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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

Claim of D'Addio v. Peter Annis, Inc.

A widow filed a claim for workers' compensation death benefits after her husband, who had an established claim for asbestosis, died. A Workers' Compensation Law Judge (WCLJ) found a work-related death and ordered the employer's carrier to deposit funds into the aggregate trust fund (ATF) in July 2010. The carrier did not appeal this initial decision. After a subsequent WCLJ decision in December 2010 reiterated the ATF deposit, the carrier sought review, arguing the deposit was unwarranted. The Workers' Compensation Board denied the carrier's application as untimely. The appellate court affirmed the Board's decision, holding that the 30-day appeal period for the July 2010 decision had expired and the later WCLJ decision did not extend that timeframe. The court found no abuse of discretion by the Board.

Workers' CompensationUntimely ApplicationAggregate Trust FundDeath BenefitsAsbestosisOccupational DiseaseAppellate ReviewBoard DiscretionTimelinessAppeal Denial
References
5
Case No. MISSING
Regular Panel Decision

Claim of Beth V. v. New York State Office of Children & Family Services

Claimant, a youth division aide, suffered severe injuries including physical assault, rape, and kidnapping during work, leading to established workers' compensation benefits and a classification of permanent partial disability. She subsequently reached a $650,000 settlement in a federal civil rights action against her employer and co-employees for the same injuries. The workers' compensation carrier waived its lien for past benefits but asserted a right to a credit for future payments against the settlement under Workers’ Compensation Law § 29. The Workers’ Compensation Board reversed a Workers’ Compensation Law Judge’s decision, ruling in favor of the carrier's credit, finding the settlement covered the same injuries for which workers' compensation benefits were awarded. The appellate court affirmed the Board's decision, confirming the carrier's entitlement to a credit against the third-party settlement recovery.

Workers' CompensationThird-Party SettlementCredit Against RecoveryLienFuture BenefitsPermanent Partial DisabilityPTSDRapeCivil Rights ClaimFederal Lawsuit
References
4
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

Castro v. New York City Transit Authority

Claimant suffered compensable right knee injuries in 1992 and 1994, leading to a stipulated 22.5% schedule loss of use award in 2001, after which the cases were closed. Upon reopening in 2005, liability shifted from the employer's workers' compensation carrier to the Special Fund for Reopened Cases under Workers’ Compensation Law § 25-a. Following a recurrence of injuries in October 2005, the Fund sought a credit for the prior schedule loss of use award paid by the carrier, which was initially denied but later granted by the Workers’ Compensation Board. Claimant appealed this decision, arguing that the Fund should not receive credit for awards commencing more than two years prior to the transfer of liability, citing Workers’ Compensation Law § 25-a (1) and prior case law. The Appellate Division affirmed the Board's decision, explaining that the Fund assumes the carrier's rights and responsibilities, including any existing credits, and distinguished the cited precedent based on a lack of injury reclassification in the current case.

Workers' Compensation Law § 25-aSchedule Loss of Use AwardSpecial Fund for Reopened CasesCredit Against AwardsLiability TransferRecurrence of InjuryAppellate DivisionWorkers' Compensation Board DecisionStipulationCase Reopening
References
5
Case No. MISSING
Regular Panel Decision

Matter of Turi v. Five L. Enterprises, Inc.

In this workers' compensation case, the claimant's spouse died in a 1993 work-related accident, leading to an award of death benefits. The employer's workers’ compensation carrier was directed to deposit a substantial sum into the Aggregate Trust Fund (ATF) but failed to do so. The claimant sought to impose a 20% penalty on the carrier for this untimely payment, arguing it violated Workers’ Compensation Law § 25 (3) (f). The Workers’ Compensation Board determined that the claimant lacked standing to request such a penalty. The appellate court affirmed the Board's decision, clarifying that issues regarding late deposits into the ATF are between the ATF and the carrier, not the claimant, and are governed by separate regulations (12 NYCRR 393.2).

