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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

Kosakow v. New Rochelle Radiology Associates, P.C.

Nancy Kosakow sued her former employer, New Rochelle Radiology Associates, alleging FMLA violations and wrongful denial of severance pay under ERISA. The court previously found FMLA claims collaterally estopped but remanded the ERISA claim to the Plan Administrator for a determination on severance eligibility. The Administrator denied severance, finding Kosakow not "terminated" and, even if so, not entitled to severance. This court reversed the "not terminated" finding, stating Kosakow was terminated due to a reduction in force. However, the court affirmed the Administrator's denial of severance, concluding that the "where applicable" clause in the Plan gave the Administrator broad discretion and that Kosakow's circumstances did not warrant severance. The court found that the denial was not unreasonable, even when considering a severance payment made to another full-time employee under different circumstances.

ERISASeverance PayFMLATerminationSummary JudgmentDe Novo ReviewPlan Administrator DiscretionEmployee BenefitsReduction in ForcePolicy Manual
References
8
Case No. MISSING
Regular Panel Decision
Dec 11, 2002

Claim of Speer v. Wackenhut Corp.

The claimant sought workers' compensation benefits for mental depression, alleging it resulted from being removed from a security guard position by their employer. The Workers' Compensation Board initially ruled the injury non-compensable under Workers' Compensation Law § 2 (7), deeming it a direct consequence of lawful personnel decisions. The claimant subsequently filed applications for full Board review and reconsideration, both of which were denied by the Board. This appeal concerns the denials of those applications. The court dismissed the appeal from the May 1, 2002 denial as untimely and affirmed the December 11, 2002 denial, finding that the Board did not abuse its discretion by not requiring transcription of oral arguments before rendering its decision.

Workers' CompensationMental DepressionStress-related InjuryPersonnel DecisionsReconsideration DenialFull Board ReviewAppellate ProcedureTimeliness of AppealOral Argument TranscriptionAdministrative Discretion
References
3
Case No. MISSING
Regular Panel Decision

Bush v. Mechanicville Warehouse Corp.

This case involves an appeal from the denial of a third-party defendant's (Yankee One Dollar Stores, Inc.) motions for summary judgment against a defendant (Mechanicville Warehouse Corp.). The plaintiff, Bush, was injured at work and sued Mechanicville, who then brought a third-party action against Yankee for indemnification. Yankee argued that plaintiff did not sustain a 'grave injury' under Workers’ Compensation Law § 11 and that there was no written contractual indemnification agreement. The appellate court affirmed the denial of summary judgment regarding the 'grave injury' claim, finding sufficient evidence of permanent total disability due to a traumatic brain injury. However, the court reversed the denial of summary judgment for contractual indemnification, ruling that Workers’ Compensation Law § 11 requires an *express written contract* of indemnification from the employer, which was not present between Yankee and Mechanicville.

Summary JudgmentThird-Party ActionWorkers' Compensation Law § 11Grave InjuryContractual IndemnificationBrain InjuryPermanent Total DisabilityHoldover TenantExpress AgreementAppellate Review
References
18
Case No. ADJ2562535 (BAK 0151733)
Regular
Jan 07, 2014

STEVE ADAMS vs. COUNTY OF KERN, Permissibly Self-Insured

The Workers' Compensation Appeals Board reversed a finding that the defendant did not unreasonably delay compensation payments. The applicant sustained an industrial injury to his pulmonary system, and medical evidence confirmed the injury was work-related. The Board found that despite the existence of an agreed medical examiner's report confirming the injury, the defendant's denial of liability persisted for an unreasonable period. Consequently, the defendant was found to have unreasonably delayed payments for temporary disability, permanent disability, and mileage reimbursement, with the penalty amount to be determined.

Industrial InjuryPulmonary SystemCode Compliance OfficerPermanent DisabilityReconsiderationLabor Code 5814Delay PenaltiesAgreed Medical ExaminerPulmonary DiseaseOccupational Asthma
References
6
Case No. MISSING
Regular Panel Decision
Jun 25, 1997

Job v. 1133 Building Corp.

The plaintiff appealed the denial of his motion for partial summary judgment on liability under Labor Law § 240 (1) after sustaining injuries from a fall while dismantling a scaffold at a building owned by 1133 Building Corp. The defendant, 1133 Building Corp., and third-party defendants, Big Apple Wrecking and HRH Construction Corporation, opposed the motion. An affidavit from the plaintiff's foreman alleged that a safety belt was provided and the plaintiff was instructed to use it. The Supreme Court denied the motion, finding a triable issue of fact regarding whether the plaintiff was a 'recalcitrant worker.' The appellate court affirmed this denial, citing conflicting evidence on the availability and use of safety devices.

