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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 04184 [150 AD3d 1589]
Regular Panel Decision
May 25, 2017

New York State Workers' Compensation Board v. Program Risk Management, Inc.

The New York State Workers' Compensation Board, acting as administrator and successor to the Community Residence Insurance Savings Plan, initiated legal action against various entities and individuals after the trust became severely underfunded. Defendants include Program Risk Management, Inc. (administrator), PRM Claims Services, Inc. (claims administrator), individual officers of PRM, the Board of Trustees, and Thomas Gosdeck (trust counsel). The plaintiff sought damages for claims such as breach of contract, breach of fiduciary duty, and legal malpractice. The Supreme Court's order partially dismissed some claims and denied others. On cross-appeal, the Appellate Division, Third Department, modified the Supreme Court's order, notably reversing the dismissal of several breach of fiduciary duty claims and common-law indemnification against PRMCS, while affirming denials of motions to dismiss breach of contract, legal malpractice, and unjust enrichment claims. The court's decision was influenced by recent rulings in State of N.Y. Workers' Compensation Bd. v Wang.

Workers' Compensation LawGroup Self-Insured TrustBreach of ContractBreach of Fiduciary DutyLegal MalpracticeUnjust EnrichmentStatute of LimitationsEquitable EstoppelAlter Ego LiabilityCommon-Law Indemnification
References
20
Case No. MISSING
Regular Panel Decision
Jun 11, 1993

Empire Insurance v. Workers' Compensation Board

Empire Insurance Company denied Hugh Wofsy's no-fault benefits claim, alleging he was a Dial-a-Car, Inc. employee requiring Workers' Compensation. An Administrative Law Judge later found Wofsy an independent contractor, denying him Workers' Compensation. Empire sought to reopen the Workers' Compensation claim to participate, which the Board denied. Empire then initiated a CPLR article 78 proceeding, where the IAS Court allowed the reopening and ordered Empire to pay Wofsy, with potential reimbursement. The Appellate Division subsequently reversed this judgment, dismissing Empire's petition, emphasizing that Workers' Compensation Law § 23 vests exclusive appeal jurisdiction with the Third Department and precludes article 78 proceedings for reviewing Board decisions' substance.

No-fault insuranceIndependent contractor disputeEmployee status determinationCPLR Article 78 proceedingAppellate Division jurisdictionWorkers' Compensation Law § 23Judicial review of administrative decisionsInsurance coverage disputeAdministrative Law Judge rulingReimbursement claim
References
2
Case No. 2017 NY Slip Op 08595 [156 AD3d 1043]
Regular Panel Decision
Dec 07, 2017

New York State Workers' Compensation Board v. Any-Time Home Care Inc.

The New York State Workers' Compensation Board, acting as administrator for a dissolved self-insured trust, initiated an action to recover a $133 million cumulative deficit from former trust members. Various defendants sought to dismiss the complaint, asserting claims were time-barred by a three-year statute of limitations for statutory liabilities, failed to adequately state claims against individual partners, and were barred by the doctrine of laches. The Supreme Court denied these motions. On appeal, the Appellate Division, Third Department, affirmed the Supreme Court's order, ruling that the claims were contractual, subject to a six-year limitation period, and that laches did not apply against the state enforcing a public right. The court also found the complaint sufficiently specific regarding the liability of individual defendants.

Workers' Compensation LawSelf-Insurance TrustJoint and Several LiabilityStatute of LimitationsContractual LiabilityLaches DoctrineAppellate ReviewGroup Self-InsurerDeficit RecoveryPartnership Liability
References
16
Case No. 2018 NY Slip Op 08227
Regular Panel Decision
Nov 29, 2018

Matter of Kelly v. New York State Workers' Compensation Bd.

In 2006, claimant Grace Kelly established a workers' compensation claim for an occupational disease. The State Insurance Fund (SIF) repeatedly sought to transfer liability to the Special Fund for Reopened Cases, which was denied by Workers' Compensation Law Judges. The Workers' Compensation Board affirmed these denials and assessed $500 penalties against both SIF and its counsel, Walsh and Hacker, for filing an application for review without reasonable grounds. Walsh and Hacker appealed the penalty imposed against them to the Appellate Division, Third Department. The Appellate Division found insufficient evidence to support the Board's finding that Walsh and Hacker's application lacked reasonable grounds, and therefore reversed the penalty against them, modifying and affirming the Board's decision.

PenaltiesAppellate ReviewSpecial Fund for Reopened CasesWorkers' Compensation Law § 25-aWorkers' Compensation Law § 114-aAttorney SanctionsAdministrative LawBoard DecisionJudiciary Law § 431
References
4
Case No. 2017 NY Slip Op 27428
Regular Panel Decision
Dec 14, 2017

New York State Workers' Compensation Bd. v. Compensation Risk Mgrs., LLC

This action was brought by the New York State Workers' Compensation Board (WCB), as an assignee of former members of the Healthcare Industry Trust of New York (HITNY), against Compensation Risk Managers, LLC (CRM), HITNY trustees, and auditing firm UHY LLP. The WCB alleged mismanagement, breach of fiduciary duty, and negligent auditing, leading to the Trust's insolvency. Defendants moved to dismiss on grounds of standing, statute of limitations, and pleading particularity. The court dismissed certain derivative claims and negligent misrepresentation claims against some trustees due to standing issues and statute of limitations. All claims against UHY LLP were dismissed for lack of a near-privity relationship or prior precedent. An implied indemnity claim against the trustees was sustained. The WCB's cross-motion to consolidate related actions was denied.

Workers' Compensation LawGroup Self-Insured Trust (GSIT)Fiduciary DutyNegligenceNegligent MisrepresentationStatute of LimitationsStandingDerivative ActionImplied IndemnityAuditing Firm Liability
References
46
Case No. MISSING
Regular Panel Decision

Claim of D'Addio v. Peter Annis, Inc.

A widow filed a claim for workers' compensation death benefits after her husband, who had an established claim for asbestosis, died. A Workers' Compensation Law Judge (WCLJ) found a work-related death and ordered the employer's carrier to deposit funds into the aggregate trust fund (ATF) in July 2010. The carrier did not appeal this initial decision. After a subsequent WCLJ decision in December 2010 reiterated the ATF deposit, the carrier sought review, arguing the deposit was unwarranted. The Workers' Compensation Board denied the carrier's application as untimely. The appellate court affirmed the Board's decision, holding that the 30-day appeal period for the July 2010 decision had expired and the later WCLJ decision did not extend that timeframe. The court found no abuse of discretion by the Board.

Workers' CompensationUntimely ApplicationAggregate Trust FundDeath BenefitsAsbestosisOccupational DiseaseAppellate ReviewBoard DiscretionTimelinessAppeal Denial
References
5
Case No. 532391
Regular Panel Decision
Nov 18, 2021

Matter of Richman v. New York State Workers' Compensation Bd.

Claimant, Rebecca Richman, appealed three decisions from the Workers' Compensation Board regarding her claim for a work-related right shoulder injury. She alleged a fall at work on January 19, 2018, but did not seek medical treatment for 19 months. A Workers' Compensation Law Judge initially established the claim, but the Board reversed, finding that Richman failed to submit sufficient, credible medical evidence to demonstrate a causally-related injury and denied her claim. The Board subsequently denied her application for reconsideration and/or full Board review. The Appellate Division affirmed the Board's decisions, concluding that the Board's finding of no causally-related injury was supported by substantial evidence and that the Board did not abuse its discretion in denying reconsideration.

Workers' Compensation ClaimCausation (Medical)Shoulder InjuryMedical Evidence SufficiencyBoard ReversalAppellate Division ReviewBurden of ProofCredibility of EvidenceOsteoarthritis DiagnosisDelayed Medical Treatment
References
8
Case No. MISSING
Regular Panel Decision

Matter of Saratoga Skydiving Adventures v. Workers' Compensation Board

Saratoga Skydiving Adventures appealed a Workers’ Compensation Board decision upholding a stop-work order. The initial order was issued after an investigation revealed the company lacked workers' compensation coverage, with owner Bob Rawlins asserting his workers were independent contractors. Following a hearing, a Workers’ Compensation Law Judge denied Saratoga Skydiving's application to lift the order. The appellate court affirmed this denial, determining that substantial evidence supported the finding of an employer-employee relationship for pilots and jump instructors, given their integral role in the business and Rawlins' control over their work. Consequently, Saratoga Skydiving was required to maintain workers' compensation coverage for these individuals.

Workers' CompensationStop-Work OrderEmployer-Employee RelationshipIndependent ContractorSkydiving BusinessHazardous EmploymentUninsured Employers’ FundAppellate ReviewSubstantial EvidenceLabor Law
References
7
Case No. 2017 NY Slip Op 08244
Regular Panel Decision
Nov 22, 2017

Matter of New York State Workers' Compensation Bd. v. Murray Bresky Consultants, Ltd

This appeal concerns the allocation of settlement proceeds from a defunct group self-insured trust. The New York State Workers' Compensation Board, as administrator of the Manufacturing Self Insurance Trust Fund, sought judicial apportionment of settlement funds recovered from third parties. Murray Bresky Consultants, Ltd, a former member of the trust, objected to the Board receiving all proceeds and asserted a counterclaim for its share and an accounting. The Supreme Court granted the Board all proceeds and dismissed Murray Bresky's objections. The Appellate Division modified this decision, ruling that Murray Bresky was entitled to share in the jointly-recovered settlement proceeds and that the Board must file a verified accounting, remitting the matter for further proceedings.

Workers' Compensation LawSelf-Insurance TrustSettlement ProceedsJudicial ApportionmentVerified AccountingCPLR Article 77Contractual InterpretationTrust DeficitAppellate ReviewFiduciary Duty
References
13
Case No. MISSING
Regular Panel Decision

Transcontinental Refrigerated Lines, Inc. v. Workers' Compensation Board

Transcontinental Refrigerated Lines, Inc. (TRL), a Pennsylvania common carrier, appealed decisions by the New York Workers' Compensation Board that denied its applications for redetermination of civil penalties. The penalties were imposed because TRL allegedly failed to secure New York workers' compensation insurance, despite having coverage in Pennsylvania. TRL contended that its interstate operations and Pennsylvania base exempted it from New York's requirements. The Board had relied on an earlier Workers’ Compensation Law Judge decision concerning an employee, Clarence Edick, which characterized TRL as a 'covered employer in NY.' The Appellate Division reversed the Board's decisions, concluding that TRL was entitled to a hearing to litigate the fundamental jurisdictional issue of its obligation under Workers' Compensation Law § 50, as the Edick proceeding did not definitively resolve this broader question.

Civil PenaltiesDue Process RightsJurisdictional DisputesInterstate EmployerInsurance ObligationAdministrative ReviewAppellate ProcedureRemand OrderStatutory ComplianceProcedural Safeguards
References
3
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