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

Case No. MISSING
Regular Panel Decision

NYSA-ILA Medical & Clinical Services Fund Ex Rel. Capo v. Catucci

The NYSA-ILA Medical & Clinical Services Fund, an employee medical services fund, sued Sabato Catucci and his three sons for allegedly withholding payments from Saleo Trucking Corporation to the fund. This action followed a prior judgment against the corporation for delinquent contributions. The plaintiff sought to hold the defendants personally liable under alter ego, breach of ERISA fiduciary duty, and embezzlement theories. The court granted summary judgment to the plaintiff on the breach of ERISA fiduciary duty claim against Sabato Catucci, finding him to be a fiduciary who misused plan assets. However, claims against his sons were dismissed due to lack of sufficient control over the corporation. The alter ego claim against Sabato Catucci will proceed to trial, and the embezzlement claim was dismissed for not supporting a private civil cause of action.

ERISA Fiduciary DutyAlter Ego LiabilityCorporate Veil PiercingDelinquent ContributionsSummary JudgmentEmployee Benefit PlanMultiemployer FundSelf-DealingCorporate ControlLabor Law
References
32
Case No. MISSING
Regular Panel Decision
Jul 29, 1996

Ray v. County of Delaware

The plaintiff sued Delaware County Mental Health Clinic for negligence, alleging failure to properly hire and supervise employee Brian Hart, a social worker who engaged in a sexual relationship with the plaintiff. Defendants moved for summary judgment, arguing proper procedures, lack of foreseeability, and plaintiff's culpable conduct. The Supreme Court granted the motion, determining the plaintiff failed to provide credible evidence for recovery. The appellate court affirmed this decision, finding that the plaintiff did not present affirmative proof to establish genuine issues of fact regarding the defendants' negligence in hiring and supervising their employee.

NegligenceSummary JudgmentAppealSupervisionEmployee MisconductSocial WorkerMental Health ClinicForeseeabilityEthical ConductProximate Cause
References
4
Case No. ADJ7962227
Regular
May 09, 2014

ANDREA REYNOSO vs. SANSUM CLINIC, EMPLOYERS COMPENSATION INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration, upholding the initial finding that she did not sustain a cumulative injury during her employment. The applicant claimed new evidence, including EMG testing for wrist issues and diagnoses of pulmonary embolism and blood clots affecting her psyche, should have been considered. However, the Board found this evidence was not "newly discovered" and could have been discovered through due diligence prior to the settlement conference or trial. Even if admitted, the new evidence would not alter the conclusion that any industrial injury occurred in 1999, not during her employment with Sansum Clinic.

Workers' Compensation Appeals BoardCumulative InjuryAgreed Medical EvaluatorPetition for ReconsiderationFindings of Fact and OrderAOE/COECarpal Tunnel SyndromePulmonary EmbolismPsyche InjuryNew Evidence
References
1
Case No. ADJ261234 (GOL 0093065) ADJ1281382 (GOL 0093064)
Regular
May 02, 2016

RITA ROBINSON vs. SANSUM SANTA BARBARA MEDICAL FOUNDATION CLINIC, DYNAMIC CLAIMS, Arrowpoint, GOLETA UNION SCHOOL DISTRICT

This case concerns an employer's (Sansum Santa Barbara Medical Foundation Clinic/Arrowood) petition for reconsideration of a prior award. The Appeals Board affirmed the award, which mandated right hip surgery and the provision of a Nurse Case Manager (NCM), finding Arrowood responsible for both. Arrowood's arguments regarding due process and utilization review were rejected, and the Board found that prior orders compelled NCM provision, which Arrowood had unilaterally ceased without sufficient medical evidence. The Board also admonished Arrowood's counsel for unprofessional conduct and misrepresentation of facts.

WCABReconsiderationNurse Case ManagerUtilization ReviewAgreed Medical ExaminerPrimary Treating PhysicianMedical Provider NetworkJoint and Several LiabilityMandatory Settlement ConferenceDeclaration of Readiness to Proceed
References
5
Case No. MISSING
Regular Panel Decision

In re Moody

Petitioner Bobba Jean Moody, a certified clinical social worker, applied pro se for an exemption from jury service in New York County. She argued that despite not being explicitly enumerated in Judiciary Law § 512, clinical social workers should be exempt due to public policy and equal protection grounds, as they provide essential mental health services comparable to other exempted professionals like psychologists and psychiatrists. Moody highlighted her full-time role at the New York State Psychiatric Institute and part-time private practice, asserting that her absence would disrupt critical public services. The court, acknowledging the legislative intent to exempt essential healthcare professionals, agreed that a certified social worker engaged in full-time clinical practice should be exempt. Consequently, the court granted a personal exemption to Bobba Jean Moody and urged the State Legislature to amend Judiciary Law § 512 to include clinical social workers.

