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

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. 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. 2020 NY Slip Op 05261 [187 AD3d 1252]
Regular Panel Decision
Oct 01, 2020

Workers' Compensation Bd. of the State of N.Y. v. Williams Auto Parts Inc.

The Workers' Compensation Board imposed a penalty on Williams Auto Parts Inc. and its president, Joseph Williams, for failing to maintain workers' compensation coverage. Following nonpayment, the Board obtained a judgment against them, which defendants subsequently moved to vacate in Supreme Court. The Supreme Court denied this motion, citing a lack of subject matter jurisdiction. On appeal, the Appellate Division, Third Department, affirmed the Supreme Court's decision, ruling that the entry of judgment by the County Clerk was a ministerial act and that only the Appellate Division holds the authority to review final determinations of the Workers' Compensation Board prior to judgment.

Workers' Compensation LawPenalty AssessmentFailure to Secure CoverageJudgment VacaturSubject Matter JurisdictionAppellate DivisionMinisterial ActStatutory InterpretationExclusive JurisdictionDue Process
References
2
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. 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
Case No. 2022 NY Slip Op 06850 [212 AD3d 126]
Regular Panel Decision
Dec 01, 2022

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

Petitioner, a licensed chiropractor, was removed from the list of authorized medical providers by the New York State Workers' Compensation Board after an investigation revealed he received unlawful payments from a durable medical equipment (DME) supplier, Elite Medical Supply of New York, LLC. This was deemed a violation of Workers' Compensation Law §§ 13-d (2) (g), 13-l (10) (g) and 8 NYCRR 29.1 (b) (3). Petitioner challenged this removal via a CPLR article 78 proceeding, asserting a statutory right to a hearing before the Chiropractic Practice Committee (CPC) prior to removal. The Supreme Court dismissed the petition, and the Appellate Division, Third Department, affirmed. The appellate court held that while Workers' Compensation Law § 13-l (10) outlines a CPC hearing process, the Chair of the Workers' Compensation Board also possesses independent authority under Workers' Compensation Law §§ 13-l (12) and 13-d (1) to investigate and remove a provider without a hearing when the underlying facts, such as petitioner's admitted receipt of unlawful payments, are undisputed and do not present questions of fact.

ChiropractorMedical ProviderAuthorization RemovalUnlawful PaymentsDurable Medical EquipmentWorkers' Compensation BoardProfessional MisconductDue ProcessAdministrative LawCPLR Article 78
References
4
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

Lubrano v. New York State Workers' Compensation Board

This case concerns a proceeding initiated by petitioners under CPLR article 78 to prevent the New York State Workers’ Compensation Board from issuing money judgments. The petitioners sought to enjoin the board until they were granted a full fact-finding hearing, challenging the board's determination that they failed to make compensation payments. The Supreme Court, Suffolk County, initially ruled in favor of the petitioners, vacating existing judgments and directing the board to provide a hearing. However, the Workers' Compensation Board appealed this decision. The Appellate Division reversed the Supreme Court's judgment and dismissed the proceeding. The appellate court held that the Appellate Division, Third Judicial Department, has exclusive jurisdiction over matters reviewable by it, thereby precluding recourse to a CPLR article 78 proceeding. Any claims of procedural due process failures in administrative decisions, according to the court, are exclusively for the appellate court to resolve.

CPLR Article 78Workers' Compensation BoardJurisdictionAppellate ReviewProcedural Due ProcessInjunctionMoney JudgmentsAdministrative DecisionSuffolk County Supreme CourtThird Judicial Department
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 05037 [163 AD3d 558]
Regular Panel Decision
Jul 05, 2018

Matter of Empire State Transp. Workers' Compensation Trust v. Special Funds Conservation Comm.

This case concerns a proceeding initiated by Empire State Transportation Workers' Compensation Trust for judicial approval of a settlement, nunc pro tunc, against the Special Funds Conservation Committee. The underlying issue stemmed from the Trust's failure to obtain consent from the Special Funds for a claimant's personal injury settlement, which led the Workers' Compensation Board to find a waiver of reimbursement rights. After an initial denial by the Supreme Court, the Appellate Division reversed and remitted, affirming the court's discretion in compelling such consent. Upon remittitur, the Supreme Court granted the petition, directing the Special Funds to provide nunc pro tunc consent. The Appellate Division affirmed this subsequent order, concluding that the settlement was reasonable, the delay was adequately explained, and no prejudice was demonstrated against the Special Disability Fund.

Workers' CompensationNunc Pro TuncSettlement ApprovalPersonal Injury ActionSpecial Funds Conservation CommitteeAppellate DiscretionReimbursement WaiverJudicial ReviewAppellate PracticeNassau County
References
14
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