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

Case No. 2017 NY Slip Op 04775
Regular Panel Decision
Jun 13, 2017

Ironshore Indemnity, Inc. v. W&W Glass, LLC

Ironshore Indemnity, Inc., as subrogee of The Related Companies, L.P., appealed a judgment that dismissed their action. The Supreme Court initially granted the Related Companies' motion to intervene, quash subpoenas, and dismiss the complaint. The Appellate Division, First Department, affirmed this judgment, finding that the Related Companies had a strong interest in the litigation. The court concluded that Ironshore had no subrogation rights because it had not made any payments or covered defense costs on behalf of the Related Companies in the underlying personal injury action. Additionally, Ironshore's subrogation claims were barred by Workers' Compensation Law § 11, as no 'grave injury' was alleged or proven.

subrogation rightsinterventionworkers' compensation lawgrave injuryadditional insuredindemnificationcontributiondefense costsappellate divisionjudgment dismissal
References
6
Case No. ADJ1124123 (BGN 0064929) ADJ3374432 (BGN 0061307)
Regular
Oct 22, 2018

MARY BAKER vs. SWEEETHEART CUPS; CIGA by SEDGWICK CMS for FREMONT INSURANCE in liquidation and PORTEOUS FASTENERS/PACIFIC INDEMNITY COMPANY, CHUBB INSURANCE

The Workers' Compensation Appeals Board granted CIGA's petition for reconsideration, reversing the finding that CIGA remained liable for permanent total disability indemnity and medical treatment for the applicant's industrial injuries. The Board found that because the applicant's injuries resulted in a joint and several award with a solvent insurer, Pacific Indemnity, CIGA has no obligation to pay as "other insurance" was available. The decision clarifies that CIGA is absolved of liability for medical treatment jointly caused by both injuries, but remains liable for treatment solely caused by the September 1979 injury. Pacific Indemnity is now solely responsible for all remaining permanent total disability indemnity and medical treatment costs, adjusting for payments already made by CIGA.

CIGASweetheart CupsPorteous FastenersFremont InsurancePacific IndemnityChubb InsuranceWilkinson doctrinejoint and several liabilitycovered claimsother insurance
References
10
Case No. SDO 0328208
Regular
Mar 17, 2008

ARMANDO ADAME vs. AUTOMOTIVE ENGINEERED PRODUCTS, INC. (dba JBA HEADERS), ZENITH INSURANCE COMPANY

The Appeals Board clarified that for Labor Code section 4656(c)(1) purposes, the commencement of temporary disability payments is the date the employer first mails a temporary disability indemnity check, not when EDD benefits begin. Furthermore, EDD benefits, even if reimbursed by the employer, do not count towards the 104-week cap on temporary disability payments. Consequently, the employer's liability for further temporary disability payments extends from the date of the first actual indemnity payment until October 6, 2007.

Workers Compensation Appeals BoardArmando AdameAutomotive Engineered ProductsZenith Insurance CompanyLabor Code section 4656(c)(1)Temporary Total DisabilityTemporary Disability IndemnityEmployment Development DepartmentUnemployment Compensation DisabilityHawkins v. Amberwood Products
References
2
Case No. ADJ4250207
Regular
Sep 14, 2022

MAHEALANI MAHEALANI vs. CITY OF SAN JOSE, INTERCARE

This case involves an applicant seeking workers' compensation benefits from the City of San Jose. The applicant and the defendant both petitioned for reconsideration of the initial findings and award regarding temporary and permanent disability indemnity and attorney's fees. The Appeals Board granted reconsideration to address these issues. The Board affirmed the attorney's fees award but amended the findings to credit the defendant for previously paid temporary and permanent disability indemnity payments. Additionally, the Board clarified that permanent disability payments commence the day after the last temporary disability payment.

ADJ4250207ADJ6554121ADJ171328ADJ2689808temporary disability indemnitypermanent disability indemnityattorney's feescompanion casescreditreconsideration
References
3
Case No. ADJ7486214
Regular
Dec 09, 2013

CYNTHIA JOHNSON vs. REGENTS OF THE UNIVERSITY OF CALIFORNIA/UNIVERSITY OF CALIFORNIA, SAN DIEGO MEDICAL CENTER

This case involves a dispute over permanent disability indemnity payments for an applicant who sustained an industrial back injury. The defendant sought a decrease in payments under Labor Code section 4658(d) for offering the applicant work, but the Board found this section inapplicable due to changed circumstances and the purpose of return-to-work incentives. The Board also removed a 10% penalty for late payment under section 4650(d), acknowledging a good faith dispute over the indemnity rate. Ultimately, the Board affirmed the original award but amended findings regarding the penalty and attorney's fees.

