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

Case No. MISSING
Regular Panel Decision

In re Striley

This case addresses an employer's constitutional challenge to the New York State Unemployment Insurance Law concerning payments to striking workers and the application of the 'experience rating' method (Labor Law, § 581). The employer questioned the constitutionality under both Federal and State Constitutions. The court referenced W. H. H. Chamberlin, Inc., v. Andrews, which previously affirmed the constitutionality of taking money from employers for a general fund to pay strikers, and extended this principle to the 'experience rating' method. The decision emphasized that the method of assessment is a legislative matter and found no unreasonable or arbitrary act or constitutional violation in the change from a percentage ratio to 'experience rating'. The court affirmed the decision of the Unemployment Insurance Board.

Unemployment Insurance LawConstitutionalityExperience RatingStriking WorkersLabor LawLegislative IntentJudicial ReviewStatutory InterpretationEmployer ContributionsBenefit Payments
References
3
Case No. ADJ360205 (LBO 0384980)
Regular
Aug 05, 2010

Gurdev Malhotra vs. STATE OF CALIFORNIA, DEPARTMENT OF DEVELOPMENTAL SERVICES FAIRVIEW; Legally Uninsured, CONTRACT SERVICES

The Workers' Compensation Appeals Board granted reconsideration of a WCJ's advisory opinion concerning permanent disability rating for grip loss. Defendant argued the WCJ erred by allowing rating for grip loss when range of motion was present, and that the QME's reports did not support grip loss rating. The Board rescinded the WCJ's findings, remanding the case for further proceedings to ensure the WCJ follows the established process for issuing rating instructions based on substantial medical evidence, as clarified in *Blackledge v. Bank of America*. The ultimate determination of permanent disability requires a proper QME opinion and subsequent rating instructions from the WCJ.

Workers' Compensation Appeals BoardGurdev MalhotraState of California Department of Developmental ServicesLegally UninsuredContract ServicesPermanent Disability RatingGrip LossAMA GuidesQualified Medical EvaluatorQME
References
1
Case No. MISSING
Regular Panel Decision
Jun 22, 2015

Claim of Barrett v. New York City Department of Transportation

The case involves an appeal from a Workers’ Compensation Board decision regarding a claimant injured in a 2011 work-related motor vehicle accident. A WCLJ classified the claimant with a permanent partial disability and a 25% loss of wage-earning capacity, ruling that he would be entitled to 250 weeks of benefits if his full wages ceased. The Board affirmed this, leading the employer to appeal, arguing that the claimant's current full wages meant a 100% wage-earning capacity, rendering the 25% loss finding unlawful. The court affirmed the Board’s decision, distinguishing between 'loss of wage-earning capacity' (fixed, for benefit duration) and 'wage-earning capacity' (fluctuating, for weekly rates).

Workers' CompensationPermanent Partial DisabilityWage-Earning CapacityLoss of Wage-Earning CapacityBenefit DurationAppellate ReviewStatutory InterpretationMotor Vehicle AccidentNew York Workers' Compensation BoardDisability Classification
References
2
Case No. MISSING
Regular Panel Decision

Claim of Cruz v. City of New York Department of Children's Services

Claimant, injured in an automobile accident while working, received workers' compensation benefits and later settled a third-party action. A Workers’ Compensation Law Judge (WCLJ) and the Workers’ Compensation Board ruled that the self-insured employer was not entitled to offset the third-party settlement against a schedule loss of use (SLU) award, even for the portion initially designated as temporary total disability. The employer appealed, arguing the offset was permissible because the weekly award exceeded statutory thresholds for basic economic loss. However, the court affirmed the Board's decision, clarifying that a schedule loss of use award is not allocable to any specific period of disability and thus is not subject to offset under Workers’ Compensation Law § 29 against first-party benefits, regardless of initial labeling or monthly rate.

Schedule Loss of Use Award OffsetThird-Party SettlementTemporary Total DisabilityPermanent Partial DisabilityBasic Economic LossNo-Fault LawInsurance LawStatutory InterpretationWorkers' Compensation Law § 29Appellate Division
References
6
Case No. ADJ4258585 (OXN 0130492) ADJ220258 (OXN 0130487)
Regular
Apr 17, 2018

ENRIQUE HERRERA vs. MAPLE LEAF FOODS, U.S. FIRE INSURANCE COMPANY, ALEA NORTH AMERICAN INSURANCE COMPANY

This notice informs parties that the Workers' Compensation Appeals Board (WCAB) intends to admit its rating instructions and a disability rater's recommended permanent disability rating into evidence. The WCAB previously granted reconsideration for further study. Parties have seven days to object to the rating instructions or the recommended rating, with specific procedures for addressing objections. If no timely objection is filed, the matters will be submitted for decision thirty days after service.

WORKERS' COMPENSATION APPEALS BOARDPermanent Disability RatingDisability Evaluation UnitRating InstructionsRecommended Permanent Disability RatingJoint RatingReconsiderationObjectionRater Cross-ExaminationRebuttal Evidence
References
0
Case No. MISSING
Regular Panel Decision

Vandewalker v. Snowball Tree Farm, Inc.

