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

Case No. 2018 NY Slip Op 08737
Regular Panel Decision
Dec 20, 2018

NYAHSA Servs., Inc., Self-Insurance Trust v. Recco Home Care Servs., Inc.

This case concerns an appeal from an order of the Supreme Court in Albany County. Plaintiff NYAHSA Services, Inc., Self-Insurance Trust, a self-insured trust providing workers' compensation coverage, sued defendant Recco Home Care Services, Inc. for unpaid adjustments after the defendant terminated its membership. Following an amendment to the complaint adding individual trustees as plaintiffs, the defendant asserted counterclaims for fraud, breach of fiduciary duty, and negligence against these trustees, which the Supreme Court dismissed as time-barred. The defendant also sought to amend its answer to include a counterclaim under General Business Law, which was denied. The Appellate Division, Third Department, found that the Supreme Court erred in dismissing the counterclaims for fraud and breach of fiduciary duty and in denying the cross-motion to amend for the General Business Law claim. Consequently, the Appellate Division modified the Supreme Court's order, reversing parts of the dismissal and denial, and affirmed the order as modified.

Workers' Compensation CoverageSelf-Insurance TrustFraud AllegationsBreach of Fiduciary DutyGeneral Business LawStatute of LimitationsAmended PleadingsCounterclaimsAppellate ReviewMotion to Dismiss
References
2
Case No. 22108137
Regular Panel Decision
Aug 23, 2023

Matter of Harrell v. Blue Diamond Sheet Metal

The Self-Insured Employer appealed a decision by the Workers' Compensation Law Judge (WCLJ) which established a claim for a consequential left knee injury. The WCLJ's decision also directed reimbursement to the claimant for out-of-pocket medical expenses related to the left knee. The Board Panel, after reviewing the evidence, found no reason to disturb the WCLJ's findings regarding the consequential left knee injury. The Board Panel also affirmed the WCLJ's directive for reimbursement of medical expenses. Therefore, the WCLJ's decision was affirmed.

consequential injuryleft knee injuryout-of-pocket medical expensesWCLJ decisionBoard Panelself-insured employerreimbursementmedical treatment
References
0
Case No. MISSING
Regular Panel Decision

Claim of Graham v. Life Rollway Corp.

The claimant sustained a leg injury on the employer’s premises and filed for workers’ compensation benefits. The self-insured employer, who had paid disability benefits, controverted the claim. It was later determined that the claimant was entitled to workers’ compensation, and an award was made. A dispute arose regarding the employer's reimbursement for disability benefits paid, specifically whether it should be the full amount or less FICA taxes. The Workers’ Compensation Board ruled the employer was entitled to full reimbursement. The appellate court affirmed this decision, finding the Board's conclusion rational since the full award was effectively paid to the claimant through direct payment and FICA remittances satisfying the claimant's obligations.

Workers' CompensationFICA TaxesDisability Benefits ReimbursementEmployer ReimbursementStatutory InterpretationDue Process ClaimOverpayment RefundAppellate DecisionSocial Security Taxes
References
0
Case No. 04-CR-156
Regular Panel Decision

United States v. Taveras

Defendant Humberto Pepin Taveras faces a homicide trial where the government seeks the death penalty for the killings of two associates during a drug trafficking dispute. Senior District Judge Jack B. Weinstein addresses the admissibility of a self-defense claim, emphasizing heightened protections for defendants in capital cases and allowing more leeway for evidence favoring the defendant. The defense intends to establish self-defense through witness statements suggesting the victims, José Rosario and Carlos Madrid, had threatened Pepin and his family. The prosecution disputes this, arguing Pepin deliberately sought out and murdered the victims, thereby precluding a self-defense claim as he initiated the confrontations. The court ultimately rules that Pepin will be permitted to argue self-defense, and related evidence will be allowed, with a self-defense instruction to the jury contingent on sufficient proof being presented.

Self-defenseCapital punishmentHomicide trialEvidentiary rulesDrug traffickingDeath penaltyJury instructionsCriminal lawDue processReasonable doubt
References
45
Case No. MISSING
Regular Panel Decision

NYAHSA Servs., Inc., Self-Insurance Trust v. People Care Inc.

This case involves an appeal from an order of the Supreme Court, which granted the plaintiff's motions for leave to amend complaints. The plaintiff, a group self-insured trust, initiated collection actions against former member employers, People Care Incorporated and Recco Home Care Services, Inc., for unpaid workers' compensation adjustment bills. The plaintiff sought to add its trustees as party plaintiffs and to update allegations to include subsequently accrued unpaid bills. The appellate court affirmed the Supreme Court's decision, clarifying that an evidentiary showing of merit is not required for leave to amend pleadings under CPLR 3025 (b) unless there is prejudice, surprise, palpable insufficiency, or patent lack of merit. The court found no such grounds for denial and also rejected the defendants' statute of limitations arguments, affirming that for contracts requiring continuing performance, each breach can restart the limitations period.

