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

Case No. 03-03-00435-CV
Regular Panel Decision
Jul 29, 2004

Texas Workers' Compensation Commission Richard Reynolds, in His Official Capacity as Executive Director of the Texas Workers' Compensation Commission/East Side Surgical Center Clinic for Special Surgery And Surgical and Diagnostic Center, L.P. v. East Side Surgical Center Clinic for Special Surgery/Texas Workers' Compensation Commission Richard Reynolds, in His Official Capacity as Executive Director of the Texas Workers' Compensation Commission

This case involves the Texas Workers’ Compensation Commission's failure to establish fee guidelines for ambulatory surgical centers under the Texas Workers’ Compensation Act. East Side Surgical Center, Clinic for Special Surgery, and intervenor Surgical and Diagnostic Center, L.P. (collectively "East Side") sued the Commission to invalidate certain default rules that applied when specific guidelines were absent. The district court declared one rule (133.304(i)) invalid and enjoined its enforcement, citing unlawful delegation of authority. On appeal, the Court of Appeals reversed the district court's judgment regarding the rule's invalidity and dissolved the injunction, citing a Texas Supreme Court decision finding no unlawful delegation. The court affirmed that East Side was not entitled to its usual and customary fee in the absence of specific guidelines.

Workers' CompensationAdministrative LawDelegation of AuthorityRulemakingAmbulatory Surgical CentersJudicial ReviewInsurance CarrierFee GuidelinesFair and Reasonable RatesStatutory Interpretation
References
38
Case No. 2021 NY Slip Op 01018 [191 AD3d 548]
Regular Panel Decision
Feb 16, 2021

Matter of Tenants United Fighting for the Lower E. Side v. City of New York Dept. of City Planning

The Appellate Division reversed a lower court order that had annulled approvals by the New York City Planning Commission (CPC) for new building constructions. The Supreme Court had initially granted petitions from Tenants United Fighting for the Lower East Side and Lower East Side Organized Neighbors. The appellate court held that the Supreme Court should have deferred to the CPC's reasonable interpretation of the New York City Zoning Resolution (ZR). Specifically, the Appellate Division clarified that ZR § 78-043's requirement for findings as a condition precedent only applies to modifications granted by special permit or authorization, not to other types of modifications to large-scale residential developments. Consequently, the petitions were denied and the proceedings dismissed.

Zoning ResolutionLarge-Scale Residential DevelopmentCity Planning CommissionAdministrative LawAppellate ReviewJudicial DeferenceStatutory InterpretationArticle 78 ProceedingNYC ZoningUrban Planning
References
7
Case No. 2022 NY Slip Op 02559
Regular Panel Decision
Apr 20, 2022

Ortega v. Panther Siding & Windows, Inc.

The plaintiff Rene Ortega was injured after falling from a roof while working as a foreman for a subcontractor, Golden Hammer Construction Group, Corp., which was working for Panther Siding & Windows, Inc. Ortega sued Panther Siding & Windows, Inc., alleging violations of Labor Law sections and common-law negligence. The Supreme Court granted the defendant's motion for summary judgment, dismissing the Labor Law § 240 (1) cause of action. On appeal, the Appellate Division, Second Department, affirmed this decision. The court found that Panther Siding & Windows, Inc., established it was neither the general contractor nor an agent of the owner at the accident site, thus lacking the nondelegable duty under Labor Law § 240 (1), and Ortega failed to raise a triable issue of fact.

Personal InjuryFall from heightLabor LawSummary JudgmentAppellate ReviewContractor LiabilitySubcontractorConstruction AccidentElevation-related riskSafety devices
References
4
Case No. MISSING
Regular Panel Decision

Texas Workers' Compensation Commission v. East Side Surgical Center

This case addresses the Texas Workers’ Compensation Commission's failure to establish fee guidelines for ambulatory surgical centers under the Texas Workers’ Compensation Act. East Side Surgical Center and related entities sued the Commission, seeking to invalidate default rules that applied in the absence of specific fee guidelines, arguing an unlawful delegation of fee-setting authority to insurance carriers. The district court initially declared rule 133.304® invalid, but the appellate court reversed this decision, holding that the rule did not constitute an unlawful delegation of the Commission’s authority. The court further clarified that providers are entitled to fair and reasonable reimbursement, not a statutory right to fee guidelines established by rule, and affirmed that East Side was not entitled to its usual and customary fee.

Workers' CompensationFee GuidelinesAdministrative LawStatutory InterpretationDelegation of AuthorityInsurance CarriersAmbulatory Surgical CentersJudicial ReviewDeclaratory ReliefInjunctive Relief
References
19
Case No. 2020 NY Slip Op 05085
Regular Panel Decision
Sep 23, 2020

Wein v. East Side 11th & 28th, LLC

Shane Wein and his wife initiated an action against East Side 11th & 28th, LLC, and SBF Construction, Inc., seeking damages for personal injuries sustained by Mr. Wein during the assembly of a tower crane at a construction site. The plaintiffs alleged violations of Labor Law §§ 200, 240 (1), and 241 (6), along with common-law negligence. The Supreme Court's order was subsequently appealed by both parties. The Appellate Division modified the order, granting the plaintiffs' motion for summary judgment on the Labor Law § 241 (6) claim predicated on 12 NYCRR 23-8.1 (f) (2) (i). Conversely, it granted the defendants' cross-motion, dismissing the Labor Law § 241 (6) claims based on 12 NYCRR 23-8.1 (f) (1) (iv) and 23-8.2 (c) (3), and the Labor Law § 200 claim against SBF Construction, Inc., as modified, the order was affirmed.

