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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

Perfect Dental, PLLC v. Allstate Insurance

In this consolidated action, plaintiffs Perfect Dental Care, P.C., Zodiac Dental, PLLC, and Smooth Dental PLLC (Dental PCs) sought unpaid insurance claims from Allstate Insurance Company and State Farm Mutual Automobile Insurance Company (Insurers). The Insurers countersued alleging insurance fraud and unjust enrichment, and initiated a third-party action against various individuals and entities. The Insurers moved for partial summary judgment, seeking a declaratory judgment that Dental PCs could not recover for services provided by dentists and physical therapists, and for summary judgment on their fraud and unjust enrichment counterclaims. The court denied summary judgment concerning dentists' services, finding a triable issue of fact regarding their employment status. However, it granted summary judgment for the Insurers regarding physical therapy services, as Dental PCs conceded these services were provided by non-employees. Consequently, the court also denied summary judgment on the fraud and unjust enrichment claims, as their resolution depended on the unresolved employment status of the dentists.

Insurance ClaimsHealthcare ServicesContract LawSummary JudgmentProfessional CorporationsIndependent ContractorsEmployment LawFraud AllegationsUnjust EnrichmentDeclaratory Judgment
References
17
Case No. 2020 NY Slip Op 01355
Regular Panel Decision
Feb 26, 2020

Naula v. Utokilen, LLC

The plaintiff, Victor Naula, commenced an action for personal injuries against Utokilen, LLC, and others. The Workers' Compensation Board (WCB) found Naula's employer, Specialized Dental Construction, Inc., uninsured and Adapt Construction, LLC, to be the general contractor, awarding Naula workers' compensation benefits. Utokilen and Nancy Marin-Rojas D.D.S., P.C., initiated a third-party action against Specialized Dental for common-law indemnification and contribution. Specialized Dental moved for summary judgment, asserting exclusivity under Workers' Compensation Law § 11, but Utokilen and Marin-Rojas cross-moved, arguing Specialized Dental could not invoke § 11 due to its uninsured status. The Supreme Court granted the cross-motion and denied Specialized Dental's motion. The Appellate Division dismissed Adapt Construction, LLC's appeal as it was not an aggrieved party and affirmed the Supreme Court's order against Specialized Dental Construction, Inc.

Personal InjuriesWorkers' Compensation LawSummary JudgmentThird-Party ClaimsIndemnificationContributionGrave InjuryUninsured EmployerAppellate PracticeCollateral Estoppel
References
7
Case No. MISSING
Regular Panel Decision

First District Dental Society v. Sencer

The petitioners, dental societies in New York City, initiated an Article 78 proceeding to challenge a directive from the New York City Department of Health. The directive, dated August 14, 1981, mandated that all radiation installation licensees, including dental offices, make complete copies of Article 175 of the New York City Health Code available for staff examination. Petitioners argued this requirement was arbitrary and capricious due to its impracticality, financial burden, and the existence of an alternative provision allowing a descriptive notice. Respondents defended the directive as a rational measure to protect public health and ensure worker instruction regarding radiation safety, aligning with state and federal regulations. The court, applying the standard for administrative review, found a rational basis for the Department's interpretation and upheld the directive, denying the petitioners' request for nullification, though a 60-day stay on enforcement was granted.

Radiation SafetyHealth CodeAdministrative LawJudicial ReviewDental PracticesRegulatory CompliancePublic HealthArticle 78 ProceedingsAgency InterpretationDirective Challenge
References
8
Case No. MISSING
Regular Panel Decision

Claim of De Beauharnais-Romanovsky v. Sheraton Corporation

Claimant, a hotel worker, sustained a facial injury in 1982, leading to a workers' compensation claim for a nose injury that was initially granted. Subsequently, he alleged additional injuries, including back, neck, jaw, dental conditions, and hearing loss. After multiple hearings, a Workers' Compensation Law Judge (WCLJ) found the jaw and dental conditions causally related. However, the Workers’ Compensation Board overturned this finding, ruling there was no credible evidence to support the causal relationship of his back, neck, jaw, or dental conditions to the 1982 accident, thereby denying his claim. The Appellate Division affirmed the Board's decision, emphasizing that resolving conflicting medical testimony falls within the Board's authority and noting that certain issues were not preserved for review.

Workers' CompensationCausal RelationshipMedical Testimony ConflictBoard JurisdictionAppellate ReviewDental ConditionsJaw ConditionsBack ConditionsNeck ConditionsHearing Loss
References
2
Case No. MISSING
Regular Panel Decision
Dec 03, 2004

Claim of Scally v. Ravena Coeymans Selkirk Central School District

In this case, a claimant appealed a Workers’ Compensation Board decision regarding apportionment of her workers' compensation award. The claimant, who suffered a work-related left knee injury in 2002, had a pre-existing non-work-related injury to the same knee from 1986. While a WCLJ initially denied apportionment, the Board reversed, directing a 50/50 apportionment based on the premise that the prior injury would have resulted in a schedule loss of use award had it been work-related. The appellate court upheld the Board's determination, deferring to its interpretation that a non-work-related injury leading to a schedule loss of use constitutes a "disability in a compensation sense" for apportionment purposes. This decision was supported by medical expert testimony indicating a schedule loss of use from the prior surgery.

