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Case Law Database

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

Case No. 2013-1461 K C
Regular Panel Decision
Mar 16, 2016

Performance Plus Med., P.C. v. Nationwide Ins.

This case involves an appeal by Performance Plus Medical, P.C., acting as an assignee, against Nationwide Ins. The plaintiff sought to recover assigned first-party no-fault benefits. The Civil Court had previously granted the defendant's motion for summary judgment, leading to the dismissal of the complaint. The Appellate Term affirmed this order, ruling that the defendant's timely verification request tolled the insurer's time to pay or deny the claim, thus rendering the plaintiff's action premature due to a failure to respond to the request. Additionally, the court found that the defendant had successfully demonstrated a prima facie case for denying claims related to the first cause of action based on the workers' compensation fee schedule, which the plaintiff failed to rebut.

No-fault benefitsSummary judgmentVerification requestInsurer's time to payPremature actionWorkers' compensation fee scheduleAppellate reviewCivil Court orderFirst-party benefitsAssigned claims
References
2
Case No. 2017 NY Slip Op 00122 [146 AD3d 488]
Regular Panel Decision
Jan 10, 2017

Nunez v. Park Plus, Inc.

Emilio Nunez was injured at a parking lot owned by DeSoto Parking, LLC, while employed by Little Man Parking, LLC, when a mechanical lift caused the amputation of his toe. DeSoto moved for summary judgment arguing the claim was barred by Workers' Compensation Law § 11, contending Nunez did not suffer a grave injury and was its special employee, and that there was a written indemnity agreement with Park Plus, Inc. The Supreme Court denied the motion. The Appellate Division affirmed the denial, agreeing Nunez did not suffer a grave injury, but found factual issues regarding DeSoto being an alter ego of Little Man Parking, LLC, and the existence of an indemnity agreement. It also concluded DeSoto failed to establish Nunez as a special employee.

Workers' CompensationGrave InjurySummary JudgmentAlter EgoIndemnification AgreementSpecial EmployeeToe AmputationPersonal InjuryAppellate ReviewParking Lot Accident
References
4
Case No. MISSING
Regular Panel Decision

Henry v. Rehab Plus Inc.

Keith Henry sued Rehab Plus, Inc., for injuries sustained while wearing a back support belt manufactured by the defendant. The plaintiff alleged negligence, strict products liability, breach of implied warranty, breach of express warranty, and unfair and deceptive trade practices. The defendant moved for summary judgment on all claims. The court granted summary judgment for Rehab Plus on the breach of express warranty and unfair and deceptive trade practices claims, finding a lack of evidence for an express warranty and no misleading conduct. However, the court denied summary judgment on the negligence, strict products liability, and breach of implied warranty claims. It determined that genuine issues of material fact existed regarding the defendant's duty to warn foreseeable users about latent dangers associated with the back support belt and whether the product was fit for its ordinary purpose, thereby precluding summary dismissal of those claims.

Product LiabilityNegligenceStrict Products LiabilityBreach of Implied WarrantySummary JudgmentFailure to WarnProduct DefectBack Support BeltIndustrial SafetyDuty to Warn
References
53
Case No. 2020-08-1004
Regular Panel Decision
Dec 06, 2021

Wright. Rashard v. April Crowder, d/b/a Mr. P's Buffalo Wings Plus

Rashard Wright sustained severe burns while working at Mr. P's Buffalo Wings Plus. He sought temporary disability benefits, medical expense reimbursement, and eligibility for the Uninsured Employers Fund (UEF). The employer, April Crowder d/b/a Mr. P’s Buffalo Wings Plus, lacked workers' compensation insurance. The court ordered the employer to pay Mr. Wright $13,079.80 for medical expenses and $1,720.00 for temporary total disability benefits, finding he would likely prevail on these claims. However, Mr. Wright was denied eligibility for the UEF due to his failure to provide timely notice of his injury to the Bureau.

Workers' CompensationExpedited HearingTemporary Disability BenefitsMedical Expense ReimbursementUninsured Employers FundBurn InjuryWorkplace AccidentEmployer LiabilityNotice RequirementsWage Loss
References
3
Case No. MISSING
Regular Panel Decision
Jun 16, 2006

Fortis Benefits v. Cantu

Vanessa Cantu suffered severe injuries in a car accident and sued multiple parties. Her medical insurer, Fortis Benefits, intervened, seeking subrogation for medical benefits paid under the policy. After Cantu settled with the defendants, Fortis pursued recovery from Cantu. Cantu argued that the equitable "made whole" doctrine barred Fortis's claim because her total losses exceeded the settlement amount plus the benefits Fortis paid. The trial court and court of appeals sided with Cantu. The Texas Supreme Court reversed, holding that the "made whole" doctrine does not override an insurer's clear contractual subrogation rights. The Court affirmed the dismissal of Fortis's claims against Ford due to a pretrial agreement.

