015-455 K C
Regular Panel Decision
Dec 19, 2017

Metro Psychological Servs., P.C. v. Travelers Prop. & Cas. Ins. Co.

This case involves Metro Psychological Services, P.C., as an assignee, seeking first-party no-fault benefits from Travelers Property & Casualty Insurance Company. The defendant moved for summary judgment, arguing the assignor's injuries occurred during employment, which would make workers' compensation benefits applicable. The Civil Court denied the defendant's motion and granted the plaintiff's cross-motion for summary judgment. The Appellate Term reversed this order, concluding there was an unresolved issue as to whether the plaintiff's assignor was acting in the course of employment at the time of the accident. Consequently, the matter was remitted to the Civil Court to be held in abeyance, pending a determination by the Workers' Compensation Board regarding the parties' rights under the Workers' Compensation Law, underscoring the Board's primary jurisdiction in such matters.

No-Fault BenefitsWorkers' Compensation LawPrimary JurisdictionAbeyanceSummary JudgmentAppellate ReviewInsurance DisputeMedical ProviderAssigneeCourse of Employment
References
9
Case No. 2021 NY Slip Op 04626 [197 AD3d 518]
Regular Panel Decision
Aug 04, 2021

D. S. v. Positive Behavior Support Consulting & Psychological Resources, P.C.

This case involves an appeal by the Port Jefferson School District from an order denying its motion to dismiss a personal injury complaint. The infant plaintiff, a special education student, was allegedly injured by a therapist, Vito Silecchia, during a behavioral therapy session. The plaintiffs sued the School District, among others, alleging Silecchia was an employee or agent. The District contended Silecchia was an independent contractor retained through Positive Behavior Support Consulting and Psychological Resources, P.C. The Appellate Division affirmed the Supreme Court's denial of the dismissal motion, stating that the complaint adequately stated a cause of action and that documentary evidence did not conclusively establish an independent contractor relationship, given provisions in the agreement suggesting the District maintained some control over the services.

Personal InjuryRespondeat SuperiorIndependent ContractorMotion to DismissAppellate ReviewVicarious LiabilitySchool District LiabilitySpecial EducationTherapist NegligenceCPLR 3211 (a) (1)
References
25
Case No. MISSING
Regular Panel Decision

Valley Psychological, P.C. v. Liberty Mutual Insurance

Plaintiff, Valley Psychological, P.C., provided psychological services to a woman involved in a motor vehicle accident, with claims assigned to plaintiff and covered by defendant, Liberty Mutual Insurance. Defendant denied these claims more than 30 days after receipt, leading plaintiff to file a commercial claim. Defendant asserted a provider fraud defense, alleging improper supervision by plaintiff's principal psychologist. Both City Court and County Court dismissed the claim based on the fraud defense, ruling that the untimely denial did not preclude this defense. However, this Court reversed, holding that defendant's untimely denial did preclude the fraud defense, as it pertained to excessive treatment rather than a strict lack of coverage. The matter was remitted to the City Court of the City of Albany to determine the judgment amount in plaintiff's favor.

no-fault insuranceuntimely denialfraud defensemedical services providerpreclusion doctrinelack of coverageexcessive treatmentworkers' compensation schedulescommercial claimappellate review
References
8
Case No. MISSING
Regular Panel Decision

Claim of Burke v. New York City Transit Authority

A subway train operator sought workers' compensation benefits for psychological injuries, alleging harassment by supervisors. A Workers’ Compensation Law Judge disallowed the claim, a decision affirmed by the Workers’ Compensation Board, which determined the claimant failed to demonstrate that the stress was greater than that of similarly situated workers. The claimant appealed this decision. The Appellate Division affirmed the Board's ruling, concluding it was supported by substantial evidence and deferring to the Board’s credibility determinations regarding witness testimonies from both the claimant and supervisors involved in the monitoring incident.

psychological injurywork-related stresssupervisory harassmentsubway operatorworkers' compensation claimAppellate Divisionsubstantial evidencecredibility determinationnormal work environment standardmental injury
References
6
Case No. MISSING
Regular Panel Decision

