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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

Claim of Ewing v. YMCA

Claimant, a kitchen worker, sustained a left leg injury in September 1989, leading to a schedule loss of use award in November 2001. After the last compensation payment, the claimant requested to reopen her case in October 2004, which was denied as it lacked grounds for reopening. A subsequent request in June 2005, supported by a March 2005 medical report indicating a worsened condition, led the Workers' Compensation Board to reopen the case and transfer liability to the Special Fund for Reopened Cases. The Special Fund appealed, challenging the Board's determination that the 2004 letter did not constitute a proper reopening application. The Court affirmed the Board's decision, finding substantial evidence supported that the 2004 letter lacked sufficient grounds for reopening, thus upholding the transfer of liability to the Special Fund based on the June 2005 request.

Reopened CasesSchedule Loss of UseWorkers' Compensation BoardSpecial FundMedical ReportLiability TransferAbuse of DiscretionAppellate ReviewWorsened Condition
References
10
Case No. MISSING
Regular Panel Decision
Apr 25, 2000

Claim of Davis v. T.J. Madden Construction Co.

Claimant suffered two work-related knee injuries in 1988 and 1992, leading to separate compensation cases. In April 1999, an application to reopen the 1988 case was filed, supported by a medical report indicating a change in the claimant's condition. The carrier for the 1988 case sought to shift liability to the Special Fund for Reopened Cases and requested reopening of the 1992 case. The Workers' Compensation Board reversed a Law Judge's decision, discharging the Special Fund from liability and placing Travelers Property Casualty (1992 carrier) back on notice. The Appellate Division affirmed the Board's decision, finding that the April 1999 medical report, despite explicitly referencing only the 1988 case, constituted sufficient notice to reopen the interconnected 1992 case within the seven-year statutory period.

Workers' CompensationSpecial Fund for Reopened CasesLiability ShiftStatute of LimitationsMedical Report as NoticeChange in ConditionKnee InjuryApportionmentBoard DecisionAppeal
References
7
Case No. MISSING
Regular Panel Decision

Faison v. City of New York Department of Human Resources

The case concerns an appeal from decisions of the Workers’ Compensation Board regarding liability for a claimant’s reopened case. The claimant sustained a permanent partial disability in 1991 and her case was closed in 1993. In 2001, she applied to reopen it. A Workers’ Compensation Law Judge and subsequently a Board panel found that the employer voluntarily made advance payments of compensation within three years of the application, thereby making the employer, not the Special Fund for Reopened Cases, liable for disability payments. The employer appealed this decision. The appellate court examined whether the employer's payment of wages, deducted from sick leave, constituted an 'advance payment of compensation' with an acknowledgment of liability. The court found that wages paid from sick leave are not advance payments of compensation, and there was no substantial evidence that the employer’s payments were made voluntarily in recognition of continuing liability. Therefore, the Board's decision was reversed, and liability was transferred to the Special Fund for Reopened Cases.

Permanent Partial DisabilityReopened CaseAdvance Payments of CompensationSick LeaveEmployer LiabilitySpecial Fund for Reopened CasesWorkers' Compensation Law § 25-aAppellate ReviewSubstantial EvidenceRemittitur
References
8
Case No. MISSING
Regular Panel Decision

Renzi v. Case Manangement Concepts

In this workers' compensation case, the claimant sustained a compensable injury in 1998, with the claim becoming the Special Fund for Reopened Cases' liability in 2006. In 2008, a licensed massage therapist submitted requests for payment for services allegedly prescribed by the claimant's treating physician. The Special Fund objected, arguing massage therapists are not authorized providers under the Workers’ Compensation Law. A Workers' Compensation Law Judge (WCLJ) initially found massage therapy compensable if performed by a licensed therapist under a physician's supervision, holding payments in abeyance pending prescription submission. The Workers' Compensation Board affirmed this in an amended decision. This Court reversed the Board's decision, concluding that there was insufficient evidence to support the Board’s determination that the Special Fund is liable, as the massage therapist was not an authorized provider nor did they fall under any statutory exceptions like being a registered nurse, person trained in diagnostic techniques, physical therapist, or occupational therapist.

Workers' Compensation LawMassage TherapyAuthorized Medical ProvidersSpecial Fund for Reopened CasesCompensability of TreatmentStatutory ExceptionsAppellate ReviewProvider AuthorizationMedical Treatment GuidelinesSupervision of Care
References
4
Case No. MISSING
Regular Panel Decision

Claim of Giglio v. Fehlhaber Horn Corp.

The claimant, a 57-year-old construction worker, suffered two compensable back injuries in 1969 and 1974, leading to a finding of total permanent disability and case closure in 1977. Later, medical examinations by Drs. Foster and Mincy prompted an apportionment change but reaffirmed permanent total disability. In 1981, the claimant applied to reopen his cases based on Dr. Teresi's report suggesting permanent partial disability, which would offer financial advantages given his retirement and Social Security benefits. The Workers’ Compensation Board denied the reopening application, asserting no change in physical condition and that the prior disability determination was conclusive as it was not appealed. The Appellate Division affirmed the Board's decision, concluding that the Board's refusal to reopen was not arbitrary or capricious, despite its misapplication of the 'law of the case' doctrine.

