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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 Schell v. Right

A claimant was injured in April 1993, establishing accident, notice, and causal relationship. Compensation was stipulated at $225 per week for physical disability. Later, a consequential psychiatric condition was affirmed, setting a higher payment rate of $358.73 per week from 1994. The workers' compensation carrier failed to pay this higher rate retroactively after the August 9, 2000 determination. A Workers' Compensation Law Judge imposed a penalty under Workers’ Compensation Law § 25 (3) (f) for this failure, but the Workers’ Compensation Board rescinded it due to a lack of sufficient evidence. The claimant appealed, arguing that the penalty provisions are self-executing and mandatory for late payments. The appellate court reversed the Board's decision, finding no substantial evidence to support the rescission, and remitted the matter for further proceedings, emphasizing the mandatory nature of the penalty for delayed award payments.

Workers' CompensationPenalty AssessmentLate PaymentRetroactive BenefitsPsychiatric DisabilityCarrier LiabilityMandatory PenaltyBoard ReversalAppellate ReviewRemand
References
3
Case No. MISSING
Regular Panel Decision
Nov 29, 2001

Claim of Caiazza v. Eastman Kodak Co.

The claimant, a former machinist, developed skin cancer in 1990 and later lung and brain cancers in 2000, attributed to occupational exposure. Following his retirement in 2001, the employer conceded the lung and brain cancers were consequential to the initial skin cancer. A Workers' Compensation Law Judge (WCLJ) found the claimant permanently totally disabled and awarded weekly benefits of $300, based on the original skin cancer disablement date of February 27, 1986. The claimant sought Workers' Compensation Board review, arguing for an April 24, 2000 disablement date (diagnosis of lung/brain cancers) to receive higher benefits of $400/week. The Board affirmed the WCLJ's decision, citing the claimant's prior stipulation to modify the original claim for consequential injuries and established law that such awards are measured by rates at the time of the original injury. The appellate court affirmed the Board's decision, finding it was not unreasonable to rely on the claimant's agreement and that the award rate was supported by substantial evidence.

Occupational DiseaseWorkers' Compensation BenefitsDate of DisablementBenefit Rate CalculationConsequential InjurySkin CancerLung CancerBrain CancerPermanent Total DisabilityAppellate Review
References
4
Case No. MISSING
Regular Panel Decision
Jun 22, 1999

Claim of Mace v. Owl Wire & Cable Co.

The claimant's husband suffered a heart attack in 1971 and died in 1991, with the death causally related to the 1971 injury. The Workers’ Compensation Board determined that a 3% interest rate, applicable to 1971 accidents under Workers’ Compensation Law § 27 (5), should be used to calculate the present value of the death benefits award to be paid into the Aggregate Trust Fund. The workers’ compensation carrier appealed, contending that the 6% rate, in effect at the time of the decedent's death in 1991, should apply. The court affirmed the Board's decision, holding that the statutory interest rate for calculating the present value of awards to the Aggregate Trust Fund is tied to the date of the original accident, not the subsequent causally-related death. This interpretation aligns with legislative intent and prior Board decisions.

Workers' CompensationAggregate Trust FundInterest Rate CalculationStatutory InterpretationDeath BenefitsDate of AccidentLegislative IntentPresent ValueInsurance Carrier LiabilityAppellate Review
References
16
Case No. ADJ2073428 (VNO 0465400) ADJ1610465 (VNO 0540972) ADJ3247765 (VNO 00384869)
Regular
Apr 04, 2011

JAY ZAVERI vs. STATE COMPENSATION INSURANCE FUND; Legally Uninsured

The applicant sought reconsideration of a workers' compensation award, arguing for a 100% permanent disability rating and challenging the permanent disability start date used for attorney fee commutation. The Appeals Board denied the petition, finding insufficient evidence to establish total permanent disability, as the applicant was currently employed and medical opinions did not definitively support such a rating. The Board also ruled that the applicant waived arguments regarding the rating of specific injuries by failing to properly object, and that even if considered, separate ratings for back, knee, and plantar fasciitis conditions would not result in a higher award due to fibromyalgia being the primary cause and rating higher. Finally, the Board clarified that the July 2, 2000 date was only relevant to the attorney fee commutation calculation and not to the determination of permanent disability indemnity payments.

WCABPetition for ReconsiderationJoint Findings and AwardWorkers' Compensation Judge (WCJ)Industrial InjuryBack InjuryHip InjuryBilateral Knee InjuryBilateral Foot InjuryBilateral Plantar Fasciitis
References
7
Case No. MISSING
Regular Panel Decision

Claim of Perrin v. Builders Resource, Inc.

The case concerns an appeal from a Workers' Compensation Board decision regarding the reimbursement rate for home health aide services provided to a claimant by their sister. Initially, the carrier denied payment but was later directed to pay. The Workers’ Compensation Law Judge set the reimbursement rate at $12 per hour for services starting in 2011, which the Board affirmed. The claimant appealed, solely challenging this rate. The court dismissed the appeal, ruling that the claimant was not an aggrieved party concerning the reimbursement rate, as the dispute was between the care provider (the sister) and the carrier. The court affirmed that the claimant received the care sought and could not raise issues on behalf of the care provider.

