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

Case No. 2021 NY Slip Op 07401
Regular Panel Decision
Dec 23, 2021

Matter of Carola B.-M. v. New York State Off. of Temporary & Disability Assistance

Petitioners Carola B.-M. and Tiara M. challenged the denial of their supplemental nutrition assistance program (SNAP) benefits by the New York State Office of Temporary and Disability Assistance and the Orleans County Department of Social Services. The benefits were denied because they were deemed ineligible college students. The Appellate Division, Fourth Department, reversed this determination, holding that participation in the Adult Career and Continuing Education Services, Vocational Rehabilitation program (ACCES-VR) qualifies as a Job Training Partnership Act (JTPA) program. This status exempts the students from certain SNAP eligibility requirements. The court found that the original determination was based on an unreasonable interpretation of relevant regulations, annulled the decision, granted the petition, and remitted the case for a calculation of retroactive benefits.

SNAP benefitscollege student eligibilityJob Training Partnership ActACCES-VRvocational rehabilitationCPLR article 78regulatory interpretationpublic assistancefood stampsAppellate Division
References
28
Case No. MISSING
Regular Panel Decision

Claim of Bruzzese v. Guardsman Elevator Co.

In 1994, the claimant sustained head, neck, and back injuries at work, leading to an award for permanent partial disability, which included a wage expectancy adjustment under Workers’ Compensation Law § 14 (5). Following back surgery in 1998, the case was reopened, and the claimant was found to be temporarily totally disabled. Benefits for this temporary total disability were calculated based on the claimant's average weekly wage at the time of injury, without applying the wage expectancy adjustment. The claimant appealed, arguing that since the permanent partial disability preceded the temporary total disability, the wage expectancy adjustment should also apply to the latter period. The court disagreed, affirming the Workers’ Compensation Board's decision, citing established case law that Workers’ Compensation Law § 14 (5) is applicable only to awards for permanent partial disability and not temporary disability.

Wage expectancyTemporary total disabilityPermanent partial disabilityWorkers' Compensation benefitsBack injuryAppellate reviewDisability calculationWorkers' Compensation BoardAverage weekly wage
References
1
Case No. 5674395Z
Regular Panel Decision
Dec 01, 2011

Baines v. Berlin

Mashon Baines, a homeless and disabled mother of three, initiated a CPLR article 78 proceeding to challenge the New York State Office of Temporary and Disability Assistance's August 31, 2011 decision to discontinue her temporary housing assistance. This decision stemmed from an alleged altercation with a shelter director, Marilyn Gonzalez, during a fire drill, leading to Baines's arrest. Baines argued that her due process rights were violated because the discontinuance notice cited only the assault on Ms. Gonzalez, while the administrative decision was based on multiple uncharged wrongdoings and failed to adequately consider video evidence. The court found that respondents failed to adequately apprise Baines of all charges, thereby violating her due process rights, and consequently annulled the August 31, 2011 fair hearing decision. The court also granted Baines's request for attorneys' fees, costs, and disbursements.

Due ProcessAdministrative HearingHomeless AssistanceShelter BenefitsDiscontinuance of BenefitsNotice RequirementsCPLR Article 78Judicial ReviewAttorneys' FeesSelf-Incrimination
References
8
Case No. ADJ198279 (VNO 0510947) ADJ3495790 (VNO 0506075)
Regular
May 04, 2009

MICHAEL BONNER vs. CITY OF LOS ANGELES; permissibly self-insured, administered by TRISTAR RISK MANAGEMENT

This case involves a firefighter, Michael Bonner, seeking workers' compensation benefits. The defendant, City of Los Angeles, sought reconsideration of a prior award granting temporary disability (TD) benefits and a penalty for unreasonable delay. The Appeals Board denied the reconsideration, holding that Labor Code section 4850 salary continuation benefits for firefighters are distinct from temporary disability and do not count against the two-year TD limit under Labor Code section 4656(c)(1). The Board affirmed the penalty, finding the City's attempt to conflate these benefits to limit TD payments unreasonable.

Labor Code section 4850Labor Code section 4656(c)(1)temporary disabilitysalary continuationInjury on Duty (IOD) timefirefighterCity of Los Angelescollective bargaining agreementWCJpetition for reconsideration
References
8
Case No. ADJ636363
Regular
2011-MM-DD

ANASTACIO ESTRADA vs. CONTINENTAL AIRLILNES, INC., GALLAGHER BASSETT SERVICES

This case concerns an applicant's industrial injury to multiple body systems sustained while employed by Continental Airlines. The Appeals Board granted reconsideration to clarify temporary disability (TD) and apportionment of permanent disability. Regarding TD, the Board modified the award to require the parties to adjust or the WCJ to determine TD based on specific treatment dates by Dr. Curtis, not the previously awarded broad period. The Board affirmed the finding of 100% permanent disability without apportionment, finding the defendant failed to meet its burden of proof. Finally, the issue of the applicant's attorney's fees was deferred for further determination by the WCJ due to calculation uncertainties.

