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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
Jun 11, 1993

Empire Insurance v. Workers' Compensation Board

Empire Insurance Company denied Hugh Wofsy's no-fault benefits claim, alleging he was a Dial-a-Car, Inc. employee requiring Workers' Compensation. An Administrative Law Judge later found Wofsy an independent contractor, denying him Workers' Compensation. Empire sought to reopen the Workers' Compensation claim to participate, which the Board denied. Empire then initiated a CPLR article 78 proceeding, where the IAS Court allowed the reopening and ordered Empire to pay Wofsy, with potential reimbursement. The Appellate Division subsequently reversed this judgment, dismissing Empire's petition, emphasizing that Workers' Compensation Law § 23 vests exclusive appeal jurisdiction with the Third Department and precludes article 78 proceedings for reviewing Board decisions' substance.

No-fault insuranceIndependent contractor disputeEmployee status determinationCPLR Article 78 proceedingAppellate Division jurisdictionWorkers' Compensation Law § 23Judicial review of administrative decisionsInsurance coverage disputeAdministrative Law Judge rulingReimbursement claim
References
2
Case No. 2018 NY Slip Op 08227
Regular Panel Decision
Nov 29, 2018

Matter of Kelly v. New York State Workers' Compensation Bd.

In 2006, claimant Grace Kelly established a workers' compensation claim for an occupational disease. The State Insurance Fund (SIF) repeatedly sought to transfer liability to the Special Fund for Reopened Cases, which was denied by Workers' Compensation Law Judges. The Workers' Compensation Board affirmed these denials and assessed $500 penalties against both SIF and its counsel, Walsh and Hacker, for filing an application for review without reasonable grounds. Walsh and Hacker appealed the penalty imposed against them to the Appellate Division, Third Department. The Appellate Division found insufficient evidence to support the Board's finding that Walsh and Hacker's application lacked reasonable grounds, and therefore reversed the penalty against them, modifying and affirming the Board's decision.

PenaltiesAppellate ReviewSpecial Fund for Reopened CasesWorkers' Compensation Law § 25-aWorkers' Compensation Law § 114-aAttorney SanctionsAdministrative LawBoard DecisionJudiciary Law § 431
References
4
Case No. 2017 NY Slip Op 27428
Regular Panel Decision
Dec 14, 2017

New York State Workers' Compensation Bd. v. Compensation Risk Mgrs., LLC

This action was brought by the New York State Workers' Compensation Board (WCB), as an assignee of former members of the Healthcare Industry Trust of New York (HITNY), against Compensation Risk Managers, LLC (CRM), HITNY trustees, and auditing firm UHY LLP. The WCB alleged mismanagement, breach of fiduciary duty, and negligent auditing, leading to the Trust's insolvency. Defendants moved to dismiss on grounds of standing, statute of limitations, and pleading particularity. The court dismissed certain derivative claims and negligent misrepresentation claims against some trustees due to standing issues and statute of limitations. All claims against UHY LLP were dismissed for lack of a near-privity relationship or prior precedent. An implied indemnity claim against the trustees was sustained. The WCB's cross-motion to consolidate related actions was denied.

Workers' Compensation LawGroup Self-Insured Trust (GSIT)Fiduciary DutyNegligenceNegligent MisrepresentationStatute of LimitationsStandingDerivative ActionImplied IndemnityAuditing Firm Liability
References
46
Case No. 532391
Regular Panel Decision
Nov 18, 2021

Matter of Richman v. New York State Workers' Compensation Bd.

Claimant, Rebecca Richman, appealed three decisions from the Workers' Compensation Board regarding her claim for a work-related right shoulder injury. She alleged a fall at work on January 19, 2018, but did not seek medical treatment for 19 months. A Workers' Compensation Law Judge initially established the claim, but the Board reversed, finding that Richman failed to submit sufficient, credible medical evidence to demonstrate a causally-related injury and denied her claim. The Board subsequently denied her application for reconsideration and/or full Board review. The Appellate Division affirmed the Board's decisions, concluding that the Board's finding of no causally-related injury was supported by substantial evidence and that the Board did not abuse its discretion in denying reconsideration.

Workers' Compensation ClaimCausation (Medical)Shoulder InjuryMedical Evidence SufficiencyBoard ReversalAppellate Division ReviewBurden of ProofCredibility of EvidenceOsteoarthritis DiagnosisDelayed Medical Treatment
References
8
Case No. MISSING
Regular Panel Decision

Matter of Saratoga Skydiving Adventures v. Workers' Compensation Board

Saratoga Skydiving Adventures appealed a Workers’ Compensation Board decision upholding a stop-work order. The initial order was issued after an investigation revealed the company lacked workers' compensation coverage, with owner Bob Rawlins asserting his workers were independent contractors. Following a hearing, a Workers’ Compensation Law Judge denied Saratoga Skydiving's application to lift the order. The appellate court affirmed this denial, determining that substantial evidence supported the finding of an employer-employee relationship for pilots and jump instructors, given their integral role in the business and Rawlins' control over their work. Consequently, Saratoga Skydiving was required to maintain workers' compensation coverage for these individuals.

