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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 Cortese v. Rochester Products Division, G.M.C.

This case concerns an appeal from decisions of the Workers’ Compensation Board regarding a claimant who developed leg and back pain, culminating in a herniated disc, after a new work assignment involving lifting heavy carburetors. The self-insured employer appealed the Board's findings that the claimant sustained a compensable injury and that her failure to give timely statutory notice was excused. The court affirmed the Board's decisions, asserting that a compensable accident can arise from repetitive trauma leading to a sudden collapse, and the specific onset of severe pain satisfies the suddenness test. Furthermore, the Board properly excused the delayed notice as it neither aggravated the injury nor hindered the defense. Substantial medical evidence supported the causal relationship between the work activities and the injury.

Repetitive TraumaHerniated DiscLaminectomyDelayed Notice ExcusedCausal ConnectionSuddenness TestWorkers' Compensation Board AppealSubstantial EvidenceWork-related InjuryEmployer Liability
References
10
Case No. MISSING
Regular Panel Decision

Pedro v. Village of Endicott

Claimant, a firefighter, sustained injuries while repairing his personal vehicle during "unstructured time" at the fire station. The self-insured employer and its plan administrator disputed the claim, arguing the activity was purely personal and not work-related. However, a Workers’ Compensation Law Judge and the Workers’ Compensation Board determined the injury was compensable, citing a departmental tolerance for such repairs during on-duty hours. The appellate court affirmed these decisions, holding that during periods of enforced waiting, reasonable activities are permissible, and the Board's finding of work-relatedness was supported by evidence of departmental tolerance.

Firefighter injurypersonal vehicle repairon-duty incidentunstructured timetolerated activityscope of employmentWorkers' Compensation Board appealcompensable injuryemployer toleranceadministrative appeal
References
7
Case No. MISSING
Regular Panel Decision
May 06, 1998

Claim of MacKenzie v. Management Recruiters

In this workers' compensation appeal, the claimant, an office manager for Management Recruiters, sought benefits for injuries sustained in a single-car accident in Ulster County. Her claim was denied by the employer's insurance carrier, arguing the injuries were not work-related and were willfully self-inflicted. After initial reversals, the Workers' Compensation Board ultimately disallowed the claim, concluding the injuries resulted from the claimant's deliberate intent to harm herself, thereby overcoming the statutory presumption against self-injury. The Appellate Division affirmed the Board's decision, finding substantial evidence, including accident reconstruction and psychiatric testimony, supported the finding of willful intent. The court reiterated that conflicting evidence creates a question of fact for the Board, whose determinations are upheld if supported by substantial evidence.

Workers' CompensationWillful Intent to InjureUnexplained AccidentStatutory PresumptionSubstantial EvidencePsychiatric IllnessSuicidal IdeationAppellate ReviewQuestion of FactMedical Testimony
References
11
Case No. ADJ8259163; ADJ8259174
Regular
Apr 29, 2014

RAMON ARCE vs. CARDENAS MARKETS, INC., CARL WARREN

This case involves applicant Ramon Arce's petition for reconsideration after the Workers' Compensation Appeals Board (WCAB) denied his claims for two separate dates of injury. The WCAB adopted the findings of the Workers' Compensation Administrative Law Judge (WCJ), denying reconsideration. The WCJ found that Arce's July 6, 2011, right knee injury was not work-related, based on conflicting testimony and medical records indicating the injury occurred at home and was related to playing soccer. Furthermore, the WCJ found the January 9, 2012, slip and fall injury to be self-inflicted, based on witness testimony suggesting Arce intentionally fell to pursue a claim. The WCAB gave great weight to the WCJ's credibility findings and denied the petition.

Petition for ReconsiderationWCJ reportGarza v. Workmen's Comp. Appeals Bd.credibility findingApplicant's occupationDates of InjuryAlleged Parts of Body InjuredManner in which injury occurredPetitioner's ContentionsLabor Code Section 5903(a)
References
2
Case No. MISSING
Regular Panel Decision
Jan 24, 2005

Claim of Jones v. New York State Department of Correction

The claimant, a bus driver for the New York City Department of Correction, sustained work-related injuries to her right shoulder and back in September 1998. After surgery in 1999, she sought treatment in 2001 for left shoulder pain, alleging it was a consequential injury from favoring her right shoulder. While a Workers’ Compensation Law Judge initially found a causally related consequential injury, the Workers’ Compensation Board reversed this decision. The Appellate Division affirmed the Board's decision, emphasizing the Board's authority to make its own factual findings and resolve conflicting medical evidence. The Board found the self-insured employer’s medical consultant more credible than the claimant’s physician, and its decision was supported by substantial evidence.

