CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

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

Case No. MISSING
Regular Panel Decision

Claim of Jacob v. New York City Transit Authority

Claimant sustained work-related injuries in January 2000 and later sought workers’ compensation benefits alleging recurrence. An issue arose regarding the veracity of the medical history provided to the employer’s independent medical examiners, specifically concerning undisclosed prior similar injuries. A workers’ compensation law judge and subsequently the Workers’ Compensation Board found that the claimant violated Workers’ Compensation Law § 114-a, leading to disqualification from wage replacement benefits. However, the Board authorized medical treatment for the January 2000 injuries. On cross appeals, the Board’s determination was affirmed, finding substantial evidence supported the violation and the appropriateness of the penalties imposed.

Workers' Compensation Law Section 114-aMedical MisrepresentationWage Replacement Benefits DisqualificationMedical Treatment AuthorizationPrior Injuries DisclosureSubstantial Evidence ReviewIndependent Medical ExaminationWorkers' Compensation Board DecisionAppellate ReviewAffirmed Decision
References
4
Case No. MISSING
Regular Panel Decision
Jul 27, 2001

Claim of Losurdo v. Asbestos Free, Inc.

The case involves a claimant appealing a Workers’ Compensation Board decision. The Board ruled that the claimant violated Workers’ Compensation Law § 114-a by failing to disclose prior left and right knee injuries to physicians and under oath, leading to disqualification from future wage replacement benefits. Although a Workers’ Compensation Law Judge initially found no fraud, the Board reversed this determination on administrative appeal, concluding the claimant knowingly made false statements. The Appellate Division affirmed the Board's decision, finding it supported by substantial evidence, emphasizing the Board's authority as the sole arbiter of witness credibility. The court rejected the claimant's explanations of forgetting the prior incidents as not credible.

Workers' Compensation FraudMisrepresentation of Medical HistoryFalse Statements Under OathWage Replacement Benefits DisqualificationWorkers' Compensation Law Section 114-aAppellate Review of Board DecisionWitness CredibilitySubstantial EvidencePrior Knee InjuriesAdministrative Appeal
References
11
Case No. MISSING
Regular Panel Decision

Matter of Covert v. Niagara County

Claimant, a public assistance recipient, suffered a work-related injury while assigned to Niagara County through a work experience program. A Workers’ Compensation Law Judge initially established the claim and determined an average weekly wage based on public assistance benefits. After public assistance benefits were suspended, the claimant sought lost wage benefits. The Workers’ Compensation Board affirmed a WCLJ decision, ruling that payments made under the work experience program constituted "wages" under the Workers’ Compensation Law. Niagara County and its third-party administrator appealed this decision. The appellate court dismissed the appeal, holding that the Board's decision was interlocutory and did not dispose of all substantive issues, thus precluding immediate appeal. The court noted that review could be sought if and when a final determination on wage replacement benefits is issued.

Wage DeterminationPublic Assistance BenefitsWork Experience ProgramInterlocutory AppealAppellate JurisdictionMedical Evidence SufficiencySchedule Loss of UseLost Wage ClaimWorkers' Compensation Board ReviewFinality of Decision
References
9
Case No. MISSING
Regular Panel Decision

Claim of House v. International Talc Co.

Arthur House suffered a compensable occupational disease in 1973, resulting in permanent total disability and received workers' compensation benefits based on his 1973 average weekly wage. He died in 1995 from lung disease. His widow, the claimant, filed for death benefits, contending the benefits should be calculated based on the average weekly wage of a comparable employee for the year preceding his death (March 17, 1994, to March 17, 1995). The Workers’ Compensation Law Judge and the Board, however, determined that death benefits should be calculated based on House's average weekly wage from the date of his original injury, April 5, 1973. This Appellate Division affirmed the Board's decision, interpreting Workers’ Compensation Law §§ 2, 14, and 38 to establish that the date of the original injury or accident is the basis for computing both disability and death benefits, not the date of death.

Death BenefitsAverage Weekly Wage CalculationOccupational DiseasePermanent Total DisabilityStatutory InterpretationDate of DisablementAppellate DivisionTalcosisClaimant's Widow
References
6
Case No. CV-22-2386
Regular Panel Decision
Mar 27, 2025

Matter of Tirado v. Symphony Space, Inc.

Claimant Alejandro Tirado, a maintenance worker, filed two claims for work-related injuries in 2013 and received wage replacement benefits. The employer's carrier alleged claimant violated Workers' Compensation Law § 114-a by knowingly misrepresenting his physical capabilities to physicians during independent medical examinations (IMEs), supported by surveillance videos. A Workers' Compensation Law Judge (WCLJ) found a violation, imposing a mandatory penalty of forfeiture of past wage replacement benefits and a discretionary lifetime bar from future wage replacement benefits due to egregious misrepresentations. The Workers' Compensation Board affirmed the WCLJ's findings and decision. The Appellate Division, Third Department, affirmed the Board's decision, finding substantial evidence, including medical testimony and surveillance videos, supported the finding that claimant feigned or exaggerated his disability for years to influence his workers' compensation claim and that the penalty was not disproportionate to the offense.