Personal InjuryLabor LawSummary JudgmentConstruction AccidentHoist OperationStatutory ViolationAppellate ReviewWorkplace SafetyNegligenceComparative Negligence
References
17
Case No. MISSING
Regular Panel Decision

Zlateff v. Contour Erection & Siding Systems, Inc.

Daniel Zlateff, president and sole shareholder of Z-Boing, Inc., was injured while bungee jumping during an exhibition event. The crane for the event was provided by Contour Erection & Siding Systems, Inc., and the event was planned by Zlateff, Linda Monforte, and Christopher Eberle. Monforte owned the property where the event occurred and also managed Erie Shores, Inc., which operated Calico Jack’s Restaurant. Eberle was the president of Contour. The Supreme Court had previously granted summary judgment dismissing the complaint against the defendants. However, the appellate court reversed this decision, reinstating the complaint, citing material issues of fact that preclude summary judgment. These issues include the existence and identity of a joint venture, the availability of workers’ compensation coverage, and whether Zlateff was an employee or acting independently to further his own business.

Bungee Jumping AccidentSummary Judgment AppealJoint Venture DisputeWorkers' Compensation CoverageEmployment StatusPersonal InjuryNegligencePremises LiabilityCorporate LiabilityAppellate Review
References
1
Case No. 2022 NY Slip Op 00945 [202 AD3d 509]
Regular Panel Decision
Feb 10, 2022

O'Flaherty v. Columbo

Plaintiff Brian O'Flaherty alleges severe, permanent injuries from an assault by employees of defendant Burgess at a construction site. Plaintiff sued multiple defendants, including TJM Construction, a subcontractor, which then initiated third-party actions against plaintiff's employer, Jackson Installation. Jackson Installation moved for summary judgment arguing the claims were barred by Workers' Compensation Law exclusivity provisions as no "grave injury" was alleged. The motion court properly denied Jackson Installation's motion, finding it failed to prima facie establish that plaintiff's injuries were not "grave." The court also found TJM Construction's argument regarding incomplete discovery on plaintiff's medical condition sufficient to deny the motion as premature. The Appellate Division, First Department, unanimously affirmed the lower court's decision.

Construction site injuryAssaultWorkers' Compensation LawGrave injurySummary judgmentCommon-law indemnificationContributionDiscoveryPremature motionAppellate review
References
5
Case No. 2019 NY Slip Op 04251 [172 AD3d 1852]
Regular Panel Decision
May 30, 2019

Matter of Aldea v. Damari Installations Corp.

Claimant Niegel Aldea, a scaffold builder, appealed a Workers' Compensation Board decision denying his claim for benefits for a lower back injury allegedly sustained on September 13, 2016, while lifting planks at work. The Workers' Compensation Law Judge initially established the claim, crediting Aldea's testimony. However, the Board reversed, finding insufficient evidence that a compensable work-related accident occurred and that timely notice was provided. The Appellate Division, Third Department, affirmed the Board's decision, deferring to its credibility assessment and concluding that the decision was supported by substantial evidence. The court found no merit in Aldea's remaining contentions.

Workers' CompensationScope of EmploymentNotice of InjuryCredibility AssessmentSubstantial EvidenceScaffold BuilderBack InjuryAppellate ReviewClaim DenialInjury Causation
References
9
Case No. 2023 NY Slip Op 06781 [222 AD3d 1291]
Regular Panel Decision
Dec 28, 2023

Matter of Reyes v. Nationwide Furniture Installers

Claimant Audis Reyes, a construction worker, established a workers' compensation claim in 2018 for causally-related chronic rhinitis, chronic sinusitis, asthma, and drug-induced diabetes following cleanup work after the World Trade Center attacks. He was initially classified with a permanent partial disability and a 55% wage-earning capacity. Reyes sought reclassification to a total industrial disability, which was denied by a Workers' Compensation Law Judge and subsequently upheld by the Workers' Compensation Board. On appeal, the Appellate Division, Third Department, affirmed the Board's decision, concluding that the Board properly considered vocational factors and that its determination of no total industrial disability was supported by substantial evidence from vocational rehabilitation experts.

Workers' CompensationPermanent Partial DisabilityTotal Industrial DisabilityWage-Earning CapacityVocational FactorsAppellate ReviewSubstantial EvidenceWorld Trade Center ClaimsChronic RhinitisAsthma
References
9
Case No. MISSING
Regular Panel Decision

Gandley v. Prestige Roofing & Siding Co.

The plaintiff appealed orders denying his motion for partial summary judgment on liability under Labor Law § 240 (1). He suffered severe injuries after falling through a skylight on a roof owned by South Huntington Union Free School District while employed by Thermotest, Inc. The defendants, Prestige Roofing & Siding Co. and South Huntington Union Free School District, were aware of a prior similar incident but failed to provide adequate safety devices. The court affirmed that Labor Law § 240 (1) imposes absolute liability on owners and contractors for such failures, and contributory negligence is not a defense. Consequently, the Supreme Court's denial of the plaintiff's motion was reversed, and his motion for partial summary judgment on liability was granted.

Personal InjuryLabor LawWorkplace AccidentSummary JudgmentAbsolute LiabilitySkylight FallConstruction SafetyProximate CauseContributory NegligenceAppellate Review
References
8
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