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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 Krausa v. Totales Debevoise Corp.

Walter Krausa's 1994 claim for silicosis was established, leading to his classification as permanently totally disabled, and his workers' compensation carrier, the State Insurance Fund, became eligible for reimbursement from the Special Disability Fund. After Krausa's death in 2007, his widow filed for death benefits, which were awarded by a Workers’ Compensation Law Judge, who simultaneously discharged the Special Disability Fund from liability. The carrier appealed this decision, seeking continued reimbursement, but the Workers’ Compensation Board denied their request. This appellate court reversed the Board's decision, clarifying that the statutory language regarding the "date of accident or date of disablement" refers to the original disablement date of September 24, 1992, not the date of death, and that death is considered a consequence of the original injury, not a new accident. Therefore, the court concluded that the carrier was indeed entitled to reimbursement from the Special Disability Fund.

Workers' CompensationSilicosisOccupational DiseaseSpecial Disability FundReimbursementDeath BenefitsStatutory InterpretationDate of DisablementDate of AccidentAppellate Review
References
13
Case No. 2018 NY Slip Op 05037 [163 AD3d 558]
Regular Panel Decision
Jul 05, 2018

Matter of Empire State Transp. Workers' Compensation Trust v. Special Funds Conservation Comm.

This case concerns a proceeding initiated by Empire State Transportation Workers' Compensation Trust for judicial approval of a settlement, nunc pro tunc, against the Special Funds Conservation Committee. The underlying issue stemmed from the Trust's failure to obtain consent from the Special Funds for a claimant's personal injury settlement, which led the Workers' Compensation Board to find a waiver of reimbursement rights. After an initial denial by the Supreme Court, the Appellate Division reversed and remitted, affirming the court's discretion in compelling such consent. Upon remittitur, the Supreme Court granted the petition, directing the Special Funds to provide nunc pro tunc consent. The Appellate Division affirmed this subsequent order, concluding that the settlement was reasonable, the delay was adequately explained, and no prejudice was demonstrated against the Special Disability Fund.

Workers' CompensationNunc Pro TuncSettlement ApprovalPersonal Injury ActionSpecial Funds Conservation CommitteeAppellate DiscretionReimbursement WaiverJudicial ReviewAppellate PracticeNassau County
References
14
Case No. MISSING
Regular Panel Decision

Vandever v. Voris

This case is an appeal from a compensation order entered by former Deputy Commissioner Voris under the Longshoremen’s and Harbor Workers’ Compensation Act. The order concerned Libellant C. M. Vandever, who suffered a 40% permanent partial disability in 1948, which combined with a previous 60% permanent partial disability from 1939, resulted in total permanent disability. The Deputy Commissioner had ordered the employer and its insurance carrier to pay $10,000 for the second injury, with the expectation that the remainder for total permanent incapacity would come from the Special Fund. The Libellant sought payment for total permanent disability, either directly or from the Special Fund. The present Deputy Commissioner moved for a remand, suggesting an error in the previous determination, but this motion was overruled. The central controversy involved the interpretation of section 8(f) and section 44 of the Act, specifically whether these sections applied only to specific member injuries or also to general injuries. The court affirmed the original award, holding that section 8(f) is not limited to specific injuries and that the Libellant is entitled to the balance of compensation for total permanent disability from the Special Fund.

Longshoremen's and Harbor Workers' Compensation ActPermanent Partial DisabilityPermanent Total DisabilitySecond Injury FundSpecial FundSubsequent InjuryDisability CompensationWage Earning CapacitySpinal InjuryPrior Injury
References
1
Case No. 2024 NY Slip Op 06200
Regular Panel Decision
Dec 11, 2024

Matter of NYAHSA Servs., Inc. v. Special Funds Group

This case concerns an appeal by NYAHSA Services, Inc., the workers' compensation insurance carrier for St. Patrick's Nursing Home, from an order denying its petition for judicial approval of a personal injury settlement nunc pro tunc. The underlying matter involved Karen DiNoia, who sustained injuries in 2001 during employment and settled a third-party personal injury action in 2005 for $400,000. Although NYAHSA consented, the Special Funds Group's consent was not obtained at the time, which is crucial for the carrier to be reimbursed from the Special Disability Fund. The Supreme Court dismissed the petition, citing a lack of required documentation. However, the Appellate Division, Second Department, reversed the decision, finding that the settlement was reasonable, the delay in seeking judicial relief was not the petitioner's fault, and the Special Funds Group was not prejudiced, thus granting the petition.

Nunc Pro TuncPersonal Injury SettlementJudicial ApprovalAppellate ReviewSpecial Disability FundInsurance Carrier ReimbursementSupreme Court DiscretionDelayPrejudiceReasonableness of Settlement
References
10
Case No. MISSING
Regular Panel Decision

Claim of Hakam v. Herman H. Schwartz, Inc.

This case concerns an appeal from a Workmen's Compensation Board decision filed March 10, 1971, which discharged the Special Disability Fund from liability under Workmen’s Compensation Law § 15(8). The claimant suffered a compensable myocardial infarction in 1963, resulting in a permanent partial disability, and another in 1968 while working for the appellant employer. The employer sought reimbursement from the Special Disability Fund, leading to a hearing on the employer's prior knowledge of the claimant's pre-existing impairment. The Referee discharged the Fund, and the Board affirmed this decision. The court, citing Matter of Bellucci v. Tip Top Farms, affirmed the Board's decision, finding substantial evidence in the record to support the Board's findings on the issues of employer knowledge and informed decision.

