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

Case No. 2017 NY Slip Op 27428
Regular Panel Decision
Dec 14, 2017

New York State Workers' Compensation Bd. v. Compensation Risk Mgrs., LLC

This action was brought by the New York State Workers' Compensation Board (WCB), as an assignee of former members of the Healthcare Industry Trust of New York (HITNY), against Compensation Risk Managers, LLC (CRM), HITNY trustees, and auditing firm UHY LLP. The WCB alleged mismanagement, breach of fiduciary duty, and negligent auditing, leading to the Trust's insolvency. Defendants moved to dismiss on grounds of standing, statute of limitations, and pleading particularity. The court dismissed certain derivative claims and negligent misrepresentation claims against some trustees due to standing issues and statute of limitations. All claims against UHY LLP were dismissed for lack of a near-privity relationship or prior precedent. An implied indemnity claim against the trustees was sustained. The WCB's cross-motion to consolidate related actions was denied.

Workers' Compensation LawGroup Self-Insured Trust (GSIT)Fiduciary DutyNegligenceNegligent MisrepresentationStatute of LimitationsStandingDerivative ActionImplied IndemnityAuditing Firm Liability
References
46
Case No. MISSING
Regular Panel Decision

Schmidt v. Falls Dodge, Inc.

The claimant was awarded a 21.43% schedule loss of use for binaural hearing loss in 2007. The Workers’ Compensation Law Judge and the Workers’ Compensation Board determined that this award was not subject to temporary disability benefits the claimant was already receiving from earlier workers' compensation cases. The employer and State Insurance Fund appealed, contending that a Court of Appeals decision overruled prior holdings regarding the overlap of schedule and nonschedule awards. The appellate court affirmed the Board's decision, distinguishing between schedule awards for future earnings loss and nonschedule awards for temporary disability during a limited time frame, concluding they do not overlap.

Workers' CompensationSchedule Loss of UseTemporary DisabilityBinaural Hearing LossAward OverlapAppellate DecisionInsurance FundEmployer LiabilityMedical BenefitsEarnings Loss
References
3
Case No. MISSING
Regular Panel Decision

Castro v. New York City Transit Authority

Claimant suffered compensable right knee injuries in 1992 and 1994, leading to a stipulated 22.5% schedule loss of use award in 2001, after which the cases were closed. Upon reopening in 2005, liability shifted from the employer's workers' compensation carrier to the Special Fund for Reopened Cases under Workers’ Compensation Law § 25-a. Following a recurrence of injuries in October 2005, the Fund sought a credit for the prior schedule loss of use award paid by the carrier, which was initially denied but later granted by the Workers’ Compensation Board. Claimant appealed this decision, arguing that the Fund should not receive credit for awards commencing more than two years prior to the transfer of liability, citing Workers’ Compensation Law § 25-a (1) and prior case law. The Appellate Division affirmed the Board's decision, explaining that the Fund assumes the carrier's rights and responsibilities, including any existing credits, and distinguished the cited precedent based on a lack of injury reclassification in the current case.

Workers' Compensation Law § 25-aSchedule Loss of Use AwardSpecial Fund for Reopened CasesCredit Against AwardsLiability TransferRecurrence of InjuryAppellate DivisionWorkers' Compensation Board DecisionStipulationCase Reopening
References
5
Case No. MISSING
Regular Panel Decision
Jul 24, 2002

In re the Claim of Miller v. North Syracuse Central School District

This case involves an appeal from a Workers' Compensation Board decision concerning overlapping workers' compensation awards. The claimant, a food services worker, filed two separate claims: one for occupational disease to her shoulders, leading to a schedule loss of use award, and another for bilateral carpal tunnel syndrome, which resulted in a temporary total disability award for the period from December 13, 1999, to February 14, 2000. The State Insurance Fund argued that the schedule loss of use award should be suspended for this period to prevent an overlap. Initially, a Workers’ Compensation Law Judge disagreed, but the Workers’ Compensation Board reversed, ruling in favor of suspending the schedule award. On appeal, the court reversed the Board's decision, clarifying that a schedule award is not allocable to a specific period of disability and therefore does not overlap with a temporary total disability award covering a limited timeframe. The court distinguished this from cases involving permanent disability awards. The matter was remitted to the Workers’ Compensation Board for recalculation of the claimant’s award.

Workers' CompensationSchedule Loss of UseTemporary Total DisabilityOverlapping AwardsEarning CapacityOccupational DiseaseCarpal Tunnel SyndromeShoulder InjuryAppellate ReviewRecalculation of Award
References
7
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. 03-03-00176-CV
Regular Panel Decision
Dec 04, 2003

Texas Workers' Compensation Insurance Fund/Texas Workers' Compensation Commission and Leonard D. Watts v. Texas Workers' Compensation Commission and Leonard D. Watts/Texas Workers' Compensation Insurance Fund

This case involves a cross-appeal stemming from a workers' compensation claim by Leonard D. Watts, who sought lifetime income benefits for injuries sustained as a truck driver. The Texas Workers' Compensation Commission (appeals panel) initially reversed a hearing officer's decision and awarded Watts benefits, but this decision was later set aside by a Travis County district court. In this appeal, the Texas Workers' Compensation Insurance Fund (Texas Mutual) and the Commission challenged the district court's ruling. The Court of Appeals addressed arguments regarding the appeals panel's statutory authority for factual-sufficiency review and the interpretation of "issue" under the labor code, including legal doctrines of res judicata and collateral estoppel. The court ultimately reversed the judgment of the district court, thereby affirming the decision of the Commission's appeals panel which granted Watts lifetime income benefits.

