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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. 2017-06-1778
Regular Panel Decision
Apr 11, 2018

Demotte, Julie v. UPS

Julie Demotte sustained a workplace injury involving a broken hip and leg in November 2016 while working for UPS. UPS initially accepted the claim and provided temporary disability benefits. Dr. Jason Evans, the authorized treating physician, placed Ms. Demotte at maximum medical improvement and assigned a three-percent whole-person impairment rating. A compensation hearing was held to determine Ms. Demotte's entitlement to permanent disability, temporary disability, and future medical benefits. The Court ordered UPS to provide lifetime medical benefits for Ms. Demotte's workplace injury, but denied her claims for both temporary and permanent disability benefits. The denial of permanent disability was based on the inadmissibility of Form C-30A as proof of impairment, as Ms. Demotte failed to present admissible evidence. Additionally, the claim for further temporary disability benefits was denied due to an earlier overpayment by UPS that exceeded any subsequent amounts due.

Workplace InjuryFuture Medical BenefitsTemporary Disability BenefitsPermanent Disability BenefitsAdmissibility of Medical ReportsForm C-30AForm C-32Impairment RatingHearsayMaximum Medical Improvement
References
2
Case No. 2015-07-0114
Regular Panel Decision
Oct 12, 2015

Miller, Torris v. TA Operating Corp.

Torris Miller, a diesel mechanic, sustained a back injury at work on November 3, 2014, while changing a tractor-trailer tire for TA Operating Corp. He filed a request for an expedited hearing seeking past medical and temporary disability benefits. The Court found that Mr. Miller provided sufficient notice of his work-related injury to the employer. Although TA Operating Corp. argued that Mr. Miller's termination for job abandonment precluded him from receiving ongoing temporary disability benefits, the Court disagreed, finding the termination improper. Consequently, the Court granted Mr. Miller temporary total disability and temporary partial disability benefits, but denied his request for payment of past medical expenses due to insufficient proof of the reasonableness of the charges.

Workers' CompensationBack InjuryTemporary DisabilityJob AbandonmentMedical ExpensesNotice RequirementEmployer LiabilityTennessee LawExpedited HearingDisability Benefits
References
13
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. 2015-01-0199
Regular Panel Decision
Feb 10, 2016

Tolbert, Christoper v. MPW Industrial Services at Volkswagen

This Expedited Hearing Order addresses Christopher Wade Tolbert's request for additional temporary disability benefits following a work-related injury to his head, neck, and back on June 29, 2015, while employed by MPW Industrial Services at Volkswagen. The central issues were Mr. Tolbert's entitlement to benefits and the correct weekly compensation rate. The Court found Mr. Tolbert was entitled to temporary total disability benefits from June 30, 2015, to July 9, 2015, and temporary partial disability benefits from July 10, 2015, to August 3, 2015, due to the employer's failure to provide accommodated work. Furthermore, he was awarded an additional $7.93 per week from August 4, 2015, to October 14, 2015, to correct an underpayment, and temporary partial disability benefits from November 11, 2015, onwards, based on ongoing medical restrictions from Dr. Stephen Dreskin. The Court established his correct weekly compensation rate as $261.28.

Workers' CompensationTemporary Disability BenefitsExpedited HearingWage StatementCompensation RateMedical TreatmentModified DutyEmployer AccommodationPain ManagementNeck Injury
References
7
Case No. 2015184839
Regular Panel Decision
Nov 17, 2015

Lallo, Ralph Joseph v. Marion Environmental, Inc.

Ralph Joseph Lallo, an employee, filed a motion seeking temporary disability benefits against his employer, Marion Environmental, Inc. Mr. Lallo sustained a compensable injury to his right upper extremity on April 2, 2015. The court found that Marion Environmental, Inc. did not terminate Mr. Lallo for cause, and thus, his separation would not preclude him from receiving temporary partial disability benefits. Medical evidence from Dr. Donald Huffman indicated substantial restrictions on Mr. Lallo's right arm, rendering him partially disabled. The court concluded that Mr. Lallo was entitled to temporary partial disability benefits and ordered Marion Environmental, Inc. to pay past benefits from May 1-6, 2015, and from September 28, 2015, onward at a compensation rate of $696.03 per week.