Jury ExemptionCertified Social WorkerClinical Social WorkHealth Care ProfessionalsJudiciary LawEqual ProtectionPublic PolicyMental Health ServicesPsychiatric InstitutePro Se Application
References
3
Case No. MISSING
Regular Panel Decision

People v. Gans

This court opinion addresses whether a certified social worker can be qualified as an expert witness to provide testimony regarding a defendant's mental capacity to proceed and future competency. The defense sought to qualify Hillel Bodek, a certified social worker specializing in forensic clinical social work, as an expert witness for these purposes. The court meticulously reviewed the qualifications of clinical social workers, acknowledging their critical role in the diagnosis of mental disorders, including their involvement in the development of the DSM III. Despite statutory provisions in CPL article 730 outlining who may serve as psychiatric examiners, the court emphasized that other appropriately trained and experienced experts can also offer testimony on competence. Ultimately, the court ruled in the affirmative, concluding that certified social workers with demonstrated training and supervised clinical experience in diagnosis and capacity assessment are qualified to provide expert testimony on these crucial issues.

Expert Witness QualificationCertified Social WorkerMental Capacity AssessmentCompetency to ProceedForensic Mental HealthDiagnostic AssessmentPrognostic StatementsCriminal Procedure Law Article 730DSM IIINon-Medical Expert Testimony
References
13
Case No. MISSING
Regular Panel Decision

Claim of Feldman v. Presbyterian Hospital

Claimant sustained a compensable back injury in 1966, leading to a closed case in 1967. The case was reopened in 1980 after claimant experienced additional lost time from work in 1979 and received treatment at the employer's clinic. The primary issue was the liability of the Special Fund for Reopened Cases under Workers’ Compensation Law § 25-a, specifically whether payments made by the employer for clinic visits and sick leave constituted advance payments of compensation. The Workers’ Compensation Board affirmed the discharge of the Special Fund, finding that there was an advance payment and the employer knew the lost time was due to the 1966 injury. On appeal, the court affirmed the Board's decision, holding that the employer's discretionary full reimbursement for clinic visits during working hours, even when sick leave was presumed exhausted, qualified as an advance payment. Therefore, the insurance carrier remained liable as the case was reopened within three years of the last payment.

Workers' CompensationSpecial Fund for Reopened CasesAdvance PaymentEmployer LiabilityMedical TreatmentLost TimeSick LeaveAppellate ReviewWorkers' Compensation Law § 25-aDiscretionary Payments
References
7
Case No. ADJ3132204 (AHM 0076439) ADJ3910647 (RIV 0069381)
Regular
Mar 04, 2013

LYNETTE WINTER vs. COUNTY OF RIVERSIDE

The Workers' Compensation Appeals Board granted reconsideration, overturning a prior decision that denied treatment at the Kerlan Jobe Clinic. The Board found that while Kerlan Jobe was located outside the standard MPN mileage/time parameters, the applicant's selection was reasonable given her complex spinal condition and the clinic's expertise. Defendant is now obligated to authorize treatment with a Kerlan Jobe physician. All other issues remain deferred.

WCABPetition for ReconsiderationMedical Provider Network (MPN)Kerlan Jobe ClinicDetrimental RelianceContract FormationExpedited HearingMinutes of HearingReport and RecommendationIndustrial Injury
References
0
Case No. MISSING
Regular Panel Decision
Dec 23, 1994

In re the Claim of Sanders

The claimant, a production worker, injured her finger while operating heavy machinery and became upset when her employer would not permit another employee to drive her to a medical clinic. She drove herself to the clinic and subsequently resigned. The Unemployment Insurance Appeal Board denied her application for unemployment insurance benefits, ruling she voluntarily left her employment without good cause. The court found that the Board's decision was supported by substantial evidence, concluding the claimant left for personal and noncompelling reasons, and affirmed the decision.

Unemployment BenefitsVoluntary ResignationGood CauseWorkplace InjuryEmployer ConductAppeal Board DecisionSubstantial EvidenceWorkers' Compensation Appeal
References
0
Case No. MISSING
Regular Panel Decision

In re Erica M.

The appellate court reversed an Erie County Family Court order finding Erica a neglected child. The petitioner failed to demonstrate, by a preponderance of evidence, that the respondent's manic-depressive diagnosis or conduct placed Erica in imminent danger or that he failed to provide adequate care. Despite a clinic report suggesting an "in-patient psych evaluation" for the respondent, there was no proof of the extent of his mental health issues or a change in his condition since he was granted sole custody. Evidence indicated the respondent consistently took Erica to day care, attended a methadone clinic, and was a loving father despite his challenges.

Child NeglectParental RightsFamily Court ActAppellate ReviewPreponderance of EvidenceMental HealthCustodyParental CareSubstance AbuseChild Welfare
References
2
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