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

Case No. ADJ6973825
Regular
May 21, 2012

MONICA BENARD vs. JENNY CRAIG, SEDGWICK CMS

This case concerns a penalty imposed on Jenny Craig for unreasonably delaying authorization for applicant Monica Benard's chiropractic treatment. The WCJ found a 25% penalty for the delay, which Jenny Craig appealed, arguing the delay was due to the applicant's choice of a chiropractor outside their Medical Provider Network (MPN). The Appeals Board affirmed the unreasonable delay finding but reduced the penalty to 20% of the delayed treatment's value, citing a failure in case management rather than intentional disregard. Jurisdiction was reserved for the parties to adjust the penalty amount.

Workers Compensation Appeals BoardMonica BenardJenny CraigSedgwick CMSADJ6973825ReconsiderationFindings and AwardLabor Code section 5814Medical Provider Network (MPN)chiropractic treatment
References
9
Case No. ADJ9932467
Regular
Oct 16, 2017

THERESA MCFARLAND vs. REDLANDS UNIFIED SCHOOL DISTRICT

The Workers' Compensation Appeals Board denied an applicant's petition for reconsideration, affirming the WCJ's decision that "Return-To-Work" supplemental payments under Labor Code section 139.48 are not "compensation" as defined by Labor Code section 3207. Therefore, the applicant was not entitled to a second penalty under Labor Code section 5814 for the employer's delay in providing a Supplemental Job Displacement Benefit voucher, as that delay did not cause a delay in a compensable benefit. The Board found that the applicant's penalty claim for the voucher delay was already resolved and that imposing a second penalty for a non-compensable benefit delay would be unfair and against the principle of balancing justice.

Labor Code section 139.48Return-To-Work supplemental paymentscompensation definitionLabor Code section 3207Labor Code section 5814 penaltyLabor Code section 4658.7 voucherSupplemental Job Displacement Benefitcompromise and release agreementGage v. Workers' Comp. Appeals Bd.unreasonable delay
References
1
Case No. MISSING
Regular Panel Decision

Blau Mechanical Corp. v. City of New York

This appeal addresses whether contractual delays, for which the plaintiff-respondent sought monetary damages for plumbing work at the New York Zoological Park, were contemplated by the parties' agreement. The court concluded that these delays were indeed contemplated, reversing a prior Supreme Court finding. The contract included a clause barring damages for delay unless caused by intentional wrongdoing, gross negligence, or willful misconduct. The plaintiff alleged delays due to structural changes, unexpected subsurface conditions, and interference from a local community group. However, the court found that the contract explicitly anticipated changes and differing subsurface conditions. Additionally, delays from community group intrusion were not attributable to the City as grossly negligent or intentional, thereby precluding recovery for damages.

Contractual DelaysDamages for DelayContemplated DelaysConstruction ContractPlumbing WorkNew York CityAppellate ReviewSubsurface ConditionsChange OrdersCommunity Interference
References
4
Case No. SBA 0076630
Regular
Mar 03, 2008

Janice Brackenridge-DeGraff vs. ACTMEDIA, INC., INTERCARE INSURANCE

The Workers' Compensation Appeals Board granted reconsideration, overturning a prior decision that denied penalties for delayed payment. The Board found the employer unreasonably delayed payment of the compromise and release agreement by 10 days beyond the agreed-upon 30-day deadline. Consequently, the Board awarded a 5% penalty on the delayed amount and a separate 5% penalty for the unreasonable delay in paying the legally owed interest.

Labor Code section 5814ReconsiderationCompromise and ReleasePenaltyUnreasonable DelayPaymentInterestAttorney's FeesCIGAWCJ
References
1
Case No. ADJ7347492
Regular
Aug 20, 2012

EDWARD ZEPEDA vs. CARNATION CO., METLIFE INS. CO. OF CONNECTICUT, Administered by TRAVELERS

Here's a summary of the case for a lawyer, in four sentences: The Board granted reconsideration to rescind the WCJ's decision, finding no unreasonable delay in the defendant's payment of a Compromise and Release settlement. The Board determined the delay was due to an inadvertent typographical error in the address for one of three settlement checks, not bad faith or intentional delay by the defendant. Consequently, penalties and attorney fees related to the alleged delay were denied. The Board also found no basis for sanctions under Labor Code section 5813.

Labor Code Section 5814Labor Code Section 5813Compromise and ReleasePetition for ReconsiderationUnreasonable DelayPenaltyAttorney FeesApplicant's CostsTypographical ErrorInadvertent Error
References
2
Case No. ADJ2464522 (OAK 0338150)
Regular
Feb 19, 2013

CHARLES COWART vs. JACK IN THE BOX, INC.