Workers' CompensationSpecial Disability FundReimbursementMyocardial InfarctionPermanent Partial DisabilityEmployer KnowledgePre-existing ImpairmentInformed DecisionAppellate Review
References
1
Case No. 2020 NY Slip Op 03711 [185 AD3d 1133]
Regular Panel Decision
Jul 02, 2020

Matter of Pratt v. Gowanda Nursing Home

Claimant Viola B. Pratt injured her back in 2000 while working as a nurse's aide. The employer's carrier sought reimbursement from the Special Disability Fund under Workers' Compensation Law § 15 (8) due to a prior injury. They relied on a pretrial conference statement signed by the Special Funds Conservation Committee (SFCC) conceding applicability. The Workers' Compensation Board discharged the Special Disability Fund from liability, ruling the statement was not legally binding as it was never adopted or approved. The carrier appealed, arguing the Special Funds Group should be equitably estopped from denying reimbursement. The Appellate Division, Third Department, affirmed the Board's decision, finding it was not reasonable for the carrier to rely on the unapproved pretrial conference statement.

Workers' CompensationSpecial Disability FundEquitable EstoppelPretrial ConferenceStipulationReimbursementPermanent Partial DisabilityAppellate DivisionWorkers' Compensation BoardPrior Injury
References
2
Case No. MISSING
Regular Panel Decision
Sep 17, 1980

Bass v. Westchester Concrete, Inc.

This case involves an appeal from a Workers’ Compensation Board decision, which was initially filed on March 14, 1980, and later amended on September 17, 1980. The employer's insurance carrier sought reimbursement from the Special Disability Fund under Workers’ Compensation Law § 15(8), claiming a known prior physical impairment of bilateral deafness in the claimant. The record established that the claimant's total disability stemmed from a severe psychoneurotic disorder, with a pre-existing psychiatric condition materially and substantially exacerbating the present disability due to a compensable accident. However, the appeal found no substantial evidence that the employer had prior knowledge of this psychiatric condition; only the bilateral deafness was known, which was deemed incidental to the current disability. Consequently, the Board's decision, which presumably denied reimbursement, was affirmed, with costs awarded to the Special Disability Fund.

Workers' CompensationSpecial Disability FundReimbursement ClaimPrior Physical ImpairmentBilateral DeafnessPsychoneurotic DisorderPre-existing ConditionEmployer KnowledgeTotal DisabilityCompensable Accident
References
0
Case No. MISSING
Regular Panel Decision
Jul 11, 1996

Claim of Saunders v. Pepsi Cola

On December 28, 1989, the claimant sustained a lower back injury while working, leading to two surgeries and workers' compensation benefits. X-rays revealed a pre-existing condition of spondylolisthesis. The employer's workers' compensation carrier sought to impose liability on the Special Disability Fund under Workers' Compensation Law § 15 (8) (d). The Workers' Compensation Board concluded that the claimant's disability was solely caused by the 1989 accident and discharged the Special Disability Fund. The Appellate Division affirmed this decision, finding substantial evidence that the spondylolisthesis was asymptomatic and did not contribute to the subsequent disability.

Workers' CompensationSpecial Disability FundSpondylolisthesisPre-existing ConditionPermanent Partial DisabilityAsymptomaticApportionmentMedical EvidenceLiabilityWorkers' Compensation Board
References
3
Case No. MISSING
Regular Panel Decision
Apr 04, 2011

Claim of Stevens v. Hotels

The case concerns an appeal from a Workers' Compensation Board decision that found a workers' compensation carrier's application for reimbursement from the Special Disability Fund to be timely. In 2005, the claimant sustained work-related injuries. The carrier filed a claim for reimbursement in September 2009, based on a medical expert's report acknowledging serious preexisting conditions that significantly increased the claimant's disability. The Special Disability Fund contested the claim's timeliness. The Board ruled the claim was timely, determining that the case was "truly closed" in July 2008, and the C-250 form was filed after reopening and prior to a finding of permanency. The Appellate Division affirmed the Board's decision, concluding that substantial evidence supported the finding that the case was closed in July 2008, thus making the subsequent reimbursement claim timely.

TimelinessReimbursementSpecial Disability FundPreexisting ConditionPermanent Partial DisabilityMaximum Medical ImprovementVocational RehabilitationWorkers' Compensation BenefitsRFA-2 FormC-250 Form
References
4
Case No. MISSING
Regular Panel Decision

Claim of McHugh v. Daily Freeman

In 2000, a claimant suffered work-related injuries and began receiving increased workers' compensation benefits due to a second job. In 2004, the employer's workers' compensation carrier sought reimbursement from the Special Disability Fund for these additional benefits. A Workers’ Compensation Law Judge initially denied the application due to an unfiled form. The Workers’ Compensation Board affirmed this denial but noted the carrier's entitlement to future reimbursement upon belated filing. The Special Disability Fund appealed both the Board's October 5, 2006 decision and a WCLJ's January 26, 2007 decision. The appellate court dismissed both appeals as untimely, finding the appeal from the Board's decision was filed outside the 30-day limit and the appeal from the WCLJ's decision lacked prior Board review, thus precluding a review of the underlying merits.

Special Disability FundReimbursement ClaimsAppeal TimelinessAdministrative ReviewJurisdictional IssuesConcurrent Employment BenefitsWorkers' Compensation CarrierAppellate Court DismissalProcedural Defects
References
4
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