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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 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

Matter of Kent v. Cuomo

Petitioners, state employees typically ineligible for overtime, challenged a determination by the State Budget Director regarding overtime compensation following Hurricane Sandy. The Budget Director's bulletin authorized overtime for hours worked beyond 47.5 per week, rather than the 40-hour threshold sought by petitioners. Petitioners argued that the Budget Director was statutorily required to compensate for all hours over 40. The Supreme Court partially dismissed their application, leading to this appeal. The appellate court deferred to the Budget Director's interpretation of Civil Service Law § 134 (6), finding the 47.5-hour threshold was not irrational or unreasonable given the agency's expertise and consistent past application. The court also held that employer respondents did not act irrationally in not requesting compensation below the 47.5-hour threshold, as this authority rests solely with the Budget Director.

Overtime CompensationExtreme EmergencyHurricane SandyState EmployeesCivil Service LawStatutory InterpretationAdministrative DiscretionNormal Workweek47.5-Hour ThresholdCPLR Article 78
References
8
Case No. MISSING
Regular Panel Decision

Claim of Cruz v. City of New York Department of Children's Services

Claimant, injured in an automobile accident while working, received workers' compensation benefits and later settled a third-party action. A Workers’ Compensation Law Judge (WCLJ) and the Workers’ Compensation Board ruled that the self-insured employer was not entitled to offset the third-party settlement against a schedule loss of use (SLU) award, even for the portion initially designated as temporary total disability. The employer appealed, arguing the offset was permissible because the weekly award exceeded statutory thresholds for basic economic loss. However, the court affirmed the Board's decision, clarifying that a schedule loss of use award is not allocable to any specific period of disability and thus is not subject to offset under Workers’ Compensation Law § 29 against first-party benefits, regardless of initial labeling or monthly rate.

Schedule Loss of Use Award OffsetThird-Party SettlementTemporary Total DisabilityPermanent Partial DisabilityBasic Economic LossNo-Fault LawInsurance LawStatutory InterpretationWorkers' Compensation Law § 29Appellate Division
References
6
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

Claim of McKenzie v. New York Jockey Injury Compensation Fund

Claimant, an exercise rider at Belmont Racetrack, suffered pelvic injuries in December 2003 while working a horse. Despite an expired license, a Workers’ Compensation Law Judge (WCLJ) established his case and determined he was a covered employee of the New York Jockey Injury Compensation Fund, holding the Fund responsible for medical treatment. The Workers’ Compensation Board upheld this decision. The Appellate Division affirmed, referencing *Matter of Adames v New York Jockey Injury Compensation Fund, Inc.* (15 AD3d 696 [2005]), which established that an exercise rider is a covered employee of the Fund under relevant Workers’ Compensation Law and Racing, Pari-Mutuel Wagering and Breeding Law provisions, irrespective of license expiration. The court found the Fund’s remaining contentions lacked merit.

Exercise RiderWorkers' CompensationJockey Injury Compensation FundExpired LicenseCovered EmployeeThoroughbred RacingPelvic InjuryAppellate DecisionBoard DecisionStatutory Interpretation
References
1
Case No. MISSING
Regular Panel Decision

Burroughs v. Empire State Agricultural Compensation Trust

Claimant, a dairy farmer, sustained work-related injuries in November 2001 when he fell from a ladder. A claim for workers’ compensation benefits was filed, which the carrier controverted, disputing claimant's employee status. A Workers’ Compensation Law Judge (WCLJ) determined that the employer was a limited liability corporation and claimant was an executive officer, thus covered under the Workers' Compensation Law. The Workers’ Compensation Board upheld the WCLJ’s findings. The appellate court reversed the Board's decision, concluding that the record was insufficient to establish the employer’s true status or claimant’s relationship to it, and remitted the matter for further development of the record.

Workers' CompensationEmployment StatusLimited Liability CorporationExecutive OfficerCoverage DisputeAppellate ReviewRemittalRecord DevelopmentNew York Workers' Compensation LawDairy Farmer
References
2
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

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. MISSING
Regular Panel Decision
Oct 24, 1997

Ashley v. Durant

The claimant, a farm laborer for Robert Durant, sustained injuries in August 1989. The Workers' Compensation Board denied his claim for benefits, determining he was not a covered employee under Workers’ Compensation Law § 3 (1) due to Durant having paid less than the statutory $1,200 threshold for farm laborers in the preceding calendar year. Claimant appealed this decision, contesting both the calculation of farm labor wages and the relevant time period for assessment. The court affirmed the Board's interpretation, clarifying that the "calendar year" runs from January 1 to December 31, and that payments to independent contractors or services from unpaid family members are not included in the $1,200 threshold. Consequently, the Board's determination, supported by substantial evidence, was upheld.

Workers' CompensationFarm LaborEmployee CoverageStatutory InterpretationCalendar YearIndependent ContractorFamily Labor$1200 ThresholdAppealLabor Law
References
2
Case No. MISSING
Regular Panel Decision
Feb 18, 1988

Claim of De Carr v. New York State Workers' Compensation Board

The claimant, an employee of the Workers’ Compensation Board, suffered a broken nose while playing softball in an off-duty State agency league. The Board initially found the injury compensable, citing the use of State-owned fields, interoffice mail, and employer equipment for league activities. However, the appellate court reversed this decision, referencing a 1983 amendment to Workers’ Compensation Law § 10 (1) which limits benefits for off-duty athletic injuries to instances of employer-required participation, compensation, or overt sponsorship. The court determined that the Board's cited factors constituted only incidental contact rather than overt employer encouragement or sponsorship, thus dismissing the claim as the injury did not arise out of and in the course of employment.

Workers' Compensation Law § 10(1)off-duty athletic injuryemployer sponsorship criteriaincidental employer contactreversal of Board decisionclaim dismissalcompensability of sports injuriesstatutory interpretationWorkers' Compensation Board appeal1983 amendment impact
References
4
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