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

Case No. ADJ7987695 ADJ7987686
Regular
May 08, 2014

VANESSA BRUCE vs. VALLEY HEALTH SYSTEM/PHYSICIANS FOR HEALTHY HOSPITALS; CRUM & FORSTER AND TRISTAR RISK MANAGEMENT

The applicant, a licensed vocational nurse, sought workers' compensation for injuries sustained when she fell asleep driving home after working three extra hours off the clock due to a coworker's issue. The Workers' Compensation Appeals Board (WCAB) denied her petition for reconsideration. The WCAB found the injury did not arise out of or occur in the course of employment, as the "going and coming rule" applied and neither the "special mission" nor "special risk" exceptions were met. The applicant's decision to stay late was voluntary, not at the employer's request, and falling asleep while driving is a common risk, not a special employment-related hazard.

Workers' Compensation Appeals BoardLicensed Vocational NurseSpecific InjuryNeck InjuryBack InjuryHeadachesCumulative InjurySleep DisorderGoing and Coming RuleSpecial Mission Exception
References
17
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. ADJ9826556
Regular
Aug 05, 2016

Spencer Bachus vs. John F. Kennedy Memorial Hospital, Hi-Desert Medical Center

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded a prior decision finding applicant sustained a work-related viral meningitis injury. Defendants argued insufficient medical evidence linked the injury to employment and that the identified virus was not definitively work-acquired. The WCAB determined the existing medical evidence, particularly the Qualified Medical Evaluator's opinions, did not sufficiently establish a special risk of exposure due to the applicant's specific job duties. The case was returned for further development of the record, including a more detailed analysis of the applicant's job tasks and potential exposure risks, and potentially a new medical evaluation by an infectious disease specialist.

Workers' Compensation Appeals BoardViral meningitisIndustrial injuryDual employmentPanel Qualified Medical Evaluator (PQME)Substantial medical evidenceCausationSpecial riskFurther proceedingsRescinded
References
0
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. ADJ6743541, ADJ6769168
Regular
Nov 03, 2014

DEBORAH PRYOR vs. INSTITUTE FOR REDESIGNED LEARNING, STATE COMPENSATION INSURANCE FUND, SPECIAL NEEDS NETWORK, INC., ENDURANCE INSURANCE COMPANY

State Compensation Insurance Fund (SCIF) sought reconsideration of an arbitrator's decision denying their contribution claim against Endurance Insurance Company. The arbitrator found that the applicant did not sustain a cumulative injury during her employment with Special Needs Network, insured by Endurance, and therefore Endurance was not liable. The Workers' Compensation Appeals Board denied SCIF's petition, adopting the arbitrator's reasoning that there was insufficient evidence of injurious exposure at Special Needs to establish Endurance's liability. The Board concluded that the applicant's symptoms were due to prior cumulative trauma from employment at Institute for Redesigned Learning, not Special Needs.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for ContributionCumulative InjuryDate of InjuryLabor Code Section 5412Labor Code Section 5500.5Injurious ExposureSubstantial EvidenceCompromise and Release Agreement
References
0
Case No. ADJ18302905
Regular
Jul 25, 2025

CHRISTIAN CHAVEZ vs. JETBLUE AIRWAYS CORPORATION, STARR INDEMNITY AND LIABILITY COMPANY

Defendant sought reconsideration of a Findings and Order (F&O) issued on April 15, 2025, by a workers' compensation administrative law judge (WCJ). The WCJ found that the applicant, Christian Chavez, sustained an injury arising out of and in the course of his employment, and that this injury was not barred by the going and coming rule, based on the special risk exception. Defendant contended that there was no evidence to support the application of the special risk exception. The Workers' Compensation Appeals Board reviewed the petition, applicant's answer, and the WCJ's report, ultimately denying the petition for reconsideration and concurring with the WCJ's findings regarding the special risk exception.

Workers Compensation Appeals BoardChristian ChavezJetBlue Airways CorporationStarr Indemnity and Liability CompanyAdjudication Number ADJ18302905Los Angeles District OfficePetition for ReconsiderationFindings and OrderArising out of and in the course of employment (AOE/COE)Going and coming rule
References
12
Case No. MISSING
Regular Panel Decision

Claim of Surianello v. Consolidated Edison Co. of New York, Inc.