The Workers' Compensation Appeals Board granted reconsideration, rescinding the prior award of penalties for unreasonable delay in funding an annuity. The Board found that applicant's own delay in providing necessary information was the primary cause of the annuity funding delay, thus not warranting a penalty. However, the Board affirmed a $10,000 penalty for the employer's unreasonable delay in paying applicant's attorney's fees, to be paid to the applicant, not the attorney. Attorney's fees for enforcing the compromise and release were deferred for trial level resolution.

Workers' Compensation Appeals BoardCompromise and ReleaseLabor Code section 5814PenaltyUnreasonable DelayAnnuity FundingAttorney's FeesReconsiderationFindings and AwardDecision After Reconsideration
References
0
Case No. ADJ3857516 (VNO 0505788)
Regular
Sep 20, 2013

ALBERTO ALCAZAR vs. PACTIV CORPORATION

This case involves a worker's compensation claim where the employer, Pactiv Corporation, was found to have unreasonably delayed necessary medical treatment, including transportation and home care. The Appeals Board modified a prior decision, finding the unreasonable delay occurred from December 20, 2010, to March 2, 2011, and reduced the penalty from 25% to 15% of the delayed benefits. The Board reversed the penalty for two instances of transportation failure by a hired company, deeming it not the employer's unreasonable conduct. Finally, attorney fees were reduced as some services were deemed unnecessary for the period of unreasonable delay.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of FactAward and OrderUnreasonable DelayMedical TreatmentTransportationHome Care AssistanceLabor Code section 5814Penalty
References
1
Case No. MISSING
Regular Panel Decision
Jul 19, 2012

Lewis v. East Ramapo Central School District

This case concerns an appeal by the East Ramapo Central School District against an order that granted a petitioner leave to serve a late notice of claim. The Supreme Court, Appellate Division, reversed the lower court's decision, denying the petition and dismissing the proceeding. The court considered four factors for granting leave: actual knowledge of the claim by the school district, the petitioner's infancy and its nexus to the delay, a reasonable excuse for the delay, and substantial prejudice to the school district. The petitioner failed to provide a reasonable excuse for the 15-month delay after reaching the age of majority and did not demonstrate that the school district had timely actual knowledge of the claim or that it would not be substantially prejudiced by the three-year-and-eight-month delay.

Late Notice of ClaimGeneral Municipal Law § 50-e(5)School District LiabilityNegligent SupervisionInfancy ExcuseActual Knowledge RequirementSubstantial PrejudiceAppellate DivisionAssault in SchoolTimeliness of Claim
References
17
Case No. 2024 NY Slip Op 00275 [223 AD3d 569]
Regular Panel Decision
Jan 23, 2024

Maurizaca v. 201 Water St., LLC

In this case, third-party defendant Apex Restoration Corp. appealed the denial of its motion for summary judgment. The motion was denied by the Supreme Court, New York County, because Apex failed to demonstrate good cause for its delay in filing the motion. Specifically, the court noted that Apex did not require an IME report to meet its prima facie burden under Workers' Compensation Law § 11 and also delayed filing for several months even after obtaining other relevant reports. The Appellate Division, First Department, unanimously affirmed the lower court's decision, emphasizing that Apex's arguments on the merits were irrelevant to establishing good cause for the delay. The court reiterated that establishing good cause for filing delays is a prerequisite for such motions.

summary judgment motiondelay in filinggood causecommon-law indemnitycontribution claimsWorkers' Compensation Lawappellate affirmationprima facie burdenprocedural errorcivil procedure rules
References
5
Case No. 2015 NY Slip Op 00361 [124 AD3d 636]
Regular Panel Decision
Jan 14, 2015

Williams v. Jamaica Hospital Medical Center

The infant plaintiff alleged personal injuries resulting from a delayed transport by the City of New York's Emergency Medical Service during his mother's labor. Approximately four years after the alleged negligence, the plaintiff served a notice of claim and moved to have it deemed timely or for leave to serve a late notice. The Supreme Court granted the plaintiff's motion and denied the City's cross-motion to dismiss. The Appellate Division, Second Department, reversed this order, finding that the City did not acquire actual knowledge of the essential facts of the claim within the statutory 90-day period or a reasonable time thereafter. The court further determined that the plaintiff's delay substantially prejudiced the City's ability to defend the action and that the plaintiff failed to provide a reasonable excuse for the significant delay, noting that infancy alone without a demonstrated nexus to the delay was insufficient.

Late Notice of ClaimGeneral Municipal LawActual Knowledge RequirementPrejudice to MunicipalityReasonable Excuse for DelayInfancyPersonal InjuryMedical Malpractice AllegationAppellate ReviewMunicipal Negligence
References
13
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