Workers' Compensation BenefitsTemporary Partial DisabilityUpper Extremity InjuryOrthopedic DiagnosisEmployment TerminationMedical Work RestrictionsWage Loss ClaimsExpedited Hearing DecisionEmployer Accommodation DisputeDr. Donald Huffman
References
9
Case No. 2016-08-0678
Regular Panel Decision
Nov 04, 2016

Booze, Barbara v. Memphis Area Transit Authority

Ms. Barbara Booze, a sixty-year-old bus driver, suffered a work-related mental injury in September 2015 after witnessing a shooting. She received temporary total disability benefits from September 2, 2015, through May 3, 2016. Ms. Booze filed a Request for Expedited Hearing, seeking temporary disability benefits from May 3 to September 8, 2016, when she reached maximum medical improvement (MMI). The employer, Memphis Area Transit Authority (MATA), offered a light duty reservationist position, but Ms. Booze declined due to her anxiety related to buses. The Workers' Compensation Judge denied her claim, finding she did not provide sufficient medical proof of total disability or light duty restrictions to support entitlement to temporary partial disability benefits for the requested period.

Workers' CompensationTemporary Disability BenefitsPost-traumatic Stress DisorderPsychological InjuryMaximum Medical ImprovementReturn to WorkLight DutyExpedited HearingMedical EvidenceEmployer Accommodation
References
3
Case No. 2016-05-1257
Regular Panel Decision
May 26, 2017

Joyce Jackson v. University of the South

Joyce Jackson, a custodian at the University of the South, fell down seven concrete steps at work, hitting her head on a railing post. She sought medical and temporary disability benefits for neck, head, and right-shoulder injuries. Dr. Michael Moran, a neurosurgeon, determined that her fall caused a disc herniation at C4-5, leading to progressive cervical myelopathy and requiring urgent surgery. The Court found Ms. Jackson is likely to prove a compensable injury and is entitled to medical treatment and temporary total disability benefits from December 12, 2016, through February 8, 2017. However, the Court denied temporary partial disability benefits due to her voluntary retirement before her disability fully manifested.

Workers' CompensationExpedited HearingMedical BenefitsTemporary Disability BenefitsCervical MyelopathyDisc HerniationWork-Related InjuryCausationIdiopathic FallStaircase Fall
References
12
Case No. 2016-06-0910
Regular Panel Decision
Jul 24, 2018

Fegan, Mark v. CSI Medical, Inc.

The case involved Mark Fegan seeking temporary disability benefits from his employer, CSI Medical, Inc., and its carrier, Am Trust, following a back injury in October 2015. Initially, Dr. Sullivan declared Fegan at maximum medical improvement (MMI) in March 2016, leading to a cessation of benefits. However, Fegan later sought treatment from Dr. Ronald Lakatos in Ohio, who performed surgery in May 2017 and provided a medical opinion contradicting Dr. Sullivan's MMI assessment. Dr. Lakatos stated that Fegan was not at MMI as of March 2016 and remained disabled through May 2017. The Court weighed the medical opinions, giving more weight to Dr. Lakatos's in-depth analysis, and found that Mr. Fegan was likely to prevail in demonstrating his entitlement to temporary disability benefits for the period from April 1, 2016, through May 30, 2017. Consequently, the Court ordered CSI to pay lump-sum temporary total disability benefits totaling $19,389.52.

Temporary DisabilityMedical ImprovementSpinal InjurySurgeryMMI DisputeMedical EvidenceExpedited HearingBenefit DeterminationCausationDisability Duration
References
2
Case No. 2016-08-0883
Regular Panel Decision
May 18, 2017

Betances, Miguel v. Brock Services, LLC

Miguel Betances, an employee, filed a Request for Expedited Hearing seeking temporary disability benefits from October 5, 2016, and ongoing, after injuring his back at work on July 18, 2016. Brock Services, LLC, the employer, contended he was not entitled to benefits, claiming he was terminated for violating workplace attendance policies. The Court found Mr. Betances' testimony credible, concluding that Brock did not properly enforce its attendance policy by actually terminating him on August 14, 2016, and failed to accommodate his light duty restrictions or provide a justifiable reason for not doing so. The Court ordered Brock to pay accrued temporary partial disability benefits from October 5, 2016, through January 26, 2017, and accrued temporary total disability benefits from January 27, 2017, and ongoing, until an approved medical provider releases him to return to work or places him at maximum medical improvement.

Temporary Disability BenefitsWorkers' Compensation JudgeExpedited HearingAttendance Policy ViolationLight Duty RestrictionsAdministrative TerminationTemporary Partial DisabilityTemporary Total DisabilityMedical TreatmentBack Injury
References
3
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