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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 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. 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 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. MISSING
Regular Panel Decision
Nov 24, 2008

Claim of Clark v. Suny Upstate Medical Center

Claimant injured her back in 1994, leading to a closed case in 1997. Following further work-related injuries in 2001 and 2003, the 1994 claim was reopened in 2004 to address apportionment of liability. The Workers’ Compensation Board determined that the Special Fund for Reopened Cases should assume liability for the 1994 claim under Workers’ Compensation Law § 25-a, a decision which the Special Fund appealed. The Appellate Division affirmed the Board’s decision, finding that the statutory time limits for shifting liability to the Special Fund (more than seven years after injury and more than three years after last payment) were satisfied. The court rejected the Special Fund's contention that the employer's carrier voluntarily paid benefits for the 1994 claim, noting that the carrier had raised the issue of Special Fund liability.

Workers' Compensation LawSpecial Fund for Reopened CasesLiability shiftingCase reopeningApportionmentStatutory time limitsVoluntary paymentsAppellate reviewBack injuryMedical opinion
References
6
Case No. 2015 NY Slip Op 01635
Regular Panel Decision
Feb 25, 2015

Empire State Transportation Workers' Compensation Trust v. Special Funds Conservation Committee

The Empire State Transportation Workers' Compensation Trust (the carrier) appealed an order denying its petition for judicial approval of a settlement nunc pro tunc. The claimant, Licinio Marrero, sustained injuries and settled a personal injury action for $100,000 without obtaining the consent of the Special Funds Conservation Committee (SFCC), which is required when SFCC liability is established prior to settlement. The Supreme Court, Nassau County, denied the carrier's request, believing it lacked discretion to compel such consent. The Appellate Division reversed this decision, clarifying that the Supreme Court does have the discretion to issue a nunc pro tunc order compelling consent if certain conditions are met: the delay was not due to the petitioner's fault, the settlement amount was reasonable, and the SFCC was not prejudiced. The case was remitted to the Supreme Court for it to exercise its discretion.

Workers' Compensation LawSpecial Disability FundNunc Pro Tunc OrderSettlement ApprovalReimbursementPersonal Injury ActionAppellate ReviewJudicial DiscretionCarrier's WaiverConsent Requirement
References
6
Case No. MISSING
Regular Panel Decision

Claim of Fuentes v. New York City Housing Authority

This case concerns an appeal by the Special Fund for Reopened Cases from a Workers’ Compensation Board decision dated November 15, 2006. The Board had transferred liability for a claimant's 1998 work-related back injury to the Special Fund, pursuant to Workers’ Compensation Law § 25-a. The Special Fund argued that certain payments made to the claimant in late 2005, between November 30 and December 17, were advance payments of compensation, which would preclude the transfer of liability. However, the Board found that these payments were charged to the claimant's accumulated sick leave and did not constitute advance payments of compensation. The court affirmed the Board's finding, concluding that the sick leave payments did not prevent the transfer of liability to the Special Fund because they were not made voluntarily in recognition of employer liability, and thus, the criteria for transferring liability to the Special Fund were met.

Special Fund for Reopened CasesWorkers' Compensation Law Section 25-aAdvance Payments of CompensationSick Leave PlanLiability TransferStale ClaimApplication to Reopen ClaimWork-Related InjuryBack InjuryTreating Physician Report
References
7
Case No. MISSING
Regular Panel Decision
Dec 14, 2007

Lynch v. Buffalo Bills, Inc.

The Workers' Compensation Board ruled that liability shifted to the Special Fund for Reopened Cases pursuant to Workers' Compensation Law § 25-a for a claimant with a permanent partial disability whose case was closed. The self-insured employer requested discharge to the Special Fund after seven years from injury and three years from the last payment. The Board affirmed the transfer of liability and the bifurcation of a new claim for reduced earnings. The Special Fund appealed. The court affirmed the Board's findings regarding the case closure and liability transfer but modified the decision, holding that the claimant's recovery was limited to payments by the Special Fund for the two-year period prior to the application, thus reversing the directive for payments by the self-insured employer.

Reopened CasesSpecial Fund LiabilityPermanent Partial DisabilityReduced Earnings ClaimWorkers' Compensation BoardStatutory InterpretationTimeliness of ApplicationEmployer DischargeAppellate ReviewCase Closure
References
10
Case No. MISSING
Regular Panel Decision

Matter of Guadagno v. RIC Steel Erectors

Claimant suffered a work-related injury in 1981, with the State Insurance Fund (SIF) paying benefits until 1989. In 2001, SIF sought to transfer liability to the Special Fund for Reopened Cases, which was approved by the Workers’ Compensation Board in 2007, effective October 23, 1999. The Special Fund subsequently reimbursed SIF $680,581.92 for medical expenses. SIF then requested $315,651.14 in interest on these reimbursements under Workers’ Compensation Law § 25 (1) (f). A Workers’ Compensation Law Judge initially awarded limited interest, but the Board reversed, finding § 25 (1) (f) inapplicable to transfers under § 25-a. This court affirmed the Board's decision, holding that § 25 (1) (f) is intended for controversies where the Board directs immediate payment pending a liability dispute, a situation not present here as SIF was obligated to pay until liability transfer.

Workers' CompensationSpecial FundReopened CasesInterest PaymentMedical ExpensesStatutory InterpretationLiability TransferAppellate ReviewReimbursementWorkers' Compensation Board
References
5
Case No. MISSING
Regular Panel Decision

De Mayo v. Rensselaer Polytech Institute

The Workers' Compensation Board directed the Special Fund for Reopened Cases to pay a penalty to a claimant under Workers’ Compensation Law § 25 for failing to timely pay an award. The Special Fund appealed this decision, contending that the penalty provision applied only to employers or insurance carriers, not to them. The court, however, disagreed with the Special Fund's interpretation. Citing prior case law, the court held that the Special Fund, once liable for compensation benefits due to the passage of time, stands in the shoes of the carrier regarding the obligation to make timely payments. Therefore, the court affirmed the Board's decision to impose the penalty, emphasizing the legislative policy for prompt compensation payments to injured workers.

Workers' CompensationPenaltyTimely PaymentStatutory InterpretationSpecial FundReopened CasesInsurance CarrierAppellate ReviewStatutory ConstructionLegislative Intent
References
5
Case No. MISSING
Regular Panel Decision

Rogers v. Labs

A claimant sustained a right hand injury in 1993, receiving workers' compensation benefits. The case was later reopened to include carpal tunnel syndrome, and then closed in 2003 regarding the right hand injury. In 2006, the case was reopened again, addressing the liability of the Special Fund for Reopened Cases under Workers’ Compensation Law § 25-a. Both the WCLJ and the Workers’ Compensation Board determined that liability had shifted to the Special Fund. The Special Fund appealed, contending the Board failed to rationally explain its departure from prior precedent. The appellate court agreed with the Special Fund, reversing the Board's decision and remitting the matter for further proceedings consistent with its ruling.

Workers' Compensation Law § 25-aSpecial Fund for Reopened CasesBoard PrecedentAppellate ReviewRemittalLiability ShiftSchedule Loss of UseCarpal Tunnel SyndromeAdministrative LawJudicial Review
References
6
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