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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

Claim of Domanico v. Woodmere Fire District

This case involves an appeal from a decision by the Workers’ Compensation Board, filed April 4, 2005, which denied an employer's request for reimbursement of wages paid to a claimant during a period of disability. The court examined whether a June 24, 2004 notice, issued by the self-insured employer, Woodmere Fire District, containing language about reimbursement, was sufficient as a request under Workers’ Compensation Law § 25 (4) (a). The court found the notice to be sufficient in form. However, a critical issue remained regarding the timeliness of this request; specifically, whether it was filed prior to the compensation award made at the January 7, 2005 hearing. Due to this unresolved issue, the court reversed the Board's decision and remitted the matter for further proceedings to determine the timeliness of the reimbursement request.

Workers' Compensation ReimbursementEmployer Wage ReimbursementDisability WagesTimeliness of Reimbursement RequestWorkers' Compensation LawBoard Decision AppealJudicial ReversalRemittal for Further ProceedingsNew York Workers' CompensationStatutory Interpretation
References
5
Case No. MISSING
Regular Panel Decision
Oct 26, 2015

Matter of Newbill v. Town of Hempstead

Claimant, a sanitation crew chief, injured his right ankle and foot at work and was awarded disability benefits. His self-insured employer paid his full weekly wages during a period of disability and timely sought reimbursement for these advanced payments. A Workers’ Compensation Law Judge granted the employer's reimbursement request against a 20% schedule loss of use award for the right foot. The Board affirmed this decision, and the claimant appealed, arguing that reimbursement should not cover periods where no compensation awards were initially made. The court affirmed the Board's decision, reiterating that an employer is entitled to full reimbursement from a schedule loss of use award for advanced wages paid during disability, as schedule awards are not allocable to specific periods of lost work.

Schedule Loss of UseReimbursementAdvanced Wage PaymentsDisability BenefitsEmployer RightsAppellate ReviewWorkers’ Compensation BoardStatutory InterpretationPermanent Partial DisabilityTimely Claim
References
10
Case No. MISSING
Regular Panel Decision

Claim of Guarascio v. Spargo Wire Co.

The claimant, a truck driver, suffered work-related back and shoulder injuries in October 1995. The employer’s workers’ compensation carrier paid benefits. In 2000, the carrier sought reimbursement from the Special Disability Fund under Workers’ Compensation Law § 15 (8) (d) for these payments. A Workers’ Compensation Law Judge (WCLJ) established the claim in 2002 and later found the claimant permanently partially disabled, ruling on apportionment but deferring the reimbursement issue. The WCLJ subsequently found the carrier’s request for reimbursement timely. The Workers’ Compensation Board affirmed this decision. This appeal concerns the Board’s ruling that the carrier’s C-250 claim for reimbursement was timely filed within the statutory 52-week period, despite the underlying claim documents being posted by the Board in 2000.

ReimbursementSpecial Disability FundTimeliness of ClaimPermanent Partial DisabilityWorkers' Compensation LawPreexisting ImpairmentWork-related InjuryC-250 ClaimStatute of LimitationsAppellate Review
References
3
Case No. MISSING
Regular Panel Decision
Apr 25, 2005

Claim of Bailey v. Verizon

Claimant, a field technician, sustained a work-related injury to his right knee in February 2004 and received wages from his employer while unable to work, concurrently filing for workers’ compensation benefits. After a Workers’ Compensation Law Judge (WCLJ) initially denied the employer's request for reimbursement of paid wages due to procedural non-compliance, the Workers’ Compensation Board (Board) modified this decision, finding a valid oral reimbursement request was made. On appeal, the Court reversed the Board's determination, concluding that the record lacked substantial evidence to support the finding of an oral reimbursement request made prior to the compensation award. The Court cited Workers’ Compensation Law § 25 (4) (a), which conditions reimbursement on a timely request, and found the Board's reliance on a "scratch sheet" indicating a future filing, not a past request, to be insufficient. Consequently, the decision was reversed, with costs, and the matter remitted to the Workers’ Compensation Board for further proceedings consistent with the Court’s ruling.

Workers' Compensation ReimbursementEmployer Reimbursement RequestOral Request for ReimbursementSubstantial Evidence ReviewWorkers' Compensation Law § 25 (4) (a)WCLJ DecisionWorkers' Compensation Board ReviewAppellate DivisionRemittalClaimant's Benefits
References
3
Case No. MISSING
Regular Panel Decision

Claim of Karl v. New Venture Gear

The claimant, an administrative assistant, filed a workers' compensation claim for bilateral carpal tunnel syndrome in 2003. The employer, who did not dispute the claim, paid both workers' compensation benefits and additional sickness and accident benefits. After an initial workers' compensation award was made for temporary total disability, the employer sought reimbursement for the sickness and accident benefits. The Workers' Compensation Board granted the reimbursement, leading the claimant to appeal its timeliness. The appellate court reversed the Board's decision, ruling that the employer's reimbursement request was untimely under Workers’ Compensation Law § 25 (4) (c) because it was made after the initial compensation award, and remitted the matter for further proceedings.

