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

Case No. 533112
Regular Panel Decision
Mar 17, 2022

Matter of Reyes v. H & L Iron Works Corp.

A claimant appealed a Workers' Compensation Board decision which found he violated Workers' Compensation Law § 114-a and permanently disqualified him from future indemnity benefits. The claimant, Leonel Reyes, sustained work-related injuries in 2016 and received benefits. However, he failed to fully disclose his disc jockey activities and the physical nature of this work to the Board, carrier, and examining physicians while collecting benefits. Surveillance videos showed him lifting heavy equipment, contradicting his testimony. The Workers' Compensation Board affirmed the WCLJ's finding of a violation and the imposition of both mandatory and discretionary penalties. The Appellate Division, Third Department, affirmed the Board's decision, concluding that substantial evidence supported the violation and that the permanent forfeiture of indemnity benefits was not a disproportionate penalty given the claimant's multiple egregious misrepresentations.

Workers' Compensation Law § 114-aFalse RepresentationIndemnity BenefitsPermanent DisqualificationUndisclosed EmploymentDisc JockeyMaterial MisrepresentationSubstantial EvidenceWitness CredibilityDiscretionary Penalty
References
7
Case No. 2020 NY Slip Op 02301 [182 AD3d 821]
Regular Panel Decision
Apr 16, 2020

Matter of Community, Work, & Independence, Inc. v. New York State Off. for People with Dev. Disabilities

This case involves a CPLR article 78 proceeding initiated by Community, Work, and Independence, Inc. (petitioner) to challenge a determination affirming the objection to its proposed discharge of M.D., an individual with developmental disabilities, from day habilitation services. M.D.'s parents objected to the discharge, and an administrative hearing sustained their objection, a decision later affirmed by the Commissioner of the Office for People with Developmental Disabilities. The Appellate Division, Third Department, confirmed the Commissioner's determination, finding that the burden of proof was appropriately placed on the service provider. The court concluded that substantial evidence supported the finding that discharging M.D. was not reasonable, considering his needs, the lack of suitable alternative programs, and despite the petitioner's financial concerns. The court suggested that financial issues for service providers should be addressed by seeking increased funding rather than by discharging individuals.

Developmental DisabilityHCBS WaiverDischarge ServicesAdministrative HearingBurden of ProofSubstantial EvidenceFinancial ConcernsService ProviderMedicaid FundingAutism Spectrum
References
7
Case No. MISSING
Regular Panel Decision
Nov 14, 1978

Claim of Spasiano v. Empire City Iron Works

The claimant, a mechanic hired in 1974, suffered a low back injury at work in November 1974. He had a pre-existing medical condition, having undergone subtotal gastrectomy in 1965. The employer's insurance carrier filed a C-250 seeking reimbursement from the Special Fund, alleging a pre-existing permanent physical impairment. To claim reimbursement, it needed to be established that the employer hired or continued the claimant with knowledge of the impairment and a good faith belief in its permanency, and that the impairment materially and substantially increased the disability. Conflicting medical opinions were presented regarding whether the claimant's prior stomach condition materially and substantially increased his disability. The Workers' Compensation Board found, based on medical evidence including Dr. Lehv's report, that the prior stomach condition did not materially and substantially increase the disability. This finding, supported by substantial evidence, led to the affirmation of the Board's decision, discharging the Special Fund from liability.

Workers' Compensation BoardSpecial Fund LiabilityPre-existing ConditionSubtotal GastrectomyLow Back InjuryMaterially and Substantially Greater DisabilityMedical EvidenceReimbursementEmployabilityPermanency
References
2
Case No. 2018 NY Slip Op 06537 [165 AD3d 667]
Regular Panel Decision
Oct 03, 2018

Matter of Heritage Mech. Servs., Inc. v. Suffolk County Dept. of Pub. Works

This case involves an appeal by Heritage Mechanical Services, Inc. (petitioner) from a judgment denying its petition to annul a determination by the Suffolk County Department of Public Works (DPW). The dispute stemmed from a general construction contract awarded to Posillico/Skanska, JV for a waste water treatment plant upgrade. Heritage was listed as a subcontractor for HVAC work, but a disagreement arose over the agreed-upon amount, with Heritage claiming a higher price for alternates not included in the initial bid figure. DPW approved Posillico's request to perform the HVAC work itself, citing Heritage's refusal as a 'legitimate construction need' under General Municipal Law § 101 (5). The Appellate Division, Second Department, affirmed the Supreme Court's judgment, finding DPW's determination was not arbitrary and capricious, affected by an error of law, or an abuse of discretion, and thus dismissed the proceeding.

Public Works ContractSubcontractor DisputeGeneral Municipal LawCPLR Article 78Administrative ReviewArbitrary and CapriciousProject Labor AgreementHVAC SubcontractBid DisputeContractual Interpretation
References
1
Case No. 2017 NY Slip Op 08382 [155 AD3d 1049]
Regular Panel Decision
Nov 29, 2017

Matter of Soliman v. Suffolk County Dept. of Pub. Works

Nader I. Soliman, a Senior Civil Engineer for Suffolk County Department of Public Works, was terminated after an arbitration award found him guilty of misconduct for accessing unauthorized, sexually explicit websites during work hours. Soliman petitioned the Supreme Court, Suffolk County, to vacate the arbitration award, but the court denied the petition, dismissed the proceeding, and confirmed the award. On appeal, the Appellate Division, Second Department, affirmed the Supreme Court's judgment, finding that Soliman failed to demonstrate by clear and convincing evidence that the arbitration award was irrational or that the arbitrator exceeded their powers.

