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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

In re the Claim of Sweet

A claimant, formerly a sewage treatment worker for a municipality, left his job and moved to Hawaii after receiving a conditional job offer at a tropical fish farm and his girlfriend's relocation there. Upon arrival, he discovered the position was no longer available. The Unemployment Insurance Appeal Board subsequently ruled that the claimant was disqualified from receiving unemployment insurance benefits, determining he had voluntarily left his employment without good cause. The appellate court affirmed the Board's decision, finding substantial evidence that the claimant failed to verify the job offer before moving and had primarily relocated for personal reasons without definite employment.

Unemployment benefitsVoluntary quitGood cause for leavingJob availabilityRelocation for personal reasonsDisqualification for benefitsAppellate reviewSubstantial evidenceMunicipality employmentHawaii job offer
References
0
Case No. MISSING
Regular Panel Decision
May 09, 2006

Claim of Atkinson v. Joseph Baldwin Construction

This is an appeal from decisions of the Workers’ Compensation Board, filed March 29, 2006, and May 9, 2006, which clarified an earlier Board decision from April 23, 2002. The claimant sustained a compensable right shoulder injury in July 1998. Subsequently, the claimant alleged problems with his left shoulder were causally related to the 1998 accident. A Workers’ Compensation Law Judge (WCLJ) initially found no causal relationship for the left shoulder injury, a determination affirmed by the Board in April 2002, although the Board's decision ambiguously mentioned developing the schedule of loss of use for 'both arms.' Following further proceedings, the WCLJ reiterated the disallowance of the left arm claim. The Board then clarified its 2002 decision in 2006, stating that it had affirmed the finding of no causal relationship for the left arm and that only the right arm's schedule loss of use was to be developed. The Appellate Division found that the Board's 2006 decisions effectively amended its 2002 decision. Upon review, the court affirmed the Board’s determination, finding substantial evidence supported the conclusion of no causal relationship for the left arm, giving deference to the Board's credibility assessments and resolution of conflicting medical evidence. The court also rejected the argument that the issue of a consequential left shoulder injury remained open, as the Board's prior decision had disallowed any causally related left arm condition.

Workers' Compensation LawCausal RelationshipLeft Shoulder InjuryRight Shoulder InjuryMedical EvidenceCredibility AssessmentAppellate ReviewBoard ClarificationAmended DecisionSchedule Loss of Use
References
6
Case No. 534614
Regular Panel Decision
Feb 16, 2023

In the Matter of the Claim of Joseph Marcellino

The case involves an appeal from a Workers' Compensation Board decision concerning claimant Joseph Marcellino's eligibility for a schedule loss of use (SLU) award for permanent injuries to his left elbow and left thumb. Following an April 2015 accident, Marcellino had established claims for multiple injuries, undergoing surgery in 2016. Conflicting medical opinions arose between his treating orthopedic surgeon, Dimitro Christoforou, who assessed significant SLU percentages, and the carrier's orthopedic surgeon, Peter Spohn, who found minimal or no SLU for the left hand, wrist, and thumb. A Workers' Compensation Law Judge (WCLJ) credited Spohn's opinion, awarding 15% SLU for the left wrist but no permanency for the left elbow or left thumb. The Workers' Compensation Board affirmed this decision. On appeal, the Appellate Division, Third Judicial Department, affirmed the Board's decision, reiterating that the Board has the discretion to resolve conflicting medical opinions and reject medical evidence even without opposing proof, finding their determination supported by substantial evidence.

Workers' Compensation LawSchedule Loss of UsePermanent Partial DisabilityMedical EvidenceConflicting Medical OpinionsCredibility AssessmentAppellate DivisionWorkers' Compensation BoardOrthopedic InjuriesElbow Injury
References
7
Case No. 2020 NY Slip Op 06434 [188 AD3d 1403]
Regular Panel Decision
Nov 12, 2020

Matter of Liuni v. Gander Mtn.

Claimant Joseph D. Liuni sustained a left distal bicep tendon rupture in 2007, resulting in a 22.5% schedule loss of use (SLU) award for his left arm. In 2014, he established a workers' compensation claim for his right shoulder, which was later amended in 2016 to include a consequential injury to his left shoulder. A physician determined a 27.5% SLU for the left arm due to the 2016 injury, which, when combined with the prior award, totaled an overall 50% SLU. The Workers' Compensation Board modified a WCLJ's determination, ruling that the bicep and shoulder injuries are not eligible for separate SLU awards as they both fall under awards for the left arm. Consequently, the Board deducted the 2007 22.5% SLU from the 2016 27.5% SLU, resulting in a 5% SLU award for the left arm. The Appellate Division affirmed the Board's decision, emphasizing that Workers' Compensation Law § 15 (3) limits SLU awards to statutorily enumerated members and that separate awards for subparts of a body member would constitute an unauthorized monetary windfall.

Schedule Loss of Use (SLU)Workers' CompensationAppellate DivisionThird DepartmentLeft Arm InjuryBicep Tendon RuptureShoulder InjuryPrior Award DeductionMonetary WindfallStatutory Interpretation
References
5
Case No. MISSING
Regular Panel Decision
Dec 05, 2003

In re the Claim of Kohen

The claimant, a social worker, filed a complaint against her employer with the Division of Human Rights alleging religious harassment. Despite continued problems, including a high-risk pregnancy, she resigned in June 2003, citing dissatisfaction with the work environment and unfair treatment. The Unemployment Insurance Appeal Board disqualified her from receiving unemployment insurance benefits, concluding she voluntarily left without good cause. The court affirmed this decision, reiterating that dissatisfaction with one's working environment does not constitute good cause for leaving employment.