WORKERS' COMPENSATION APPEALS BOARDOPINION AND DECISION AFTER RECONSIDERATIONADJ7486214INDUSTRIAL INJURYPERMANENT DISABILITYAPPORTIONMENTLABOR CODE SECTION 4658LABOR CODE SECTION 4650(d)RETURN-TO-WORK INCENTIVESFINDINGS AND AWARD
References
0
Case No. ADJ4541361 (AHM 0136152)
Regular
Nov 24, 2010

CHRIS FAIRFIELD vs. GUITAR CENTER, ZURICH

This case concerns the commencement date for calculating temporary disability indemnity limits under Labor Code section 4656(c)(1). The Appeals Board reversed a prior award, holding that the two-year limit for temporary disability payments began on March 5, 2006, when the applicant first received such payments. This decision was based on a stipulation that confirmed this initial payment, overriding the WCJ's calculation based on a later date. Consequently, the applicant's entitlement to temporary total disability indemnity for the period of April 18, 2008, to April 23, 2009, was denied.

Workers' Compensation Appeals BoardReconsiderationTemporary Total Disability (TTD)Labor Code Section 4656Commencement of Temporary DisabilityAggregate Disability PaymentsTwo-Year LimitationStipulationFindings Award and Order (F&A)Agreed Medical Evaluation (AME)
References
7
Case No. ADJ2608381 (VNO 0557652)
Regular
Mar 15, 2010

LINDA HARRIS-BOYD vs. NORTHWEST AIRLINES, INC., LIBERTY MUTUAL INSURANCE COMPANY

This case concerns the application of Labor Code section 4656(c)(1), which limits temporary disability indemnity to 104 weeks within a two-year period. The Workers' Compensation Appeals Board (WCAB) rescinded the prior award because the administrative law judge (ALJ) incorrectly concluded that out-of-state compensation payments did not trigger the two-year limit. The WCAB clarified that section 4656(c)(1) applies to all temporary disability, regardless of whether it's total or partial, and includes payments made under foreign jurisdictions. The case was remanded for further proceedings to determine the commencement date of temporary disability payments and calculate any additional indemnity due.

Labor Code section 4656(c)(1)temporary disability indemnity104 compensable weekstwo-year periodMichigan lawaggregate disability paymentstemporary partial disabilitytemporary total disabilitySB 899Industrial Disability Leave
References
10
Case No. MISSING
Regular Panel Decision

Matter of McQueer v. Adirondack Tank Services, Inc.

This case concerns appeals from decisions of the Workers’ Compensation Board regarding a claimant’s entitlement to resumed indemnity payments. The claimant suffered work-related injuries and settled a third-party action, leading to a stipulation for a carrier’s offset holiday from indemnity payments for 198.72 weeks. After the holiday was deemed expired by a WCLJ in January 2009, and the claimant sought to resume payments in July 2012, the Board affirmed the WCLJ's decision. The carrier appealed, arguing a departure from precedent regarding the claimant's burden to prove continuing disability during the holiday. The appellate court affirmed the Board, finding its decision supported by substantial evidence and that the stipulation did not require the claimant to demonstrate ongoing disability.

Workers' Compensation OffsetThird-Party SettlementIndemnity PaymentsCarrier Holiday ExpirationStipulation AgreementMedical EvidenceTotal Temporary DisabilityAppellate ReviewBoard PrecedentReconsideration Denial
References
9
Case No. 15 Civ. 3975 (NRB)
Regular Panel Decision

National Indemnity Co. v. IRB Brasil Resseguros S.A.

This case involves a dispute between National Indemnity Company (NICO) and IRB Brasil Resseguros S.A. (IRB) over reinsurance obligations. Following contentious arbitrations, a tribunal issued three awards favoring NICO. NICO petitioned the U.S. District Court to confirm these awards, while IRB cross-petitioned for vacatur, citing alleged 'evident partiality' of the neutral umpire, Daniel Schmidt, due to his concurrent service in an unrelated arbitration involving a NICO affiliate (Equitas) and challenging the tribunal's jurisdiction. The court found Schmidt's disclosures reasonable and his concurrent assignments insufficient to demonstrate partiality. It also affirmed the arbitration panel's jurisdiction over the disputed 2008 premium and associated fees. Consequently, the court granted NICO's petition to confirm the awards and denied IRB's cross-petition to vacate them.

ArbitrationReinsurance DisputeEvident PartialityUmpire DisclosureVacatur of Arbitration AwardConfirmation of Arbitration AwardFederal Arbitration ActNew York ConventionArbitration ClauseContract Interpretation
References
42
Case No. MISSING
Regular Panel Decision
Jun 30, 1992

National General Insurance v. Hartford Accident & Indemnity Co.

This case concerns a declaratory judgment action regarding insurance coverage following a fatal airplane crash. Warren Geddes, president of American Investor Services, Inc. (AIS), was piloting a plane carrying Gary Conway, an AIS employee, when it crashed, killing both. National General Insurance Company, insurer of the plane owner, sought for Hartford Accident and Indemnity Company, AIS's workers' compensation insurer, to defend and indemnify AIS and Geddes' Estate in a wrongful death action. Hartford denied coverage for Geddes' Estate, arguing he was not a named or additional insured under their policy. The court modified the initial judgment, declaring that Hartford has no duty to defend or indemnify the Estate of Geddes, while otherwise affirming the judgment.

Insurance CoverageDeclaratory JudgmentWrongful DeathDuty to DefendDuty to IndemnifyNamed InsuredAdditional InsuredWorkers' Compensation PolicyAirplane CrashEstate Liability
References
5
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