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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

Employers' Mutual Liability Insurance v. McLellan

This motion, brought by a plaintiff insurance carrier and Flying Tigers, Inc., sought to stay payment to defendant John Johnstone. The payment was awarded by Deputy Commissioner McLellan under the Longshoremen’s and Harbor Workers’ Compensation Act for the death of James M. Johnstone. Plaintiffs argued that the Deputy Commissioner's findings on dependency and jurisdiction were erroneous and that they would suffer irreparable harm without a stay due to no provision for repayment under the Act. However, the court found the application inadequate, citing insufficient facts, rebutted dependency claims, and legally insufficient assertions of irreparable injury. Consequently, the motion for a stay of payment was denied.

Longshoremen's and Harbor Workers' Compensation ActWorkers' CompensationStay of PaymentPreliminary InjunctionIrreparable HarmDependencyJurisdictionCompensation AwardPenalty for Non-PaymentInsurance Carrier
References
8
Case No. MISSING
Regular Panel Decision

Williams v. Glass

The petitioner, a paternal grandmother, sought foster care payments for three children who had been in her custody since July 30, 1988, following their placement by the Department of Social Services (DSS). DSS initially provided payments until July 29, 1988, but subsequently denied further funding, asserting that the foster care placement had automatically terminated. The court, in reviewing the Commissioner's determination, held that under the Interstate Compact on the Placement of Children (Social Services Law § 374-a), DSS, as the sending agency, retained jurisdiction and financial responsibility for the children. The court found that the voluntary 'discharge' of the children to the grandmother was an insufficient basis to terminate DSS's ongoing supervisory and financial responsibilities. Consequently, the Commissioner's determination denying foster care payments was annulled, and the petition seeking such payments was granted.

Foster careInterstate CompactSocial Services LawCPLR article 78Judicial reviewAnnulmentChild custodyFinancial responsibilityAgency responsibilityNew York law
References
4
Case No. MISSING
Regular Panel Decision

Claim of Backus v. Wesley Health Care Center, Inc.

The Workers’ Compensation Board denied the carrier’s application for review of a February 8, 2002 decision, deeming it untimely as it was filed more than two years after the WCLJ’s initial decision. The carrier had argued that the average weekly wage was miscalculated due to a mistaken assumption about salary payment frequency. The Board also denied the carrier's subsequent application for reconsideration and/or full Board review. The appellate court affirmed the Board’s decisions, finding no abuse of discretion given the carrier’s failure to provide an explanation for the significant delay and the absence of new evidence warranting a rehearing.

Workers' Compensation BenefitsApplication TimelinessAverage Weekly WageAppellate ReviewBoard DiscretionRehearing DenialReconsideration DenialSubstantial EvidenceWorkers' Compensation LawNew York Regulations
References
6
Case No. MISSING
Regular Panel Decision
Nov 02, 1990

Claim of Mortenson v. United Parcel Service

Claimant filed a workers' compensation claim on July 29, 1987, alleging a myocardial infarction from work performed on June 15, 1985. The claim was deemed untimely by the workers' compensation insurance carrier under Workers’ Compensation Law § 28, which requires claims within two years of the accident unless an advance payment of compensation was made. The claimant argued that continued wage payments from his employer constituted such an advance payment. However, the Workers’ Compensation Board concluded that these payments were part of company policy, irrespective of the injury's cause, and thus did not qualify as an advance payment. The Appellate Division affirmed the Board's decision, emphasizing that remuneration must be linked to an acknowledgment of liability under workers' compensation law to be considered an advance payment.

Workers' CompensationMyocardial InfarctionTimeliness of ClaimAdvance PaymentWage ContinuanceEmployer LiabilityInsurance CarrierBoard DecisionAppellate ReviewStatutory Interpretation
References
2
Case No. MISSING
Regular Panel Decision

Claim of Joslin v. City of Albany Fire Department

The claimant appealed a Workers’ Compensation Board decision regarding the method of payment for his hearing loss benefits, specifically challenging the biweekly installment plan. The claimant argued that Workers’ Compensation Law § 49-bb, which governs occupational loss of hearing claims, mandated a different payment method. The court rejected this contention, asserting that Workers’ Compensation Law § 15 (3) (m), which covers schedule awards for hearing losses generally, and § 49-cc, which directs occupational loss of hearing compensation to align with § 15 (3), govern the payment. Consequently, the court affirmed that the claimant was entitled to biweekly scheduled payments, consistent with other schedule loss awards.

Hearing lossWorkers' CompensationOccupational diseaseSchedule awardBiweekly paymentsStatutory interpretationAppealCompensation benefitsWorkers' Compensation Board
References
2
Case No. MISSING
Regular Panel Decision
Jun 20, 1986

Claim of Foglia v. New York City Housing Authority

The claimant, a New York City Housing Authority police officer, sustained a compensable knee injury in 1974. The case was reopened in 1983 due to increased disability, and the Special Fund for Reopened Cases was put on notice for potential liability under Workers' Compensation Law § 25-a. The issue was whether there was an advance payment of compensation, which would relieve the Special Fund from liability. The claimant testified that he retired in 1983 but had been on limited duty performing clerical work at full salary since 1982 due to his injury. The Workers' Compensation Board determined that these full salary payments for lighter work constituted an advance payment of compensation. The court affirmed the Board's decision, finding substantial evidence to support the determination that an advance payment of compensation relieved the Special Fund from liability.

