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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
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

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. MISSING
Regular Panel Decision

Jeffries v. Pension Trust Fund of the Pension, Hospitalization & Benefit Plan of the Electrical Industry

Plaintiff Claude Jeffries, a retired electrician, sued the Pension Trust Fund of the Electrical Industry under ERISA, seeking to include pension credits from 1969-1975 in his current benefits. He alleged the Plan should have declared a partial termination during a 1975-1979 New York recession, which would have vested his benefits. The defendant moved to dismiss the complaint, arguing lack of standing and statute of limitations, while plaintiff moved for class certification for similarly affected members. The court denied the defendant's motion to dismiss the claim for benefits, finding it timely, but granted dismissal for the breach of fiduciary duty claim as time-barred. The plaintiff's motion for class certification was denied due to insufficient evidence for numerosity, with leave to refile after discovery.

ERISAPension BenefitsClass CertificationMotion to DismissStatute of LimitationsFiduciary DutyPartial TerminationBenefit ForfeitureUnemploymentLabor Union
References
15
Case No. ADJ8807582, ADJ8554344, ADJ9162648
Regular
Jun 16, 2015

CHRIS ALVAREZ vs. WESTERN EXTERMINATOR COMPANY, XL SPECIALTY INSURANCE

The Workers' Compensation Appeals Board granted the applicant's petition for reconsideration. The Board will strike a finding from the Minutes of Hearing stating that all temporary total disability (TTD) benefits were resolved. This finding conflicts with the Stipulation and Award, which did not address TTD benefits. The case is returned to the WCJ for further proceedings and a decision on the disputed TTD benefits.

Workers' Compensation Appeals BoardPetition for ReconsiderationMinutes of HearingStipulation and AwardTemporary Total Disability (TTD)Code of Civil Procedure section 473Report and RecommendationPetition for RemovalDeclaration of ReadinessEmployment Development Department lien
References
4
Case No. MISSING
Regular Panel Decision
Jan 15, 1988

Pension Benefit Guaranty Corp. v. LTV Corp.

David H. Miller and William W. Shaffer ("Miller and Shaffer") moved to intervene individually and as representatives of participants in the Jones & Laughlin Retirement Plan in an action filed by the Pension Benefit Guaranty Corporation (PBGC) against LTV Corporation and LTV Steel Company ("LTV"). LTV did not object to individual intervention but opposed class action intervention, arguing it would delay the PBGC action. The court granted the motion, allowing Miller and Shaffer to intervene both individually and as class representatives. The decision emphasized that Miller and Shaffer met the minimal burden of showing that PBGC's representation might be inadequate, as their interests, seeking full plan benefits, could diverge from PBGC's role as plan administrator. This opinion allows the class action to proceed under Rule 23(e), preventing dismissal or compromise without court approval.

InterventionERISAPension PlansBankruptcyClass ActionRule 24Rule 23(e)Adequate RepresentationPlan TerminationRestoration
References
6
Case No. 2021 NY Slip Op 04070
Regular Panel Decision
Jun 24, 2021

Matter of Cisnero v. Independent Livery Driver Benefit Fund

Claimant Jeffrey Cisnero, an independent livery driver, sustained injuries when he was shot during a dispatch. He filed a claim for workers' compensation benefits, which was initially disallowed by a WCLJ but later reversed by the Workers' Compensation Board, finding coverage through the Independent Livery Driver Benefit Fund (ILDBF). The carrier appealed, arguing misinterpretation of the relevant statutes, particularly Executive Law § 160-ddd (1). The Appellate Division, Third Department, affirmed the Board's decision, determining that Cisnero's injuries arose out of and in the course of providing covered services as an independent livery driver dispatched by an ILDBF member. The court found that the vehicle's attenuated affiliation with the New York Black Car Operators' Injury Compensation Fund, Inc. did not alter ILDBF's liability.

