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

Case No. G107 435
Regular Panel Decision
Jun 02, 2023

Matter of Marku v. ABM Industries

This case concerns the claim of Denise Perry under the Workers' Compensation Law. The Workers' Compensation Law Judge (WCLJ) previously found that the employer, Adventist Home Care, established a violation of Workers' Compensation Law § 114-a by the claimant for willfully making false statements to obtain benefits. Consequently, the WCLJ disallowed indemnity benefits and imposed both mandatory and discretionary penalties. A Board Panel decision filed on February 17, 2022, affirmed the WCLJ's findings. The claimant subsequently filed an application for reconsideration on March 18, 2022, which the Board Panel reviewed. After considering the claimant’s arguments, the Board Panel determined that the application did not raise new issues or present new material evidence, nor did it demonstrate an erroneous statement of material fact or law in the prior decision. Therefore, the Board Panel, by a majority vote, affirmed its prior decision.

Workers' Compensation FraudFalse RepresentationIndemnity Benefits DisallowanceWCL § 114-a PenaltyApplication for Reconsideration DeniedBoard Panel AffirmationWillful MisrepresentationWorkers' Compensation Law Judge DecisionEmployer Established Violation
References
0
Case No. 2021 NY Slip Op 06069 [199 AD3d 438]
Regular Panel Decision
Nov 09, 2021

Matter of Ashanti v. New York City Conflicts of Interest Bd.

The Appellate Division, First Department, confirmed the determination of the New York City Conflicts of Interest Board, finding that petitioner Karl J. Ashanti violated New York City Charter and City rule provisions. Ashanti was ordered to pay an aggregate civil penalty of $8,500. The court found substantial evidence supported the determination that Ashanti used his City position to gain personal advantage in negotiations on behalf of his wife and utilized City letterhead to advance a legal position contrary to the City's interests. The court rejected the petitioner's due process and agency bias claims, concluding that the penalty imposed did not shock the conscience.

Conflicts of InterestPublic OfficialsEthical ViolationsCivil PenaltyDue ProcessAgency BiasSubstantial EvidenceAppellate ReviewAdministrative Law JudgeCredibility Determinations
References
4
Case No. MISSING
Regular Panel Decision

Texas Workers' Compensation Insurance Fund v. Texas Workers' Compensation Commission

The Texas Workers’ Compensation Insurance Fund, now Texas Mutual, challenged an appeals panel decision by the Texas Workers’ Compensation Commission which awarded lifetime income benefits to claimant Leonard D. Watts. Watts, a truck driver for Mono Chem Corporation, sustained a leg injury in 1994, leading to severe medical conditions and ultimately the loss of use of both feet. A hearing officer initially denied lifetime benefits due to insufficient evidence of a causal connection to the original injury, but the appeals panel twice reversed this decision, rendering a new decision in favor of Watts. Texas Mutual sought judicial review, arguing the appeals panel exceeded its statutory authority and improperly engaged in factual-sufficiency review. The district court set aside the appeals panel's decision. This court, however, reversed the district court's decision, affirming the appeals panel’s award of lifetime income benefits to Watts, holding that the appeals panel acted within its statutory authority.

Workers' CompensationLifetime Income BenefitsAppeals Panel ReviewJudicial ReviewFactual SufficiencyStatutory AuthorityCausationRes JudicataCollateral EstoppelTexas Labor Code
References
13
Case No. ADJ20165742
Regular
Jul 18, 2025

DEBRA SILVEIRA vs. FEDEX GROUND PACKAGE SYSTEM, INCORPORATED

Applicant Debra Silveira sought reconsideration of an April 29, 2025 Findings of Fact and Order, which deemed a Qualified Medical Evaluator (QME) panel valid despite being requested by defendant FedEx Ground Package System, Incorporated, with an incorrect claim number. The Appeals Board granted the petition, rescinded the prior decision, and substituted new findings. The Board ruled that strict compliance with Administrative Director Rule 30 regarding complete and correct claim numbers for QME panel requests is required to ensure due process and prevent conflicting or overlapping panels. Consequently, the defendant's panel (7773036) was deemed invalid, and the applicant's panel (7775940) was declared valid.

QME panel validityincorrect claim numberAD Rule 30due processadministrative law judgePetition for Reconsiderationremoval standardDWC Medical Unitprocedural defectinadvertent error
References
11
Case No. MISSING
Regular Panel Decision

Matter of Burns v. New York State Workers' Compensation Board

Claimant sought workers' compensation benefits due to injuries from an automobile accident. As an employee of the Workers’ Compensation Board, his claim was processed through a neutral outside arbitration process. An arbitrator established his claim and average weekly wage. Claimant appealed, arguing his average weekly wage should have been calculated differently due to a recent promotion, as per Workers’ Compensation Law § 14 (2). An arbitration panel declined to address this argument because it was not raised before the arbitrator. The appellate court affirmed the panel's decision, citing that the panel could decline review of issues not previously raised, consistent with 12 NYCRR 300.13 [e] [1] [iii].