Workers' Compensation BoardAdvance PaymentSpecial FundReopened CasesDisabilitySchedule LossPolice OfficerLimited DutySubstantial EvidenceFactual Determination
References
2
Case No. MISSING
Regular Panel Decision

Claim of Marchese v. New York State Department of Correctional Services

Claimant, injured in October 1997, initially received full wages from their employer, then workers' compensation benefits after employment termination. Following an award of benefits in February 2000, a dispute arose regarding the payment of claimant's counsel fee. The Workers’ Compensation Board ruled that the fee should be paid in installments from continuing payments to the claimant, rather than from the portion reimbursing the employer. Claimant appealed this decision, arguing that continuing payments were subject to adjustment and thus not an award of compensation. The Appellate Division affirmed the Board's decision, emphasizing the Board's broad discretion under Workers’ Compensation Law § 24 and finding no unfairness in the payment method, as the award was sufficient to cover both employer reimbursement and the attorneys' lien.

Attorney FeesWorkers' Compensation LawLien on CompensationContinuing PaymentsBoard DiscretionAppellate ReviewEmployer ReimbursementAward Payment MethodStatutory InterpretationCounsel Fee
References
2
Case No. ADJ2233663 (LAO 0511232)
Regular
Feb 28, 2025

MULJI PATEL vs. BOEING NORTH AMERICAN, AIG CLAIMS SERVICES

Applicant sought removal of a Minutes of Hearing and Order Taking Off Calendar (OTOC) issued by a WCJ on April 13, 2023. The WCJ had ordered the matter off calendar due to no pending issues, defendant's lack of counsel, and an improper declaration of readiness to proceed. Applicant contended errors leading to an unjust outcome, including issues with permanent disability payments, medical co-payments, a lien, and allegations against a prior attorney, and presented a QME report from Dr. David. Defendant did not file an answer to the petition for removal, and the WCJ recommended dismissal as untimely and without merit. The Appeals Board dismissed the petition, concurring it was untimely filed more than 25 days after the OTOC, and would have denied it on merits as applicant failed to show substantial prejudice or irreparable harm.

Petition for RemovalOrder Taking Off CalendarDeclaration of Readiness to ProceedPermanent Disability PaymentsMedical Co-paymentsLienOrder Suspending ProceedsQualified Medical EvaluatorChronic PancreatitisDiabetes
References
5
Case No. MISSING
Regular Panel Decision

Claim of Gabak v. New Venture Gear

The claimant sustained a left knee injury, and an independent medical examination (IME) in August 2003 concluded no ongoing work-related disability. Subsequently, a Workers’ Compensation Law Judge (WCLJ) suspended benefits and later precluded the IME report due to untimely filing. The WCLJ also granted the employer's request to cross-examine the treating physician and ordered continued payments. The Workers’ Compensation Board affirmed the WCLJ's decision, which the appellate court further affirmed. The appellate court found that the faxed IME report on August 11, 2003, did not substantially comply with filing requirements, and the official report with IME-4 form was received untimely on August 21, 2003. It also ruled that the doctrine of laches did not apply, upholding the order for continued payments.

Independent Medical ExaminationTimely FilingWorkers' Compensation BoardAppellate ReviewMedical Evidence PreclusionLaches DoctrineCausalityContinuing DisabilityWorkers' Compensation Law § 137NYCRR 300.2 Filing Requirements
References
2
Case No. 2015-447 K C
Regular Panel Decision
Dec 19, 2017

Precious Acupuncture Care, P.C. v. GEICO Gen. Ins. Co.

Precious Acupuncture Care, P.C., as assignee of Vorel Hopkins, initiated an action against GEICO General Insurance Company to recover assigned first-party no-fault benefits. The plaintiff moved for summary judgment, while the defendant cross-moved for summary judgment to dismiss claims for services rendered on March 4 and 6, 2013, due to untimely submission, and other claims arguing full payment according to the workers' compensation fee schedule for services billed under CPT codes 97813 and 97814. The Civil Court denied the defendant's cross-motion. The Appellate Term, Second Department, reversed the Civil Court's order, finding that the defendant had presented sufficient proof of full payment for the CPT code services in line with the workers' compensation fee schedule and that the claims from March 4 and 6, 2013, were indeed untimely submitted. Consequently, the defendant's cross-motion for summary judgment regarding these specific claims was granted.

No-Fault BenefitsAcupuncture ServicesSummary JudgmentCPT CodesWorkers' Compensation Fee ScheduleUntimely SubmissionAppellate ReviewCivil Court OrderInsurance Claim
References
2
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