Workers' Compensation Law § 114-aMisrepresentationExaggerated DisabilitySurveillance VideoWage Replacement BenefitsMandatory PenaltyDiscretionary PenaltyLifetime BarIndependent Medical Examination (IME)Appellate Division Affirmance
References
9
Case No. MISSING
Regular Panel Decision
Jul 19, 2004

Claim of Clarke v. Lomasney Combustion, Inc.

Claimant was receiving wage replacement benefits for a work-related injury. The employer alleged fraud stemming from claimant’s failure to disclose engagement in certain employment. A workers’ compensation law judge and subsequently the Workers’ Compensation Board found claimant violated Workers’ Compensation Law § 114-a. The Board affirmed the forfeiture of benefits and permanently disqualified claimant from receiving future wage replacement benefits due to the serious nature of the misconduct. The Appellate Division affirmed the Board’s decision, citing substantial evidence including business records, tax documents, and claimant’s admissions.

fraudwage replacement benefitsworkers' compensationmisrepresentationforfeiture of benefitsdisqualificationsubstantial evidenceemployment disclosureappellate reviewwork-related injury
References
8
Case No. MISSING
Regular Panel Decision

Matter of Petrillo v. Comp USA

Claimant appealed a Workers' Compensation Board decision that found she violated Workers’ Compensation Law § 114-a and disqualified her from future wage replacement benefits. The employer's workers' compensation carrier alleged claimant failed to report employment while receiving benefits, specifically a part-time training position at a florist. Claimant initially testified she was unpaid but later admitted receiving $430, though she maintained it was for vocational evaluation, not actual employment. The Board found claimant made false representations regarding material facts and imposed permanent disqualification from wage replacement benefits. The Appellate Division affirmed the Board's determination, finding it supported by substantial evidence and the discretionary penalty warranted.

Workers' Compensation Law § 114-aFraudMisrepresentationPermanent DisqualificationWage Replacement BenefitsSubstantial EvidenceCredibility DeterminationAppellate ReviewWorkers' Compensation Board DecisionFalse Representation
References
5
Case No. 526239
Regular Panel Decision
Dec 20, 2018

Matter of Papadakis v. Fresh Meadow Power NE LLC

Claimant Matt Papadakis sustained work-related injuries in January 2015 and was awarded workers' compensation benefits. Subsequently, surveillance footage and social media evidence revealed that the claimant had made false representations regarding his physical limitations and activities. The Workers' Compensation Board affirmed a Workers' Compensation Law Judge's ruling that claimant violated Workers' Compensation Law § 114-a and disqualified him from receiving future wage replacement benefits. The Appellate Division affirmed the finding of a violation based on substantial evidence but remitted the matter to the Board because it failed to provide a reason for the imposition of the discretionary sanction disqualifying future wage replacement benefits, thus preventing appellate review.

Workers' Compensation BenefitsFalse StatementMaterial FactSurveillance EvidenceSocial Media EvidenceWage Replacement BenefitsDisqualificationAppellate ReviewRemittalJudicial Review
References
12
Case No. MISSING
Regular Panel Decision
Feb 17, 2005

Claim of Baldwin v. Ben Funk, Inc.

Claimant, a mechanic, filed a workers' compensation claim for a lower back injury, which the State Insurance Fund (SIF) accepted. After being classified with a permanent partial disability, claimant started his own lawn and garden equipment repair business. SIF contended that claimant was no longer entitled to wage replacement benefits because his new business's average weekly wage was higher than previously awarded. A Workers' Compensation Law Judge (WCLJ) determined claimant was entitled to reduced wage replacement benefits, computing actual earnings by subtracting necessary/mandatory business expenses but disallowing optional/elective ones. The Workers’ Compensation Board affirmed this decision, finding its factual determination on expense classification proper, and thus affirmed the Board's decision.

Workers' Compensation LawReduced EarningsPermanent Partial DisabilityBusiness ExpensesWage Replacement BenefitsAppellate ReviewSubstantial EvidenceFactual DeterminationWorkers' Compensation Board DecisionSelf-Employment Income Calculation
References
2
Case No. CV-22-2386
Regular Panel Decision
Mar 27, 2025

In the Matter of the Claim of Alejandro Tirado

The claimant, Alejandro Tirado, appealed a Workers' Compensation Board decision that found he violated Workers' Compensation Law § 114-a by misrepresenting his physical capabilities. He received wage replacement benefits for work-related injuries from 2013. Surveillance videos from 2018-2021 showed him performing activities inconsistent with his reported disability during Independent Medical Examinations (IMEs), leading to findings by a Workers' Compensation Law Judge and the Board that he exaggerated his condition and used a cane as a prop. Consequently, he was subjected to a mandatory penalty disqualifying him from past wage replacement benefits and a discretionary lifetime bar from future benefits due to egregious misrepresentations. The Appellate Division affirmed the Board's decision, concluding that it was supported by substantial evidence and the discretionary penalty was not an abuse of discretion.

Workers' Compensation Law § 114-aDisqualification of BenefitsWage Replacement BenefitsSurveillance Video EvidenceIndependent Medical Examinations (IMEs)Exaggerated DisabilityFraudulent ClaimAppellate ReviewEgregious MisrepresentationsLifetime Bar
References
10
Showing 1-10 of 7,729 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational