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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

Belmonte v. Snashall

The case involves licensed physicians challenging the Workers' Compensation Board's interpretation of "board certified" concerning independent medical examinations (IMEs) under Workers' Compensation Law § 137 (3) (a). The Board had defined "board certified" as certification by a specialty board recognized by the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA), which the petitioners disputed. The Supreme Court initially sided with the petitioners, invalidating the Board's interpretation and regulations, and annulling denials of authorization. On appeal, the court held that the Board's interpretation was not owed deference as it was a matter of pure statutory interpretation. The appellate court concluded that the Legislature intended "board certified" to mean certification by the Workers' Compensation Board itself, rather than by external medical specialty boards, and therefore affirmed the lower court's judgment.

Independent Medical ExaminationsWorkers' Compensation LawStatutory InterpretationBoard CertificationAdministrative Agency DeferenceMedical Specialty BoardsLegislative IntentPhysiciansPodiatristsAppellate Review
References
20
Case No. MISSING
Regular Panel Decision

Certified Multi-media Solutions, Ltd. v. Preferred Contractors Insurance Co. Risk Retention Group, LLC

This case involves a dispute over insurance coverage between Certified MultiMedia Solutions, LTD (Plaintiff) and Preferred Contractors Insurance Company Risk Retention Group, LLC (Defendant) regarding a commercial general liability policy. Plaintiff sought a declaratory judgment that the Defendant is obligated to defend and indemnify it in a third-party action related to a worker's injury by Anthony Balzano. The core dispute centered on the interpretation of Endorsement 23 of the policy, which the Defendant argued limited coverage to $10,000 for bodily injury claims. The Court, however, adopted the Plaintiff's interpretation, finding that the $10,000 limit only applied if the employee sustained a 'grave injury' under New York State Workers’ Compensation Law, which was not the case here. Consequently, the Defendant's motion to dismiss was denied, and the Plaintiff's motion for summary judgment was granted, entitling the Plaintiff to coverage up to the $1,000,000 policy limit.

Insurance Coverage DisputeDeclaratory JudgmentCommercial General Liability PolicyContractual IndemnificationWorkers' Compensation LawGrave Injury DefinitionPolicy InterpretationSummary JudgmentFederal Rules of Civil ProcedureThird-Party Action
References
38
Case No. ADJ7658730
Regular
Mar 27, 2014

Maria Perez vs. TS STAFFING, LUMBERMEN'S UNDERWRITING ALLIANCE

This case concerns a lien claim for interpretation services provided by Santana, Lopez & Associates, LLC. The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior order, finding that Santana failed to prove its interpreters were "qualified" for 14 medical appointments. The interpreters for these appointments were neither certified nor provisionally certified, nor were they documented as provisionally utilized by the treating physician, thus invalidating the lien for those services. Consequently, Santana is not entitled to further payment on its lien.

Santana Lopez & AssociatesLumbermen's Underwriting Alliancequalified interpretercertified interpreterprovisionally certifiedGovernment Code section 11435.55Labor Code section 4622Labor Code section 4603.2(b)Labor Code section 5813Administrative Director's Rule 9795.1
References
1
Case No. MISSING
Regular Panel Decision

In re Yovanny L.

This case addresses the accuracy of court interpreter translations in a juvenile delinquency proceeding. The Assistant Corporation Counsel moved to strike the complainant's testimony, alleging significant errors by the court-appointed Mandarin interpreter. After conducting a hearing and considering testimony from both the Assistant Corporation Counsel and the interpreter, the court acknowledged that some minor errors in translation and interpreter conduct occurred. However, the court ultimately found these errors to be isolated instances and not sufficiently serious or pervasive to cause major prejudice to any party. Consequently, the drastic remedy of striking the testimony and starting anew was denied, and the trial was ordered to resume with a different Mandarin interpreter.

Juvenile DelinquencyCourt InterpretersTranslation AccuracyDue Process RightsEvidentiary MotionTestimony AdmissibilityMandarin LanguageFamily Court ProcedureJudicial ReviewProcedural Errors
References
7
Case No. 2022 NY Slip Op 00229
Regular Panel Decision
Jan 13, 2022

Matter of Patsis (Legal Interpreting Servs., Inc.--Commissioner of Labor)

The case concerns an appeal by Legal Interpreting Services, Inc. (LIS) from a decision of the Unemployment Insurance Appeal Board. The Board had ruled that Louiza Patsis, a linguist working for LIS, was an employee and that LIS was liable for unemployment insurance contributions. LIS contended that Patsis was an independent contractor and challenged the Board's adherence to Department of Labor guidelines. The Appellate Division, Third Department, affirmed the Board's decision, finding substantial evidence supported the finding of an employment relationship. The court noted the control LIS exercised over its linguists through a written agreement and job assignments, and found no inconsistency with the Department of Labor guidelines.

unemployment insuranceemployment relationshipindependent contractorappellate divisionlabor lawunemployment benefitsstatutory interpretationsubstantial evidenceadministrative reviewlegal interpreting
References
7
Case No. 2022 NY Slip Op 00228 [201 AD3d 1164]
Regular Panel Decision
Jan 13, 2022

Matter of Debora (Legal Interpreting Servs., Inc.--Commissioner of Labor)

This case concerns an appeal by Legal Interpreting Services, Inc. (LIS) from decisions by the Unemployment Insurance Appeal Board. The Board determined that Fausto Debora, a linguist, was an employee of LIS and that LIS was liable for unemployment insurance contributions. The Appellate Division, Third Department, affirmed the Board's finding, concluding that substantial evidence supported the existence of an employment relationship. The court noted that LIS exercised sufficient control over its linguists by screening qualifications, negotiating pay, and assigning jobs, despite some flexibility offered to the linguists. The decision also dismissed LIS's argument regarding Department of Labor guidelines, stating no inconsistency was found with established common-law tests for employment.

