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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

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. 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 Roselli v. Middletown School District

A maintenance worker sustained injuries to his shoulder, knee, and rib area after falling from a ladder. Initial medical reports indicated no permanent disability. However, the employer's insurance carrier later sought apportionment of the award due to a pre-existing knee injury. A subsequent report by the Board's Medical Examiner, Dr. Shera, indicated a permanent partial disability. The Workers' Compensation Law Judge (WCLJ) apportioned the award, but the Workers’ Compensation Board modified this, finding the disability entirely accident-related. On appeal, the carrier contested the Board's decision, arguing it should have been allowed to call its physician and cross-examine Dr. Shera. The appellate court upheld the denial to call the carrier's physician but found it arbitrary and capricious to deny cross-examination of Dr. Shera, reversing and remitting the case for further proceedings.

Workers' Compensation LawApportionmentPermanent Partial DisabilityMedical Examiner ReportCross-examination RightsDue ProcessPre-existing InjurySchedule Loss of UseAdjournment DenialSubstantial Evidence
References
7
Case No. MISSING
Regular Panel Decision
Nov 08, 2012

Claim of Bailey v. Achieve Rehab & Nursing

Claimant, a nursing assistant, was granted workers' compensation benefits for a permanent partial disability. Following an independent medical examination, the employer's workers' compensation carrier repeatedly attempted to reopen the claim, citing counsel's failure to provide updates on claimant's job search. The Workers' Compensation Board denied these requests, emphasizing the lack of sufficient supporting evidence beyond non-response. Consequently, the Board assessed a $1,000 cost against the carrier under Workers’ Compensation Law § 114-a (3) (i) for pursuing proceedings without reasonable grounds after being clearly advised on evidentiary requirements. The appellate court affirmed this decision, finding no abuse of discretion in the Board's assessment of costs.

Workers' CompensationPermanent Partial DisabilityWork SearchReopening ClaimCosts AssessmentAbuse of DiscretionIndependent Medical ExaminationAppellate ReviewBoard DecisionCarrier Responsibility
References
2
Case No. MISSING
Regular Panel Decision

Claim of Good v. Town of Brutus

A claimant, employed as a court clerk since 2002, developed carpal tunnel syndrome and filed a workers’ compensation claim in 2007, which was established as an occupational disease. She was awarded a 25% schedule loss of use of the left hand. The employer’s workers’ compensation carrier sought apportionment of liability with her two most recent prior employers under Workers’ Compensation Law § 44. A Workers’ Compensation Law Judge and the Board denied this request, finding no medical evidence of the condition arising from prior employment. The Appellate Division affirmed the Board’s determination, stating that despite the claimant experiencing symptoms previously and an independent medical examiner suggesting apportionment, there was no objective medical proof that she contracted the condition while working for a previous employer. The court emphasized that the focus for apportionment is whether the claimant contracted the occupational disease during that specific employment.

Occupational DiseaseCarpal Tunnel SyndromeApportionment of LiabilityWorkers' Compensation Law § 44Prior EmployersMedical EvidenceIndependent Medical ExaminerSchedule Loss of UseWorkers' Compensation BoardAppellate Review
References
3
Case No. MISSING
Regular Panel Decision
Oct 04, 2006

Claim of McKenzie v. UJA-FED

Claimant, employed in data entry, developed bilateral carpal tunnel syndrome and sought workers' compensation benefits. The Workers' Compensation Law Judge initially dismissed the claim, but the Workers' Compensation Board reversed, finding the condition to be an occupational disease causally related to employment, based on agreement between the treating physician and an independent medical examiner, and the carrier's failure to request cross-examination. The carrier appealed, arguing the Board erred in its finding regarding cross-examination and mischaracterized medical evidence. The appellate court affirmed the Board's decision, ruling that the carrier waived its right to cross-examination by not making a timely request and finding no basis to disturb the Board's assessment of the medical evidence.