Workers' CompensationDisability ClassificationCase ReopeningPermanent Total DisabilityPermanent Partial DisabilityMedical EvidenceJudicial ReviewBoard DiscretionAppellate ProcedureFinancial Advantage
References
3
Case No. MISSING
Regular Panel Decision
Jul 05, 2011

Claim of Mucci v. New York State Department of Corrections

In December 1996, a claimant suffered a work-related left knee injury, and the case was closed in February 1998 after the last benefit payment in May 1997. Following a non-work-related reinjury in July 2009, the claimant sought a reopening of the 1996 case, prompting the employer's carrier to request a liability shift to the Special Fund for Reopened Cases under Workers’ Compensation Law § 25-a. Both the Workers’ Compensation Law Judge and the Board affirmed this shift. The Special Fund appealed, arguing the case was not truly closed due to a medical report anticipating future arthritic changes. The Appellate Division affirmed the Board's decision, ruling that the case was indeed truly closed in 1998 as no further proceedings or payments were contemplated.

Workers' CompensationSpecial Fund for Reopened CasesLiability ShiftCase ReopeningWork-Related InjuryKnee InjuryMedical PermanencyAppellate ReviewStatutory InterpretationSection 25-a
References
10
Case No. MISSING
Regular Panel Decision
Feb 11, 2005

Claim of Cook v. Staffing

Claimant sustained back and facial injuries in a 1994 work accident, leading to a 1997 award for facial disfigurement, no lost time, and continued back treatment, then case closure. In 2000, the case reopened to address medical reports and potential benefits, but was subsequently ruled resolved and "not truly closed" by a WCLJ, preventing Workers’ Compensation Law § 25-a liability shift to the Special Fund for Reopened Cases. In 2004, claimant sought lost time compensation, and the Workers’ Compensation Board modified the WCLJ's decision, finding the case was indeed closed in 2000, thereby meeting the requirements for § 25-a liability to shift. The Special Fund appealed this determination, arguing the case was not truly closed. The appellate court affirmed the Board's decision, concluding that the finding of true closure in 2000 was supported by evidence showing all pending issues had been resolved and no further proceedings were contemplated at that time.

Workers' Compensation Board AppealSpecial Fund LiabilityCase Reopening CriteriaWorkers’ Compensation Law § 25-aPermanent Facial DisfigurementLost Time BenefitsWorkers' Compensation LawAppellate Court AffirmationDate of Case ClosureMedical Treatment Coverage
References
4
Case No. MISSING
Regular Panel Decision

Claim of Feldman v. Presbyterian Hospital

Claimant sustained a compensable back injury in 1966, leading to a closed case in 1967. The case was reopened in 1980 after claimant experienced additional lost time from work in 1979 and received treatment at the employer's clinic. The primary issue was the liability of the Special Fund for Reopened Cases under Workers’ Compensation Law § 25-a, specifically whether payments made by the employer for clinic visits and sick leave constituted advance payments of compensation. The Workers’ Compensation Board affirmed the discharge of the Special Fund, finding that there was an advance payment and the employer knew the lost time was due to the 1966 injury. On appeal, the court affirmed the Board's decision, holding that the employer's discretionary full reimbursement for clinic visits during working hours, even when sick leave was presumed exhausted, qualified as an advance payment. Therefore, the insurance carrier remained liable as the case was reopened within three years of the last payment.

Workers' CompensationSpecial Fund for Reopened CasesAdvance PaymentEmployer LiabilityMedical TreatmentLost TimeSick LeaveAppellate ReviewWorkers' Compensation Law § 25-aDiscretionary Payments
References
7
Case No. 58107472
Regular Panel Decision

Claim of Klouse v. City of Albany

Claimant, a firefighter, sustained multiple compensable back injuries, leading to the reopening of two 1981 cases. The Workers' Compensation Law Judge initially held the Special Fund for Reopened Cases liable, but the Board reversed, finding that a November 1987 medical report by Dr. Dominic Belmonte constituted a timely request to reopen, thus discharging the Special Fund. Reliance Insurance Company, the carrier for the 1981 cases, sought full Board review, citing lack of notice and the report's insufficiency, but the Board denied it, affirming its prior decision that the report was adequate. The employer and Reliance appealed these Board decisions to the Appellate Division. The Appellate Division affirmed the Board's decisions, agreeing that substantial evidence supported the finding that an application to reopen was made within seven years.

Workers' CompensationSpecial Fund for Reopened CasesApportionment of DisabilityMedical ReportSeven-Year RuleNotice RequirementsBack InjuryInsurance Carrier LiabilityBoard ReviewAppellate Review
References
4
Case No. MISSING
Regular Panel Decision
Oct 06, 2004

Belleville v. Madame Pirie's, Inc.

Claimant sustained a work-related back injury in 1991 and began receiving workers' compensation benefits. After a third-party personal injury action settlement in 1994, the case was closed in October 1998 with no present deficiency for compensation payments. In 2004, the case was reopened due to a possible new causally connected injury. A WCLJ found no compensable lost time from April 1998 to July 2004, authorized medical treatment, and directed the Special Fund for Reopened Cases was responsible. The Workers’ Compensation Board affirmed this decision, finding that the time periods specified in Workers’ Compensation Law § 25-a (8) were met due to the passage of time without compensation payment in a closed case, and no application for deficiency compensation was made upon reopening. The Special Fund appealed, and the Board's decision was affirmed.

Workers' CompensationSpecial FundReopened CasesLiability ShiftWorkers’ Compensation Law § 25-aThird-Party SettlementBack InjuryDeficiency CompensationMedical Treatment
References
7
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