Workers' Compensation CoverageSelf-Insured TrustBreach of ContractUnjust EnrichmentPleading AmendmentCPLR 3025 (b)Statute of LimitationsPrejudiceAppellate ReviewSupreme Court Order
References
18
Case No. 2017 NY Slip Op 07909 [155 AD3d 1208]
Regular Panel Decision
Nov 09, 2017

NYAHSA Services, Inc., Self-Insurance Trust v. People Care Inc.

Plaintiff, a self-insured trust, commenced a collection action against defendant, a former member, for unpaid assessments related to workers' compensation claims. Defendant counterclaimed and filed a third-party action against Cool Insuring Agency, the trust's administrators, alleging mismanagement. During discovery, a dispute arose over a report commissioned by defendant's counsel from a consultant, which Cool and plaintiff sought to compel. Defendant asserted attorney-client privilege, attorney work product, and material prepared in anticipation of litigation. The Supreme Court partially granted the motions to compel, a decision largely affirmed by the Appellate Division, Third Department, with a modification regarding a specific email exchange found to be protected attorney work product.

Discovery DisputeAttorney-Client PrivilegeAttorney Work ProductMaterial Prepared for LitigationSelf-Insurance TrustWorkers' Compensation BenefitsBreach of ContractUnjust EnrichmentThird-Party ActionClaims Administration
References
20
Case No. MISSING
Regular Panel Decision
Mar 19, 1969

Claim of Korcz v. Worthington Corp.

The claimant, a crane operator, experienced a seizure at work and was subsequently diagnosed by some physicians with carbon monoxide poisoning due to conditions in the plant, despite the employer's contention otherwise. The self-insured employer appealed the Workmen’s Compensation Board's decision, arguing a lack of substantial evidence regarding carbon monoxide exposure or a causal link to the claimant's illness. Despite conflicting medical testimonies and the absence of direct carbon monoxide tests at the time of the incident, the Board's factual findings, which relied on medical opinions excluding other probable causes, were upheld. The court affirmed the Board's decision, emphasizing its power in fact-finding within its jurisdiction.

Workers' CompensationCarbon Monoxide PoisoningCausal RelationshipMedical TestimonySubstantial EvidenceFact-Finding PowerAppellate ReviewCrane OperatorOccupational IllnessIndustrial Accident
References
2
Case No. MISSING
Regular Panel Decision

In re the Arbitration between Agress & Brouillet

Petitioner sought an order to direct arbitration against the respondents after they allegedly refused to permit the petitioner to complete a contract for work, labor, and services on the respondents' premises. The contract included a specific arbitration clause covering disputes concerning the construction/meaning of specifications or the true value of extra work. The respondents opposed, arguing that the issue of contract termination or its justification was not covered by the arbitration clause. The court, citing precedent, determined that the arbitration clause was limited and did not encompass disputes regarding a breach of contract by either party. Consequently, finding no arbitrable dispute under the contract, the court denied the motion to direct arbitration.

ArbitrationContract DisputeScope of Arbitration ClauseMotion to Compel ArbitrationBreach of ContractLimited Arbitration Clause
References
3
Case No. MISSING
Regular Panel Decision

Place v. Ryder

Claimant, who received workers' compensation benefits from a self-insured employer, settled a third-party action. A dispute arose regarding whether the employer had waived its statutory offset rights against the claimant's net recovery from the third-party action, as there was no written agreement. The Workers' Compensation Board affirmed a Workers' Compensation Law Judge's decision, finding that the self-insured employer had reserved its offset rights. The appellate court affirmed the Board's decision, concluding that the employer's attorney's correspondence provided substantial evidence to support the Board's finding that offset rights were explicitly reserved.

Workers' CompensationOffset RightsThird-Party SettlementEmployer's LienStatutory WaiverAttorney CorrespondenceAppellate ReviewSubstantial EvidenceWorkers' Compensation BoardNew York
References
7
Case No. AD.J9352393, AD.J9352398, AD.J9531390
Regular
Apr 11, 2016

NORMAN WESEMAN vs. CITY OF CATHEDRAL CITY, Permissibly Self-Insured, SUPERIOR READY MIX, Permissibly Self-Insured

This case involves a petition for reconsideration filed by the defendants, City of Cathedral City and Superior Ready Mix. The Workers' Compensation Appeals Board (WCAB) has granted this petition. Reconsideration was granted due to statutory time constraints and the need for further study of the factual and legal issues. The WCAB aims to thoroughly understand the record to issue a just decision. All future correspondence related to the petition must be filed directly with the WCAB Commissioners, not district offices or e-filed.

PETITION FOR RECONSIDERATIONWORKERS' COMPENSATION APPEALS BOARDCITY OF CATHEDRAL CITYSUPERIOR READY MIXPERMISSIBLY SELF-INSUREDADJUDICATION MANAGEMENT SYSTEMEAMSJUDICIAL ATTORNEY'S FEESCOMPROMISE AND RELEASE AGREEMENTSSTIPULATIONS WITH REQUEST FOR AWARD
References
0
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