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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. ADJ1543435
Regular
Feb 04, 2013

Sergio Cordero vs. Michael Bernier dba Pacific Services, Stellrecht Company, State Compensation Insurance Fund, Uninsured Employers Benefit Trust Fund

The Workers' Compensation Appeals Board denied reconsideration, upholding the finding that the applicant was injured in the course and scope of employment with an unlicensed contractor, Michael Bernier. The Board gave great weight to the Workers' Compensation Judge's credibility determination regarding the employer's testimony. The applicant's injury occurred while he was directed by Bernier to remove solar panels from a property owned by Stellrecht Company. The Board clarified the distinction between "course of employment" and "scope of employment" in workers' compensation law to affirm the decision.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ credibilitycourse and scope of employmentunlicensed contractoruninsured contractorgeneral-special relationshipLabor Code §2750.5B&P §7125.2Blew v. Horner
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 Sarlo v. Antona Trucking Co.

The State Insurance Fund appealed a Workers' Compensation Board decision from December 1, 1981, which found it liable due to an improper cancellation of an employer's policy. The Board ruled the cancellation failed to comply with Workers’ Compensation Law § 54(5), which requires certified or registered mail with return receipt for notice of cancellation. The State Insurance Fund only provided a mailing manifest, lacking proof that a cancellation notice was actually sent, and offered no evidence of office practice to invoke a presumption of regularity. The appellate court affirmed the Board's decision, agreeing that strict statutory conformity is necessary for policy cancellation, and awarded costs to the Uninsured Employers’ Fund.

Workers' CompensationInsurance Policy CancellationNotice RequirementsCertified MailReturn Receipt RequestedStatutory CompliancePresumption of RegularityMailing ManifestEmployer LiabilityAppellate Review
References
3
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. MISSING
Regular Panel Decision
Feb 11, 1980

Claim of Porta v. Otis Glazebrook Associates, Inc.

The Uninsured Employers’ Fund appealed a Workers’ Compensation Board decision from February 11, 1980. The fund contended that a compensation insurance policy issued by Royal Globe Insurance Co. to a corporate employer was improperly canceled and should have remained in effect after the claimant's injury. The court found that the carrier mailed the cancellation notice in the required form to the employer's last known business address and to the Workers’ Compensation Board chairman. The court stated that the insurance agency's knowledge of the employer's president living elsewhere did not require a deviation from the legal prerequisites for valid cancellation under Workers’ Compensation Law, § 54, subd 5. The decision affirmed the board's determination, concluding that substantial evidence supported it and no abuse of discretion was shown in rejecting the fund's argument.

Workers' CompensationInsurance CancellationUninsured Employers' FundPolicy CancellationStatutory ComplianceAppealSubstantial EvidenceAppellate ReviewRoyal Globe Insurance
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
Case No. MISSING
Regular Panel Decision
Feb 02, 1987

Claim of Betances v. Hexreed Industries, Inc.

This case concerns an appeal from a Workers’ Compensation Board decision, filed on February 2, 1987, which found the State Insurance Fund (SIF) not liable for compensation benefits to a claimant. The employer, Hexreed Industries, Inc., and the Uninsured Employers’ Fund (appellants) challenged SIF’s cancellation of Hexreed’s workers’ compensation policy, effective January 5, 1980, for nonpayment of premium. The core issue was whether SIF complied with Workers’ Compensation Law § 54 (5) regarding the mailing of cancellation notices via certified or registered mail with a return receipt. Appellants argued that SIF failed to produce a return receipt and that a discrepancy existed in its mailing manifest. However, the Board credited testimony from SIF's senior underwriter regarding standard office procedures for cancellations. The appellate court affirmed the Board's decision, ruling that the failure to produce a return receipt does not preclude a finding of proper cancellation and that the statutory requirement of a specified date refers to the cancellation date itself, not the filing date.

Workers' Compensation InsurancePolicy CancellationNotice of CancellationCertified MailReturn ReceiptStatutory ComplianceMailing ProceduresWorkers' Compensation BoardAppellate ReviewEmployer Liability
References
8
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. 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
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