Insurance SubrogationMade Whole DoctrineContractual SubrogationEquitable SubrogationERISATexas LawInsurance Policy InterpretationPersonal InjuryAutomobile AccidentSettlement Proceeds
References
28
Case No. MISSING
Regular Panel Decision

Rittgers v. United States

Colbert Rittgers sued the United States of America and the Department of the Army, alleging violations of the Privacy Act of 1974 and the Federal Tort Claims Act (FTCA). Rittgers claimed the government improperly disclosed private information regarding child pornography accusations found on his work computer and used his personal information in employment-related administrative actions, leading to mental distress and lost financial opportunities. The government moved to dismiss the complaint for lack of jurisdiction and failure to state a claim. The court granted the motion, dismissing the Privacy Act claims as time-barred under Rule 12(b)(6). It also dismissed the FTCA claims for invasion of privacy-false light, stigma-plus, defamation-plus, and intentional infliction of emotional distress due to sovereign immunity exceptions under Rule 12(b)(1). Finally, the FTCA claim for abuse of process was dismissed under Rule 12(b)(1) as preempted by the Federal Employees Compensation Act (FECA).

Privacy ActFederal Tort Claims ActSovereign ImmunityMotion to DismissJurisdictionStatute of LimitationsEquitable TollingFederal Employees Compensation ActPreemptionDefamation
References
46
Case No. 2024-60-5319
Regular Panel Decision
Sep 30, 2025

Anderson, Phyllis D. v. SP Plus, Inc.

The employee, Phyllis D. Anderson, reported a left knee injury at work and subsequently filed a petition for benefit determination. After unsuccessful mediation, her attorney withdrew. The employee then failed to appear for multiple status hearings and a show cause hearing, and did not respond to the employer's motion to dismiss. Consequently, the trial court dismissed her petition with prejudice for failure to prosecute. The employee appealed this decision, but failed to file a brief or offer substantive arguments explaining how the trial court erred. The Appeals Board affirmed the trial court's order, concluding that the dismissal for failure to prosecute was within the trial court's discretion, and the issue of dismissal with prejudice was waived due to lack of argument from the employee.

Workers' Compensation AppealsDismissal with PrejudiceFailure to ProsecuteAttorney WithdrawalShow Cause HearingEmployee Non-AppearanceAppellate ReviewTrial Court DiscretionKnee InjuryMediation Failure
References
7
Case No. 2024 NY Slip Op 05006
Regular Panel Decision
Oct 10, 2024

Matter of Brown v. Plans Plus Ltd.

Claimant Janice Brown was injured in a work-related accident in 2010, resulting in a permanent partial disability and 80% loss of wage earning capacity. She was entitled to 425 weeks of indemnity benefits. Prior to their exhaustion, she sought an extreme hardship redetermination to be reclassified to permanent total disability, which the Workers' Compensation Law Judge and subsequently the Workers' Compensation Board denied. The Board interpreted 'extreme hardship' as requiring financial hardship beyond the ordinary, considering claimant's assets, income, and expenses. The Appellate Division, Third Department, affirmed the Board's decision, finding its interpretation and application of the extreme hardship standard rational and supported by substantial evidence, noting claimant's home equity loan and luxury vehicle lease.

Workers' Compensation LawPermanent Partial DisabilityExtreme Hardship RedeterminationWage Earning CapacityIndemnity BenefitsReclassificationPermanent Total DisabilityFinancial HardshipSubstantial EvidenceAppellate Review
References
3
Case No. MISSING
Regular Panel Decision

North Star Reinsurance Corp. v. Continental Insurance

The court addresses the novel legal issue of "preindemnification" and the application of the "antisubrogation rule" in cases involving disputes among insurance carriers over work site injuries. It rejects the "preindemnification" doctrine, which contractors asserted would prioritize owners' insurance coverage over their own, citing lack of support from contractual language, premium disparities, or common-law indemnification principles. However, the court affirms and extends the narrower antisubrogation rule, preventing an insurer from seeking recovery from its own insured for the same risk, even when multiple policies are involved. This rule is applied to bar subrogation claims in the cases of Prince and Valentin, but not in North Star due to specific policy exclusions.

Insurance LawIndemnificationSubrogationPreindemnification DoctrineAntisubrogation RuleWorkers' CompensationGeneral Contractors' Liability (GCL) InsuranceOwners' Contractors' Protective (OCP) InsuranceVicarious LiabilityContractual Obligation
References
29
Case No. MISSING
Regular Panel Decision

Blake v. Plus Mark, Inc.

Mary Blake filed a workers' compensation claim against her employer, Plus Mark, Inc., and the Second Injury Fund, alleging permanent partial disability. The employer filed an answer pleading the statute of limitations and lack of notice, and also a counterclaim seeking a determination of the parties' rights and obligations. The trial court denied Blake's motion for a continuance, after which she took a non-suit to dismiss her complaint without prejudice. The trial court then proceeded on the employer's counterclaim, entering a judgment of no liability for the employer without hearing any proof. On appeal, the Supreme Court reversed the trial court's judgment, finding that while the employer's counterclaim could survive the non-suit, the trial court erred in awarding judgment without proof, and remanded the case for further proceedings.

Workers' CompensationPermanent Partial DisabilityNon-suitCounterclaimDenial of ContinuanceBurden of ProofDeclaratory JudgmentStatute of LimitationsNotice of InjuryAppellate Review
References
9
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