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

Case No. 2025 NYSlipOp 01414 [236 AD3d 1165]
Regular Panel Decision
Mar 13, 2025

Matter of DeBryne v. Pittsford Mercury, Inc.

Claimant Jeffery DeBryne, classified as permanently totally disabled due to work-related injuries, was found by a Workers' Compensation Law Judge to have violated Workers' Compensation Law § 114-a for operating a business and providing a home improvement estimate while denying for-profit activity. The Workers' Compensation Board affirmed the finding and the imposition of a mandatory penalty and a six-month discretionary disqualification. On appeal, the Appellate Division, Third Department, affirmed the Board's discretionary penalty, finding no abuse of discretion given the Board's rationale that no actual work was observed. However, the court modified the decision regarding the effective date of the mandatory penalty, remitting that aspect for further proceedings, and otherwise affirmed the decision.

Workers' Compensation Law § 114-aDisability Benefits FraudPermanent Total DisabilityMandatory PenaltyDiscretionary PenaltyWorkers' Compensation BoardAppellate Division ReviewSurveillance EvidenceHome Improvement ActivityEgregious Deception
References
5
Case No. 533556
Regular Panel Decision
Feb 02, 2023

In the Matter of the Claim of Alastair Kennedy

Claimant, an operating engineer, sustained work-related injuries in October 2019 after falling into a hole at a job site. He initially filed for workers' compensation benefits, which were accepted for left foot and ankle injuries. He later alleged neck and left shoulder injuries, which the carrier contested, also raising a Workers' Compensation Law § 114-a violation due to alleged misrepresentations. A Workers' Compensation Law Judge (WCLJ) found claimant's testimony not credible regarding the accident and prior injuries, disallowed the neck and shoulder claims, and imposed both mandatory and discretionary penalties under § 114-a. The Workers' Compensation Board affirmed these findings. On appeal, the Appellate Division affirmed the Board's decision to disallow the claims for neck and shoulder injuries and upheld the mandatory penalty for misrepresentation, finding it supported by substantial evidence. However, the Court reversed the imposition of the discretionary penalty of total disqualification from future wage loss benefits, deeming it disproportionate to the offense, thereby modifying the Board's decision.

Workers' Compensation BenefitsCausally-Related InjuriesCredibility DeterminationMisrepresentationWorkers' Compensation Law § 114-aMandatory PenaltyDiscretionary PenaltyWage Loss BenefitsAppellate ReviewSubstantial Evidence
References
16
Case No. 526239
Regular Panel Decision
Dec 20, 2018

Matter of Papadakis v. Fresh Meadow Power NE LLC

Claimant Matt Papadakis sustained work-related injuries in January 2015 and was awarded workers' compensation benefits. Subsequently, surveillance footage and social media evidence revealed that the claimant had made false representations regarding his physical limitations and activities. The Workers' Compensation Board affirmed a Workers' Compensation Law Judge's ruling that claimant violated Workers' Compensation Law § 114-a and disqualified him from receiving future wage replacement benefits. The Appellate Division affirmed the finding of a violation based on substantial evidence but remitted the matter to the Board because it failed to provide a reason for the imposition of the discretionary sanction disqualifying future wage replacement benefits, thus preventing appellate review.

Workers' Compensation BenefitsFalse StatementMaterial FactSurveillance EvidenceSocial Media EvidenceWage Replacement BenefitsDisqualificationAppellate ReviewRemittalJudicial Review
References
12
Case No. MISSING
Regular Panel Decision

Claim of McCormack v. Eastport Manor Construction

The claimant suffered a work-related accident in May 2001 and initially denied returning to work or performing volunteer work. Later, he amended his testimony, admitting to working for Casa Concrete and performing volunteer work at ground zero after September 11, 2001. The Workers’ Compensation Board found the claimant violated Workers’ Compensation Law § 114-a by knowingly making false statements to obtain benefits, disqualifying him. The appellate court agreed with the Board's finding of false testimony but reversed the decision regarding the penalty. The court found that the Board's decision lacked clarity on whether the penalty was mandatory or discretionary and the rationale for its imposition, thus remitting the case for further proceedings to elaborate on the penalty's basis.

Workers' CompensationFalse TestimonyMisrepresentation of Work ActivitiesDisqualification from BenefitsSection 114-a ViolationAppellate ReviewRemittalPenalty AssessmentDue ProcessSubstantial Evidence
References
3
Case No. 533112
Regular Panel Decision
Mar 17, 2022

Matter of Reyes v. H & L Iron Works Corp.

A claimant appealed a Workers' Compensation Board decision which found he violated Workers' Compensation Law § 114-a and permanently disqualified him from future indemnity benefits. The claimant, Leonel Reyes, sustained work-related injuries in 2016 and received benefits. However, he failed to fully disclose his disc jockey activities and the physical nature of this work to the Board, carrier, and examining physicians while collecting benefits. Surveillance videos showed him lifting heavy equipment, contradicting his testimony. The Workers' Compensation Board affirmed the WCLJ's finding of a violation and the imposition of both mandatory and discretionary penalties. The Appellate Division, Third Department, affirmed the Board's decision, concluding that substantial evidence supported the violation and that the permanent forfeiture of indemnity benefits was not a disproportionate penalty given the claimant's multiple egregious misrepresentations.

