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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 07023 [154 AD3d 1037]
Regular Panel Decision
Oct 05, 2017

Matter of Passero v. Uninsured Employers' Fund

The claimant, Edmund Passero, a bricklayer, filed a workers' compensation claim in 2011 for an occupational disease resulting from repetitive stress. A Workers' Compensation Law Judge (WCLJ) initially established the claim against DeSpirit Mosaic & Marble Co. and later apportioned liability among three employers, including J. William Pustelak Inc., found to be uninsured. The Uninsured Employers' Fund (UEF) sought administrative review, but the Workers' Compensation Board denied the appeal as untimely. The Appellate Division, Third Department, reversed the Board's finding on the timeliness of UEF's application, holding that UEF would not have incurred an obligation until the WCLJ's December 2014 decision which apportioned liability. The case was remitted to the Workers' Compensation Board to consider the merits of UEF's appeal.

Workers' CompensationOccupational DiseaseUntimely AppealAdministrative ReviewLiability ApportionmentUninsured EmployerDate of DisablementThird DepartmentAppellate DivisionClaimant Benefits
References
5
Case No. LAO 0784069
Regular
Feb 11, 2008

RICARDO LOPEZ vs. HYON SEOP KIM, Individually and dba H.B. CONSTRUCTION, AARON SONG, an Individual, Illegally Uninsured, THE DIRECTOR OF INDUSTRIAL RELATIONS, As Administrator of THE UNINSURED EMPLOYERS BENEFITS TRUST FUND

The Uninsured Employers Benefits Trust Fund (UEBTF) was not liable for a penalty on an attorney's fee award due to unreasonable delay. However, Labor Code section 3716.2 obligates the UEBTF to seek such penalties in civil enforcement actions against uninsured employers. Therefore, the Appeals Board amended the award to clarify that while UEBTF is not directly liable for the penalty, it remains part of the underlying award that UEBTF must pursue from the uninsured employers.

Uninsured Employers Benefits Trust FundUEBTFAttorney's fee awardLabor Code section 5814Labor Code section 3716.2Civil suitReconsiderationFindings and AwardWCJPenalty
References
1
Case No. MISSING
Regular Panel Decision

Claim of Shutter v. Philips Display Components Co.

The claimant, injured in a work-related single-car accident, received workers' compensation benefits and also pursued an uninsured motorist claim, recovering $124,697.95. The Workers' Compensation Board ruled that the employer's insurance carrier was entitled to offset this recovery against future compensation benefits, overturning a prior WCLJ decision. The claimant appealed, arguing that Workers' Compensation Law § 29's offset provisions apply only to third-party tortfeasor actions, not uninsured motorist proceeds. The court rejected this argument, finding the statute's general terminology encompasses uninsured motorist benefits and that legislative intent for exclusion only exists for no-fault benefits, not uninsured motorist benefits under Insurance Law § 3420 (f). Consequently, the Board's decision was affirmed.

Uninsured motoristWorkers' Compensation LawOffsetInsurance carrierThird-party tortfeasorLien provisionsStatutory interpretationLegislative intentNo-fault insuranceCompensation benefits
References
3
Case No. MISSING
Regular Panel Decision

In re the Arbitration between Williams

Amoco Oil appealed two judgments from the Supreme Court, Nassau County, concerning arbitration for uninsured motorist and no-fault benefits. The first judgment, dated January 6, 1977, granted New Hampshire Insurance Company's application to stay arbitration, deeming Amoco Oil's coverage primary and New Hampshire's secondary for uninsured motorist benefits. The second judgment, dated March 30, 1977, permanently stayed arbitration for no-fault benefits under New Hampshire's policy. The Appellate Division affirmed both judgments, concluding that the claimant was "occupying" the Amoco Oil vehicle, making Amoco Oil primarily liable for uninsured motorist benefits. However, the claimant was precluded from receiving these benefits due to already receiving workers' compensation benefits in excess of the maximum, and was also ineligible for no-fault benefits under the New Hampshire policy.

Insurance DisputeArbitration ProceedingsUninsured Motorist CoverageNo-Fault InsuranceWorkers' CompensationPrimary vs Secondary LiabilityAppellate DivisionNassau County Supreme CourtVehicle OccupancyBenefit Eligibility
References
3
Case No. ADJ843966 (SDO 0338705)
Regular
Dec 13, 2013

Reed Thomas Kirby vs. Arthur Gonzales, STATE FARM INSURANCE COMPANY, KEITH PATRICK DONNELLY, UNINSURED EMPLOYERS BENEFITS TRUST FUND

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to amend a prior award. The WCAB affirmed the finding that the applicant sustained an injury while employed as a tree trimmer by an uninsured employer, Keith Patrick Donnelly. However, the WCAB amended the award to reflect that liability rests solely with the uninsured employer, not the Uninsured Employers Benefits Trust Fund (UEBTF), as UEBTF's liability is derivative. The WCAB rejected arguments that the City of San Diego was also responsible and confirmed the applicant is entitled to benefits from Donnelly.

