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

Case No. 05-CV-1573
Regular Panel Decision

Magin v. Cellco Partnership

This action was brought under ERISA by David Magin against Verizon Wireless entities and MetLife Corporation after his short-term disability benefits were denied. Plaintiff also implicitly sought long-term disability benefits. The court considered cross-motions for summary judgment. Applying an arbitrary and capricious standard of review, the court found MetLife's denial of short-term disability benefits was not an abuse of discretion, citing a lack of material medical evidence. The claim for long-term disability benefits was dismissed as it was never properly filed. Consequently, the defendants' motion for summary judgment was granted, and the plaintiff's complaint was dismissed.

ERISADisability BenefitsShort Term DisabilityLong Term DisabilitySummary JudgmentAbuse of DiscretionDe Novo ReviewFiduciary DutyClaims DenialMedical Evidence
References
38
Case No. MISSING
Regular Panel Decision

Medoy v. Warnaco Employees' Long Term Disability Insurance Plan

Plaintiff, Audrey Medoy, sued Warnaco Employees’ Long Term Disability Insurance Plan and Warnaco, Inc. (Defendants) under ERISA, alleging wrongful termination of disability benefits, failure to provide requested documents, and failure to retain claims records. Medoy's disability benefits were discontinued in 1987 without notice. After years of requesting information and appealing the decision, which was hampered by the destruction of her claims file, she filed this action in 1997. Defendants moved to dismiss the complaint, arguing that the claims were untimely, that Medoy was not a 'participant' entitled to disclosure, and that ERISA § 1027 did not cover claims records. The court denied Defendants' motion to dismiss on all grounds, finding her claims timely, her status as a 'participant' colorable, and claims records subject to retention under ERISA § 1027.

ERISALong-term Disability BenefitsStatute of LimitationsFailure to DiscloseRecord RetentionFutility ExceptionAccrual of ActionPlan Administrator DutiesParticipant StatusMotion to Dismiss
References
37
Case No. MISSING
Regular Panel Decision

Rector v. Sylvania

Plaintiff Sylvia Rector sued her former employer, Osram Sylvania, alleging disability discrimination under the Americans with Disabilities Act (ADA) after her termination. Rector suffered a shoulder injury requiring surgery and received short-term and long-term disability benefits. She was eventually cleared to return to work without restrictions, but Sylvania was undergoing a reduction in force and had no available position. The court granted Sylvania's motion for summary judgment, concluding that Rector's temporary shoulder injury did not constitute a disability under the ADA as it lacked the required permanent or long-term impact on a major life activity.

ADADisability DiscriminationSummary JudgmentEmployment LawShoulder InjuryTendonitisImpingement SyndromeTemporary DisabilityMajor Life ActivityReduction in Force
References
15
Case No. 12 Civ. 5645(KPF)
Regular Panel Decision
Feb 18, 2015

Wedge v. Shawmut Design & Construction Group Long Term Disability Insurance Plan

This case involves Plaintiff William Wedge's challenge under ERISA against the Shawmut Plan and Reliance Standard Life Insurance Company (RSLI) for the termination of his long-term disability benefits. Wedge, a former Senior Project Manager, suffered from Central Serous Chorioretinopathy (CSCR) and had his benefits denied by RSLI, which determined he was not "Totally Disabled" under the "Any Occupation" clause. The court applied an arbitrary and capricious standard of review, considering RSLI's structural conflict of interest but finding it warranted minimal weight. Ultimately, the court concluded that RSLI's decision, supported by comprehensive medical and vocational evidence, including an Independent Medical Examination, was reasonable and not arbitrary or capricious. Therefore, Plaintiff's motion for summary judgment was denied, and Defendants' motion was granted.

ERISA LitigationLong Term DisabilityBenefits DenialArbitrary and Capricious ReviewSummary Judgment MotionDiscretionary AuthorityConflict of InterestCentral Serous ChorioretinopathyMedical EvidenceVocational Assessment
References
46
Case No. 2020 NY Slip Op 01694
Regular Panel Decision
Mar 12, 2020

Matter of Christakis v. New York City Tr. Auth.

Petitioner Gregorios Christakis appealed a Supreme Court judgment denying his petition to annul the New York City Transit Authority's denial of short-term disability benefits. Christakis, a General Superintendent, sought benefits for PTSD after his Workers' Compensation claim was denied. The respondent denied his short-term disability application, citing a prohibition against using sick leave for injury on duty and an alleged ineligibility for those who filed Workers' Compensation, neither of which was explicitly stated in policy. The Appellate Division found the denial arbitrary and capricious because the respondent failed to notify Christakis of the true reason, there was no risk of 'double-dipping' as the Workers' Compensation claim had been denied, and the sick leave exhaustion argument was disingenuous. The court reversed the lower court's decision, granted the petition, and remanded the matter for calculation of petitioner's benefits.

