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

Case No. 2010 NY Slip Op 31684(U)
Regular Panel Decision

Paul v. New York City Housing Authority

Petitioner, a Section 8 rent subsidy recipient, was found by NYCHA to have failed to report over $25,000 in income between 2001-2005, leading to a calculated overpayment of $6,412. She subsequently entered into a stipulation to repay this sum, but later fell behind on payments, exacerbated by personal circumstances including domestic violence and periods in shelters. NYCHA initiated termination of her Section 8 subsidy, a decision upheld after a hearing where her defense regarding the erroneous basis of the overpayment was limited. Petitioner commenced an article 78 proceeding, asserting she was a victim of identity theft which caused the incorrect income attribution. The court determined that the stipulation was based on a mutual mistake of fact regarding her true income, thus rendering it void. Consequently, the court annulled NYCHA's determination to terminate her subsidy, further noting the severe and disproportionate impact of such termination given her disability and the needs of her minor son.

Section 8rent subsidyincome overpaymentidentity theftmutual mistake of factstipulation voidanceArticle 78 proceedingagency determination annulmenthousing terminationdisability
References
2
Case No. MISSING
Regular Panel Decision

Watson v. Cencom Cable Income Partners

The court granted summary judgment for the defendant, Cencom Cable Income Partners d/b/a Charter Communications, in a case brought by Rex M. Watson. Watson alleged discrimination under the Americans with Disabilities Act (ADA) and the Tennessee Human Rights Act (THRA), and retaliation for a workers' compensation claim, due to his termination stemming from carpal tunnel syndrome. The court found that Watson failed to establish a prima facie case of discrimination under the ADA, as he could not demonstrate that his impairment substantially limited a major life activity. Specifically, the court noted that carpal tunnel syndrome alone was insufficient to prove disability under the ADA's definition. Consequently, the federal ADA claim was dismissed with prejudice, and the state law claims were dismissed without prejudice, as the court declined to exercise supplemental jurisdiction.

Americans with Disabilities ActCarpal Tunnel SyndromeSummary JudgmentEmployment DiscriminationWorkers' Compensation RetaliationTennessee Human Rights ActSubstantially LimitsMajor Life ActivityPrima Facie CaseRepetitive Motion Injury
References
15
Case No. 03-18-00364-CV
Regular Panel Decision
Apr 30, 2020

Low Income Consumers, Mary Wilson and Hipolita Lutz v. Public Utility Commission of Texas

This case involves a direct appeal challenging amendments to Rules 25.478 and 25.480 adopted by the Public Utility Commission (PUC) of Texas. The appellants, "Low Income Consumers," Mary Wilson, and Hipolita Lutz, along with the intervenor City of Houston, argued that the PUC failed to comply with the rulemaking provisions of the Administrative Procedure Act (APA) and misconstrued relevant statutes. They specifically contested the repeal of the split-deposit provision in former Rule 25.478(e)(3) and amendments to Rule 25.480 concerning late fees and deferred payment plans, asserting these were essential customer protections rather than benefits tied to the expired System Benefit Fund (SBF). The Court of Appeals affirmed the Commission’s order, concluding that the Commission acted within its statutory authority and adhered to the APA's notice and reasoned justification requirements. The court found that the contested provisions were not mandated protections under other sections of the Public Utility Regulatory Act (PURA).

Public Utility CommissionAdministrative Procedure Act (APA)System Benefit Fund (SBF)RulemakingCustomer ProtectionsLow-income customersSplit-deposit provisionDeferred payment plansLate-fee waiverStatutory interpretation
References
22
Case No. MISSING
Regular Panel Decision

Matthanasak v. Sullivan

Plaintiff Syno Matthanasak, on his own behalf and as representative payee for his disabled daughter Chantala, challenged the Secretary of Health and Human Services' denial of a waiver for a $4,853.73 Supplemental Security Income (SSI) overpayment. Mr. Matthanasak, an immigrant from Laos with limited English, failed to report income and the opening of a joint bank account with his wife, leading to the overpayment. He argued he was 'without fault' due to language barriers and misunderstanding reporting requirements. The Administrative Law Judge and the Appeals Council denied the waiver, finding he should have known his obligations. Chief Judge Telesca upheld the Secretary's decision, concluding that substantial evidence supported the finding that Mr. Matthanasak was not without fault, as he was aware of the need for translation and had opportunities to seek assistance.

Supplemental Security IncomeOverpayment WaiverAdministrative Law JudgeSocial Security AdministrationReporting RequirementsLanguage BarrierFault DeterminationSubstantial EvidenceJudgment on the PleadingsRepresentative Payee
References
9
Case No. MISSING
Regular Panel Decision

Cianciulli v. Perales

This case concerns a petitioner's challenge under CPLR article 78 against determinations by the New York State Commissioner of Social Services. The Commissioner affirmed a local agency's decision to discontinue the petitioner's Aid to Families with Dependent Children (AFDC) grant due to receiving a lump-sum income exceeding household needs. The Commissioner also affirmed that a $2,600 loan repayment was not a life-threatening circumstance, thus not deductible from the lump-sum income for AFDC reapplication. The court confirmed both determinations, finding the petitioner's arguments lacked merit. It rejected claims that regulation 18 NYCRR 352.29 [h] violates constitutional duties or statutory mandates, or creates an invalid conclusive presumption of income availability. The court upheld the Commissioner's interpretation that life-threatening situations occur after lump-sum receipt, not for prior debts, even if those debts were for life-threatening circumstances at the time they were incurred.

