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Case Law Database

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

Case No. MISSING
Regular Panel Decision

Klem v. Special Response Corp.

This case involves an appeal from an order regarding the distribution of settlement proceeds and a workers' compensation lien. The plaintiff sustained an ankle injury during employment and subsequently settled a personal injury action against Special Response Corporation. Zurich Insurance Company, the workers' compensation insurer for the plaintiff's employer, had paid over $114,000 in benefits and claimed a lien against the $70,000 settlement proceeds. The Supreme Court initially ruled that Zurich was not entitled to assert a lien. However, the appellate court reversed this decision, affirming Zurich's right to a lien, but remitted the matter to the Supreme Court for further proceedings to properly calculate the lien amount, taking into account statutory reductions for benefits paid in lieu of first-party benefits and an equitable apportionment of litigation costs, including attorneys' fees.

Workers' CompensationLien RightsSettlement ProceedsPersonal InjuryAppellate ReviewInsurance LawEquitable ApportionmentLitigation CostsFirst-Party BenefitsNo-Fault Law
References
6
Case No. MISSING
Regular Panel Decision
May 05, 2011

Spadaro v. Meza

The plaintiffs appealed an order from the Supreme Court, Kings County, which denied their motion to determine that nonparty respondents Pacific Employers Insurance Company, c/o Gallagher Bassett, and the Special Funds Conservation Committee had no enforceable workers’ compensation lien on settlement proceeds. The injured plaintiff had two workers' compensation claims from accidents in 1998 and 2004. An agreement from 2008 allowed Gallagher Bassett and Special Funds to reserve their right to assert liens on settlement proceeds from the 2004 claim. Plaintiffs argued the lien amounts could not be accurately established due to a lack of apportionment between the claims. The Supreme Court correctly denied the motion, as Gallagher Bassett only made benefit payments related to the 2004 accident, making the lien amount ascertainable. The order was affirmed.

Workers' Compensation LienSettlement ProceedsPersonal InjuriesApportionment of ClaimsInsurance CarrierSpecial Funds Conservation CommitteeLump Sum AwardWaiver of BenefitsSupreme Court AppealCivil Procedure
References
3
Case No. 03-08-00481-CV
Regular Panel Decision
Jul 10, 2009

Resolution Oversight Corporation as Special Receiver of Financial Insurance Company of America v. Arturo Garza

Resolution Oversight Corporation, acting as the special receiver for Financial Insurance Company of America (FIC), sought to enforce FIC's subrogation rights against funds paid by Home State County Mutual Insurance Company to Arturo Garza. Garza, an injured employee, had received workers' compensation benefits from FIC following an automobile accident and subsequently settled a claim with Home State, the uninsured/underinsured motorist (UIM) carrier for his employer, Texas Towing. The trial court initially granted summary judgment in favor of Garza, denying FIC's subrogation interest in the UIM proceeds. On appeal, the court reversed this decision, affirming FIC's valid subrogation lien and rejecting the 'made whole' doctrine for statutory subrogation. The appellate court further determined that Garza was entitled to reasonable attorney's fees from FIC's recovery, remanding the case for their determination.

Workers' CompensationSubrogation rightsUninsured/Underinsured Motorist (UIM) benefitsSummary JudgmentStatutory ConstructionAttorney's FeesInsurer Receivership ActTexas Labor CodeContractual LiabilityThird-party action
References
27
Case No. MISSING
Regular Panel Decision
Jan 27, 1965

Rivera v. Hellman

This case involves a motion to confirm a Special Referee's report concerning the amounts and priorities of various liens. The Special Referee conducted a hearing and reported on claims from an attorney for the plaintiff ($793.50), Roosevelt Hospital ($846.53), and the Millinery Health Fund ($641.00, later adjusted to $528). The report established the amounts of each lien and recommended priorities, placing the attorney's lien first, followed by the hospital lien (except for a $12 outpatient service), and then the compensation lien. The court concurred with the Special Referee's report and recommendations, granting the motion to confirm.