Workers' CompensationHome Health Aide ServicesReimbursement RateAppeal DismissalAggrieved PartyCare ProviderWorkers' Compensation BoardAppellate ProcedureNew York LawCarrier Liability
References
4
Case No. MISSING
Regular Panel Decision
Sep 15, 2011

Colortone Camera, Inc. v. New York State Compensation Insurance Rating Board

Colortone Camera, Inc. challenged the reclassification of its employees from Workers' Compensation Classification Code 8017 to 8018, which resulted in significantly increased insurance rates. The company's appeal to the Superintendent of Insurance, affirming the New York State Compensation Insurance Rating Board's determination, was reviewed in this hybrid CPLR article 78 proceeding. The court confirmed the Superintendent's determination, finding it supported by substantial evidence that Colortone's business was primarily wholesale. Additionally, Colortone sought a declaratory judgment that portions of the Workers Compensation & Employers Liability Insurance Manual were unconstitutional for vagueness. This aspect of the case was remitted to the Supreme Court, Westchester County, for severance and further proceedings, as it was not properly before the appellate court.

Workers' CompensationInsurance RatesBusiness ReclassificationAdministrative ReviewJudicial ReviewCPLR Article 78Declaratory JudgmentConstitutional LawVagueness ChallengeSubstantial Evidence
References
8
Case No. MISSING
Regular Panel Decision
Aug 02, 2012

Keefe v. Aramatic Refreshment Services Inc.

The claimant had two established workers' compensation claims for back injuries from 2004 and 2009, with benefits equally apportioned. The dispute arose regarding the calculation of benefits for the 2009 claim, specifically whether to use the claimant's 2009 wages or the higher 2004 wages. The Workers’ Compensation Board ruled that the 2009 wages should be used for the 2009 claim, aligning with Workers’ Compensation Law § 15 (5) and § 15 (7). The Appellate Division affirmed this aspect of the Board's decision. However, the Board's unexplained reduction of a temporary total disability award to a marked temporary partial disability was found to be an error, leading to a remittal of the matter to the Board for further proceedings to address this inconsistency.

Workers' CompensationBack InjuriesDisability BenefitsWage CalculationTemporary Partial DisabilityTemporary Total DisabilityStatutory InterpretationRemittalApportionmentJudicial Review
References
3
Case No. ADJ10091553
Regular
May 06, 2019

DWIGHT STILLWELL vs. WYLATTI RESOURCE MANAGEMENT, INC., STATE COMPENSATION INSURANCE FUND

In this workers' compensation case, the applicant challenged the administrative law judge's (WCJ) permanent disability rating of $76\%$. The applicant argued that the WCJ improperly combined medical impairments when an agreed medical evaluator suggested adding them for a higher rating of $88\%$. The WCJ acknowledged misinterpreting the medical evidence in their report, admitting that the agreed medical evaluator did indicate adding impairments was more appropriate. Consequently, the Workers' Compensation Appeals Board granted reconsideration to allow the WCJ to re-evaluate the permanent disability rating based on the correct understanding of the medical evidence.

Agreed Medical EvaluatorAMA GuidesPermanent Disability RatingPetition for ReconsiderationWorkers' Compensation Appeals BoardFindings and AwardCVCSchedule for Rating Permanent DisabilitiesOrthopedistIndustrial Injury
References
0
Case No. 2017 NY Slip Op 27428
Regular Panel Decision
Dec 14, 2017

New York State Workers' Compensation Bd. v. Compensation Risk Mgrs., LLC

This action was brought by the New York State Workers' Compensation Board (WCB), as an assignee of former members of the Healthcare Industry Trust of New York (HITNY), against Compensation Risk Managers, LLC (CRM), HITNY trustees, and auditing firm UHY LLP. The WCB alleged mismanagement, breach of fiduciary duty, and negligent auditing, leading to the Trust's insolvency. Defendants moved to dismiss on grounds of standing, statute of limitations, and pleading particularity. The court dismissed certain derivative claims and negligent misrepresentation claims against some trustees due to standing issues and statute of limitations. All claims against UHY LLP were dismissed for lack of a near-privity relationship or prior precedent. An implied indemnity claim against the trustees was sustained. The WCB's cross-motion to consolidate related actions was denied.

Workers' Compensation LawGroup Self-Insured Trust (GSIT)Fiduciary DutyNegligenceNegligent MisrepresentationStatute of LimitationsStandingDerivative ActionImplied IndemnityAuditing Firm Liability
References
46
Case No. MISSING
Regular Panel Decision
Mar 27, 1984

Coakley v. General Motors Corp. Harrison Radiator Division

The claimant sustained a compensable injury in 1968, resulting in a schedule award, and retired in 1975. In 1980, she suffered a consequential injury to her right leg, held to be the responsibility of the Special Fund for Reopened Cases. A schedule award was established in 1983 based on the consequential injury date. The claimant sought a penalty against the Special Fund, arguing the compensation rate should be based on the consequential injury date, not the original injury date. The Workers' Compensation Board ruled that the rate for a consequential injury is determined by the rate applicable at the time of the origin of the injury and modified the award accordingly. The appellate court affirmed the Board's decision, asserting that a consequential injury emanates solely from the original injury, and the pertinent rate of compensation should be measured by the original period.

Workers' CompensationConsequential InjurySchedule AwardSpecial Fund for Reopened CasesCompensation RateOriginal Injury DateRetirementAppellate ReviewJurisdictional CorrectionNew York Workers' Compensation Board
References
3
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