Personal InjuryLabor LawScaffold AccidentSummary JudgmentRecalcitrant WorkerSafety DevicesAppellate ReviewPremises LiabilityConstruction SiteThird-Party Action
References
5
Case No. MISSING
Regular Panel Decision

Claim of Snarski v. New Jersey Manufacturers Insurance Group

The Workers' Compensation Board denied an application by New Jersey Manufacturers Insurance Group for reconsideration of a prior decision finding it liable as the workers' compensation carrier for a claimant's back injury. The claimant, an equipment operator, sustained the injury in October 2000 in Sullivan County, New York, while working for a New Jersey corporation. Initially, the carrier controverted the New York claim, asserting its policy only covered jobs in New Jersey. However, a Workers’ Compensation Law Judge and the Board found the policy vague and ruled the carrier liable. The carrier appealed the Board's denial of reconsideration, but not the underlying liability decision. The court affirmed the Board's denial, finding it was not arbitrary or capricious, and the carrier presented no new evidence to warrant a change.

Workers' Compensation LawInsurance CoverageAppellate ReviewBoard DecisionReconsideration DenialArbitrary and Capricious StandardAbuse of DiscretionPolicy InterpretationJurisdictionBack Injury
References
4
Case No. MISSING
Regular Panel Decision

Ribya BB. v. Wing

Petitioner initiated a CPLR article 78 proceeding to challenge the denial of her request to expunge her name from the State Central Register of Child Abuse and Maltreatment. An indicated report of child maltreatment was filed after she allegedly left her severely disabled and autistic child unsupervised on three occasions in November 1994. Despite her claim that a cousin was watching the child, an administrative review and subsequent hearing found 'some credible evidence as well as a fair preponderance' of evidence supporting maltreatment, leading to the denial of her expungement request. The Appellate Division confirmed the respondent's determination, citing substantial evidence including admissible double hearsay and inconsistencies in testimony, and dismissed the petition.

Child MaltreatmentExpungementState Central RegisterChild AbuseAdministrative LawJudicial ReviewSubstantial EvidenceHearsay AdmissibilityCredibility AssessmentParental Responsibility
References
11
Case No. MISSING
Regular Panel Decision
Jun 25, 2002

Barreiros v. JJR Associates, Inc.

This case concerns an appeal by a third-party defendant following the denial of its motion for summary judgment to dismiss a third-party complaint in a personal injury action. The appellate court reversed the Supreme Court's order, granting the motion and dismissing the complaint. The court found that the third-party defendant successfully demonstrated that the plaintiff's injuries, though serious, did not constitute 'grave' injuries under Workers’ Compensation Law § 11. Additionally, it was established that the third-party defendant had fulfilled the insurance requirements stipulated in the parties' agreement. Therefore, the Supreme Court's initial denial of the summary judgment motion was deemed erroneous.

Personal InjurySummary JudgmentThird-Party ComplaintWorkers' Compensation LawGrave InjuryAppellate ReviewMotion GrantedOrder ReversedInsurance ComplianceSuffolk County
References
6
Case No. ADJ9489540
Regular
Jun 03, 2019

KEN JENSEN vs. COUNTY OF SANTA BARBARA, DEPARTMENT OF SOCIAL SERVICES, Permissibly Self-Insured, CORVEL CORPORATION (Claims Administrator)

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration of an award. The applicant sought multiple penalties for the defendant's alleged continuous unreasonable denial and delay of benefits. However, the Board found that the defendant's conduct constituted a single unreasonable act, not multiple distinct acts required for separate penalties under Labor Code section 5814. The applicant is entitled to only one penalty.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and AwardLabor Code section 5813Labor Code section 5814unreasonable denial of benefitsfrivolous delaysanctionsattorney's feespenalty
References
2
Case No. OXN 0133895
Regular
Aug 11, 2008

DIANE GONZALEZ-SMITH, DIANE GONZALES-SMITH vs. ADECCO EMPLOYMENT SERVICES, INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA

The applicant sought reconsideration of a denial for penalties, interest, and attorney fees stemming from a workers' compensation settlement. The applicant contended the employer unreasonably delayed payment of the Compromise and Release (C&R) proceeds, which were mailed on the 30th day after approval. The Appeals Board denied reconsideration, finding the employer's actions were not unreasonable given the C&R terms and that issues not raised at trial were waived.

Workers' Compensation Appeals BoardAdecco Employment ServicesInsurance Company of the State of PennsylvaniaCompromise and ReleaseLabor Code section 5814Labor Code section 5814.5Labor Code section 5800unreasonable delaypenaltyattorneys' fees
References
2
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