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

Case No. MISSING
Regular Panel Decision

W & G Ltd. v. Workers' Compensation Board

This court case addresses whether an arbitrator's decision, upholding a 'just cause' discharge of an employee after a compensable accident, prevents the Workers' Compensation Board (WCB) from hearing a claim of discriminatory discharge under Workers’ Compensation Law § 120. The court ruled that such an arbitration decision does not preclude the WCB, emphasizing the overriding public policy to have retaliatory discharge claims determined by the WCB as the statutorily mandated exclusive forum. It distinguishes between a contractual just cause discharge and a discriminatory firing, noting that the former could be a pretext for the latter. The court denied the petition to preclude the WCB, asserting that the public policy underlying Workers’ Compensation Law § 120 takes precedence over issue preclusion principles. It also suggests that the WCB can consider arbitration decisions as persuasive evidence but not conclusive.

Workers' Compensation Law § 120Discriminatory DischargeRetaliatory FiringIssue PreclusionArbitration AwardPublic PolicyWCB JurisdictionCPLR Article 78Just Cause DischargeCollective Bargaining Agreement
References
18
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. MISSING
Regular Panel Decision

Matter of Burns v. New York State Workers' Compensation Board

Claimant sought workers' compensation benefits due to injuries from an automobile accident. As an employee of the Workers’ Compensation Board, his claim was processed through a neutral outside arbitration process. An arbitrator established his claim and average weekly wage. Claimant appealed, arguing his average weekly wage should have been calculated differently due to a recent promotion, as per Workers’ Compensation Law § 14 (2). An arbitration panel declined to address this argument because it was not raised before the arbitrator. The appellate court affirmed the panel's decision, citing that the panel could decline review of issues not previously raised, consistent with 12 NYCRR 300.13 [e] [1] [iii].

ArbitrationAverage Weekly WageWorkers' CompensationAppellate ReviewIssue PreservationAdministrative LawProcedural Due ProcessStatutory InterpretationWorkers’ Compensation Board
References
2
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
Jul 30, 2012

Matter of Monarch Consulting, Inc. v. National Union Fire Ins. Co. of Pittsburgh, PA.

Justice Gische dissents from the majority's decision, arguing that arbitrators, not the court, should determine the enforceability of payment agreements containing arbitration clauses in workers' compensation cases. The dissent highlights that the payment agreements were not filed with the Workers’ Compensation Insurance Rating Bureau (WCIRB), an issue the insureds use to invalidate the arbitration provisions. Citing the Federal Arbitration Act (FAA) and Supreme Court precedent, Gische, J. contends that challenges to the contract as a whole should be decided by arbitrators. Furthermore, the dissent disagrees with the majority's application of the McCarran-Ferguson Act, asserting that California law does not prohibit arbitration in insurance disputes and that arbitration does not undermine filing requirements. The dissent critiques the Ceradyne decision as inconsistent with Supreme Court rulings on severability and arbitrability.

Arbitration ClausesArbitrabilityFederal Arbitration ActMcCarran-Ferguson ActWorkers' Compensation InsuranceCalifornia Insurance CodeContract EnforceabilityGateway IssuesDissenting OpinionJudicial Review
References
17
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

United Environmental Workers v. Buffalo Sewer Authority

This case addresses whether a union member can receive both Workers' Compensation benefits and sick pay under a union contract for the same injury, especially when the Workers' Compensation Board and an arbitrator made conflicting findings on the injury's causation. The Workers' Compensation Board found the injury job-related, while the arbitrator found it non-job-related, and the union member failed to inform the arbitrator of the Workers' Compensation decision. The court ruled that Workers' Compensation Law § 11 establishes an exclusive remedy, precluding additional recovery in contract once Workers' Compensation is obtained, thereby preventing the union member from 'having it both ways.' Furthermore, the court found the petitioner's failure to apprise the arbitrator of the compensation determination improper under CPLR 7511 (b) (1) (i) and that confirming the award would be inequitable. Consequently, the court denied the application to confirm the arbitration award and granted the cross-motion to vacate it.

Workers' Compensation ExclusivityArbitration Award ConfirmationSick Pay EntitlementConflicting DeterminationsFailure to DisclosePublic PolicyContractual ClaimsJudicial ReviewNew York LawRes Judicata Implications
References
11
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. MISSING
Regular Panel Decision
Jul 13, 2001

A.I. Transport v. New York State Insurance Fund

The Supreme Court, New York County, denied a liability insurer’s application to stay an arbitration initiated by a workers’ compensation insurer. The workers’ compensation insurer sought to recover benefits paid to a bus passenger injured in an accident, where the bus was insured by the liability insurer. The court interpreted Insurance Law § 5105 (a) to allow a workers’ compensation provider, paying benefits in lieu of first party benefits, to recover amounts paid from the insurer of a liable party, even if one of the vehicles involved is a bus. It was determined that an exception for losses arising from the use of a motor vehicle (Insurance Law § 5103 [a] [1]) did not apply, as the respondent was a workers’ compensation insurer and not an automobile insurer. Consequently, the arbitration was allowed to proceed, and the petition to stay it was dismissed and unanimously affirmed.

Arbitration DisputeInsurance Law InterpretationNo-Fault BenefitsWorkers' Compensation SubrogationBus AccidentLiability CoverageStatutory ConstructionAppellate ReviewInsurer Recovery
References
4
Case No. 2024 NY Slip Op 04463
Regular Panel Decision
Sep 18, 2024

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

The petitioner, Josseth Henry, appealed a Supreme Court judgment that denied her petition to vacate or modify an arbitration award. The arbitration award upheld her termination from the New York State Workers' Compensation Board for misconduct and insubordination. The Appellate Division affirmed the Supreme Court's judgment, determining that the petitioner failed to demonstrate that the arbitration award violated a strong public policy, was irrational, or exceeded the arbitrator's power. Furthermore, the court found that the penalty of termination was not disproportionate to the offenses, and the petitioner had waived her contention regarding the arbitrator's impartiality.

Arbitration AwardEmployment TerminationMisconductInsubordinationJudicial Review of ArbitrationCollective Bargaining AgreementPublic Policy ViolationArbitrator's PowerPenalty ProportionalityWaiver of Impartiality
References
10
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