Claimant sustained a left foot injury in November 1982, leading to amputation and subsequent surgeries. The Workers' Compensation Law Judge (WCU) initially found a 70% schedule loss of use, later increasing it to 100% after further medical examination in August 1987. The WCU awarded compensation at $105 per week, with a temporary total disability rate of $183.33 for a specific period. The employer appealed, and the Workers' Compensation Board modified the award, asserting the permanent partial disability rate of $105 per week applied for the entire schedule loss. Claimant appealed this modification, arguing for the higher temporary total disability rate during the protracted healing period. The court affirmed the Board's decision, holding that the injury was classified as a permanent partial disability dating from the accident, and therefore the maximum permanent partial disability rate of $105 per week was appropriate for the entire award period.

Schedule Loss of UsePermanent Partial DisabilityTemporary Total DisabilityAverage Weekly WageAmputationBenefit ModificationAppellate ReviewMedical Examiner ReportJudiciary LawFoot Injury
References
9
Case No. ADJ8782360
Regular
Jun 01, 2018

Eldridge Taylor vs. California Department of Corrections and Rehabilitation, STATE COMPENSATION INSURANCE FUND

The California Workers' Compensation Appeals Board denied a petition for reconsideration, affirming a prior award to Eldridge Taylor. The award included permanent disability for cumulative trauma injuries, sleep disorder, and hearing loss. The employer argued the sleep disorder rating was subsumed by orthopedic pain, the hearing loss lacked substantial evidence, and the WCJ failed to properly apportion non-industrial factors. The Board adopted the WCJ's report, finding sufficient medical evidence for the sleep disorder and hearing loss. The dissenting opinion argued the sleep disorder award should be rescinded as it stemmed solely from industrial pain already rated.

Workers' Compensation Appeals BoardEldridge TaylorCalifornia Department of Corrections and RehabilitationLegally UninsuredState Compensation Insurance FundADJ8782360Cumulative TraumaCorrectional OfficerParole OfficerSleep Disorder
References
1
Case No. ADJ10187704, ADJ10924724
Regular
May 17, 2018

STEVEN CASE vs. GOLDEN GATE BRIDGE HIGHWAY AND TRANSPORTATION DISTRICT

The Workers' Compensation Appeals Board granted reconsideration to increase applicant's permanent disability rating for bilateral shoulder injury from 9% to 38%. The Board found the Agreed Medical Evaluator's (AME) alternative rating, based on strength loss, was substantial medical evidence and properly considered within the AMA Guides. The WCJ erred in applying an overly restrictive interpretation of "complex or extraordinary" cases for deviating from strict AMA Guides ratings. The AME's use of strength loss data from the AMA Guides, even for an age outside the specified range, was permissible under the *Almaraz-Guzman* line of cases when justified by clinical judgment.

Workers' Compensation Appeals BoardJoint Findings and AwardPetition for ReconsiderationAgreed Medical Evaluator (AME)permanent disability ratingbilateral shouldersorthopedic AMEAMA GuidesAlmaraz-Guzmanstrength loss index
References
20
Case No. Axelrod I, Axelrod II, Veit
Regular Panel Decision
Feb 19, 1985

Society of the New York Hospital v. Axelrod

This case concerns the Commissioner of Health of New York State's establishment of Medicaid, Blue Cross, workers' compensation, and no-fault insurance reimbursement rates for hospitals. In response to increased labor costs for hospitals affiliated with the League of Voluntary Hospitals, SHIF (Supplemental Hospital Index Factor) benefits were introduced to provide waivers based on actual increased labor costs. Eligibility for SHIF was determined by an "affordability" factor, utilizing a current ratio analysis where a ratio of current assets to liabilities less than 1:1 indicated eligibility. The Society of The New York Hospital and The New York Eye & Ear Infirmary were denied SHIF benefits due to their current ratios, while some other hospital groups with similar financial statuses received benefits. The Supreme Court initially found a rational basis for the rates but questioned the uniform application. The Appellate Division modified the decision, finding the application of eligibility tests to Hospital and Infirmary to be arbitrary, capricious, and discriminatory, thereby violating equal protection clauses. The court granted summary judgment to Hospital and Infirmary, declaring the denial of SHIF benefits arbitrary and capricious, and remanded for an assessment of due benefits.

Reimbursement RatesMedicaidWorkers' CompensationNo-Fault InsurancePublic Health LawSHIF BenefitsAffordability FactorCurrent Ratio TestArbitrary and CapriciousEqual Protection
References
5
Case No. MISSING
Regular Panel Decision

People v. Young

An attorney representing an indigent defendant in Monroe County filed an application seeking reimbursement for legal services at a rate of $200 per hour, mirroring the rate charged by the Special Prosecutor, rather than the statutory rates under County Law § 722-b. The attorney argued that the significant disparity in hourly compensation violated the defendant's right to equal protection and that his qualifications justified the requested rate. The New York State Association of Criminal Defense Lawyers supported the application as amicus curiae, while Monroe County opposed it, arguing the request was untimely and lacked extraordinary circumstances. Presiding Judge Donald J. Mark, J., acknowledged the court's authority to grant compensation in excess of statutory limits under extraordinary circumstances but ultimately denied the application. The denial was based on the court's reasoning that an analogous argument was previously rejected, that linking assigned counsel rates to prosecutor rates would render County Law § 722-b ineffective, and that extraordinary circumstances could not be demonstrated prior to the conclusion of the criminal action. The court, however, reserved the right to reconsider an increased hourly fee upon the case's termination if such circumstances are then proven.

Assigned CounselLegal Aid CompensationCounty Law Section 722-bHourly Rate DisputeSpecial Prosecutor FeesIndigent RightsJudicial DiscretionExtraordinary CircumstancesMonroe County LawEqual Protection Challenge
References
16
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