Disability BenefitsShort Term DisabilityWorkers' CompensationArticle 78 PetitionArbitrary and CapriciousAdministrative LawSick LeavePost-Traumatic Stress DisorderBenefit DenialJudicial Review
References
4
Case No. MISSING
Regular Panel Decision
Nov 06, 2012

Brooklyn Center for Independence of Disabled v. Bloomberg

This case, initiated shortly after Hurricane Irene in 2011, addresses whether New York City's emergency preparedness plans adequately serve individuals with disabilities. Non-profit organizations and individual plaintiffs sued the City of New York and Mayor Michael R. Bloomberg, alleging a systemic failure to meet the needs of disabled persons, in violation of the Rehabilitation Act, Americans with Disabilities Act, and New York City Human Rights Law. Specific concerns include inaccessible public transportation for evacuations, lack of high-rise evacuation strategies, ineffective emergency shelters, and insufficient provisions for immediate assistance for people with disabilities. The court found that the plaintiffs had standing to bring their claims and subsequently granted their motion for class certification, with a modified class definition, allowing the case to proceed as a class action.

Disability RightsEmergency PreparednessClass ActionAmericans with Disabilities ActRehabilitation ActNew York City Human Rights LawHurricane IreneMobility DisabilitiesPublic SafetyInjunctive Relief
References
53
Case No. MISSING
Regular Panel Decision

Mylette v. Mylette

The plaintiff moved to have the defendant's disability pension, from the New York City Police Pension Fund, classified as a marital asset subject to equitable distribution under Domestic Relations Law § 236 (B) (4) (b). The defendant, a former New York City police officer, received the disability pension after a line-of-duty knee injury, terminating his employment after 12 years, short of the 15 years required for vesting. The court reviewed legal precedents from various states and New York, which generally treat disability pensions as separate property, particularly when compensating for personal injuries rather than deferred compensation. The court found that the defendant's pension was purely compensation for his injury, distinguishing it from retirement benefits, and that he had no option to choose a regular retirement package. Therefore, the court denied the plaintiff's motion, ruling that the disability pension is the defendant's separate property.

Domestic Relations LawDisability PensionMarital PropertyEquitable DistributionSeparate PropertyPolice Pension FundPersonal Injury CompensationNonvested BenefitsFamily LawProperty Classification
References
31
Case No. MISSING
Regular Panel Decision

Short v. Durez Division-Hooker Chemicals & Plastic Corp.

Terry Short, an employee of Davis Refrigeration Company, sustained injuries while climbing a ladder at a plant owned by Occidental Chemical Corporation (OCC). He and his wife initiated an action against OCC, asserting a claim under Labor Law § 240 (1). Defendants sought summary judgment, arguing the claim was precluded by Workers’ Compensation Law and that Short was engaged in routine maintenance. Plaintiffs cross-moved for partial summary judgment. The Supreme Court denied defendants’ motion to dismiss based on Workers’ Compensation Law, citing factual disputes regarding special employment status. However, the court erred in granting defendants’ motion for summary judgment on the Labor Law § 240 (1) claim, as there was an issue of fact concerning whether Short's activity constituted routine maintenance or protected repair work. Consequently, the appellate court modified the order, denying defendants' motion for summary judgment on the Labor Law § 240 (1) cause of action and reinstating it, while also denying the plaintiffs' cross-motion for partial summary judgment.

Labor Law 240(1)Workers' Compensation LawSummary Judgment MotionSpecial Employment DoctrineRoutine Maintenance ExceptionConstruction WorkLadder AccidentFactual DisputeAppellate ReviewOrder Modification
References
9
Case No. MISSING
Regular Panel Decision

Lampo v. Eastman Kodak Co.

The claimant appealed three decisions by the Workers' Compensation Board that denied additional disability benefits and rejected an application for reconsideration of a discrimination claim. The court found substantial evidence in Dr. David Smith's testimony, which indicated normal visual performance, supporting the Board's conclusion that the claimant had no loss of visual acuity. It was also noted that the claimant received 26 weeks of disability payments, and the employer's long-term disability plan, which exceeds state requirements, is governed solely by ERISA. The Board's decision to deny reconsideration of the discrimination claim was deemed neither an abuse of discretion nor arbitrary, as no new evidence was presented. Consequently, the court affirmed the Board's decisions.

Workers' Compensation BoardDisability BenefitsVisual AcuityERISADiscrimination ClaimReconsideration DenialSubstantial EvidenceCredibility IssueAppellate ReviewAffirmed Decision
References
3
Case No. MISSING
Regular Panel Decision

Smith v. New York State & Local Retirement Systems

Petitioner, a taxpayer services representative, sustained a back injury in March 1981 while lifting forms, leading to a decline in attendance and eventual termination in November 1989. She applied for accidental and ordinary disability retirement benefits, both of which were denied by the Comptroller. The accidental disability claim was denied because the incident was not deemed an 'accident' under Retirement and Security Law § 63. The ordinary disability claim was denied as untimely, having been filed approximately six months after her termination, exceeding the 90-day limit stipulated by Retirement and Social Security Law § 62. The Supreme Court dismissed the challenge to the ordinary disability denial due to untimeliness and transferred the accidental disability challenge to this Court. This Court confirmed the Comptroller's determination on both counts, rejecting the petitioner's estoppel argument regarding the untimely ordinary disability application and finding substantial evidence to support the finding that the injury did not constitute an 'accident' within the meaning of the relevant law, as it resulted from ordinary employment duties without an unexpected event.

Disability Retirement BenefitsAccidental DisabilityOrdinary DisabilityUntimely ApplicationEstoppel Against GovernmentWork-Related InjuryBack InjuryDefinition of AccidentOrdinary Employment DutiesSubstantial Evidence Review
References
16
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