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Case Law Database

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

Case No. MISSING
Regular Panel Decision

Claim of Kenney v. Walsh Construction Co.

This Per Curiam decision addresses appeals concerning whether employers and their carriers are entitled to credit for lump-sum settlements in reopened workers' compensation cases. The cases of Kenney v. Walsh Construction Co. and Yurivich v. Sans Souci Nursing Home both involve claimants who received lump-sum awards for partial disabilities but later experienced worsening conditions, leading to reopened cases and increased awards. The Workmen’s Compensation Board denied credit to the carriers for the original lump-sum settlements, a decision affirmed by the Appellate Division. The court held that lump-sum settlements under Workmen’s Compensation Law § 15(5-b) cannot be indefinitely extended by excluding weeks where the claimant earned pre-injury wages. It affirmed that carriers assume the risk of reopened cases due to changed conditions, with no statutory or decisional basis for adjusting for claimant earnings during the period the lump-sum award covered.

Lump-sum settlementWorkmen's Compensation Law § 15(5-b)Credit for settlementReopened caseIncreased disabilityPost-disability earningsPre-disability earningsNonschedule adjustmentCaisson diseaseHerniated disc
References
5
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

Claim of Cordell v. City of Oneida Youth Division

This workers' compensation case involved a claimant who, following a lump-sum settlement in 1983 for a 1980 back injury, sought to reopen the claim and receive payment for a CAT scan due to a change in medical condition. Although the case was inadvertently reopened and a Workers' Compensation Law Judge initially ordered the carrier to resume medical payments, the Board reversed this decision, asserting the lump-sum settlement barred further benefits without proper reopening. The central issue revolved around whether medical expenses are encompassed within the term 'compensation' as defined by Workers' Compensation Law § 15 (5-b), which governs comprehensive lump-sum settlements. The court ultimately affirmed the Board's decision, concluding that a lump-sum settlement under § 15 (5-b) generally forecloses additional medical expenses unless the case is properly reopened due to uncontemplated changes in the claimant's medical condition, a stance supported by legislative intent and precedent.

Lump-Sum SettlementMedical ExpensesPermanent Partial DisabilityReopening ClaimStatutory InterpretationWorkers' Compensation Law § 15(5-b)Workers' Compensation Law § 13Carrier LiabilityBoard DecisionCausally Related Medical Expenses
References
4
Case No. MISSING
Regular Panel Decision

Kowalczyk v. Flintkote Co.

Stanley Kowalczyk, an employee of The Flintkote Company, filed a declaratory judgment action to interpret a noncontributory employees’ pension plan agreement. Kowalczyk sustained a serious injury and received a lump-sum workmen's compensation settlement, after which he applied for monthly retirement benefits. Flintkote denied these benefits, arguing that the pension plan's deduction clause for 'annuity, pension or payment of similar kind' included the lump-sum settlement. Kowalczyk contended the clause was ambiguous and did not apply to his settlement. The court concluded that a lump-sum workmen's compensation settlement was not contemplated by the agreement to reduce an employee’s monthly retirement benefit, granting summary judgment in favor of Kowalczyk.

Pension PlanEmployee BenefitsWorkmen's CompensationLump-sum SettlementContract InterpretationAmbiguity in ContractSummary JudgmentRetirement BenefitsWage LossCollective Bargaining Agreement
References
1
Case No. MISSING
Regular Panel Decision

LaCroix v. Syracuse Executive Air Service, Inc.

This case concerns whether Workers’ Compensation Law allows for lump-sum payment of "schedule loss of use" awards for permanent partial disability, or if payments must be made periodically. Claimant Marie LaCroix, a baggage handler, fractured her wrist and tore her rotator cuff, leading to a 75% loss of use of her left arm. The Workers’ Compensation Board and Appellate Division affirmed a lump-sum payment. However, the Court of Appeals reversed, holding that the statute's directive for "periodically" payments precludes a lump-sum policy, unless specific commutation procedures for individual cases are followed, requiring actuarial reduction. The court emphasized that any departure from periodic payment must originate from the Legislature.

