CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

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

Case No. MISSING
Regular Panel Decision

Howell v. County of Albany

A correction officer's General Municipal Law § 207-c benefits were suspended by the Albany County Sheriff after he refused a light duty assignment following a workplace injury in September 2009. The officer initiated a CPLR article 78 proceeding, alleging due process violations because the Hearing Officer supposedly refused to consider proof of post-traumatic stress disorder and relied on evidence outside the record. The Court determined that the petitioner was afforded due process, noting that a predetermination hearing was held where he presented witnesses and cross-examined the respondents'. The Court found no violation of procedural due process as the petitioner did not raise a genuine dispute regarding his PTSD diagnosis before the hearing. Ultimately, the Court confirmed the determination to suspend benefits and dismissed the petition.

Due ProcessGeneral Municipal Law 207-cLight Duty AssignmentDisability BenefitsCorrection OfficerAdministrative HearingProcedural Due ProcessWorkers' Compensation ClaimPost-Traumatic Stress DisorderCredibility Assessment
References
8
Case No. 2019-06-2140
Regular Panel Decision
Jul 13, 2020

Gentry, Charles v. Arapazuma, Inc.

Charles Gentry, an employee, requested temporary disability benefits for a shoulder injury after Arapazuma, the employer, suspended payments. The suspension occurred because Mr. Gentry did not attend a scheduled independent medical examination (IME) with Dr. Damon Petty, citing a prior negative experience and a belief that he would report the doctor. Mr. Gentry credibly testified that the claims adjuster, Ms. Fuerstenau, agreed to find an alternative physician, and he did not refuse the examination but relied on this promise. The Court found Arapazuma improperly suspended benefits, as Mr. Gentry demonstrated a willingness to undergo an examination with another physician, Dr. Blake Garside. Consequently, the Court ordered Arapazuma to immediately pay Mr. Gentry $4,541.67 in temporary disability benefits for the period between September 13 to November 15, 2019.

Temporary Disability BenefitsIndependent Medical ExaminationSuspension of BenefitsEmployer's PhysicianWorkers' Compensation ClaimsExpedited HearingCredibility FindingEmployee CooperationMedical Examiner DisputeAdjuster Agreement
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. 2017-08-1205
Regular Panel Decision
Apr 27, 2018

Washington, John v. UPS Ground Freight, Inc.

John Washington, an employee of UPS Ground Freight, Inc., requested additional medical and temporary disability benefits for a September 7, 2017 work injury. UPS maintained it had paid all entitled benefits and had provided multiple panels of neurologists, which Mr. Washington largely rejected due to subjective concerns. The Court found that UPS had complied with its statutory duty to provide physicians, but Mr. Washington had not complied with his duty to choose one. The Court ordered UPS to allow Mr. Washington to choose another neurologist from the previously provided panels, warning that benefits could remain suspended if he failed to comply. The Court denied Mr. Washington's requests for payment of unauthorized emergency room bills, personal care assistant payments, additional temporary disability benefits, and adjustments to his wage rate calculation, concluding that his refusal to accept medical services justified the suspension of temporary benefits.

Workers' CompensationMedical BenefitsTemporary DisabilityExpedited HearingNeurology EvaluationPost-Concussion SyndromeWage Rate CalculationUnauthorized TreatmentPhysician PanelEmployee Non-Compliance
References
6
Case No. 2020-05-1028
Regular Panel Decision
Aug 27, 2021

Moore, Jeffrey v. Transforce, Inc.

Jeffrey Moore, an employee of Transforce, Inc., sustained a left shoulder injury on September 24, 2020. Following surgery and physical therapy, temporary disability benefits were initiated but later suspended by Transforce when Mr. Moore missed a medical appointment, despite his attempt to reschedule. The Court ruled that Mr. Moore is likely entitled to temporary partial disability benefits for the period of April 8 through April 22, finding Transforce's suspension of benefits due to the missed appointment to be premature and unreasonable. Consequently, Transforce was ordered to pay Mr. Moore $768.15. The case was also referred to the Compliance Program for investigation into the improper denial of benefits.

Workers' compensationTemporary partial disabilityExpedited hearingMedical non-complianceMissed appointmentLight-duty workBenefits suspensionOrthopedic injuryShoulder injuryMaximum medical improvement
References
3
Case No. MISSING
Regular Panel Decision
Feb 22, 1984

Barnhardt v. Hudson Valley District Council of Carpenters Benefit Funds

The plaintiff, injured in May 1978 during maintenance work, was denied workers' compensation due to the absence of an employer-employee relationship. Subsequently, he sought reimbursement for medical expenses from the Hudson Valley District Council of Carpenters Benefit Funds (Benefit Funds) through a union insurance policy. Continental Assurance Company (Continental), Benefit Funds' insurer, rejected the claim, citing an employment-related injury exclusion in the policy. The plaintiff then initiated an action against Benefit Funds, which in turn filed a third-party action against Continental seeking indemnification. Continental's motion for summary judgment, asserting the exclusion, was denied by the County Court. The appellate court affirmed this denial, ruling that the exclusionary language was ambiguous and applied only in cases where a clear employer-employee relationship existed, a fact still to be determined.