MisconductArbitration AwardVacaturCPLR Article 75Appellate ReviewPublic EmploymentTerminationEmployee MisconductRationality of AwardArbitrator Powers
References
10
Case No. MISSING
Regular Panel Decision

Mamaroneck Village Tile Distributors, Inc. v. Workers' Compensation Board

Mamaroneck Village Tile Distributors, Inc. received a stop-work order after an investigator found evidence of employees cutting stone while wearing company T-shirts, despite the president's claim that the company had no employees and lacked workers' compensation insurance. Mamaroneck sought a redetermination, arguing it had no employees and therefore no obligation for insurance. A Workers' Compensation Law Judge (WCLJ) credited the investigator's testimony and upheld the order, finding substantial evidence of employment. Mamaroneck appealed this decision. The appellate court affirmed, ruling that the procedures provided ample due process and that substantial evidence supported the WCLJ's determination that Mamaroneck had employees.

Workers' Compensation LawStop-Work OrderUninsured EmployerSubstantial EvidenceDue ProcessAdministrative AppealEmployee StatusAppellate ReviewNew York LawLabor Law Enforcement
References
14
Case No. MISSING
Regular Panel Decision
Jan 03, 1995

Merritt Meridian Construction Corp. v. Old Country Iron Works, Inc.

Plaintiff, a general contractor, sued defendant, a subcontractor, for breach of contract on a construction project at West Point. Plaintiff alleged wrongful detention of materials, unfinished work costs, delay damages, and Davis-Bacon Act violations. Defendant counterclaimed for the unpaid balance of $24,700, arguing substantial performance. The Supreme Court found for the defendant, ruling delay damages were covered by stipulation, plaintiff's completion costs lacked evidence, and plaintiff had no standing for Davis-Bacon Act claims, awarding defendant the full counterclaim. On appeal, the higher court affirmed the finding of substantial performance but modified the judgment, reducing defendant's award by $4,200 for two uncompleted staircases. The appellate court upheld the lower court's findings regarding delay damages and plaintiff's lack of standing for Davis-Bacon Act violations.

Breach of ContractConstruction LawSubcontractor DisputeSubstantial PerformanceDelay DamagesDavis-Bacon ActStipulationAppellate ReviewDamage CalculationJudgment Modification
References
8
Case No. 2020 NY Slip Op 06423 [188 AD3d 1378]
Regular Panel Decision
Nov 12, 2020

Matter of Foster v. FedEx Frgt. Inc.

The case involves an appeal by FedEx Freight Inc. from a Workers' Compensation Board decision that established claimant James Foster's average weekly wage using a 260 multiple. Foster was injured at work, and the Workers' Compensation Law Judge (WCLJ) determined his average weekly wage based on working "substantially the whole of the year," despite working 225 days, which is less than the traditional 234-day guideline. The Board affirmed, asserting its discretion to find that 225 days constituted "substantially the whole of the year" for a five-day worker under Workers' Compensation Law § 14 (1). The Appellate Division, Third Department, affirmed the Board's decision, holding that the statute does not require a specific number of days for this finding and that the Board's calculation was supported by substantial evidence.

Average Weekly WageWorkers' Compensation Law § 14Substantially Whole of the Year260 MultipleWage CalculationAppellate Division DecisionWorkers' Compensation Board ReviewStatutory InterpretationFull-time EmploymentFive-day Worker
References
12
Case No. 533112
Regular Panel Decision
Mar 17, 2022

In the Matter of the Claim of Leonel Reyes

Claimant Leonel Reyes sustained work-related injuries in 2016, and his claim for workers' compensation benefits was established. Subsequently, the employer and its carrier raised concerns that Reyes had violated Workers' Compensation Law § 114-a by failing to fully disclose his private business activities as a disc jockey while collecting indemnity benefits. After multiple hearings, a WCLJ and the Workers' Compensation Board found that Reyes knowingly made false statements regarding the physical nature of his work and failed to disclose critical information to examining physicians. The Board imposed both mandatory and discretionary penalties, permanently disqualifying him from receiving future indemnity benefits. The Appellate Division affirmed the Board's decision, concluding that it was supported by substantial evidence and that the discretionary penalty was warranted given the egregious nature of the multiple misrepresentations.

Workers' Compensation FraudMisrepresentation of Physical ActivityDisqualification of BenefitsDiscretionary PenaltySubstantial EvidenceAppellate ReviewWitness CredibilityMedical TestimonyIndemnity BenefitsFalse Statements
References
7
Case No. MISSING
Regular Panel Decision

Claim of Gates v. McBride Transportation, Inc.

The claimant, a dispatcher for McBride Transportation, Inc., suffered an acute myocardial infarction at work on January 9, 1979. The Workers' Compensation Board initially found that emotional tension and stress at work precipitated the condition. However, an appeal ensued to determine if there was substantial evidence to sustain this decision. The claimant described his work as routine but mentioned a canceled order from a prime customer aggravated him. Dr. Levy, who did not examine the claimant but reviewed a letter, opined that extreme unusual stress could precipitate the condition, contingent on the accuracy of the attorney's letter. The employer's doctor testified the condition was not work-related, attributing it to obesity, hypertension, and smoking. The appellate court concluded there was no substantial evidence to support the Board's determination, thus reversing the decision and dismissing the claim.

myocardial infarctionwork stressemotional tensioncausationsubstantial evidenceappellate reviewreversed decisionclaim dismissalcoronary artery diseasepreexisting condition
References
1
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