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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

Reyes v. Krasdale Foods, Inc.

Wilfredo Reyes, a former IT technician for Krasdale Foods, Inc., sued his employer and its HR Director, Bernard Patton, for disability discrimination and retaliation under the ADA and NYSHRL. Reyes, a Type 1 diabetic, requested a 30-minute shift adjustment to manage his insulin schedule, which defendants denied, citing disruption to IT coverage. Despite providing a doctor's note that merely requested 'accommodat[ing] his working hours' (later clarified by the doctor to mean time off for appointments, not a schedule change), Krasdale deemed the medical evidence insufficient to support the requested shift modification. The court granted summary judgment to the defendants on the ADA claims, finding Reyes failed to establish a prima facie case of discrimination due to insufficient medical evidence for his requested accommodation and lacked a causal connection for his retaliation claim as the denial predated his EEOC filing. The court declined supplemental jurisdiction over the remaining NYSHRL claims.

Disability DiscriminationADANYSHRLRetaliationReasonable AccommodationSummary JudgmentType 1 DiabetesEmployment LawShift ScheduleMedical Documentation
References
26
Case No. MISSING
Regular Panel Decision

Suarez v. Food Emporium, Inc.

Plaintiff, a job coach for Casita Unida Clubhouse, was injured after slipping on a wet floor while filling in for a transitional employee at defendant Food Emporium. Although he received workers' compensation benefits, plaintiff also commenced a personal injury action against Food Emporium. Defendants moved for summary judgment, asserting the action was barred because plaintiff was a 'special employee' of Food Emporium. The Supreme Court initially denied this motion, but the appellate court reversed. The court determined, as a matter of law, that plaintiff was a special employee due to Food Emporium's control over his work, thus dismissing the complaint.

Summary JudgmentSpecial EmployeeWorkers' Compensation BarPersonal InjuryControl and DirectionAppellate ReviewDeli DepartmentJob CoachEmployer LiabilityMotion to Dismiss
References
4
Case No. MISSING
Regular Panel Decision

Claim of Reese v. Sysco Food Services-Albany

The claimant, injured in 2007 while working for a food service company, initially received temporary partial disability payments for back and left hamstring injuries. A consequential injury to his right fifth metacarpal was later added to the claim. The Workers’ Compensation Board found that the claimant voluntarily removed himself from the labor market in May 2010 by not returning to a light duty assignment despite medical clearance. After further injuries and employment termination in 2012, the claimant sought an award for reduced earnings, arguing his current job was less demanding. Both the WCLJ and the Board denied this request, ruling that his reduction in earnings was not causally related to his compensable disability, a decision which was affirmed on appeal due to substantial evidence.

Reduced earningsVoluntary removal from labor marketLight duty assignmentCausally related disabilityWorkers' compensation appealBack injuryLeft lower extremity injuryRight fifth metacarpal fractureLeft knee problemsMedical clearance
References
5
Case No. MISSING
Regular Panel Decision

Queens Blvd. Medical, P.C. v. Travelers Indemnity Co.

The plaintiff, Queens Blvd. Medical, P.C., sought $950 in first-party no-fault benefits for biofeedback medical services provided to its assignor for lower back and chronic pain syndrome. The central issue at trial was the medical necessity of these services under Insurance Law § 5102 (a) (1). The plaintiff established a prima facie case with expert testimony from a board-certified neurologist affirming the medical appropriateness of biofeedback. The defendant insurance company failed to present admissible evidence to disprove medical necessity, as its expert was deemed incompetent to testify on biofeedback for back pain. Consequently, the court granted the plaintiff's motion for a directed verdict, awarding judgment for $950 along with statutory costs, interest, and attorney's fees.

No-fault benefitsMedical necessityBiofeedback treatmentExpert testimonyDirected verdictInsurance lawChronic pain syndromeBack injuryCPT codesBurden of proof
References
9
Case No. MISSING
Regular Panel Decision

Claim of Cummins v. North Medical Family Physicians

A claimant sustained a work-related back injury and sought continued medical treatment, which was initially authorized. Disputes over authorization led the claimant to retain an attorney. A Workers’ Compensation Law Judge authorized continued medical treatment but denied counsel fees, stating no "money passing" occurred. The Workers' Compensation Board upheld this decision. The claimant appealed, arguing the Board unconstitutionally applied Workers’ Compensation Law § 24, misinterpreted the statute regarding fee payment from medical benefits, and abused its discretion. The appellate court affirmed the Board's decision, ruling that counsel fees must be paid from "compensation," defined as a money allowance, and medical benefits are not considered "compensation" for this purpose, thus finding no abuse of discretion.

Workers' CompensationCounsel FeesAttorney FeesMedical TreatmentStatutory InterpretationConstitutional LawLienCompensation DefinitionAppellate ReviewBoard Decision
References
3
Case No. 2021 NY Slip Op 02212 [193 AD3d 1224]
Regular Panel Decision
Apr 08, 2021

Matter of Takacs v. Kraft Foods Group Inc.