Permanent Partial DisabilitySchedule Loss of UseLump Sum PaymentPeriodic PaymentWorkers' Compensation LawStatutory InterpretationAppellate ReviewReimbursementEarning CapacityWage Loss
References
8
Case No. 534882
Regular Panel Decision
Dec 15, 2022

In the Matter of the Claim of Joseph Lambert

Claimant Joseph Lambert, a token booth agent and bus driver, sustained work-related injuries in 2016, leading to a schedule loss of use (SLU) award. The award was initially to be paid weekly until August 2023. In March 2021, Lambert requested the remaining unpaid portion of his SLU award be paid in a lump sum. This request was granted by a Workers' Compensation Law Judge and affirmed by the Workers' Compensation Board. The employer appealed, arguing that a lump sum request must be made at the time of the initial award. The Appellate Division affirmed the Board's decision, stating that Workers' Compensation Law §§ 15 (3) (u) and 25 (1) (b) do not impose a timeframe limitation on an injured employee's request for a lump sum payment of an SLU award.

Workers' CompensationSchedule Loss of UseLump Sum PaymentStatutory InterpretationPermanent Partial DisabilityAppellate ReviewEmployer AppealClaimant RequestLegislative IntentInjury Benefits
References
8
Case No. 2022 NY Slip Op 07123 [211 AD3d 1298]
Regular Panel Decision
Dec 15, 2022

Matter of Lambert v. Manhattan & Bronx Surface Tr. Operating Auth.

The case involves Joseph Lambert, a claimant seeking workers' compensation benefits for work-related repetitive use injuries. A Workers' Compensation Law Judge (WCLJ) initially awarded a schedule loss of use (SLU) for his right arm, left arm, and right leg, payable weekly. Subsequently, Lambert requested the remaining SLU award be paid in a lump sum, which the WCLJ and the Workers' Compensation Board affirmed. The employer, Manhattan and Bronx Surface Transit Operating Authority, appealed this decision, arguing that a lump sum request must be made at the time of the initial award. The Appellate Division, Third Department, affirmed the Board's decision, ruling that Workers' Compensation Law §§ 15 (3) (u) and 25 (1) (b) do not impose time limitations on an injured employee's request for a lump sum payment of an SLU award.

Schedule Loss of UseLump Sum PaymentWorkers' Compensation BoardAppellate DivisionStatutory InterpretationPermanent Partial DisabilityClaimant RightsEmployer AppealLegislative IntentPayment Timing
References
8
Case No. MISSING
Regular Panel Decision

Claim of Giuffre v. South General Swiss International Co.

Claimant suffered a compensable injury and received a lump-sum nonschedule adjustment, after which her case was closed. She subsequently submitted a bill for medical treatment, but the workers' compensation carrier objected. The Workers' Compensation Board ruled that the lump-sum settlement barred further benefit payments and found the carrier not liable, as there was no established change in the claimant's condition or degree of disability to justify reopening the claim. The Appellate Division affirmed the Board's decision, without costs.

Lump-sum settlementMedical benefitsClaim reopeningBoard decisionAppellate reviewDisabilityCarrier liabilityCompensable injuryNonschedule adjustmentFurther benefits
References
1
Case No. ADJ2549830 (LAO 0657500)
Regular
Apr 04, 2011

ANTHONY WELCH vs. SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Subsequent Injuries Benefits Trust Fund (SIBTF) sought reconsideration of a WCJ award that included a $29,000 lump-sum attorney fee. The SIBTF argued this violated Labor Code section 5100.5, which prohibits commutation of SIBTF benefits for attorney fees. The Appeals Board granted reconsideration, finding the attorney's unilateral addition of the lump sum to stipulations unacceptable. The Board amended the award to provide the attorney a fee of 15% of each weekly indemnity payment, affirming the remainder of the award.

Subsequent Injuries Benefits Trust FundPetition for ReconsiderationAttorney FeesLabor Code Section 5100.5CommutationStipulations with Request for AwardUnilateral AlterationWCJ AwardPermanent Disability IndemnityLife Pension Indemnity
References
1
Case No. MON 0238441
Regular
Sep 07, 2007

LINDA J. O'HAGAN vs. LOS ANGELES UNIFIED SCHOOL DISTRICT

This case involves a dispute over the commutation of an applicant's permanent total disability indemnity to a lump sum. The applicant, a teacher injured in 1993, was awarded 100% permanent disability and lifetime indemnity payments. The administrative law judge commuted these payments to a lump sum for the applicant to purchase a home and rental property, deeming it in her best interest. The defendant sought reconsideration, arguing this investment purpose defeats the purpose of permanent disability benefits. The majority denied reconsideration, adopting the WCJ's report, while one commissioner dissented, believing the investment purpose was not within the scope of commutation.

CommutationPermanent Total DisabilityLabor Code section 5100Best InterestRental PropertyResidential PropertyLife PensionWCJ ReportReconsiderationDissenting Opinion
References
1
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