AFDCLump-sum incomePublic assistanceSocial Services LawLife-threatening circumstanceLoan repaymentAdministrative reviewConstitutional lawStatutory interpretationEligibility criteria
References
7
Case No. MISSING
Regular Panel Decision

Insurance Co. of State of the Pennsylvania v. Moore

This appeal addresses whether a worker's compensation carrier is entitled to a proportionate reduction in supplemental income benefits (SIBs) equal to the percentage of reduction for impairment income benefits (IIBs) for a prior compensable injury under the Texas Workers’ Compensation Act. Appellant, Insurance Company of Pennsylvania, sought an 11/17ths reduction in Appellee John H. Moore's SIBs, matching the reduction applied to his IIBs for a previous back injury. A hearing officer granted the IIB reduction but denied the SIB reduction. The trial court upheld this decision. The appellate court reversed, holding that Texas Labor Code § 408.084 is unambiguous and mandates that both IIBs and SIBs be reduced by the same proportion when contribution is warranted for a prior injury. Consequently, Appellant is entitled to an 11/17ths reduction of Appellee’s supplemental income benefits.

Workers' CompensationSupplemental Income Benefits (SIBs)Impairment Income Benefits (IIBs)Prior Compensable InjuryProportionate ReductionStatutory InterpretationTexas Labor CodeSummary JudgmentAppellate ReviewCommission Appeals Panel
References
24
Case No. MISSING
Regular Panel Decision
Jun 24, 1991

Marziliano v. Sullivan

Plaintiff Josephine Marziliano sought review of a determination by the Secretary of the United States Department of Health and Human Services that denied her request to waive recovery of an overpayment of Supplemental Security Income benefits. The Magistrate Judge recommended that the matter be referred to the Secretary for a new hearing, emphasizing the importance of giving required deference to the treating physician’s opinions in such overpayment waiver proceedings. The defendant objected to the application of the treating physician rule in these proceedings. District Judge Goettel adopted the Magistrate Judge's report and recommendation, affirming that the treating physician rule applies with full force when determining whether a claimant was 'at fault' in accepting an overpayment and ordered the case remanded for a new hearing.

Supplemental Security Income (SSI)Overpayment WaiverTreating Physician RuleMental ImpairmentAdministrative Law Judge (ALJ)RemandSocial Security Administration (SSA)Disability BenefitsResource LimitationsReporting Requirements
References
8
Case No. E2012-02499-COA-R3-CV
Regular Panel Decision
Mar 19, 2014

Melissa L. Blackshear (Thompson) v. Stephen D. Blackshear

This appeal concerns post-divorce child support modification. The father petitioned to reduce his child support obligation due to a significant decrease in income. The trial court modified the father's child support from $2,000 to $73 per month, awarded a $21,124 judgment to the father for overpayment, and granted him $10,000 in attorney's fees. The mother appealed, challenging the existence of a significant variance and the trial court's awards. The Court of Appeals vacated the trial court's ruling regarding the father's income calculation for child support, finding it unclear whether income was properly determined, and remanded the case for specific findings of fact and reconsideration of the reimbursement and attorney's fee awards.

Child SupportModificationIncome VarianceDivorce LawPost-Divorce IssuesAlimonyCapital GainsBusiness IncomeAttorney's FeesReimbursement
References
21
Case No. MISSING
Regular Panel Decision

Communications Workers v. SBC Disability Income Plan

This case addresses defendants' motions to dismiss the Communications Workers of America, AFL-CIO (CWA) as a party-plaintiff. CWA and Rene Anzaldua initiated the lawsuit to challenge the denial of Mr. Anzaldua's long-term disability benefits under the SBC Disability Income Plan, citing violations of the Employees Retirement Income Security Act of 1974 (ERISA). Defendants argued that CWA lacked standing, as ERISA limits plaintiffs to 'participants,' 'beneficiaries,' or 'fiduciaries,' none of which apply to CWA. The court analyzed statutory definitions and rejected CWA's claims of derivative or associational standing, highlighting the necessity of individual member participation for benefit determination. Furthermore, the court found that Mr. Anzaldua adequately represented the union's interests. Consequently, the motions to dismiss CWA as a party-plaintiff were granted.

ERISAStanding to SueLabor UnionsDisability BenefitsMotion to DismissStatutory ConstructionEmployee BenefitsLong-Term DisabilityAssociational StandingFederal Jurisdiction
References
20
Case No. Dkt. # 6, Dkt. # 7
Regular Panel Decision
Feb 05, 2013

Crayton v. Astrue

Plaintiff appeals the denial of supplemental security income benefits by the Commissioner of Social Security. Plaintiff filed an application for Supplemental Security Income benefits in 2009, alleging inability to work due to various medical conditions. An Administrative Law Judge (ALJ) denied the application, and the Appeals Council denied review, making the ALJ's decision final. The District Court reviews the Commissioner's decision, finding that while the ALJ's assessment of exertional limitations was supported by substantial evidence, the ALJ failed to apply the Psychiatric Review Technique (PRT) in analyzing non-exertional limitations. Consequently, the court remands the matter for further proceedings consistent with its opinion, specifically for proper application of the PRT.

Supplemental Security IncomeSocial Security ActDisability BenefitsAdministrative Law JudgePsychiatric Review TechniqueRFCExertional LimitationsNon-exertional LimitationsDepressionAnxiety
References
15
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