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

Case No. 2017 NY Slip Op 04184 [150 AD3d 1589]
Regular Panel Decision
May 25, 2017

New York State Workers' Compensation Board v. Program Risk Management, Inc.

The New York State Workers' Compensation Board, acting as administrator and successor to the Community Residence Insurance Savings Plan, initiated legal action against various entities and individuals after the trust became severely underfunded. Defendants include Program Risk Management, Inc. (administrator), PRM Claims Services, Inc. (claims administrator), individual officers of PRM, the Board of Trustees, and Thomas Gosdeck (trust counsel). The plaintiff sought damages for claims such as breach of contract, breach of fiduciary duty, and legal malpractice. The Supreme Court's order partially dismissed some claims and denied others. On cross-appeal, the Appellate Division, Third Department, modified the Supreme Court's order, notably reversing the dismissal of several breach of fiduciary duty claims and common-law indemnification against PRMCS, while affirming denials of motions to dismiss breach of contract, legal malpractice, and unjust enrichment claims. The court's decision was influenced by recent rulings in State of N.Y. Workers' Compensation Bd. v Wang.

Workers' Compensation LawGroup Self-Insured TrustBreach of ContractBreach of Fiduciary DutyLegal MalpracticeUnjust EnrichmentStatute of LimitationsEquitable EstoppelAlter Ego LiabilityCommon-Law Indemnification
References
20
Case No. ADJ6857384
Regular
Dec 07, 2009

KATHLEEN BACA vs. COUNTY OF MARIN, TRI STAR RISK MANAGEMENT

"The appeals board granted defendant's petition to remove the finding that Jeffrey Amheiter was a managing agent. The board affirmed the order, except for amending it to reflect that Amheiter is not a managing agent."

Petition for RemovalManaging AgentCode of Civil Procedure section 1987(b)DepositionSupervisory ClassificationIndustrial InjuryNerves and PsycheClass SpecificationWCJ Report and RecommendationWorkers' Compensation Appeals Board
References
0
Case No. MISSING
Regular Panel Decision

Tri-State Employment Services, Inc. v. Mountbatten Surety Co.

The United States Court of Appeals for the Second Circuit certified a question to the New York Court of Appeals regarding whether a professional employer organization (PEO) may be a proper claimant under a labor and materials surety bond. Plaintiff Tri-State Employment Services, Inc., a PEO, provided employee leasing services to Team Star Contractors, Inc. for a construction project, covering payroll, taxes, and insurance. When Team Star failed to pay, Tri-State filed a claim with the surety, Mountbatten Surety Company, Inc., which was dismissed by the District Court. The New York Court of Appeals determined that a PEO's primary role as an administrative services provider and payroll financier creates a presumption that it does not provide labor for the purpose of a payment bond claim. The Court found that Tri-State failed to overcome this presumption by demonstrating sufficient direction and control over the workers. Consequently, the Court answered the certified question in the negative, ruling that Tri-State Employment Services, Inc. is not a proper claimant under the surety bond in the circumstances presented.

Professional Employer OrganizationSurety BondLabor and Materials BondClaimant StatusEmployee LeasingPayroll ServicesAdministrative ServicesConstruction ContractCertified QuestionNew York Law
References
16
Case No. 2017 NY Slip Op 27428
Regular Panel Decision
Dec 14, 2017

New York State Workers' Compensation Bd. v. Compensation Risk Mgrs., LLC

This action was brought by the New York State Workers' Compensation Board (WCB), as an assignee of former members of the Healthcare Industry Trust of New York (HITNY), against Compensation Risk Managers, LLC (CRM), HITNY trustees, and auditing firm UHY LLP. The WCB alleged mismanagement, breach of fiduciary duty, and negligent auditing, leading to the Trust's insolvency. Defendants moved to dismiss on grounds of standing, statute of limitations, and pleading particularity. The court dismissed certain derivative claims and negligent misrepresentation claims against some trustees due to standing issues and statute of limitations. All claims against UHY LLP were dismissed for lack of a near-privity relationship or prior precedent. An implied indemnity claim against the trustees was sustained. The WCB's cross-motion to consolidate related actions was denied.

Workers' Compensation LawGroup Self-Insured Trust (GSIT)Fiduciary DutyNegligenceNegligent MisrepresentationStatute of LimitationsStandingDerivative ActionImplied IndemnityAuditing Firm Liability
References
46
Case No. MISSING
Regular Panel Decision
Jul 26, 2000

AIU Insurance v. Unicover Managers, Inc.

This case involves plaintiff insurance companies, AIG, seeking a declaration that defendant ReliaStar Life Insurance Company was bound to reinsure AIG for certain workers' compensation risks based on reinsurance slips signed by Unicover Managers, Inc., ReliaStar's managing general underwriter. The Supreme Court, New York County, dismissed AIG's complaint against ReliaStar and Unicover, and ReliaStar's third-party complaint against E.W. Blanch Company. The appellate court affirmed the dismissal, finding that the parties' correspondence and conduct established that reinsurance would only be bound upon ReliaStar's own signature, negating any actual or apparent authority of Unicover or ratification by ReliaStar. Estoppel and misrepresentation claims against both defendants were also dismissed. The judgment was modified to explicitly dismiss all remaining cross claims and counterclaims, and the initial dismissal was otherwise affirmed.