Workers' CompensationStop-Work OrderEmployer-Employee RelationshipIndependent ContractorSkydiving BusinessHazardous EmploymentUninsured Employers’ FundAppellate ReviewSubstantial EvidenceLabor Law
References
7
Case No. MISSING
Regular Panel Decision
Jul 02, 2008

LMK Psychological Service, P.C. v. American Transit Insurance

The plaintiffs, as assignees of no-fault benefits, sought to recover for health services rendered to beneficiaries of the defendant’s no-fault insurance contracts. The Supreme Court initially denied the plaintiffs' motion for summary judgment and granted the defendant's cross-motion to dismiss several causes of action, citing Workers' Compensation Law § 11 because the injuries occurred during employment. Upon reargument, the court adhered to its original decision. The appellate court modified this determination, vacating the dismissal of those causes of action. The matter was remitted to the Supreme Court, Westchester County, for a new determination after the Workers’ Compensation Board makes a finding on the parties’ rights under the Workers’ Compensation Law, emphasizing the Board's primary jurisdiction over such factual issues.

Workers' CompensationNo-Fault InsuranceMedical PaymentsSummary JudgmentPrimary JurisdictionAppellate ReviewRemittalInsurance LawAutomobile AccidentJurisdictional Dispute
References
7
Case No. MISSING
Regular Panel Decision

Nuara v. State of New York Workers' Compensation Board

Petitioners, two terminated group self-insured trusts (GSITs), challenged monetary assessments levied against them by the New York State Workers' Compensation Board and its chairman. The assessments were imposed pursuant to various sections of the Workers’ Compensation Law, utilizing a "pure premium calculation" method established by 2007 amendments. The court considered new 2008 legislation that further amended the calculation method for ceased self-insurers but declined to apply it retroactively. Ultimately, the court found the Board's interpretation of "the preceding year" in its pure premium calculation for terminated GSITs to be unreasonable and contrary to the clear statutory language. Consequently, the levied assessments were annulled and vacated.

Group Self-Insured TrustsMonetary AssessmentsStatutory InterpretationRetroactive ApplicationPure Premium CalculationAdministrative LawCPLR Article 78Legislative IntentStatutory ConstructionSelf-Insurance Liabilities
References
19
Case No. MISSING
Regular Panel Decision

W & G Ltd. v. Workers' Compensation Board

This court case addresses whether an arbitrator's decision, upholding a 'just cause' discharge of an employee after a compensable accident, prevents the Workers' Compensation Board (WCB) from hearing a claim of discriminatory discharge under Workers’ Compensation Law § 120. The court ruled that such an arbitration decision does not preclude the WCB, emphasizing the overriding public policy to have retaliatory discharge claims determined by the WCB as the statutorily mandated exclusive forum. It distinguishes between a contractual just cause discharge and a discriminatory firing, noting that the former could be a pretext for the latter. The court denied the petition to preclude the WCB, asserting that the public policy underlying Workers’ Compensation Law § 120 takes precedence over issue preclusion principles. It also suggests that the WCB can consider arbitration decisions as persuasive evidence but not conclusive.

Workers' Compensation Law § 120Discriminatory DischargeRetaliatory FiringIssue PreclusionArbitration AwardPublic PolicyWCB JurisdictionCPLR Article 78Just Cause DischargeCollective Bargaining Agreement
References
18
Case No. MISSING
Regular Panel Decision

Transcontinental Refrigerated Lines, Inc. v. Workers' Compensation Board

Transcontinental Refrigerated Lines, Inc. (TRL), a Pennsylvania common carrier, appealed decisions by the New York Workers' Compensation Board that denied its applications for redetermination of civil penalties. The penalties were imposed because TRL allegedly failed to secure New York workers' compensation insurance, despite having coverage in Pennsylvania. TRL contended that its interstate operations and Pennsylvania base exempted it from New York's requirements. The Board had relied on an earlier Workers’ Compensation Law Judge decision concerning an employee, Clarence Edick, which characterized TRL as a 'covered employer in NY.' The Appellate Division reversed the Board's decisions, concluding that TRL was entitled to a hearing to litigate the fundamental jurisdictional issue of its obligation under Workers' Compensation Law § 50, as the Edick proceeding did not definitively resolve this broader question.

Civil PenaltiesDue Process RightsJurisdictional DisputesInterstate EmployerInsurance ObligationAdministrative ReviewAppellate ProcedureRemand OrderStatutory ComplianceProcedural Safeguards
References
3
Case No. 2022 NY Slip Op 06850 [212 AD3d 126]
Regular Panel Decision
Dec 01, 2022

Matter of Levi v. New York State Workers' Compensation Bd.

Petitioner, a licensed chiropractor, was removed from the list of authorized medical providers by the New York State Workers' Compensation Board after an investigation revealed he received unlawful payments from a durable medical equipment (DME) supplier, Elite Medical Supply of New York, LLC. This was deemed a violation of Workers' Compensation Law §§ 13-d (2) (g), 13-l (10) (g) and 8 NYCRR 29.1 (b) (3). Petitioner challenged this removal via a CPLR article 78 proceeding, asserting a statutory right to a hearing before the Chiropractic Practice Committee (CPC) prior to removal. The Supreme Court dismissed the petition, and the Appellate Division, Third Department, affirmed. The appellate court held that while Workers' Compensation Law § 13-l (10) outlines a CPC hearing process, the Chair of the Workers' Compensation Board also possesses independent authority under Workers' Compensation Law §§ 13-l (12) and 13-d (1) to investigate and remove a provider without a hearing when the underlying facts, such as petitioner's admitted receipt of unlawful payments, are undisputed and do not present questions of fact.

ChiropractorMedical ProviderAuthorization RemovalUnlawful PaymentsDurable Medical EquipmentWorkers' Compensation BoardProfessional MisconductDue ProcessAdministrative LawCPLR Article 78
References
4
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