Workers' CompensationLifetime Income BenefitsAppeals Panel ReviewFactual SufficiencyStatutory AuthorityCross-AppealRes JudicataCollateral EstoppelCausationMaximum Medical Improvement
References
17
Case No. MISSING
Regular Panel Decision

Claim of Pedro v. Liberty Lines Express

The claimant, a mechanic, sustained an injury resulting in the amputation of his right thumb. The Workers’ Compensation Board determined this constituted a 50% schedule loss of the use of his right hand and awarded benefits. The employer appealed this decision, arguing that the injury was exclusively to the thumb and that the Workers’ Compensation Law does not explicitly allow for a single digit loss to be compensated as a partial loss of hand function. The court adopted a flexible approach, asserting that schedule allowances should not be deemed exclusive when treating a smaller member's loss as a percentage of a larger member's loss. Based on the testimony of the Board’s principal medical examiner, who stated the thumb injury diminished the prehensile function of the entire right hand, the court affirmed the Board's finding, concluding it was supported by substantial evidence.

Workers’ CompensationSchedule LossThumb AmputationRight Hand InjuryPrehensile FunctionAppellate ReviewMedical TestimonyInjury CompensationStatutory InterpretationDisability Benefits
References
5
Case No. MISSING
Regular Panel Decision
May 06, 2011

Claim of Sola v. Corwin

Claimant sustained a left foot injury while working for the employer and was awarded workers' compensation benefits. The employer's Independent Medical Examination (IME) report was deemed inadmissible by the Workers' Compensation Law Judge for non-compliance with Workers' Compensation Law § 137, specifically regarding submission timelines. The Workers' Compensation Board affirmed this decision, accepting the treating physician's opinion of a 35% schedule loss of use of the foot. The employer appealed this affirmation. The Appellate Division affirmed the Board's decision, concluding that the IME report was properly excluded and the Board's determination was supported by substantial evidence from the treating physician's testimony.

Schedule loss of useWorkers' Compensation BoardIME report preclusionWorkers' Compensation Law § 137Admissibility of evidenceTreating physician testimonyFoot injuryMaximum medical improvementAppellate reviewSubstantial evidence
References
4
Case No. 2020 NY Slip Op 05264
Regular Panel Decision
Oct 01, 2020

Matter of Rickard v. Central New York Psychiatric Ctr.

Claimant James Rickard suffered a work-related injury to his left knee while restraining a patient. An orthopedist determined he sustained a 17.5% schedule loss of use (SLU) of his left leg, specifically 7.5% for loss of extension and 10% for chondromalacia. The workers' compensation carrier sought credit for a prior 10% SLU award to the same left leg stemming from a 2015 hip injury. Both the Workers' Compensation Law Judge and the Workers' Compensation Board affirmed this credit, resulting in a 7.5% SLU award for the current injury. The Appellate Division, Third Department, affirmed the Board's decision, holding that prior SLU awards for the same body member should be credited against subsequent awards, as all impairments to separate parts of a member are encompassed by the overall SLU award for that member.

Workers' CompensationSchedule Loss of UseLeft Leg InjuryPrior Injury CreditMaximum Medical ImprovementChondromalaciaKnee InjuryHip InjuryAppellate Division DecisionCredit Application
References
4
Case No. 2020 NY Slip Op 06424 [188 AD3d 1381]
Regular Panel Decision
Nov 12, 2020

Matter of Hluska v. Central New York Psychiatric Ctr.

Claimant Kevin Hluska, who previously received a 13% schedule loss of use (SLU) award for his left arm due to a 2016 shoulder injury, sustained a new work-related injury to his left elbow in 2017. His physician determined this new injury resulted in a 10% SLU of the left arm. The Workers' Compensation Law Judge and the Workers' Compensation Board ruled that claimant was not entitled to a further SLU award for the elbow injury because the previous SLU award for the same arm exceeded the current impairment. The Appellate Division, Third Department, affirmed this decision, citing Workers' Compensation Law § 15 (3), which limits SLU awards for permanent impairments to specific body parts and allows for multiple awards only if for more than one member or parts of more than one member, but the total award for a member is capped.

Schedule Loss of UseSLU AwardLeft Arm InjuryElbow InjuryShoulder InjuryWorkers' Compensation Board DecisionAppellate Division Third DepartmentPermanent ImpairmentPrior AwardSubsequent Injury
References
4
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