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

Case No. 2023 NY Slip Op 03287
Regular Panel Decision
Jun 15, 2023

Dejesus v. Downtown Re Holdings LLC

Plaintiff Brian Dejesus was injured when a steel tubing fell through a gap in a sidewalk bridge at a construction site. The Appellate Division, First Department, modified a Supreme Court order, addressing multiple indemnification and breach of contract claims among the owner (Downtown Re Holdings LLC), general contractor (Noble Construction Group, LLC), and various subcontractors. The court found triable issues of fact regarding Noble's negligence and granted Downtown summary judgment for common-law indemnification against Rockledge Scaffold Corp. due to its negligence in bridge erection. Claims against City Safety Compliance Corp. were dismissed as its role was merely advisory. The decision also involved contractual indemnification between Downtown/Noble and The Safety Group, Ltd., granting a breach of contract claim against TSG for failing to procure required insurance.

Construction AccidentSidewalk Bridge DefectIndemnification ClaimsCommon-Law IndemnificationContractual IndemnificationSummary JudgmentGeneral Contractor NegligenceSubcontractor LiabilityInsurance ProcurementBreach of Contract
References
12
Case No. MISSING
Regular Panel Decision

Matter of Hills v. New York City Board of Education

The claimant suffered a work-related wrist injury and was awarded workers' compensation benefits, including a schedule loss of use payment. The self-insured employer mailed a check for $4,580.20, but the claimant asserted non-receipt and denied endorsing the cancelled check. Initially, a Workers’ Compensation Law Judge ordered the employer to re-issue payment and investigate. However, the Workers' Compensation Board reversed this decision, concluding that timely mailing constituted payment and absolved the employer of further obligation. The Appellate Division found the Board's reversal arbitrary and capricious, as it failed to provide a rationale for deviating from its own conflicting precedents regarding employer responsibility in cases of unreceived or improperly endorsed payments. Consequently, the court modified the Board's decision, reversing the determination that the employer was not required to issue another check, and remitted the matter for additional proceedings consistent with its ruling.

Workers' CompensationSchedule Loss of UsePayment DisputeCheck Non-receiptEmployer LiabilityWorkers' Compensation BoardAppellate ReviewAdministrative LawArbitrary and CapriciousRemittal
References
11
Case No. MISSING
Regular Panel Decision

National Union Fire Insurance Co. of Pittsburgh v. American Re-Insurance Co.

The case revolves around a dispute between National Union Fire Insurance Company and American Re-Insurance Company regarding a pollution exclusion clause in a reinsurance policy. National Union sought reimbursement from American Re after settling claims where employees were exposed to metalworking fluids. American Re denied coverage, arguing its pollution exclusion applied. The court, applying Ohio law, found American Re's pollution exclusion ambiguous due to its broad language and its intended purpose of covering environmental contamination. Consequently, American Re's motion for summary judgment was denied, and National Union's motion to strike American Re's defense was granted, requiring American Re to "follow the fortunes" of National Union.

ReinsurancePollution Exclusion ClauseContract InterpretationFollow the Fortunes DoctrineSummary JudgmentInsurance CoverageAmbiguity in ContractsOhio State LawDiversity JurisdictionIndustrial Contamination
References
31
Case No. ADJ4141215 (MON 0288595) ADJ4160601 (MON 0288596) ADJ2249717 (MON 0300098)
Regular
Dec 27, 2011

DOREEN LABOY vs. STATE OF CALIFORNIA, DEPARTMENT OF MENTAL HEALTH, Legally Uninsured; STATE COMPENSATION INSURANCE FUND / STATE CONTRACT SERVICES, Adjusting Agency

The Workers' Compensation Appeals Board (WCAB) denied the defendant's Petition for Reconsideration, finding their argument regarding AMA Guidelines irrelevant due to a prior stipulation to the 1997 Rating Schedule. The WCAB granted removal to issue notices of intention to impose sanctions and award attorney's fees/costs against the defendant and their counsel. This action is based on the defendant's frivolous and bad-faith tactics in raising an issue for the first time on reconsideration that was not previously litigated or argued. The defendant's petition is deemed without merit and solely intended to cause unnecessary delay.

LABOYDOREENSTATE OF CALIFORNIADEPARTMENT OF MENTAL HEALTHSTATE COMPENSATION INSURANCE FUNDJOINT FINDINGS AND AWARDPETITION FOR RECONSIDERATIONREMOVALNOTICES OF INTENTIONORDER TO PAY EXPENSES
References
6
Case No. MISSING
Regular Panel Decision

In re Frank F.

The mother appealed an order of disposition from the Family Court, Queens County, dated November 14, 2003, which, upon a fact-finding order, found her to have abused and neglected her child and released the child to the father. The appellate court affirmed the order, ruling that the child's out-of-court statements of abuse and neglect were sufficiently corroborated by a social worker's personal observations of the child’s injuries and the child's medical records. The court found no reason to disturb the Family Court's determination of factual issues and issues of credibility, stating that a preponderance of the evidence established the child was abused and neglected by the mother.

child protective serviceschild abusechild neglectcorroborationout-of-court statementsmedical recordssocial worker observationsFamily Court ActappealQueens County
References
9
Case No. MISSING
Regular Panel Decision

Unsecured Claims Estate Representative of Teligent, Inc. v. Cigna Healthcare, Inc. (In Re Teligent Inc.)