Workers' CompensationApportionmentKnee InjuryNon-work-related InjurySchedule Loss of UsePreexisting ConditionMedical Expert TestimonyBoard InterpretationJudicial ReviewAppellate Decision
References
13
Case No. ADJ4018708 (SBA 0079160)
Regular
Apr 23, 2010

KATHY KELLERMANN vs. REGENTS OF UCSB, SEDGWICK CLAIMS MANAGEMENT SERVICES

This case involves Kathy Kellermann's claim for workers' compensation benefits, where the administrative law judge initially found a cumulative trauma injury to her psyche but not to her dental, neurological, or internal systems, awarding 8% permanent disability. Ms. Kellermann sought reconsideration, arguing the judge erred by excluding dental, neurological, and internal injuries, acting in excess of powers regarding an independent medical exam, and improperly relying on certain medical reports for disability assessment. The Appeals Board granted reconsideration to clarify the scope of injury, affirming the finding of psyche injury but not other systems as a compensable consequence. The Board also upheld the 8% permanent disability award, citing precedent allowing reliance on a single physician's relevant and considered opinion even if inconsistent with others.

ADJ4018708SBA 0079160Kathy KellermannRegents of UCSBSedgwick Claims Management ServicesOpinion and Order Granting ReconsiderationDecision After Reconsiderationindustrial cumulative trauma injurypsyche injurydental injury
References
2
Case No. MISSING
Regular Panel Decision

In re Eastern District Repetitive Stress Injury Litigation

The defendants sought to transfer 78 repetitive stress injury (RSI) cases from the Eastern District of New York to districts where the claims arose, also seeking severance of individual claims. Over 450 RSI cases, involving over 1,000 plaintiffs against more than 100 equipment manufacturers, were initially consolidated in the Eastern District. However, the Second Circuit later vacated the consolidation orders, finding it an abuse of discretion due to lack of common facts and varying state laws. Relying on this guidance, the court granted transfer in 75 cases and denied it in three, citing factors such as convenience of parties and witnesses, judicial economy, and the public interest in local adjudication of local controversies. The court also ordered severance where necessary to facilitate transfer.

Transfer of VenueMultidistrict LitigationRepetitive Stress InjuryProducts LiabilityForum Non ConveniensSeverance of ClaimsConsolidation of CasesJudicial EconomyWitness ConvenienceChoice of Forum
References
16
Case No. ADJ488924 (SDO 0329999), ADJ226519 (SDO 0302236), ADJ2353553 (SDO 0250184), ADJ4021935 (SDO 0269434)
Regular
Dec 10, 2020

Craig Stevens vs. Subsequent Injuries Benefits Trust Fund

The Workers' Compensation Appeals Board (WCAB) rescinded a previous order denying benefits from the Subsequent Injuries Benefits Trust Fund (SIBTF). Applicant Craig Stevens sought SIBTF benefits for a claimed subsequent cumulative trauma injury to his neck ending April 2, 2009, with a compensable consequence injury to his right shoulder and low back. The WCAB found the medical evidence regarding the causation, date of injury, and permanent disability ratings for the alleged subsequent injuries, as well as prior injuries, to be insufficient and inconsistent. The case was returned to the trial level for further development of the record, including obtaining new medical opinions to clarify the various injuries and establish SIBTF eligibility thresholds.

Subsequent Injuries Benefits Trust FundSIBTF eligibilitycumulative trauma injurycompensable consequence injurypermanent disabilityapportionmentmedical evidencecausationfurther development of the recordLabor Code section 4751
References
9
Case No. ADJ3388364 (VNO 0526713) ADJ2633182 (VNO 0342427)
Regular
Oct 24, 2014

RICHARD FROMKNECHT vs. SUBSEQUENT INJURIES BENEFITS TRUST FUND

The applicant sought reconsideration of a decision denying him benefits from the Subsequent Injuries Benefits Trust Fund (SIBTF). The applicant claimed a pre-existing disability from a 1996 spinal injury caused further permanent disability with a subsequent 1998 spinal injury. However, both injuries became permanent and stationary concurrently, meaning there was no distinct pre-existing ratable disability at the time of the second injury. Therefore, the applicant did not meet the criteria for SIBTF benefits under Labor Code section 4751, and his petition for reconsideration was denied.

Subsequent Injuries Benefits Trust FundLabor Code section 4751Petition for ReconsiderationFindings and OrderStipulations with Requests for AwardsAgreed Medical Evaluatorapportionmentpermanent and stationarypreexisting disabilityindustrial injury
References
0
Case No. ADJ5621413
Regular
Sep 15, 2016

LORI RENFRO vs. SUMMIT COUNSELING AND EDUCATION, STATE COMPENSATION INSURANCE FUND, SUBSEQUENT INJURIES BENEFIT TRUST FUND

This case involves applicant Lori Renfro's claim for Subsequent Injuries Benefit Trust Fund (SIBTF) benefits following a work injury. The WCJ initially awarded benefits, finding the industrial injury's standalone disability exceeded the 35% threshold. The SIBTF appealed, arguing the injury's standalone disability was below 35% and the prior disability should be measured at the time of the subsequent injury. The Appeals Board rescinded the award, finding the WCJ erred by not properly applying the 35% threshold for the subsequent injury alone. The matter is remanded to determine the applicability of Labor Code section 4751(a) and to re-evaluate the 70% combined disability threshold, measuring prior disability as it existed before the subsequent injury.

Subsequent Injuries Benefit Trust FundSIBTFpermanent disability thresholdapportionmentLabor Code section 4751combined disabilityprior disabilitysubsequent injuryvocational expertQME
References
4
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