Workers' CompensationLivery DriverIndependent ContractorBenefit FundAccidental InjuryCourse of EmploymentStatutory InterpretationExecutive LawWorkers' Compensation LawAppellate Review
References
3
Case No. ADJ1160304 (AHM 0123404) ADJ1025764 (AHM 0123405) ADJ3228397 (ANA 0363148)
Regular
Mar 02, 2009

RICHARD JESUS RIVERO vs. LONG BEACH POLICE DEPARTMENT, CITY OF LONG BEACH

The Workers' Compensation Appeals Board granted reconsideration of a prior award finding temporary total disability (TTD) for an applicant police officer. The defendant argued there was no medical evidence for TTD and that the applicant's termination for misconduct disqualified him from Labor Code section 4850 benefits. The Board found the medical evidence regarding TTD was inconsistent and required further development by the trial judge. Additionally, the judge must clarify the applicant's termination circumstances and their impact on section 4850 benefits.

Workers' Compensation Appeals BoardLong Beach Police DepartmentCity of Long BeachRichard Jesus RiveroADJ1160304ADJ1025764ADJ3228397ReconsiderationTemporary Total DisabilityLabor Code Section 4850
References
2
Case No. ADJ7319186 (MF) ADJ7320878
Regular
Oct 26, 2018

WENDY BOYD vs. CASTAIC UNION SCHOOL DISTRICT

This case concerns a dispute over temporary total disability (TTD) benefits for Wendy Boyd against the Castaic Union School District. The Workers' Compensation Appeals Board (WCAB) granted both parties' petitions for reconsideration. The WCAB rescinded previous findings and remanded the matter to the trial level to further develop the record regarding TTD benefits. Specifically, the WCAB requires evidence addressing whether the employer recouped TTD payments from the applicant's sick leave/vacation time, as this issue was inadequately addressed by the trial judge.

WCABPetition for ReconsiderationSupplemental Joint FindingsTemporary Total Disability (TTD)Labor Code section 4656Agreed Medical Evaluator (AME)Continuous TraumaAOE/COERecoupmentSick Leave
References
3
Case No. MISSING
Regular Panel Decision
Feb 02, 1984

Krebbeks v. Regan

Petitioner, the widow of a Department of Transportation employee, applied for accidental death benefits after her husband's service-connected death in July 1981. Although her application for accidental death benefits was approved, these benefits were entirely offset by workers' compensation payments, leaving her with no current payments from the State Employees’ Retirement System. Subsequently, petitioner sought a lump-sum ordinary death benefit, which was denied because she was deemed eligible for accidental death benefits, even if offset. This appeal ensued after the denial of her application by a hearing officer and Special Term's concurrence. The court affirmed the denial, citing Retirement and Social Security Law § 60 (a) (3), which states an ordinary death benefit is not payable if an accidental death benefit is payable, with a narrow exception not applicable here.

Accidental Death BenefitsOrdinary Death BenefitsWorkers' Compensation OffsetRetirement and Social Security LawStatutory InterpretationDeath Benefits EligibilityPublic Employee BenefitsAdministrative Law AppealDeath Benefit Offset
References
2
Case No. MISSING
Regular Panel Decision

In re the Claims of Noss

Claimants, employees of Lawrence Aviation Industries, Inc. and union members, commenced a strike in 1984. During the strike, they received weekly strike benefits from their union and later unemployment insurance benefits. The employer challenged these benefits, arguing that strike benefits were contingent on performing union duties, making claimants not 'totally unemployed,' and alleged willful misrepresentation. Both the Administrative Law Judge and the Unemployment Insurance Appeal Board found that the strike benefits were not conditional and no misrepresentation occurred. The appellate court affirmed the Board's decision, emphasizing that strike benefits not conditioned on services are not considered remuneration under 12 NYCRR 490.2 (b) and that the Board's factual findings, supported by substantial evidence, should not be disturbed.

Unemployment BenefitsStrike BenefitsTotal UnemploymentWillful MisrepresentationLabor UnionAdministrative LawJudicial ReviewSubstantial EvidenceConditional PaymentsNew York Labor Law
References
4
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