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

Case No. ADJ9896370
Regular
Oct 19, 2017

GUILLERMO RESTREPO vs. SAN GORGONIO MEMORIAL HOSPITAL, ALPHA FUND

The applicant sought compensation for an industrial injury sustained in a car accident while commuting to work, arguing it fell under exceptions to the going and coming rule. The Workers' Compensation Appeals Board (WCAB) affirmed the administrative law judge's denial of the claim. The WCAB found the applicant's testimony regarding the necessity of using his personal vehicle for work-related tasks lacked credibility. Crucially, the evidence did not establish that the employer expressly or impliedly required the applicant to use his vehicle or that such use was a custom and practice relied upon by the employer.

Going and Coming RuleIndustrial InjuryWorkers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrdersWCJDirector of Environmental ServicesMotor Vehicle AccidentEmployment ContractJob Duties
References
12
Case No. MISSING
Regular Panel Decision

Baughman v. Merchants Mutual Insurance

This case involves an appeal by Donald H. Baughman and Donald H. Baughman, Inc. from a declaration in favor of Merchants Mutual Insurance Company. The dispute centers on whether a commercial insurance policy clause excluded coverage for a 1978 single-vehicle accident. The accident occurred when Ralph E. Landwehr, an employee of Baughman, Inc. dispatched to John R. Schutt, Jr., Inc., made a personal detour in a leased tractor after completing his work duties. Landwehr was seriously injured, and the Workers' Compensation Board denied his claim, stating the accident was outside the scope of employment. Baughman and Baughman, Inc. faced a substantial unpaid judgment after Landwehr sued them. Merchants Mutual denied coverage, citing an exclusionary clause requiring the vehicle to be used 'exclusively' in the business of the named insured (Schutt). The court affirmed the Appellate Division's decision, concluding that Landwehr's purely personal detour removed the vehicle from policy coverage, as it was not exclusively used in Schutt's business.

Insurance CoveragePolicy ExclusionCommercial InsuranceScope of EmploymentDeclaratory JudgmentVehicle AccidentPersonal UseEn Route InterpretationWorkers' Compensation PrinciplesContract Interpretation
References
8
Case No. MISSING
Regular Panel Decision
Jan 06, 2003

Yanulavich v. Appeals Board of Administrative Adjudication Bureau of the New York State Department of Motor Vehicles

The petitioner appealed the dismissal of his CPLR article 78 proceeding, which challenged the Department of Motor Vehicles' (DMV) revocation of his driver's license. The revocation stemmed from an incident where the petitioner, who reported vision issues due to diabetes, struck a flag person. After failing initial vision tests and subsequently passing with corrective lenses, the petitioner failed a road test, leading to the license revocation. The appellate court affirmed the lower court's decision, ruling that the DMV had reasonable grounds, based on the accident, the petitioner's statement, and his physician's report, to require a road test, thus supporting the revocation.

driver's licenselicense revocationvision impairmentdiabetesroad test failureadministrative appealCPLR Article 78Vehicle and Traffic Lawreasonable groundsmotor vehicle accident
References
2
Case No. ADJ9099900
Regular
May 04, 2015

JESSEKA BETTS vs. YMCA OF THE EAST VALLEY, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the employer's petition for reconsideration, affirming a prior award. The applicant, a YMCA site director, sustained injuries in a car accident while en route to a work-related meeting. The Board found that the "required vehicle exception" to the going and coming rule applied, as the applicant was required to use her personal vehicle for her job duties, for which she was reimbursed mileage. Therefore, her injuries were deemed to have arisen out of and in the course of employment.

Workers' Compensation Appeals Boardgoing and coming defenserequired vehicle exceptionmaterial deviationwork-related meetingmileage reimbursementsplit shiftssite directorcar insurancelicensing inspection
References
8
Case No. ADJ10954204
Regular
Sep 15, 2022

MARIA FLORES vs. PINNACLE HEALTH CORP., SUMMARY OF EVIDENCE INSURANCE COMPANY OF THE WEST, AFFINITY HOME HEALTH CARE SERVICES, FALLS LAKE FIRE & CASUALTY INSURANCE, SEDGWICK CMS, HOME HEALTH CARE SOLUTIONS, INC.

The Workers' Compensation Appeals Board denied a petition for reconsideration filed by Home Health Care Solutions. The applicant, an LVN, was injured in a car accident while traveling between patients for multiple agencies. The Board adopted the WCJ's report, which found the injury arose out of and occurred in the course of employment for Home Health Care Solutions. This decision was based on the fact that the applicant was required to use her own vehicle, which extended the employer-employee relationship beyond direct service. The WCJ also found the going and coming rule did not bar the claim due to the required use of transportation between patient locations.

Workers' Compensation Appeals BoardPetition for ReconsiderationGoing and Coming RuleAOE/COELVNCar AccidentAutomobile ExceptionTransitEmployment RelationshipRequired Vehicle Use
References
6
Case No. MISSING
Regular Panel Decision
Sep 20, 1979

Claim of Tsapatoris v. G. L. M. Corp.