Workers' Compensation Law § 114-aFalse RepresentationIndemnity BenefitsPermanent DisqualificationUndisclosed EmploymentDisc JockeyMaterial MisrepresentationSubstantial EvidenceWitness CredibilityDiscretionary Penalty
References
7
Case No. MISSING
Regular Panel Decision
Jun 17, 1996

Claim of Lehsten v. NACM-Upstate New York

Claimant, a collection assistant, sustained an acute sprain of her lower back after twisting her body while getting up from her desk on May 26, 1993, resulting in a mild partial disability. Her claim for workers’ compensation benefits was controverted by her employer, NACM-Upstate New York, and its insurance carrier, Commercial Union Insurance Company. A Workers’ Compensation Law Judge (WCLJ) and a Workers’ Compensation Board panel affirmed the claim. A penalty was assessed against the employer for withholding payment during an application for full Board review. The court affirmed the Board's finding of a work-related accident, noting substantial evidence that the injury arose out of and in the course of employment due to an identifiable work-related cause. However, the court reversed the imposition of the penalty, ruling that Workers’ Compensation Law § 25 (3) (f) precludes such penalties when an employer applies for Board review, regardless of whether the review is mandatory or discretionary.

Back InjuryWorkers' CompensationPenalty AssessmentStatutory InterpretationAccident DefinitionWork-Related InjuryEmployer LiabilityInsurance CarrierAppellate ProcedureBoard Review
References
8
Case No. 2022 NY Slip Op 05362 [208 AD3d 1565]
Regular Panel Decision
Sep 29, 2022

Matter of Sausto v. Wildlife Conservation Socy.

Claimant Frank P. Sausto was injured while working and received workers' compensation benefits. He was found to have violated Workers' Compensation Law § 114-a for making material misrepresentations concerning his work activities with his custom knife business, FS Blades, while collecting total disability benefits. A Workers' Compensation Law Judge initially imposed both mandatory and discretionary penalties. The Workers' Compensation Board modified this decision, imposing only a mandatory penalty for a specified period and finding a discretionary penalty unwarranted due to the claimant's disclosures and forthright testimony. The employer and its carrier appealed the Board's modification, but the Appellate Division affirmed the Board's decision, concluding that its factual findings were supported by substantial evidence and its decision regarding the discretionary penalty was not an abuse of discretion.

Workers' Compensation FraudMisrepresentation of Work ActivitiesDisability BenefitsMandatory PenaltyDiscretionary PenaltyAppellate ReviewSubstantial EvidenceAbuse of DiscretionWorkers' Compensation LawCredibility Assessment
References
10
Case No. MISSING
Regular Panel Decision

Losurdo v. Asbestos Free, Inc.

The New York Court of Appeals addressed whether Workers’ Compensation Law section 114-a (1) authorizes the Workers’ Compensation Board to disqualify a claimant from receiving wage replacement benefits even when the forfeited compensation is not "directly attributable" to a false statement. The court held that while the mandatory penalty requires a direct link, the Board possesses discretionary power to impose disqualification, which can include forfeiture of all or a portion of benefits, regardless of whether the false statement enabled the claimant to receive compensation. The court defined "material fact" broadly as significant or essential to the issue at hand. In the cases of James Losurdo and Florencia Machado, where the Board had imposed disqualifications for misrepresentations, the court reversed and remitted the matters. It directed the Board to clarify whether mandatory or discretionary penalties were applied and to provide an explanation for the proportionality of any disqualification imposed under its discretionary power.

Workers' Compensation LawFraudWage Replacement BenefitsMaterial FactDisqualificationDiscretionary PenaltyMandatory PenaltyApportionmentPreexisting InjurySurveillance
References
11
Case No. ADJ3231538 (SJO 0237619)
Regular
Apr 23, 2009

NANCY ANN WILLIAMSON vs. XP FORESIGHT ELECTRONICS, INC., LUMBERMANS MUTUAL CASUALTY COMPANY, BROADSPIRE, a CRAWFORD COMPANY

This Workers' Compensation Appeals Board case involved a defendant challenging a Finding and Award regarding a medical lien. The defendant argued the awarded lien amount was unreasonable, citing procedural errors and witness bias, and also disputed the imposition of interest and penalties. The Board granted reconsideration to correct a clerical error, reducing the penalty increase for unpaid charges from 15% to 10% as per statutory guidance. The Board otherwise affirmed the original decision, finding the lien claimant's charges reasonable and the imposition of interest warranted.

Workers' Compensation Appeals BoardLien ClaimantReconsiderationFindings and AwardAdministrative Law JudgeLabor Code section 4603.2(b)Reasonable ValueUnpaid ChargesInterestPenalties
References
4
Case No. ADJ8990594
Regular
Feb 22, 2000

SHAWN GUTE vs. THE RYAN COMPANY, OLD REPUBLIC WORK COMP

Here's a summary of the case for a lawyer: The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding the denial of a credit for temporary disability overpayments against the applicant's permanent disability award. The Board found that allowing the credit would effectively eliminate the permanent disability benefits and that such credit allowances are discretionary. The WCAB adopted the WCJ's reasoning, emphasizing that the statutory purpose of permanent disability benefits would be undermined. The defendant's argument that they overpaid temporary disability after the agreed medical evaluator found the applicant permanent and stationary was rejected as a basis to disturb the WCJ's discretionary denial of credit.

Petition for ReconsiderationTemporary DisabilityPermanent DisabilityCreditOverpaymentAgreed Medical EvaluatorMaximum Medical ImprovementDiscretionaryWorkers' Compensation Appeals BoardWorkers' Compensation Judge
References
2
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