The claimant, an electrical construction mechanic, developed lung disease after working at the World Trade Center (WTC) site. He filed workers' compensation claims, and was eventually found permanently totally disabled. The self-insured employer sought reimbursement from the Special Disability Fund, arguing a preexisting lung condition contributed to the disability. The Workers’ Compensation Board denied reimbursement, concluding the disability was solely caused by WTC site exposure. However, the appellate court reversed, citing medical evidence from pulmonologists Carl Friedman and Neil Schacter, which indicated the claimant's overall disability was materially and substantially greater due to a preexisting restrictive lung disease, not just WTC exposure. The case was remitted to the Board for further proceedings.

WTC Site ExposureOccupational Lung DiseaseSpecial Disability FundReimbursement ClaimPreexisting Medical ConditionPermanent Total DisabilityCausationMedical Expert OpinionAppellate ReviewWorkers' Compensation Board
References
7
Case No. 2016 NY Slip Op 02965 [138 AD3d 927]
Regular Panel Decision
Apr 20, 2016

Jardin v. A Very Special Place, Inc.

Jean-Paul Jardin, injured in a construction site fall from an unsecured ladder, sued A Very Special Place, Inc. (VSP) and Kang Suk Construction, Inc. under Labor Law § 240(1). VSP sought contractual indemnification from Kang Suk and Trinity Interior Coatings, Inc. The Appellate Division affirmed the denial of Jardin's summary judgment motion due to factual disputes regarding his site authorization. However, the court modified a prior order, granting VSP conditional summary judgment for contractual indemnification against Kang Suk, finding VSP free from negligence. VSP's claim against Trinity was denied as their indemnification agreement was signed after the accident and lacked retroactive intent.

Construction Site AccidentLadder SafetyLabor Law ViolationContractual IndemnificationSummary JudgmentThird-Party LiabilitySubcontractor AgreementsRetroactive Contract ApplicationAppellate Division ReviewPersonal Injury Litigation
References
16
Case No. MISSING
Regular Panel Decision

Claim of McLeod v. Ground Handling, Inc.

This case addresses whether an accident occurring on a public street, away from the immediate place of employment but near the workplace, arose out of and in the course of employment. The court examined the 'gray area' where risks of street travel merge with employment risks, emphasizing the need for a special hazard at the accident point and a close association of the access route with the premises. The Board found no special hazard on the county road, which was used by the general public and not controlled by the employer. Consequently, the accident was deemed a risk shared by the general public, not related to the claimant's employment. The decision affirming the Board's finding that the injury did not arise out of and in the course of employment was upheld.

Workers' CompensationCourse of EmploymentOff-premises AccidentSpecial Hazard RuleStreet RiskGoing and Coming RulePublic RoadAccess RouteEmployer ControlAppellate Review
References
5
Case No. MISSING
Regular Panel Decision

Claim of Roberts v. Agway, Inc.

This case involves an appeal from a Workers' Compensation Board decision that found an occupational disease and resulting death of claimant's husband due to harmful dust exposure during employment, discharging the Special Disability Fund. Appellants, the employer Agway, Inc. and its insurance carrier, contended that the claim should be reimbursable from the Special Disability Fund under provisions relating to silicosis or other dust diseases. The decedent had incurred chronic bronchitis, diffuse pulmonary emphysema, and chronic corpulmonale, resulting in his death. The court affirmed the prior award to the claimant, stating that cereal grain exposure is not a 'dust disease' covered by the specific Workers' Compensation Law sections for reimbursement from the Special Disability Fund. The board's decision, supported by unanimous medical opinion that the decedent did not suffer from silicosis or other pneumoconiosis, was affirmed.

Occupational DiseaseDust DiseaseWorkers' Compensation LawSpecial Disability FundCausal RelationshipChronic BronchitisPulmonary EmphysemaChronic CorpulmonaleSilicosisPneumoconiosis
References
6
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