In February 2015, claimant Christina Takacs stopped working for Kraft Foods Group Inc. due to work-related disabling back problems, which led to workers' compensation benefits. From 2018, claimant documented her job search efforts within medical restrictions. However, attempts to verify these applications showed some were unconfirmed, and others were submitted with an incorrect resume. The employer and its carrier argued that the claimant made knowing misrepresentations regarding her attachment to the labor market, seeking disqualification from benefits under Workers' Compensation Law § 114-a. Both the Workers' Compensation Law Judge and the Workers' Compensation Board found no violation, crediting claimant's testimony that errors were due to lack of computer savvy, not deliberate misrepresentation. The Appellate Division, Third Department, affirmed the Board's decision, concluding that the Board's finding was supported by substantial evidence.

Workers' Compensation BenefitsFraud AllegationLabor Market AttachmentMisrepresentation of FactAppellate Division Third DepartmentSubstantial Evidence ReviewJob Search EffortsClaimant CredibilityEmployer AppealBoard Affirmation
References
5
Case No. MISSING
Regular Panel Decision

Rechenberger v. Nassau County Medical Center

Edward Rechenberger suffered hip fractures and underwent two operations at Nassau County Medical Center in May 1982. Following a re-injury and later diagnosis, he learned the surgical hardware was improperly implanted, leading to further operations. Mr. Rechenberger sought leave to serve a late notice of claim against the medical center. The Supreme Court initially denied the motion, but the Appellate Division reversed this decision, finding that the hospital had actual knowledge of the essential facts of the claim within the statutory 90-day period through its own medical records. The court concluded that the delay in serving the notice of claim was not substantially prejudicial to the hospital, and thus, granted the petitioners leave to serve the late notice of claim.

Medical MalpracticeLate Notice of ClaimNassau CountyHip FractureSurgical ErrorContinuous Treatment DoctrineActual NoticePrejudiceAppellate ReviewMunicipal Corporation
References
11
Case No. MISSING
Regular Panel Decision
Feb 10, 2017

Mitchell v. SUNY Upstate Medical University

Plaintiff Robbie Mitchell sued SUNY Upstate Medical Center for alleged Title VII violations, including race discrimination and retaliation, after experiencing a series of adverse employment actions. These actions included reassignment, disciplinary notices (NODs), a mandatory medical examination, a formal counseling memorandum, a verbal dispute, and eventual termination. The defendant moved for summary judgment, arguing the plaintiff failed to establish a prima facie case for most claims and that their actions were based on legitimate, non-discriminatory reasons. The court granted summary judgment in favor of SUNY Upstate Medical Center, concluding that the plaintiff failed to provide sufficient evidence of discrimination or that retaliation was the but-for cause of the challenged employment actions, and consequently, the case was closed.

Title VIICivil Rights ActEmployment DiscriminationRetaliationSummary JudgmentAdverse Employment ActionMcDonnell Douglas FrameworkWorkplace ConductDisciplinary ActionPaid Administrative Leave
References
49
Case No. ADJ2789055 (SAL 0090971) ADJ3651266 (SAL 0098921) ADJ3642697 (SAL 0115568)
Regular
Oct 06, 2017

MARIA CAMACHO vs. AGRILINK FOODS, LUMBERMENS MUTUAL CASUALTY COMPANY, NATIONAL CUSTOM PACKING, STATE COMPENSATION INSURANCE FUND

This case involves an appeal by Agrilink Foods regarding a WCJ's order that an arbitrator's decision did not extinguish prior medical awards. The WCJ directed the State Compensation Insurance Fund to administer existing medical awards and noted that the apportionment of current treatment needs to prior injuries was a medical issue requiring further development. The Appeals Board dismissed Agrilink's petition for reconsideration because it was not aggrieved by a final order, as the Opinion on Decision was not the operative decision. Any disputes regarding further medical record development should be addressed by the arbitrator, whose decisions remain subject to reconsideration.

Workers' Compensation Appeals BoardPetition for ReconsiderationDismissedAggrieved PartyFinal OrderArbitrator DecisionMedical AwardCumulative InjurySpecific InjuryAdministrative Law Judge
References
2
Case No. MISSING
Regular Panel Decision

Yklik Medical Supply, Inc. v. Allstate Insurance

Plaintiff Yklik Medical Supply, Inc., a medical supply provider, sued Allstate Insurance Company to recover $317 in unpaid medical bills for equipment supplied to its assignor, Tammy Agosto. Yklik moved for summary judgment, asserting proper bill submission and Allstate's failure to timely pay or deny the claim. Allstate argued that the charges exceeded the Workers' Compensation fee schedule and that a partial payment had been made. The court found that Yklik established a prima facie case. The central issue was whether Allstate's fee schedule defense was precluded due to its failure to issue a timely denial within 30 days as mandated by Insurance Law § 5106 (a) and 11 NYCRR 65-3.5. The court ruled that since Allstate waited 56 days to send its denial, it was precluded from raising the fee schedule defense, and therefore, summary judgment was granted to the plaintiff.

No-fault insurancesummary judgmenttimely denialfee schedulepreclusion ruleinsurance lawmedical supplybilling practicespersonal injury protectionassignor
References
19
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