Occupational DiseaseCarpal Tunnel SyndromeWorkers' CompensationMedical EvidenceCross-Examination WaiverAppellate ReviewCausationEmployment-Related InjuryMedical Expert TestimonyBoard Decision Appeal
References
6
Case No. MISSING
Regular Panel Decision

Claim of Dixon v. State University College

Claimant sustained a work-related back injury in July 1995. The treating physician prescribed home whirlpool and hydrotherapy after a February 1996 examination, which the employer's workers' compensation carrier denied for an in-home whirlpool, instead authorizing treatment at a YMCA. Claimant purchased a whirlpool tub and sought reimbursement under Workers' Compensation Law § 13 (a). The Workers' Compensation Board denied the request. On appeal, the court affirmed the Board's decision, finding no merit to the claimant's arguments regarding untimely denial or the sufficiency of the physician's prescription due to a lack of documented medical necessity for home treatment over a facility.

Workers' Compensation BenefitsMedical NecessityHome HydrotherapyWhirlpool ReimbursementCarrier AuthorizationTimeliness of RequestAppellate ReviewTreating Physician RecommendationBack InjuryPhysical Therapy
References
2
Case No. MISSING
Regular Panel Decision
May 14, 1986

Claim of MacMullan v. Associated Press

William Von Stein appealed a Workers’ Compensation Board decision filed May 14, 1986, which denied his application to reopen Philip MacMullan’s previously closed compensation case. The Board determined that any new claim for compensation related to MacMullan's ulcer was barred by the two-year Statute of Limitations under Workers’ Compensation Law § 28. This appeal originated from a medical malpractice action in Supreme Court, where Von Stein, a coemployee and doctor, was accused of failing to inform MacMullan of an ulcer discovered during an employer-conducted medical examination. The Appellate Division affirmed the Board's decision, holding that Von Stein lacked standing to reopen MacMullan’s case and that the requested declaratory ruling on the ulcer's compensability fell outside the Board's authority. Consequently, the court concluded that the judicial forum, not the Workers’ Compensation Board, was the appropriate venue for resolving the dispute concerning MacMullan's injury.

Workers' Compensation Law § 28Statute of LimitationsReopening Closed CaseMedical MalpracticeStanding to SueBoard JurisdictionDeclaratory RulingUlcer ConditionAngina PectorisCoemployee Immunity
References
2
Case No. MISSING
Regular Panel Decision
Apr 01, 2004

Claim of Pace v. Concepts in Wood of CNY, Inc.

This case involves an appeal from an amended decision of the Workers’ Compensation Board, filed on April 1, 2004. The Board's decision had ruled that the claimant sustained a compensable injury and was entitled to workers’ compensation benefits. The appellate court reviewed the claimant’s procedural arguments against the Board's decision, ultimately rejecting them as unfounded. Key points addressed included the authority of a reconstituted three-member Board to issue an amended decision reversing itself, which the court affirmed by referencing relevant Workers’ Compensation Law sections. Furthermore, the court dismissed the claimant's concerns regarding the staleness of reports from an independent medical examiner, clarifying that unlike treating physicians, independent medical examiners are not subject to statutory or regulatory requirements for routine progress reports. Consequently, the amended decision of the Workers’ Compensation Board was affirmed.

Workers' CompensationBoard Decision AppealProcedural ArgumentsAmended DecisionIndependent Medical ExaminerMedical ReportsStalenessCompensable InjuryNew York LawStatutory Interpretation
References
6
Case No. MISSING
Regular Panel Decision

Claim of Pistone v. Sam's Club

Claimant, a sales representative, injured her back in October 1999 while lifting heavy materials and subsequently filed a workers' compensation claim. A Workers’ Compensation Law Judge (WCLJ) found a causally related temporary total disability and awarded benefits, a decision affirmed by the Workers’ Compensation Board. However, the WCLJ denied the employer's carrier's request to cross-examine the claimant’s attending physician. The Appellate Division reversed the Board's decision, citing prejudice to the employer due to the denial of cross-examination and inconsistencies in medical reports. The court also noted a conflicting opinion from an independent medical examination. The case was remitted for further proceedings.

Workers' Compensation AppealBack Injury ClaimMedical Evidence DiscrepancyRight to Cross-ExamineDue Process ViolationRemittalTemporary Total DisabilityIndependent Medical ExaminationAppellate Division Review
References
6
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