Insurance Policy InterpretationEmployment StatusWorkers' Compensation ExclusionSummary Judgment MotionContractual AmbiguityGroup Health InsuranceMedical Expense ReimbursementThird-Party ActionAppellate ReviewEmployer-Employee Relationship
References
10
Case No. MISSING
Regular Panel Decision
Mar 20, 2001

Claim of Derr v. VIP Structures

The claimant, who had a work-related permanent total disability, was convicted of assault in March 1999 and subsequently incarcerated. The Workers’ Compensation Board ruled that the claimant was not entitled to benefits during his incarceration after the conviction of a crime. The claimant appealed this decision, arguing for continued benefits due to his total disability and resulting lack of earning capacity, regardless of his incarceration status. The court affirmed the Board's decision, stating that the suspension of workers’ compensation benefits during incarceration after a criminal conviction is based on public policy, and this principle applies to both partial and total disabilities. The court concluded that suspending benefits in such circumstances does not conflict with the Workers’ Compensation Law's goals.

IncarcerationWorkers' Compensation BenefitsTotal DisabilityPublic PolicyAssault ConvictionBenefit SuspensionCriminal ConductAppellate ReviewDisability Benefits
References
5
Case No. MISSING
Regular Panel Decision

Jamal v. Gohel

This case involves an appeal by the New York State Insurance Fund (SIF) from an order of the Supreme Court, Dutchess County. The Supreme Court had granted the plaintiff's motion to extinguish SIF's right to claim a credit or offset against Workers' Compensation death benefits and to compel reinstatement and retroactive payment of these benefits. The plaintiff had initially received death benefits from SIF after her husband's work-related death, and also won a jury award in a wrongful death action against a third party. SIF later asserted a right to a credit or offset against the death benefits for the jury award proceeds, suspending payments, which the plaintiff challenged. The appellate court reversed the Supreme Court's order, ruling that primary jurisdiction for determining the applicability of Workers' Compensation Law, particularly regarding an insurer's right to claim a credit or offset, rests with the Workers’ Compensation Board, not the Supreme Court.

Wrongful DeathWorkers' Compensation BenefitsInsurance FundCredit or OffsetPrimary JurisdictionWorkers' Compensation BoardAppellate ReviewDutchess CountyStatutory RightsDeath Benefits
References
7
Case No. MISSING
Regular Panel Decision

Cook v. Pension Benefit Guarantee Corp.

The Trustees of the Local 852 General Warehouseman’s Union Pension Fund sued the Pension Benefit Guarantee Corporation (PBGC) seeking reimbursement for pension benefits paid to retirees of two closed warehouses. The Fund argued for recovery based on equitable estoppel, asserting detrimental reliance on an initial PBGC determination that it would guarantee these benefits. The PBGC moved for summary judgment, contending that estoppel against a federal agency requires a showing of affirmative misconduct or manifest injustice. The Court found no evidence of affirmative misconduct by the PBGC and concluded that its change in determination, made to conform with Congressional intent, did not constitute manifest injustice. Consequently, the Court granted the PBGC's motion for summary judgment, ruling that equitable estoppel was inapplicable.

Equitable EstoppelFederal Agency EstoppelSummary JudgmentERISAPension BenefitsMulti-employer PlanPension Benefit Guarantee Corporation (PBGC)Affirmative MisconductManifest InjusticeDetrimental Reliance
References
10
Case No. Civ. A. No. 3:93-CV-0171-G.
Regular Panel Decision
Aug 31, 1993

Mills v. INJURY BENEFITS PLAN OF SCHEPPS-FOREMOST

Walter Mills was injured during his employment and sought benefits under his employer's Injury Benefits Plan. He subsequently filed a civil action alleging wrongful termination in retaliation for filing a workers' compensation claim under Texas law. Defendants removed the case to federal court, asserting ERISA preemption. The court granted the defendants' motion to dismiss Mills' claims against the Injury Benefits Plan, finding them preempted by ERISA. However, the court denied the dismissal of Mills' state law claims against Schepps-Foremost, Inc., d/b/a Oak Farms Dairies. Ultimately, the court remanded the remaining state law claims against Schepps-Foremost, Inc. to the County Court at Law Number 5 of Dallas County, Texas, due to a lack of federal subject matter jurisdiction.

ERISA preemptionWorkers' CompensationRetaliatory dischargeTexas lawFederal jurisdictionMotion to dismissRemandEmployee benefitsCivil procedureDallas County
References
18
Showing 1-10 of 10,758 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational