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Case Law Database

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

Case No. MISSING
Regular Panel Decision

Emspak v. Conroy

The defendants moved for a further bill of particulars regarding item 30 and requested the entire bill be verified by a union officer. The plaintiff's attorney acknowledged the omission for item 30 was an oversight and agreed to provide it. He argued his self-verification was proper under subdivision 3 of rule 99 of the Rules of Civil Practice, citing the plaintiff's absence from the county, and claimed defendants waived objection by not returning the bill within 24 hours. The court clarified that Rules 10 and 11 do not apply to verification. While an attorney can verify a bill of particulars under rule 117, the court ruled that merely stating the party is out of county is insufficient; the attorney must also detail the basis of their knowledge, especially given a prior order requiring an oath for inability to furnish particulars. The motion for a further bill was granted.

Bill of particularsVerificationAttorney verificationRules of Civil PracticeWaiverMotionCourt procedurePleadingSufficiency of verification
References
3
Case No. MISSING
Regular Panel Decision

Commissioners of the State Insurance Fund v. Country Carting Corp.

The Supreme Court, New York County, entered a judgment on August 5, 1998, in favor of the plaintiff and against the defendants for unpaid workers’ compensation premiums totaling $399,833.88. This judgment was unanimously affirmed on appeal. The plaintiff presented unrebutted business records, including the insurance application, audit worksheets, and invoices, which sufficiently established a prima facie case for the judgment. The defendants' request for disclosure regarding the plaintiff's assumptions and methodologies was rejected due to their prior inactivity and failure to explain discrepancies in the bills. The appellate court found the defendants' remaining arguments unpersuasive.

Workers' Compensation PremiumsUnpaid PremiumsBusiness RecordsPrima Facie EvidenceDisclosureAppellate ReviewAffirmed JudgmentSupreme CourtNew York County
References
1
Case No. ADJ9417187
Regular
Jun 05, 2018

CARLOS CAMMON vs. COUNTY OF ORANGE permissibly selfinsured, administered by YORK RISK SERVICES GROUP, INC.

This case involves lien claimants Western Medical Center and Cedars Sinai seeking reconsideration of a decision regarding their unpaid medical bills. The administrative law judge had ruled the bills were subject to independent bill review and deemed satisfied due to a failure to request second bill review. The Appeals Board rescinded the original decision, finding that the threshold issue of whether the defendant was a beneficiary of a PPO contract needed to be determined first. Furthermore, the timeliness of Cedars Sinai's second bill review request remains unresolved, necessitating further proceedings to develop the record on this issue.

Workers' Compensation Appeals BoardLien ClaimantsIndependent Bill Review (IBR)Second Bill ReviewLabor Code Section 4603.2Labor Code Section 4603.3PPO ContractExplanation of Review (EOR)Guardian Ad LitemStipulations with Request for Award
References
0
Case No. MISSING
Regular Panel Decision

At & T Corp. v. New York City Health & Hospitals Corp.

AT&T sued the New York City Health and Hospitals Corporation (HHC) for unpaid telephone bills. HHC subsequently filed a third-party complaint against NEC Business Network Solutions, Inc. (NEC), alleging faulty design and installation of a telecommunications system. NEC moved to dismiss the third-party complaint for lack of subject matter jurisdiction. District Judge Kaplan granted NEC's motion, deciding that the issues in the third-party claim, such as contract breach and negligence, substantially predominated over the original federal claim concerning unpaid telephone bills. The court declined to exercise supplemental jurisdiction as permitted under 28 U.S.C. § 1367(c).

Supplemental JurisdictionSubject Matter JurisdictionThird-Party ComplaintMotion to DismissPredominance of ClaimsJudicial DiscretionUnpaid Telephone BillsContract BreachNegligent InstallationTelecommunications Law
References
10
Case No. MISSING
Regular Panel Decision

NYAHSA Servs., Inc., Self-Insurance Trust v. People Care Inc.

This case involves an appeal from an order of the Supreme Court, which granted the plaintiff's motions for leave to amend complaints. The plaintiff, a group self-insured trust, initiated collection actions against former member employers, People Care Incorporated and Recco Home Care Services, Inc., for unpaid workers' compensation adjustment bills. The plaintiff sought to add its trustees as party plaintiffs and to update allegations to include subsequently accrued unpaid bills. The appellate court affirmed the Supreme Court's decision, clarifying that an evidentiary showing of merit is not required for leave to amend pleadings under CPLR 3025 (b) unless there is prejudice, surprise, palpable insufficiency, or patent lack of merit. The court found no such grounds for denial and also rejected the defendants' statute of limitations arguments, affirming that for contracts requiring continuing performance, each breach can restart the limitations period.

Workers' Compensation CoverageSelf-Insured TrustBreach of ContractUnjust EnrichmentPleading AmendmentCPLR 3025 (b)Statute of LimitationsPrejudiceAppellate ReviewSupreme Court Order
References
18
Case No. MISSING
Regular Panel Decision

Hojnowski v. Buffalo Bills, Inc.

David Hojnowski, a former equipment manager for the Buffalo Bills, sued his former employer alleging age discrimination under the Age Discrimination in Employment Act, New York State Human Rights Law, and violations of the Employee Retirement Income Security Act. The Buffalo Bills moved to dismiss the claims and compel arbitration, citing an arbitration clause in Hojnowski's employment contract. Hojnowski contended that the arbitration agreement was unenforceable due to the absence of arbitration rules and unconscionability. The court determined that the arbitration rules were sufficiently incorporated into the agreement and that the contract was not unconscionable. Consequently, the court granted the Bills' motion, compelling Hojnowski to arbitration and dismissing his complaint.

Arbitration AgreementEmployment LawAge DiscriminationERISANew York State Human Rights LawMotion to DismissContract EnforceabilityUnconscionability DefenseFederal Arbitration ActNFL Commissioner
References
25
Case No. ADJ8485371
Regular
Dec 01, 2014

MICHAEL (MIKE) STRATTON vs. SAN DIEGO CHARGERS, ZENITH NORTH AMERICA, BUFFALO BILLS

The Workers' Compensation Appeals Board reconsidered a prior decision regarding Michael Stratton's cumulative injury claim against the San Diego Chargers and Buffalo Bills. While the original judge found Stratton's claim against the Bills timely, the Board reversed this, determining it was barred by the statute of limitations. The Board found that neither employer breached a duty to notify Stratton of his workers' compensation rights at the time of his employment. Therefore, the statute of limitations was not tolled, and Stratton's claim against the Buffalo Bills is dismissed.

WCABStatute of LimitationsLabor Code Section 5405Date of InjuryTollingCumulative InjuryProfessional Football PlayerSan Diego ChargersBuffalo BillsZenith North America
References
17
Case No. ADJ4653538
Regular
Jun 17, 2009

DAVID ZUBIA vs. EARTHWISE TRUCKING, GALLAGHER BASSETT SCOTTSDALE

The Appeals Board granted reconsideration to amend a prior decision, but otherwise affirmed it. The employer, Earthwise Trucking, appealed a penalty and interest assessed on an unpaid medical bill, arguing they paid at the "rate in effect" and the bill was not "properly documented." The Board found that the employer's stipulation of an outstanding balance meant they did not pay the full amount due under the Official Medical Fee Schedule (OMFS) within the statutory timeframe. The Board clarified that timely payment is required according to the OMFS rate in effect on the date of service, not based on the employer's internal bill review.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardLien ClaimantPenaltyInterestOfficial Medical Fee ScheduleOMFSProperly DocumentedStipulation
References
2
Case No. MISSING
Regular Panel Decision
Nov 12, 2003

Commissioners of State Insurance Fund v. Trio Asbestos Removal Corp.

This case involves an appeal from an order of the Supreme Court, Westchester County, concerning an action to recover unpaid workers' compensation insurance premiums. The plaintiff, an insurance fund, sought premiums from the defendant for policy periods between November 1993 and December 1996. The defendant moved for summary judgment, arguing that claims for estimated premiums for the periods from November 1993 to November 1996 were barred by the six-year statute of limitations, CPLR 213 (2). The Appellate Division modified the Supreme Court's order, agreeing that the claims for unpaid estimated premiums for those specific periods were time-barred. However, the court found that claims for final audit premiums issued after July 30, 1996, were not time-barred. Additionally, the Appellate Division granted summary judgment to the plaintiff, dismissing the defendant's counterclaim, on the grounds that such counterclaims against the State Insurance Fund are only cognizable in the Court of Claims.

Workers' Compensation InsuranceUnpaid PremiumsStatute of LimitationsSummary JudgmentCounterclaimInstallment PaymentsEstimated PremiumsAudit AdjustmentAppellate DivisionNew York Law
References
2
Case No. MISSING
Regular Panel Decision
Apr 21, 2004

Zenteno v. Geils

The defendants appealed an order from the Supreme Court, Westchester County, which granted the plaintiff's motion to restore a personal injury action to the trial calendar and for leave to serve a supplemental bill of particulars. The Appellate Division affirmed the order, finding that the plaintiff demonstrated a meritorious cause of action and a reasonable excuse for delay, citing extensive medical evaluations and difficulties obtaining authorization from the Workers’ Compensation Board. The court also determined that the defendants were not prejudiced by the restoration. Furthermore, an alleged agreement to proceed to arbitration was deemed unenforceable due to non-compliance with CPLR 2104 "open court" requirements. Finally, the Supreme Court's decision to grant leave for a supplemental bill of particulars was upheld, as it pertained to continuing consequences of existing injuries rather than new ones, aligning with CPLR 3043 [b].

Personal InjuryTrial Calendar RestorationSupplemental Bill of ParticularsArbitration Agreement EnforcementCPLR 2104CPLR 3043Medical ExaminationsWorkers' Compensation IssuesAppellate ReviewProcedural Motion
References
20
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