Claim of Cook-Schoonover v. Corning Hospital

Claimant, an employee at Corning Hospital, suffered psychological injuries due to a verbally harassing work environment from coworkers Lori Glass and Michelle Lewis, leading to hospitalizations and a diagnosis of anxiety attacks, panic disorder, and depression. She filed for workers' compensation benefits, which were initially dismissed by the Workers’ Compensation Law Judge but later found compensable by the Workers’ Compensation Board, supported by medical reports from Frank Bourke, Michael Cilip, and Albert Wolkoff. The employer and carrier appealed, alleging due process violations, but the court found no record of these requests. The court affirmed the Board's decision, citing substantial evidence from claimant's testimony and medical reports, and emphasized that psychic injury can result from extended emotional stress and pre-existing vulnerability does not preclude benefits.

work-related stresspsychological injuryhostile work environmentverbal harassmentpanic disorderdepressionworkers' compensation benefitsmedical evidencewitness credibilitydue process
References
9
Case No. 231 AD3d 1379
Regular Panel Decision
Oct 24, 2024

Matter of Lewis v. NYC Admin. for Children Servs.

Claimant Monique Lewis, a social worker, filed for workers' compensation benefits after a dog charged at her during a home visit, causing a chest injury and psychological trauma including PTSD. Initially, the employer accepted the chest injury, and a Workers' Compensation Law Judge established the psychological injuries. However, the Workers' Compensation Board subsequently disallowed the psychological claim, ruling that the stress experienced was not greater than that of similarly situated workers. The Appellate Division, Third Department, reversed this decision, clarifying that the 'greater stress' standard does not apply when psychological injuries directly result from a workplace accident involving physical impact. The court remitted the matter to the Board to determine the causal connection between the established workplace accident and the alleged psychological injuries.

Psychological InjuryPost-traumatic Stress DisorderAnxietyAcute Stress DisorderWorkplace AccidentPhysical ImpactCausal ConnectionAppellate ReviewRemittalDog Attack
References
9
Case No. ADJ10800397
Regular
May 20, 2019

MARILYN RAMIREZ GALVEZ vs. NIAGARA BOTTLING LLC, SAFETY NATIONAL INSURANCE CO.

The applicant sought a QME panel in psychology for a claimed psychiatric injury after orthopedic and internal medicine evaluations. The WCJ denied the request, finding no substantial medical evidence for a psychological QME. The Appeals Board granted removal, rescinded the WCJ's order, and found good cause for a psychological QME panel. This decision allows the applicant to pursue necessary medical-legal discovery regarding her disputed psychological injury claim.

Petition for RemovalFindings and OrderQualified Medical EvaluatorQME panelpsychologypsychiatric injurydiscoveryinternal medicineorthopedic QMEhypertension
References
1
Case No. ADJ7197363
Regular
Feb 11, 2014

NARCISO NOVA vs. JC SALES, dba SHIMS BARGAIN, LIBERTY MUTUAL INSURANCE COMPANY

This case concerns a lien claimant, California Psychological Associates, seeking reconsideration for disallowed costs of psychological treatment for applicant Narciso Nova. The Workers' Compensation Appeals Board denied the petition, adopting the Administrative Law Judge's report. The judge found no evidence of an injury to the psyche or that the psychological treatment was medically necessary for the admitted cervical spine injury. Furthermore, the psychological reports were not incorporated into any primary treating physician reports, and treatment began nearly two years after the applicant reached maximum medical improvement.

WCABPetition for ReconsiderationPsychological treatmentMedical necessityPrimary treating physicianMaximum medical improvementLien claimantStipulations with Request for AwardPermanent disabilityReferral
References
0
Case No. CV-23-0279
Regular Panel Decision
Oct 24, 2024

In the Matter of the Claim of Monique Lewis

The case involves Monique Lewis, a social worker, who sustained a chest injury and alleged psychological injuries after being attacked by a dog during a home visit. The Workers' Compensation Board initially disallowed her claim for psychological injuries, applying a standard that required stress greater than that experienced by similarly situated workers. The Supreme Court, Appellate Division, Third Judicial Department, reversed this decision. It ruled that since a workplace accident with physical impact was established for the chest injury, the Board erred in applying the "greater stress" standard for direct psychological injuries resulting from the same incident. The matter was remitted to the Board to determine the causal connection between the accident and the claimed psychological conditions, including PTSD, anxiety, and acute stress disorder.

Workers' CompensationPsychological InjuryPTSDAnxietyAcute Stress DisorderPhysical ImpactWorkplace AccidentCausationAppellate ReviewSocial Worker
References
9
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