Workers' Compensation Appeals BoardAnastacio EstradaContinental AirlinesGallagher Bassett ServicesADJ636363Opinion and Order Granting ReconsiderationFindings and AwardPulmonary systemsHypertensionPsyche
References
6
Case No. SDO 0335050
Regular
Jan 25, 2008

WALLACE N. BARNES vs. RON & SONS TRUCKING, INC., STATE COMPENSATION INSURANCE FUND

The Appeals Board granted reconsideration to correct a clerical error in the original findings regarding the applicant's temporary disability rate. Despite a stipulation stating the temporary disability rate was $479.36, evidence showed payments were made at $319.57, prompting the correction. The Board clarified that defendant paid TD at $319.57 from April 1, 2005, to March 31, 2007, and the applicant is entitled to TD benefits from June 28, 2005, through approximately June 28, 2007, with jurisdiction reserved for rate adjustment and attorney fees.

Workers' Compensation Appeals BoardIndustrial InjuryTruck DriverTemporary DisabilityReconsiderationFindings and AwardStipulationsIndemnity RateAverage Weekly WageClerical Error
References
1
Case No. MISSING
Regular Panel Decision

Matter of Brady v. Northeast Riggers & Erectors

In March 2012, the claimant, a union construction laborer, sustained a work-related back and abdomen injury. A Workers' Compensation Law Judge (WCLJ) initially found the claimant attached to the labor market but deemed a total industrial disability finding premature because permanent disability had not yet been classified. The Workers’ Compensation Board upheld this determination. The claimant appealed, arguing the Board erred in declining to classify him with a temporary total industrial disability. The Court affirmed the Board's decision, asserting that a classification of temporary total industrial disability cannot be made without a prior determination of permanency.

Workers' CompensationIndustrial DisabilityPermanent DisabilityTemporary DisabilityLabor MarketAppellate DivisionBoard DecisionPremature DeterminationGainful EmploymentWork History
References
6
Case No. ADJ1237800 (AHM0151777)
Regular
Jan 22, 2016

KENNETH ROSENBERG vs. STATE OF CALIFORNIA, CALIFORNIA HIGHWAY PATROL DISABILITY AND RETIREMENT, Legally Uninsured, STATE COMPENSATION INSURANCE FUND/STATE CONTRACT SERVICES, Adjusting Agency

The Workers' Compensation Appeals Board granted reconsideration to clarify clerical errors in a previous award. The Board amended the award to reflect that the defendant, California Highway Patrol, is "legally uninsured" and affirmed the application of the "duty belt" presumption (Labor Code section 3213.2). The Board also affirmed the finding of $43\%$ permanent disability, temporary disability, and the denial of apportionment, finding that the defendant waived any due process claims regarding temporary disability by not objecting at trial.

Workers' Compensation Appeals BoardCalifornia Highway PatrolLegally UninsuredState Compensation Insurance FundPetition for ReconsiderationFindings and AwardAdministrative Law JudgePermissibly Self-InsuredLow Back InjuryLeft Shoulder Injury
References
2
Case No. 2018 NY Slip Op 01108 [158 AD3d 965]
Regular Panel Decision
Feb 15, 2018

Matter of Williams v. New York State Off. of Temporary Disability & Assistance

Claimant, Theresa J. Williams, appealed a Workers' Compensation Board decision denying her claim for benefits. She alleged an elevator door struck her, causing sprains and contusions. The Workers' Compensation Law Judge (WCLJ) and the Board disallowed the claim, finding she exaggerated the incident and her injuries did not arise from employment, based significantly on video surveillance that contradicted her account. The Appellate Division, Third Department, affirmed the Board's decision, emphasizing the Board's authority to resolve factual issues and assess witness credibility. The court concluded that the Board's determination was supported by substantial evidence and that there was no medical opinion establishing causation based on the incident as depicted in the video.

Workers' Compensation BenefitsAccidental InjuryCourse of EmploymentCredibility AssessmentVideo Surveillance EvidenceElevator IncidentClaim DisallowanceBoard Decision AffirmationFactual Issue ResolutionSubstantial Evidence Review
References
6
Case No. ADJ7807144
Regular
Jul 19, 2013

JOSE ARZATE vs. MILLENNIUM CONCRETE, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration of both defendant and applicant's attorney petitions. The Board rescinded the original award and substituted a new one, deferring several issues for further proceedings at the trial level. These deferred issues include the temporary disability indemnity rate, the applicability of Labor Code section 4656 to the TD period, the Employment Development Department's lien, and attorney fees against TD benefits. The Board affirmed the 15% permanent disability increase and the attorney fees awarded against permanent disability.

Workers' Compensation Appeals BoardReconsiderationTemporary DisabilityPermanent DisabilityLabor Code Section 4658(d)Labor Code Section 4656Attorney FeesEmployment Development Department LienStipulationIndustrial Injury
References
0
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