This case is an appeal by Savage & Associates, P.C., acting as the Unsecured Claims Estate Representative for Teligent, Inc., against Cigna Healthcare. The Representative challenged the Bankruptcy Court's summary judgment ruling, which determined that Teligent had assumed a group insurance contract with Cigna. The central issue on appeal was whether the original insurance policy terminated due to periodic rate renewals, thereby giving rise to new contracts and allowing the recovery of preference payments made to Cigna. The Bankruptcy Court concluded that the insurance contract was a single, continuous agreement, with re-ratings merely adjustments rather than terminations. The District Court affirmed this decision, holding that the policy lacked a fixed term and continued indefinitely, and that rate renewals did not constitute new contracts.

BankruptcyInsurance ContractExecutory ContractContract AssumptionSummary JudgmentAppealPreference PaymentsRate RenewalContract InterpretationDelaware Law
References
36
Case No. MISSING
Regular Panel Decision
Jun 20, 1986

Claim of Foglia v. New York City Housing Authority

The claimant, a New York City Housing Authority police officer, sustained a compensable knee injury in 1974. The case was reopened in 1983 due to increased disability, and the Special Fund for Reopened Cases was put on notice for potential liability under Workers' Compensation Law § 25-a. The issue was whether there was an advance payment of compensation, which would relieve the Special Fund from liability. The claimant testified that he retired in 1983 but had been on limited duty performing clerical work at full salary since 1982 due to his injury. The Workers' Compensation Board determined that these full salary payments for lighter work constituted an advance payment of compensation. The court affirmed the Board's decision, finding substantial evidence to support the determination that an advance payment of compensation relieved the Special Fund from liability.

Workers' Compensation BoardAdvance PaymentSpecial FundReopened CasesDisabilitySchedule LossPolice OfficerLimited DutySubstantial EvidenceFactual Determination
References
2
Case No. MISSING
Regular Panel Decision

In re the Establishment of a Supplemental Needs Trust for Kennedy

John Kennedy, a disabled person under 65, receives Social Security disability payments. His guardian, Hope Kennedy, petitioned to establish a supplemental needs trust solely funded by these payments to avoid Medicaid spend-down requirements. The court addressed the apparent conflict between New York's Social Services Law concerning spend-down (366[2][a][7]) and supplemental needs trusts (366[2][b][2][iii]), determining that such trusts serve as an exception to general Medicaid rules. Noticing parties, the Nassau County Department of Social Services and the New York State Attorney General’s Office, did not object to the trust's formation or funding source, though the Attorney General raised objections to specific provisions. The court granted the application, approving the trust under specific conditions, including provisions related to the trustee's counsel, housing investments, annual accounting with the Surrogate's Court, and ensuring state reimbursement priority upon John Kennedy's death in accordance with POMS guidelines.

Supplemental Needs TrustMedicaid EligibilitySocial Security DisabilitySpend Down ProgramPayback TrustException TrustGuardianshipRepresentative PayeeStatutory InterpretationAdministrative Deference
References
19
Case No. MISSING
Regular Panel Decision

In re Charny

Nathaniel K. Charny, an attorney, pleaded guilty to conspiracy to defraud the United States by making false statements regarding campaign contributions. The Departmental Disciplinary Committee sought his suspension. The Court had previously issued an interim suspension and ordered a hearing. After a Hearing Panel recommended a two-year retroactive suspension, the Committee moved to confirm, while Charny cross-moved for an 18-month suspension and immediate reinstatement. The Court ruled to suspend Charny for two years, retroactive to April 15, 1999, with reinstatement on April 15, 2001, acknowledging mitigating factors like his inexperience, lack of financial gain, and significant cooperation with authorities in its decision to grant partial relief on the cross-motion.

Attorney MisconductProfessional DisciplineLegal EthicsConspiracy to DefraudFalse StatementsCampaign FinanceInterim SuspensionRetroactive SuspensionMitigationNew York Law
References
8
Case No. MISSING
Regular Panel Decision

In re Pinti

This case concerns an appeal from a decision by the Unemployment Insurance Appeal Board, which reversed a referee's decision and determined that emergency medical technicians (EMTs) working for an ambulance service employer were employees, not independent contractors, thus assessing the employer contributions. The central question for review was whether substantial evidence supported the board's conclusion regarding the employer-employee relationship. The court examined the record, noting factors such as EMTs' scheduling, payment structure, lack of business investment, and the employer's provision of liability and workers' compensation insurance. Despite some factors that could support a contrary finding, the court concluded that the board's determination was supported by substantial evidence. Consequently, the decision of the Unemployment Insurance Appeal Board was affirmed without costs.

Unemployment InsuranceEmployer-Employee RelationshipIndependent Contractor StatusEmergency Medical TechniciansSubstantial Evidence ReviewAppellate ReviewLabor Law ContributionsAmbulance Service IndustryWorkers' Compensation InsuranceBoard Decision Affirmation
References
5
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