Reinsurance AgreementSummary JudgmentContract InterpretationAgency AuthorityApparent AuthorityRatificationEstoppelMisrepresentationWorkers' Compensation RisksCross Claims
References
3
Case No. ADJ4090183 (AHM 0145662) ADJ3895909 (ANA 0396258)
Regular
Sep 21, 2015

Deena Newland vs. CHOC Children's Hospital, TRI-STAR RISK MANAGEMENT

This case concerns a petition for removal filed by Jacquelyn Sherlin, the attorney for the defendant, who sought removal of an order denying her request for reassignment and change of venue. Sherlin alleged a conflict of interest and inadequacy of sanctions against a lien claimant stemming from an incident at a lien conference. The Appeals Board denied removal, finding Sherlin lacked standing as she is not a party to the case but rather a witness and alleged victim. The Board also affirmed the venue and the WCJ's denial of Sherlin's requests.

Workers' Compensation Appeals BoardPetition for RemovalAdministrative Law JudgeMonetary SanctionsLien ClaimantConflict of InterestSubstantial PrejudiceIrreparable HarmStandingAutomatic Reassignment
References
0
Case No. ADJ7199986 ADJ7399845
Regular
Oct 03, 2011

ELMIRA SMITH vs. PACIFIC AUTISM CENTER FOR EDUCATION, TRI- STAR RISK MANAGEMENT

The applicant sought removal to challenge a finding that defendant's requested Qualified Medical Evaluator (QME) panel was properly assigned. The Appeals Board granted removal, rescinded the finding, and determined that *neither* panel was properly assigned. Both panel requests were found to be premature as they were made before the statutory 10-day period for agreeing on an Agreed Medical Evaluator had expired, plus an additional five days for mail service. This decision clarifies the timing requirements for QME panel requests following an unsuccessful attempt to select an AME.

Petition for RemovalQualified Medical Evaluator (QME)Agreed Medical Evaluator (AME)Labor Code section 4062.2(b)WCAB Rule 10507Messele v. Pitco FoodsInc.Premature RequestPanel AssignmentMedical Unit
References
2
Case No. ADJ158605 (RIV 0028842)
Regular
Nov 14, 2008

CHARLES WEBSTER vs. COUNTY OF RIVERSIDE RISK MANAGEMENT

The Workers' Compensation Appeals Board denied Charles Webster's petition for reconsideration in his case against County of Riverside Risk Management. The Board adopted the findings and reasoning of the workers' compensation administrative law judge in their decision. This order formally denies Webster's request to have the case reconsidered.

Workers' Compensation Appeals BoardOrder Denying ReconsiderationWCJ ReportPetition for ReconsiderationTapia v. Skill Masters StaffingAppeals Board en bancADJ158605RIV 0028842County of Riverside Risk ManagementCharles Webster
References
1
Case No. ADJ3968337 (LAO 0844136) ADJ4336885 (LAO 0805868) ADJ672008 (LAO 0805870)
Regular
Sep 24, 2015

ARMIDA BELTRAN vs. MCDONALD'S, HAZELRIGG RISK MANAGEMENT SERVICES

This case involves a petition for reconsideration by McDonald's and Hazelrigg Risk Management Services regarding deposition attorney fees. The Workers' Compensation Appeals Board (WCAB) is dismissing the petition because the petitioner has withdrawn it. This withdrawal is consistent with a prior WCJ order rescinding the attorney fee orders, allowing for further discovery on deposition attorney fee payments. Consequently, the petition for reconsideration is dismissed.

Petition for ReconsiderationWCJrescindeddeposition attorney fee ordersCIGAOrder of Rescissioncrossed in the mailwithdrawn petitionfurther discoveryprior payment
References
0
Case No. 2016 NY Slip Op 00302 [135 AD3d 572]
Regular Panel Decision
Jan 19, 2016

Domaszowec v. Residential Management Group LLC

Plaintiff Tracy Domaszowec's decedent died from a fall while cleaning a window on the 13th floor of an apartment building. The Appellate Division, First Department, modified a Supreme Court order, granting plaintiff's motion for partial summary judgment on her Labor Law § 240 (1) claim against Residential Management Group LLC and 40 Fifth Avenue Corporation (40 Fifth defendants), the building owner and manager. The court found the decedent was engaged in "commercial window washing," thereby making Labor Law § 240 (1) applicable. The court affirmed the dismissal of Labor Law § 202 against Veronica Bulgari and Stephen Haimo due to lack of exclusive control, and common-law negligence claims against T&L Contracting of N.Y., Inc. and Greenpoint Woodworking Inc. due to the lack of an exception to the contractual obligation rule. Issues of fact precluded summary judgment on negligence claims against Panorama Windows, Ltd., and the doctrine of res ipsa loquitur was deemed inapplicable to certain defendants.

Window cleaner fatalityScaffold LawSummary judgment appealAppellate Division First DepartmentCommercial vs. routine window washingLabor Law applicabilityContractual tort liabilityRes ipsa loquitur in negligencePunitive damages dismissalExpert witness evidence
References
8
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