Aggregate Trust FundDeath BenefitsPenalty ImpositionTimely DepositStandingWorkers' Compensation CarrierWorkers' Compensation BoardLate PaymentActuarial ComputationJudicial Review
References
2
Case No. MISSING
Regular Panel Decision

Claim of Morelli v. Tops Markets

Claimant, having sustained work-related injuries in 2007 and receiving benefits, was questioned by a Workers' Compensation Law Judge (WCLJ) regarding work activities at a 2011 hearing. Immediately after, the employer and its carrier sought to introduce surveillance video and investigator testimony, alleging a violation of Workers' Compensation Law § 114-a. The WCLJ denied this request and precluded the evidence, ruling that the carrier failed to disclose the surveillance prior to the claimant's testimony. The Workers' Compensation Board affirmed this decision, reiterating the established requirement for timely disclosure of surveillance materials to prevent 'gamesmanship.' The appellate court subsequently affirmed the Board's decision, finding no arbitrary or capricious action, as the carrier had an opportunity to disclose the evidence before prompting the WCLJ's questioning and before the claimant testified.

Workers' Compensation LawSurveillance EvidenceDisclosure ObligationPreclusion of EvidenceAppellate ReviewEvidence AdmissibilityClaimant TestimonyEmployer ResponsibilitiesCarrier ResponsibilitiesBoard Decision
References
11
Case No. MISSING
Regular Panel Decision
Apr 12, 2001

Claim of Skippon v. T.M. Kenney's Inc.

The claimant appealed a Workers' Compensation Board decision which ruled that the employer’s workers’ compensation carrier timely raised a Workers’ Compensation Law § 28 defense. The claimant sustained work-related injuries in 1991, and a subsequent claim in 1999 for carpal tunnel syndrome, attributed to the 1991 accident, was challenged by the carrier. The Board concluded that the carrier's general statement of "all issues" at the initial hearing was sufficient to raise the statute of limitations defense. The appellate court affirmed the Board's decision, finding that the parties and the Workers’ Compensation Law Judge understood that the carrier's statement encompassed a timeliness objection.

Statute of LimitationsWorkers' Compensation BoardTimelinessCarpal Tunnel SyndromeWork-related InjuryPermanent Partial DisabilityConsequential InjuryDirect InjuryWorkers' Compensation Law Section 28Appeal
References
1
Case No. MISSING
Regular Panel Decision

Texas Workers' Compensation Insurance Fund v. Martinez

The Texas Workers’ Compensation Insurance Fund (carrier) appealed a summary judgment affirming a ruling by the Texas Workers’ Compensation Appeals Panel. The panel upheld a hearing officer's decision that the carrier waived its opportunity to contest the compensability of Martinez’s injury. Martinez was injured in 1993, and in a 1995 benefit review conference, the carrier agreed in writing to the compensability of his injuries, including his heart condition, and waived the right to dispute it. Later, the carrier attempted to dispute the heart condition, claiming it was a newly discovered congenital defect (HOC), but evidence showed they were aware of a similar condition (IHSS) at the time of the waiver. The appeals board and trial court concluded that HOC and IHSS were essentially the same condition, and the carrier's waiver was binding, thereby affirming the summary judgment in Martinez’s favor.

Workers' CompensationSummary JudgmentWaiverEstoppelCompensabilityHeart ConditionHydrogen Sulfide ExposureBenefit Review ConferenceAppeals PanelJudicial Review
References
10
Case No. MISSING
Regular Panel Decision
Dec 27, 2004

McComber v. Lehrer McGovern Bovis, Inc.

This case involves an appeal of an order from the Supreme Court, New York County, which fixed a nonparty-appellant workers’ compensation carrier’s lien at $23,355.68. The original action was for personal injuries at a work site, resulting in a $14.5 million recovery for the plaintiff through a high-low settlement. The carrier had paid $228,605.18 in past compensation benefits and was assessed to have a present value of $387,143.30 in future compensation benefits that it would have paid. The appellate court affirmed the lower court's decision, which applied the Kelly formula to reduce the carrier's lien by its equitable share of litigation costs, encompassing both past and future benefits. The court also rejected the carrier's argument that the plaintiff violated Workers’ Compensation Law § 29 (5) by not obtaining consent for the settlement, clarifying that such consent is only required for settlements less than the statutory benefits, which was not the case here. Furthermore, any required judicial approval was deemed properly granted nunc pro tunc.

Lien ReductionKelly FormulaFuture Benefits ValuationHigh-Low SettlementJudicial DiscretionNunc Pro Tunc ApprovalWorkers' Compensation Law § 29 (5)Equitable ApportionmentSubrogation RightsPersonal Injury Recovery
References
7
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
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