Lien PriorityAttorney's LienHospital LienDisability BenefitsWorkmen's Compensation LawSpecial Referee ReportMotion GrantedNew York Supreme CourtLien LawMotion Practice
References
2
Case No. MISSING
Regular Panel Decision
Feb 05, 1999

Atkinson v. City of New York

This case concerns a CPLR article 78 proceeding initiated by a petitioner against the City of New York. The petitioner sought to prevent the City from imposing a Workers’ Compensation lien on an award received through the National Vaccine Injury Compensation Program. The Supreme Court, Queens County, granted the petition and prohibited the lien. On appeal, the decision was affirmed, with the court reiterating that Workers’ Compensation liens are applicable only against recoveries from third-party tortfeasors responsible for injuries, as per Matter of Shutter v Philips Display Components Co. The court determined that the vaccine injury award did not constitute such a recovery, thus precluding the lien. The case Matter of Ryan v General Elec. Co. was distinguished as involving an award against a tortfeasor under the Military Claims Act.

Workers' Compensation LienNational Vaccine Injury Compensation ProgramCPLR Article 78Third-Party TortfeasorAppellate ReviewStatutory InterpretationLien ProhibitionVaccine Injury AwardMilitary Claims ActNew York Appellate Courts
References
2
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

Kesick v. Ulster County Self Insurance Plan

Paul Kesick, a police officer, was involved in two automobile accidents, leading to workers' compensation claims for knee injuries. Kesick and his wife settled a personal injury action against the drivers for $50,000 and $75,000 without the consent of the Ulster County Self Insurance Plan, their workers' compensation carrier. The Supreme Court granted their application for a nunc pro tunc order approving the settlement but denied the carrier's request for a workers' compensation lien against the settlement proceeds. The carrier appealed, arguing it was entitled to a lien for amounts exceeding $50,000, which are not considered first-party benefits. The appellate court agreed, modifying the order by granting the carrier a lien of $5,969.49 to be held in escrow, preventing an impermissible double recovery for the petitioners.

Workers' Compensation LawLienSettlementThird-Party ActionFirst-Party BenefitsNo-Fault Insurance LawDouble RecoveryAutomobile AccidentAppellate CourtStatutory Interpretation
References
3
Case No. ADJ6981750
Regular
Jan 13, 2017

GUMERSINDO DELEON vs. ESPARZA ENTERPRISES, INC.

This case concerns a lien claimant's failure to pay a $100.00 lien activation fee required by Labor Code section 4903.06 by the date of a lien conference. The Workers' Compensation Appeals Board (WCAB) is considering rescinding the order dismissing the lien, but only if the fee is paid within ten days of this notice. The WCAB's intention is based on a court order allowing lien activation fees to be paid between November 9, 2015, and December 31, 2015, and the lien claimant's assertion of computer problems. If payment is received, the lien claim will be returned to the trial level for further proceedings.

Lien activation feeLabor Code Section 4903.06ReconsiderationOrder Dismissing Lien ClaimWCJDWCAngelotti Chiropractic v. BakerPreliminary injunctionNinth CircuitVacating injunction
References
7
Case No. ADJ1035201
Regular
Oct 04, 2016

VICTOR DURAN vs. DONUT INN, STATE FARM INSURANCE COMPANY

The Appeals Board is considering rescinding an order that dismissed Metro Med Shockwave's lien claim for failure to pay a $\$100$ lien activation fee. The WCJ dismissed the lien because the fee was not paid before the lien conference, citing prior precedent. However, the lien claimant argues they had until December 31, 2015, to pay the fee based on a DWC Newsline article referencing a court order. The Board intends to rescind the dismissal if the fee is paid within ten days, allowing further proceedings on the lien claim.

Labor Code section 4903.06Lien activation feeWorkers' Compensation Appeals BoardMetro Med ShockwaveFigueroa v. B.C Doering Co.Angelotti Chiropractic v. BakerPreliminary injunctionDWC NewslineReconsiderationRescind order
References
2
Case No. MISSING
Regular Panel Decision
Apr 13, 1973

Vic's Auto Body & Repair v. Granito

This case concerns an Article 78 proceeding challenging the denial of a special exception permit for an automobile body and fender repair shop. Initially, the Supreme Court, Nassau County, annulled the denial and directed the issuance of the permit. However, the appellate court reversed this judgment, reinstating the appellants' original determination and dismissing the petition. The appellate court found that the appellants' denial was supported by evidence of potential noise, fumes, visual blight from wrecked cars, the residential nature of the vicinity, and the severe negative impact on a neighboring medical practice. The court concluded that the proposed use failed to meet the standards for a special exception permit.

Special Exception PermitZoning DenialAutomobile Repair ShopNuisanceResidential CharacterMedical Practice ImpactCPLR Article 78Abuse of Discretion ReviewProperty ValueAppellate Review
References
1
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