The claimant appealed a decision from the Workers' Compensation Board which denied compensation for injuries sustained in a motor vehicle accident. The accident occurred while the claimant, a construction worker, was driving his personal vehicle to work approximately 10 miles from his home, prior to his scheduled work hours. The Board concluded that the injuries did not arise out of and in the course of his employment, noting that the use of his personal vehicle was not a requirement of his job and any tools carried were for personal convenience. The court found substantial evidence to support the Board's determination and affirmed the decision.

Workers' CompensationMotor Vehicle AccidentCourse of EmploymentCommuting RulePersonal VehicleTravel ExpensesSubstantial EvidenceAppellate DecisionInjury CompensationBoard Determination
References
3
Case No. MISSING
Regular Panel Decision

Claim of Hampton v. Kelly

The employer and its insurance carrier appealed a decision by the Workmen’s Compensation Board which awarded death benefits to the decedent’s beneficiaries. The decedent, a part-time liquor store employee, was fatally injured in December 1967 while commuting to work in his personal vehicle. The Board had affirmed a Referee’s award, reasoning that the decedent’s use of his car for occasional deliveries benefited the employer, thus making his commute work-related. However, the appellate court reversed this decision, finding no substantial evidence to support that the decedent’s car use was required by the employer or for business purposes. The court concluded that the decedent used his car for personal convenience, and the store policy was against deliveries, therefore, his travel to work did not fall within the course of employment.

Death Benefits ClaimEmployment ScopeCommute RulePersonal Vehicle UseEmployer Benefit TestAccident InjuryAppellate Court DecisionReversal of AwardSubstantial Evidence ReviewWork-Related Injury
References
2
Case No. MISSING
Regular Panel Decision

Property Clerk v. Aponte

This special proceeding addresses the forfeiture of a 1987 Volkswagen seized during the respondent's arrest for drug possession. The respondent drove his vehicle to a known drug location, purchased heroin, and was apprehended upon driving away. Although initially charged with criminal possession, he pleaded guilty to disorderly conduct. The core legal question revolves around the required nexus between the vehicle and the alleged crime for forfeiture under section 14-140 (b) of the Administrative Code of the City of New York. The court, drawing on interpretations from similar statutes, concluded that the vehicle’s use was merely for locomotion and did not substantially aid or further the commission of the drug purchase. Consequently, the court denied the forfeiture, ruling that the petitioner failed to demonstrate a sufficient connection, and ordered the return of the automobile to the respondent.

ForfeitureVehicle SeizureDrug PossessionAdministrative CodeNexus RequirementDisorderly ConductPenal LawPublic Health LawInstrumentality of CrimeAttenuated Connection
References
13
Case No. MISSING
Regular Panel Decision

American Fidelity Fire Insurance v. Pardo

An insurance company initiated an action seeking a declaratory judgment and an injunction, asserting that its liability policy did not cover an accident involving defendant Pardo's vehicle, which it claimed was used as a 'public or livery conveyance.' Pardo, who operated an employment agency, used the vehicle to transport domestic workers, with a portion of their earnings paid to him irrespective of transportation use. The trial court initially ruled in favor of the insurer. However, the appellate court reversed this judgment. It determined that the exclusionary clause regarding 'public or livery conveyance' was ambiguous and, construing it against the insurer, concluded that Pardo's specific and limited use of the vehicle for his employment agency clients did not fall within the exclusion, thereby obligating the policy to cover the claims.

Insurance policyVehicle exclusion clausePublic or livery conveyanceDeclaratory judgment actionInjunctionAmbiguity in insurance policyConstruction against insurerBurden of proofAutomobile liability insuranceEmployment agency transport
References
14
Case No. MISSING
Regular Panel Decision

Hill v. Speckard

Plaintiff, an employee of the State University, was injured in a car collision with defendant Hubert J. Speckard, who was also a State employee and superintendent of a correctional facility. Both were returning home from work in State-owned vehicles at the time of the accident. Plaintiff sued defendant for personal injuries, but the defendant raised an affirmative defense, asserting that workers' compensation was the plaintiff's exclusive remedy due to co-employment. The court examined whether the defendant was acting in the course of his employment, applying an exception for employer-provided vehicles used for commuting when the employer benefits. It was determined that because the defendant was on call 24 hours a day and used a State-provided vehicle equipped for work, his use of the vehicle was within the course of employment, making workers' compensation the plaintiff's exclusive remedy. Consequently, the cross-motion for summary judgment was granted, and the complaint against defendant Speckard was dismissed.

Co-employment defenseExclusive remedyAutomobile collisionCommuting exceptionEmployer benefit ruleState employeesSummary judgmentAffirmative defenseScope of employmentVehicle provision
References
8
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