Workers' Compensation Board DecisionAppellate DivisionCausal RelationshipConsequential InjuryCredibility of WitnessesConflicting Medical EvidenceShoulder InjuriesBus DriverNew York City Department of CorrectionAffirmed Decision
References
3
Case No. MISSING
Regular Panel Decision
May 23, 2001

Reno v. County of Westchester

The plaintiffs appealed an order from the Supreme Court, Westchester County, which dismissed their third and fifth causes of action for personal injuries against the County of Westchester for failure to state a cause of action. The appellate court affirmed the lower court's decision. It was determined that the plaintiffs failed to adequately state causes of action for intentional infliction of emotional distress or intentional tort under a theory of respondeat superior. Furthermore, the negligence claims were properly dismissed because they were barred by the exclusivity provisions of the Workers’ Compensation Law, as plaintiff Robert Reno had already received Workers' Compensation benefits for his injuries.

Personal InjuryMotion to DismissCPLR 3211Intentional Infliction of Emotional DistressRespondeat SuperiorWorkers' Compensation LawExclusivity ProvisionAppellate ReviewCounty LiabilityNegligence
References
6
Case No. ADJ9352393, ADJ9352398, ADJ9531390
Regular
Apr 21, 2016

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

This case consolidates three workers' compensation claims for applicant Norman Weseman. The Appeals Board affirmed findings that claims against Superior Ready Mix (ADJ9531390) and the City of Cathedral City (ADJ9352398) for heart/hypertension and firefighter injuries were not barred by the statute of limitations. However, the Board rescinded a finding regarding a specific injury claim against the City of Cathedral City (ADJ9352393) due to insufficient medical evidence on the injury's manifestation date and returned it for further proceedings. The core legal issue concerns when the statute of limitations begins to run for latent industrial injuries.

WORKERS' COMPENSATION APPEALS BOARDNorman WesemanCity of Cathedral CitySuperior Ready MixADJ9352393ADJ9352398ADJ9531390Findings and OrdersReconsiderationStatute of Limitations
References
2
Case No. MISSING
Regular Panel Decision

Kesick v. Ulster County Self Insurance Plan

Paul Kesick, a police officer, was involved in two automobile accidents, leading to workers' compensation claims for knee injuries. Kesick and his wife settled a personal injury action against the drivers for $50,000 and $75,000 without the consent of the Ulster County Self Insurance Plan, their workers' compensation carrier. The Supreme Court granted their application for a nunc pro tunc order approving the settlement but denied the carrier's request for a workers' compensation lien against the settlement proceeds. The carrier appealed, arguing it was entitled to a lien for amounts exceeding $50,000, which are not considered first-party benefits. The appellate court agreed, modifying the order by granting the carrier a lien of $5,969.49 to be held in escrow, preventing an impermissible double recovery for the petitioners.

Workers' Compensation LawLienSettlementThird-Party ActionFirst-Party BenefitsNo-Fault Insurance LawDouble RecoveryAutomobile AccidentAppellate CourtStatutory Interpretation
References
3
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. ADJ2100251 (LBO 0332162)
Regular
Jan 15, 2013

JO ELLEN ANDERSON vs. CITY OF RANCHO, Permissibly Self-Insured, SUBSEQUENT INJURIES BENEFITS TRUST FUND, YORK INSURANCE

The Workers' Compensation Appeals Board granted reconsideration to address issues concerning permanent disability apportionment and Subsequent Injuries Benefits Trust Fund (SIF) eligibility. The applicant sustained an industrial injury in 2000, with prior significant rheumatoid arthritis and multiple surgeries. The Board rescinded the prior award, finding that the original apportionment of permanent disability between the employer and SIF was unsupported by the necessary factual findings. The case is returned for further proceedings to determine the extent of pre-existing disability and proper apportionment under Labor Code sections 4751, 4663, and 4664(a).

Subsequent Injuries Benefits Trust FundLabor Code section 4751permanent total disabilityapportionmentrheumatoid arthritischronic pain syndromepermanent stationary dateLabor Code section 4664(a)Labor Code section 4663preexisting disability
References
4
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