Unemployment BenefitsVoluntary ResignationGood CauseWork EnvironmentHarassmentPregnancyAppealSocial WorkerDissatisfactionUnfair Treatment
References
2
Case No. MISSING
Regular Panel Decision

In re the Claim of Elkan-Moore

The case involves a claimant's appeal from a decision by the Unemployment Insurance Appeal Board, which ruled she was disqualified from receiving benefits due to voluntarily leaving her employment without good cause. The claimant, a museum director for five years, contended she resigned due to distress over allegations by a former Board of Trustees president and ongoing harassment from staff. However, the court found that issues with co-workers do not constitute good cause for leaving. An investigation had cleared the claimant of the allegations, and the Board was actively working to resolve the situation and retain her. The court ultimately affirmed the Board's decision, concluding that the claimant left her job due to general dissatisfaction with work conditions.

Unemployment InsuranceVoluntary QuittingGood CauseJob DissatisfactionWorkplace HarassmentBoard of TrusteesEmployer-Employee RelationsAppellate ReviewBenefit DisqualificationClaimant Appeal
References
5
Case No. ADJ12320361
Regular
Feb 18, 2025

LINDA ERNEST vs. TRADER JOE'S, SEDGWICK CLAIMS MANAGEMENT SERVICES

The Appeals Board considered a Petition for Reconsideration filed by Defendant Trader Joe's, administered by Sedgwick Claims Management Services. The petition challenged the Workers' Compensation Judge's (WCJ) decision dated November 26, 2024, which found that the defendant did not meet its burden of proof regarding apportionment for injuries to the applicant's left hand, left wrist, and left knee. The WCJ's decision awarded 51% permanent disability based on the medical reporting of PQME Michael Slutzker, MD, but only found apportionment for the low back injury. The defendant specifically contended that the WCJ erred in not allowing apportionment for the left knee. The Appeals Board denied the petition, adopting and incorporating the WCJ's report, which concluded that the Qualified Medical Evaluator's (QME) report lacked sufficient explanation and detail to support the proposed apportionment for the left knee, thus failing to meet the defendant's burden of proof.

Workers Compensation Appeals BoardPetition for ReconsiderationLabor Code Section 5909Transmission of CaseElectronic Adjudication Management SystemReport and RecommendationApportionmentPermanent DisabilityCausationQualified Medical Evaluator
References
11
Case No. 2023 NY Slip Op 03890
Regular Panel Decision
Jul 20, 2023

Matter of Perry v. DOCCS Clinton Corr. Facility

Claimant Robert Perry, a correction officer, initially filed a workers' compensation claim in January 2017 for injuries to his left hand and wrist. This claim was established, leading to an award for schedule loss of use of his left hand in September 2019. Subsequently, in May 2020, Perry was diagnosed with left elbow epicondylitis, which he sought to include as a causally-related injury to his existing claim. The employer and carrier argued the amendment was untimely under Workers' Compensation Law § 28. While a Workers' Compensation Law Judge initially permitted the amendment, the Workers' Compensation Board reversed, deeming the left elbow claim time-barred due to not being filed within two years of the original accident. The Appellate Division, Third Department, affirmed the Board's decision, concluding that the Board properly found no evidence of an injury to the left elbow in claimant's medical records prior to May 2020, and that the Board, as the sole arbiter of credibility, was free to prioritize medical records over claimant's conflicting testimony regarding earlier elbow pain, thus upholding the denial of the claim and the subsequent denial of reconsideration.

Workers' Compensation LawTimeliness of ClaimLeft Elbow InjuryMedical MisdiagnosisSchedule Loss of UseWorkers' Compensation Board DecisionAppellate DivisionCorrectional OfficerClaim AmendmentStatute of Limitations
References
6
Case No. ADJ9023782
Regular
Sep 20, 2019

REFUGIO PACAS vs. BARON HR. LLC, ZURICH AMERICAN INSURANCE

The Workers' Compensation Appeals Board granted reconsideration of a decision that denied new and further disability for the applicant's November 25, 2012 injury. While the Board found no new disability for the left wrist and lumbar spine, it identified potential new and further disability in the applicant's left knee. The matter is returned for further development of the record, specifically to clarify the applicant's left knee impairment with the agreed medical evaluator. The Board requires clarification on the rating methodology used for the left knee and whether it deviates from the AMA Guides.

Petition to ReopenNew and Further DisabilityStipulated AwardAgreed Medical EvaluatorRange of MotionWhole Person ImpairmentDiagnosis Related EstimateGait DerangementMuscle AtrophyArthritis
References
1
Case No. ADJ9799720
Regular
Jan 29, 2016

HOWARD GARNER vs. DEPARTMENT OF CORRECTIONS AND REHABILITATION, legally uninsured; STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration to correct a transcription error, amending the findings to reflect an injury to the applicant's left "little" toe instead of the left "middle" toe. The applicant's petition for reconsideration was denied, as the Board found no evidence to support claims of injury to his hand, hip, or a deformed left little toe, and the medical examiner did examine the relevant body part. The decision affirmed the findings of no permanent disability or need for further treatment for the left little toe.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of FactInmate LaborerPanel Qualified Medical ExaminerTranscription ErrorLeft Little ToePermanent Partial DisabilityFurther Medical TreatmentDepartment of Corrections and Rehabilitation
References
0
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