Unemployment InsuranceEmployment RelationshipIndependent ContractorAppellate ReviewSubstantial EvidenceLinguist ServicesControl TestDepartment of Labor GuidelinesEmployer LiabilityStatutory Interpretation
References
10
Case No. ADJ1781281 (MON 0350482) ADJ4191242 (MON 0350483)
Regular
Aug 11, 2011

ANGEL ACOSTA vs. GUILDCRAFT FURNITURE MANUFACTURING COMPANY, AMERICAN CASUALTY

This case involves a lien claimant seeking payment for interpreting services provided to an injured worker. The Workers' Compensation Appeals Board affirmed the WCJ's decision to disallow the lien claimant's claim for $25,573.00. The Board found that the lien claimant failed to meet its burden of proof to establish that the interpreting services were reasonably necessary, that the interpreters were qualified, and that the fees were reasonable. Crucially, no evidence was presented demonstrating a need for an interpreter for effective doctor-patient communication or that the interpreters were certified as required by law.

Lien claimantInterpreting servicesQualified interpreterBurden of proofReasonableness of feesIndustrial injuryMedical treatmentLabor Code section 4600(f)Compensable servicesWorkers' compensation administrative law judge
References
6
Case No. ADJ6755214
Regular
Sep 04, 2012

IGNACIO LOZANO vs. HAWAIIAN GARDENS CASINO, CNA CLAIMS PLUS

The Workers' Compensation Appeals Board granted the defendant's Petition for Reconsideration, rescinded the original award, and disallowed both lien claims. The Board found that neither Scandoc Imaging nor Certified Interpreters met their burden of proof to establish the compensability of their respective liens. Specifically, Scandoc Imaging failed to provide evidence of the reasonableness of its charges, and Certified Interpreters lacked substantial evidence to support their claim. Consequently, both lien claimants were ordered to take nothing further.

WCABPetition for ReconsiderationLien ClaimsScandoc ImagingCertified InterpretersBurden of ProofReasonableness of ChargesDiscoveryLabor Code Section 5703Findings and Award
References
3
Case No. MISSING
Regular Panel Decision

Rosenblum v. New York State Workers' Compensation Board

Petitioner, Jay Alan Rosenblum, M.D., brought a CPLR article 78 proceeding challenging the Workers’ Compensation Board’s (WCB) interpretation of Workers’ Compensation Law § 137 (3) (a). Dr. Rosenblum, a neurologist certified by the WCB since 1966, was denied authorization to conduct independent medical examinations under new regulations. These regulations mandated that such examinations be conducted by physicians 'board certified' by specialty boards recognized by the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA). Dr. Rosenblum, an M.D. without ABMS/AOA certification, argued that the WCB’s narrow definition was improper and that the regulations should have included a grandfathering provision. The court upheld the WCB’s interpretation, finding it neither arbitrary nor capricious, emphasizing judicial deference to agency expertise. Consequently, the court denied the petition to vacate the denial and annul the regulations, and granted the WCB’s motion to dismiss the proceeding.

Workers' Compensation BoardIndependent Medical ExaminationBoard CertificationPhysician LicensingMedical Specialty BoardsABMSAOAAdministrative LawJudicial ReviewStatutory Interpretation
References
8
Case No. 2025 NY Slip Op 06527
Regular Panel Decision
Nov 24, 2025

Government Employees Ins. Co. v. Mayzenberg

This case addresses a certified question from the Second Circuit regarding whether an insurer can deny no-fault benefits claims if a healthcare provider engaged in professional misconduct by paying for patient referrals, violating Education Law § 6530 (18) and 8 NYCRR 29.1 (b) (3). The New York Court of Appeals defers to the Department of Financial Services' (DFS) interpretation of 11 NYCRR 65-3.16 (a) (12). DFS contends that the regulation permits claim denial only when a provider fails to meet foundational licensing requirements necessary to perform healthcare services, not for professional misconduct short of ceding control to an unlicensed party. Consequently, the court answers the certified question in the negative, concluding that insurers cannot unilaterally deny claims based on alleged professional misconduct like kickback schemes under this regulation. The dissenting opinion argues this interpretation undermines efforts to combat fraud and is inconsistent with prior court rulings and DFS's previous stances.

No-fault insuranceKickback schemeProfessional misconductLicensing requirementsFee-splittingDepartment of Financial Services (DFS)Agency deferenceStatutory interpretationFraud preventionAutomobile insurance
References
33
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