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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. 10-96-146-CV
Regular Panel Decision
Dec 17, 1997

William T. Dub Draper v. Rockett Special Utility District

William T. "Dub" Draper sued his former employer, Rockett Special Utility District, for wrongful discharge, alleging both retaliation for filing a worker's compensation claim and breach of contract. The trial court granted summary judgment for Rockett on both claims and imposed discovery sanctions against Draper. The appellate court affirmed the summary judgment on the breach of contract claim, finding that Rockett's administrative policies did not alter the at-will employment relationship. However, the court reversed the summary judgment on the retaliatory discharge claim, concluding that material fact issues existed regarding Draper's alleged misconduct and his ability to perform job functions. The appellate court also upheld the discovery sanctions imposed by the trial court, deeming them just and serving the legitimate purposes of discovery sanctions. The retaliatory discharge claim was remanded to the trial court for further proceedings consistent with the opinion.

Wrongful DischargeRetaliatory DischargeWorker's CompensationSummary JudgmentBreach of ContractAt-Will EmploymentDiscovery SanctionsAbuse of DiscretionAppellate ReviewTexas Law
References
23
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. 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. 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
Feb 08, 2013

Claim of Pankiw v. Eastman Kodak Co.

The case involves an appeal from a Workers’ Compensation Board decision regarding the shifting of liability to the Special Fund for Reopened Cases under Workers’ Compensation Law § 25-a. Claimant, who suffered work-related injuries in 2004, had a 20% schedule loss of use of his left arm opined in 2007, and a consequential right shoulder injury was added in 2008 with a 30% schedule loss of use, for which the Special Fund became liable. In 2011, claimant sought further action, leading a WCLJ to transfer liability to the Special Fund. However, the Board reversed, finding the case was not "truly closed" because the issue of the left arm injury remained unaddressed. The Appellate Division affirmed the Board's decision, holding that the lack of resolution on the left arm injury meant further proceedings were contemplated, thus preventing the case from being deemed truly closed for liability transfer to the Special Fund.

Workers' CompensationSpecial Fund for Reopened CasesSchedule Loss of UseConsequential InjuryCase ClosureLiability ShiftAppellate DivisionFactual DeterminationCompensation PaymentsUnaddressed Issues
References
5
Case No. MISSING
Regular Panel Decision
Dec 08, 1961

SPECIAL PRODUCTS COMPANY OF TENN. v. Jennings

Sixty-two striking employees of Special Products Company claimed unemployment benefits after their jobs were filled during a labor dispute. The Commissioner and Board of Review allowed these claims, a decision upheld by the Chancery Court of Hamilton County. Special Products Company appealed to the Supreme Court of Tennessee, arguing against benefit payments and seeking a non-charge against its experience rating. The Supreme Court affirmed the lower court's decree, ruling that the disqualification for a labor dispute ceased once the strike was abandoned and employees sought re-employment. The Court found that the subsequent unemployment was due to the unavailability of jobs, not the strike itself, thereby entitling the former employees to benefits.

Unemployment BenefitsLabor DisputeStrikeJob ReplacementsEmployment Security ActVoluntary Quitting DisqualificationMisconduct DisqualificationExperience Rating PenaltySupreme Court DecisionStrike Termination
References
5
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. MISSING
Regular Panel Decision

Claim of Palermo v. Primo Coat Corp.

The claimant, a seamstress, sustained a work-related right knee injury in 2000 and later had her claim amended to include other ailments, though a consequential left elbow injury remained unresolved. She was permanently disqualified from lost wage benefits in 2005 due to fraudulently collecting workers' compensation benefits, but her medical expenses continued. In 2008, the employer and its carrier sought to shift liability to the Special Fund for Reopened Cases under Workers’ Compensation Law § 25-a, which the Workers' Compensation Board granted. The Special Fund appealed, arguing the case was not truly closed due to the unresolved left elbow injury. The court affirmed the Board's decision, finding that even with outstanding issues related to medical expenses, the case was considered truly closed for compensation purposes as the claimant was disqualified from lost wage benefits.

Workers' CompensationSpecial Fund for Reopened CasesLost Wage BenefitsMedical ExpensesCase ClosureFraudulent CollectionPetit LarcenyLiability ShiftWorkers' Compensation BoardAppellate Review
References
12
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