ArbitrationAverage Weekly WageWorkers' CompensationAppellate ReviewIssue PreservationAdministrative LawProcedural Due ProcessStatutory InterpretationWorkers’ Compensation Board
References
2
Case No. MISSING
Regular Panel Decision

Claim of Mulligan v. Workers' Compensation Board

The claimant, a former workers' compensation law judge, appealed the denial of reduced earning benefits, which stemmed from his claim that stress from his job caused him to voluntarily withdraw from the labor market. He had previously received benefits for a 1995 angina attack. An arbitrator and subsequent arbitration panel concluded that he voluntarily withdrew from the labor market, a determination the claimant contested, asserting his retirement was due to work-related stress. The court, led by Judge Carpinello, found substantial evidence supported the panel's decision, noting the claimant never complained of stress to supervisors, sought accommodations, or applied for disability retirement. The court affirmed the arbitration panel's decision, denying the claimant's appeal.

Voluntary Withdrawal from Labor MarketReduced Earning BenefitsWorkers Compensation BenefitsArbitration Panel DecisionSubstantial EvidenceDisability RetirementJob-Related StressAppellate ReviewLabor Market WithdrawalClaim Denial
References
8
Case No. G0291404
Regular Panel Decision
Mar 17, 2022

Matter of Toliver v. New York State Department of Corrections and Community Supervision

The claimant, Claude Dean, suffered a compensable right shoulder injury on July 10, 2019. A subsequent incident on February 23, 2021, led to a dispute regarding a causally related further disability to the same shoulder. The Workers' Compensation Law Judge (WCLJ) initially found no causal relationship for the 2021 incident and closed the case. However, conflicting medical evidence, specifically consultant reports from Dr. Lallana and Dr. Reback, presented differing opinions on the causal connection. Upon review, the Board Panel determined that the WCLJ's decision was premature due to an incomplete record and the absence of testimony, especially given the unresolved medical conflict. Consequently, the Board Panel rescinded the WCLJ's decision and restored the case to the trial calendar to further develop the record on the issue of causally related disability from the February 23, 2021 incident, and for the WCLJ to issue a new decision.

Right Shoulder InjuryCausally Related DisabilityConflicting Medical EvidenceWCLJ Decision RescindedCase Restored to Trial CalendarRecord DevelopmentAttorney AppealDate of Injury DisputeMedical Consultant ReportAdministrative Review
References
0
Case No. ADJ6816825
Regular
Jun 14, 2010

KAI CHRISTOPHER vs. TIME WARNER CABLE, ESIS

The Appeals Board granted defendant's petition for removal, finding the WCJ erred in denying a QME panel request. This denial was based on Administrative Director Rule 30(d)(3), which previously stated only the employee could request a QME panel after a total denial of injury. However, the Board's recent en banc decision in *Mendoza v. Huntington Hospital* invalidated this rule as conflicting with Labor Code sections 4060(c) and 4062.2, which allow either party to request a QME panel. Therefore, the prior order was rescinded, and the matter returned to the trial level with instructions to issue a QME panel.

Petition for RemovalQualified Medical Evaluator (QME)Administrative Director RuleInvalid RuleMendoza v. Huntington HospitalLabor Code sections 4060(c)Labor Code sections 4062.2Denial of InjuryEither Party RequestMedical Director
References
1
Case No. W2004-00373-SC-WCM-CV
Regular Panel Decision
Nov 08, 2004

William G. Norvell v. Menlo Logistics, Inc.

The employee, William G. Norvell, appealed a trial court's decision denying workers' compensation benefits for a back injury, which the court found not causally related to a work accident. The Special Workers' Compensation Appeals Panel reversed this finding, determining that the back injury was indeed work-related. The Panel highlighted that Norvell reported both back and knee pain immediately after the October 1999 accident, though initially only knee treatment was provided. Conflicting medical opinions, including one establishing a causal link and a 10% permanent impairment, led the Panel to conclude the trial court erred. The case was remanded to the Chancery Court for an award of benefits, and the Supreme Court of Tennessee subsequently denied the employer's motion for review, affirming the Panel's decision.

Back InjuryCausationMedical OpinionAppellate ReviewRemandEmployer LiabilityEmployee BenefitsOrthopedic SurgeonPermanent ImpairmentTipton County
References
11
Case No. WCB No. G076 2707
Regular Panel Decision
Dec 09, 2021

Matter of Duncan v. John Wiley & Sons, Inc.

This Board Panel Decision concerns an appeal by the applicant, Joseph Lafayette, regarding a Workers' Compensation Law Judge's (WCLJ) finding on the causal relationship of his back injury. The applicant sustained injuries to his back, neck, and shoulder during his employment. The WCLJ had previously established a causal relationship for the neck and shoulder injuries but disallowed the claim for the back injury. Upon review, the Board Panel determined that the medical evidence in the record supports a causal relationship between the claimant's employment and his lower back injury. As a result, the Panel modified the WCLJ's decision to establish a causal relationship for the back injury, while affirming the other aspects of the original decision.

Workers' CompensationBack InjuryNeck InjuryShoulder InjuryCausal RelationshipMedical EvidencePanel ReviewWCLJ DecisionModificationAppeal
References
2
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