Uninsured Employers Benefits Trust FundUEBTFKeith Patrick DonnellyTarzan Tree SpecialistsArthur GonzalesState Farm Insurance Companytree trimmerderivative defendantLabor Code section 3352(h)City of San Diego
References
2
Case No. ADJ387954 (OXN 0145858) ADJ2973719 (OXN 0145147)
Regular
Oct 27, 2017

FRANCISCO PRIETO vs. O.C. CONTRACTING, INC., AMERICAN INTERNATIONAL GROUP, INC., UNINSURED EMPLOYERS BENEFITS TRUST FUND

This case concerns a Petition for Reimbursement filed by Granite State Insurance Company against the Uninsured Employers Benefits Trust Fund (UEBTF). Granite State mistakenly paid workers' compensation benefits to an employee injured while working for an uninsured employer. The Workers' Compensation Appeals Board (WCAB) rescinded a prior order granting reimbursement, holding that UEBTF is not statutorily liable to reimburse insurance carriers for erroneous payments. The WCAB emphasized that UEBTF's purpose is to provide benefits to injured workers of uninsured employers, not to indemnify insurers. A dissenting opinion argued for amending the order to allow reimbursement to Granite State through applicant from funds UEBTF owes the applicant.

Uninsured Employers Benefits Trust FundGranite State Insurance CompanyPetition for ReimbursementLabor Code sections 37153716mistaken paymentillegally uninsured employerLabor Code section 4909creditdirect reimbursement
References
0
Case No. LAO 0722567
Significant

Daniel Milbauer, Applicant vs. Erez Boostan, an individual and dba American Runner Attorney Service, uninsured; Uninsured Employers Fund

The Appeals Board dismisses the Uninsured Employers Fund's petition for reconsideration because UEF is not legally 'aggrieved' by the prior decision, the challenged procedures are not a 'final' order, and the petition is successive.

Uninsured Employers FundPetition for ReconsiderationEn BancActing Director of Industrial RelationsAdministrative Law JudgeSupplemental Findings and AwardIndustrial InjuryLegal Identity of EmployerAggrieved PartyFinal Order
References
9
Case No. LAO 0722567
Significant

Daniel Milbauer, Applicant vs. Erez Boostan, Uninsured Employers Fund

The Appeals Board affirms a judge's finding on the correct legal identity of an uninsured employer and establishes procedures to ensure the Uninsured Employers Fund (UEF) actively assists in identifying employers in future cases to avoid significant delays.

Uninsured Employers FundEn Banc DecisionJurisdictional IssueEmployer IdentityService of ProcessSubstantial EvidenceGood Faith EffortProvisional AppearanceDirector of Industrial RelationsLabor Code Section 3716(d)(4)
References
13
Case No. ADJ4422874 (VNO 0482500)
Regular
Sep 24, 2009

BLANCA ANCHONDO vs. DIANE LIN dba PANORAMA MOTEL, illegally uninsured, and UNINSURED EMPLOYERS BENEFIT TRUST FUND

The Workers' Compensation Appeals Board dismissed Blanca Anchondo's petition for reconsideration because she failed to properly serve the Uninsured Employers Benefit Trust Fund, a party in the case. This procedural defect alone is grounds for dismissal under Labor Code section 5905. Even if considered on its merits, the Board would have denied the petition, upholding the Administrative Law Judge's finding that the applicant did not sustain an injury arising out of and in the course of employment. The Board gave significant weight to the judge's credibility determinations.

WORKERS' COMPENSATION APPEALS BOARDPetition for ReconsiderationFindings and Ordercumulative periodtimely denydeposition transcript testimonylast day of trialpost-termination defenseUninsured Employers Benefit Trust Fundservice of petition
References
1
Case No. MISSING
Regular Panel Decision

Claim of Jones v. Uninsured Employers' Fund

A claimant sustained injuries while working for Rhonda Hartley Construction (RHC), a subcontractor hired for tree limb removal from Erie County recreational areas following storm damage. Initially, RHC, along with other contractors American Site Developers LLC and Ray Debris Removal, were found uninsured, leading to the Uninsured Employers’ Fund being liable for benefits. The Fund appealed, arguing that Erie County should be held liable under Workers’ Compensation Law § 56 as an owner of timber. Both the Workers’ Compensation Board and the appellate court affirmed that Erie County was not liable. The decision was based on the absence of a direct contractual relationship between Erie County and the claimant's employer, RHC, a prerequisite for imposing liability under the statute.

Workers' Compensation Law § 56Timber Owner LiabilityContractual RelationshipSubcontractor LiabilityUninsured Employers' FundTree Trimming InjuryStorm DamageErie CountyAppellate ReviewWorkers' Compensation Board
References
3
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