Workers' Compensation LawReimbursementTimeliness of ClaimSchedule Loss of UseCarpal Tunnel SyndromeOccupational DiseaseSickness and Accident BenefitsAppellate ReviewStatutory InterpretationBenefit Payments
References
5
Case No. 534672
Regular Panel Decision
Jun 01, 2023

In the Matter of the Claim of Delon Nelson

The claimant, Delon A. Nelson, appealed two decisions from the Workers' Compensation Board. The case involved an established claim for work-related injuries, for which the self-insured employer, NYC Health & Hospital Corp., continued to pay claimant's wages during a period of disability. The employer sought reimbursement for these wages against a schedule loss of use award previously made to the claimant. The claimant argued that the employer had waived its right to reimbursement by not requesting it before the award was made or by failing to object to a proposed decision. The Workers' Compensation Board ruled in favor of the employer, finding its reimbursement request timely, and denied claimant's application for reconsideration. The Appellate Division affirmed the Board's decisions, concluding that the employer's earlier filing of a C-669 form constituted a timely request for reimbursement under Workers' Compensation Law § 25 (4) (a), and denying reimbursement would result in unjust enrichment for the claimant.

Wage ReimbursementWorkers' Compensation BenefitsSchedule Loss of UseAdvance PaymentsEmployer Reimbursement ClaimTimeliness of ClaimUnjust EnrichmentAppellate ReviewBoard DecisionsPermanent Partial Disability
References
13
Case No. MISSING
Regular Panel Decision
Dec 09, 2005

Claim of Salatti v. Crucible Materials Corp.

The claimant, a data entry clerk, sustained work-related injuries to their left wrist. A Workers' Compensation Law Judge (WCLJ) initially awarded lost wage benefits and directed employer reimbursement on May 2, 2003. The employer's carrier appealed, and the Workers' Compensation Board affirmed the reimbursement order on August 5, 2003. Subsequently, the claimant's attorney challenged the reimbursement direction, but the WCLJ, in a June 8, 2005 decision, declined to address it due to untimeliness, as the issue was not raised in the initial appeal. The Board denied full review of this issue. The Appellate Division affirmed the Board's decision, emphasizing the Board's broad discretion regarding the timeliness of review applications under Workers' Compensation Law § 23, and finding no abuse of discretion in deeming the claimant's request untimely.

Workers' CompensationUntimely AppealEmployer ReimbursementBoard DiscretionLost Wage BenefitsWork-Related InjuryAppellate ReviewSection 23
References
2
Case No. MISSING
Regular Panel Decision
Aug 05, 1996

Tagliavento v. Borg-Warner Auto

The employer and its workers' compensation insurance carrier appealed a decision by the Workers' Compensation Board. The Board had discharged the Special Disability Fund from liability, ruling that the carrier's claim for reimbursement was not timely filed. The carrier contended its application was timely, arguing that the 52-week period for filing should run from the claimant's formal C-3 filing date. The Appellate Division affirmed the Board's decision, finding substantial evidence to support that a claim for compensation was implicitly made earlier, thereby rendering the reimbursement application untimely.

Workers' CompensationSpecial Disability FundReimbursement ClaimTimeliness of ClaimWorkers' Compensation Law § 15(8)(f)Workers' Compensation Law § 28Appellate DivisionWorkers' Compensation BoardDate of DisabilityC-3 Form
References
3
Case No. MISSING
Regular Panel Decision

Claim of Velji v. Rural Farms Workers Opportunity

The employer and its carrier appealed a Workers’ Compensation Board decision from June 9, 1982, which denied their request for reimbursement of wages paid to a claimant during a disability period. The carrier had filed C-9 forms indicating lost time, full wages paid, and specifically requested reimbursement. The Board denied this, asserting that a C-9 form could not be used for a reimbursement claim, thereby adding an unauthorized limitation to Section 25 (subd 4, par [a]) of the Workers’ Compensation Law. The court found the Board’s rationale irrational, especially since the C-9 forms explicitly requested reimbursement. The court reversed the Board’s decision and remitted the matter for further proceedings.

Workers' Compensation LawReimbursement ClaimWage PaymentStatutory InterpretationC-9 FormAppellate ReviewBoard Decision ReversalEmployer RightsCarrier ReimbursementDisability Benefits
References
5
Case No. 2015-06-0547
Regular Panel Decision
Apr 12, 2016

Mathis, Valley v. The Kroger, Co.

Valley Mathis, a former stock clerk for The Kroger Co., sought medical treatment, reimbursement, and temporary disability benefits for an alleged workplace injury via an expedited hearing. Mathis claimed she fell on May 12 or 14, 2015, and reported it to her supervisor, Grady Wilkes. However, Wilkes denied receiving such a report, and Mathis provided inconsistent injury dates in various documents, often listing dates in June 2015, which was after her employment with Kroger was terminated on May 18, 2015, for dishonesty. The Court found Mathis failed to prove her injury occurred during her employment with Kroger due to these inconsistencies and the supervisor's testimony. Consequently, the Court denied her request for medical and temporary disability benefits and reimbursement of medical expenses, scheduling an Initial (Scheduling) Hearing for May 23, 2016.

Expedited HearingWorkers' Compensation ClaimCompensabilityMedical Treatment EntitlementTemporary Disability BenefitsBurden of ProofPreponderance of EvidenceInjury Arising out of EmploymentCourse and Scope of EmploymentCredibility Assessment
References
3
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