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

Case No. 2020 NY Slip Op 00652
Regular Panel Decision
Jan 30, 2020

Matter of Froehlich v. New York State Dept. of Corr. & Community Supervision

Petitioner Jason Froehlich, a correction sergeant, was injured while attempting to subdue a combative parolee. Following a year of workers' compensation leave, his employment was terminated by respondent, New York State Department of Corrections and Community Supervision, pursuant to Civil Service Law § 71. Froehlich argued he was entitled to a two-year leave of absence, asserting his injuries resulted from an assault during employment. Respondent denied this, defining "assault" as an intentional physical act of violence directed toward an employee, and found no evidence the parolee intentionally directed violence at Froehlich. The Supreme Court dismissed Froehlich's CPLR article 78 petition. The Appellate Division, Third Department, affirmed the judgment, concluding that respondent's definition of assault was rational and its application to the facts, finding no intentional physical act directed at Froehlich, was also rational. A dissenting opinion argued that the inmate's actions, under respondent's own definition, constituted an assault.

Civil Service Law § 71workers' compensation leavedisability leaveassault in employmentintentional physical act of violenceCPLR article 78 proceedingadministrative determinationrational basis reviewarbitrary and capriciouscorrection sergeant
References
7
Case No. 2015-2337 Q C
Regular Panel Decision
May 18, 2018

Sama Physical Therapy, P.C. v. Hereford Ins. Co.

This case concerns an action by Sama Physical Therapy, P.C., as assignee, to recover first-party no-fault benefits from Hereford Insurance Co. The defendant argued that the plaintiff's assignor had been injured during the course of employment. The Civil Court conditionally granted defendant's cross-motion for summary judgment, ordering the plaintiff to file an application with the Workers' Compensation Board within 90 days. Plaintiff failed to comply with this order, and upon renewal, the Civil Court adhered to its prior determination. The Appellate Term, Second Department, affirmed the Civil Court's order, finding that the plaintiff did not demonstrate compliance with the order to make a proper application under the Workers' Compensation Law.

No-Fault BenefitsSummary JudgmentWorkers' Compensation BoardAppellate ReviewConditional GrantFailure to ComplyRenewal MotionInsurance LawAssigneeMedical Provider
References
1
Case No. MISSING
Regular Panel Decision
Jun 28, 1993

Gagliardi v. Trapp

The plaintiff, a correction officer, appealed an order granting summary judgment to the defendants in her action for assault and negligence. She alleged physical and mental harm after being punched by a fellow correction officer, Darrell Harris, and claimed her employers, New York City Department of Correction and the City of New York, attempted to conceal the incident and discriminated against her. The Supreme Court correctly determined that her negligence claim was barred by Workers’ Compensation Law as she had already received benefits, and her allegations did not meet the high standard for an intentional tort to circumvent the exclusivity provision. Furthermore, her discrimination claims under Executive Law § 296 were found to be conclusory and unsupported.

AssaultNegligenceWorkers' CompensationSummary JudgmentDiscriminationExclusive RemedyAppellate DecisionCorrection OfficerRikers IslandEmployers' Liability
References
11
Case No. 2015-608 Q C
Regular Panel Decision
Dec 19, 2017

Adelaida Physical Therapy, P.C. v. 21st Century Ins. Co.

In this case, Adelaida Physical Therapy, P.C., acting as an assignee, appealed an order from the Civil Court of the City of New York, Queens County. The original order had granted 21st Century Insurance Company's motion for summary judgment, dismissing parts of a complaint seeking first-party no-fault benefits for services billed under specific CPT codes (97010, 97110, and 97124). The Appellate Term, Second Department, reversed the lower court's decision. The appellate court found that 21st Century Insurance Company failed to demonstrate that it had used the correct conversion factor to calculate the reimbursement rate, thus not establishing its defense that the charged fees exceeded the workers' compensation fee schedule. As a result, the branches of the defendant's motion for summary judgment related to those CPT codes were denied.

No-Fault BenefitsCPT CodesSummary JudgmentWorkers' Compensation Fee ScheduleReimbursement RateAppellate ReviewInsurance DisputeCivil ProcedureConversion FactorMedical Billing
References
2
Case No. 2016-198 Q C
Regular Panel Decision
Jun 01, 2018

Comprehensive Care Physical Therapy, P.C. v. Allstate Ins. Co.

This case concerns a provider, Comprehensive Care Physical Therapy, P.C., seeking no-fault benefits from Allstate Insurance Company. The Civil Court initially denied the plaintiff's summary judgment motion and granted the defendant's cross-motion, dismissing the complaint based on the assignor's failure to appear for independent medical examinations (IMEs) and claims exceeding the fee schedule. On appeal, the Appellate Term modified this order, finding that Allstate failed to provide sufficient proof of timely denial form mailing, thereby precluding its defenses regarding IMEs and the fee schedule. Consequently, Allstate's cross-motion for summary judgment was denied, reversing that part of the lower court's decision. However, the Appellate Term affirmed the denial of the plaintiff's summary judgment motion, as the plaintiff also failed to establish their claims.

no-fault insurancesummary judgmentindependent medical examinationstimely denialinsurance defenseappellate reviewmedical billingassignee rightsprocedural requirementsfee schedule
References
5
Case No. 46885/05, 47943/05, 47945/05
Regular Panel Decision

Robert Physical Therapy, P.C. v. State Farm Mutual Automobile Insurance

This case involves three consolidated claims for first-party no-fault benefits related to physical therapy services. The plaintiff's assignors received physical therapy, and the defendant, an insurer, denied some claims due to disputes over billing codes. The central legal issues concerned whether a physical therapist could utilize billing codes from the medicine fee schedule when such services were not explicitly in the physical medicine schedule, and if range of motion and muscle testing could be billed separately from evaluation and management on the same day. The court determined that physical therapists are not confined to the physical medicine section and can use codes from any section of the medical fee schedule. Furthermore, the defendant failed to provide sufficient evidence to justify its denials regarding separate billing for range of motion and muscle testing. Consequently, the court ruled in favor of the plaintiff, awarding judgment for all disputed amounts.

Physical Therapy BillingNo-Fault BenefitsMedical Fee ScheduleCPT CodesWorkers' Compensation RegulationsEvaluation and Management ServicesRange of Motion TestingMuscle TestingProvider SpecialtyBilling Disputes
References
4
Case No. 2025 NY Slip Op 05850
Regular Panel Decision
Oct 23, 2025

People v. Flanigan

Defendant Razeah S. Flanigan appealed convictions for assault in the second degree and reckless endangerment in the second degree, stemming from an incident where he fired a flare gun, injuring the victim's arm. The Appellate Division, Third Department, reviewed the weight of the evidence for the assault conviction, concluding that the victim suffered a serious physical injury due to disfigurement and protracted impairment. The court affirmed the assault conviction but found that reckless endangerment in the second degree was an erroneous lesser included offense of assault in the first degree, though harmless as it was a proper lesser included offense of another count. Ultimately, the court determined that reckless endangerment in the second degree was a lesser included offense of assault in the second degree, leading to the dismissal of the reckless endangerment conviction. The judgment was modified to dismiss the conviction on count 3 and affirmed as modified.

Assault Second DegreeReckless EndangermentSerious Physical InjuryLesser Included OffenseFlare Gun InjuryCriminal Weapon PossessionJustification DefenseWeight of Evidence ReviewAppellate DivisionConviction Modification
References
16
Case No. MISSING
Regular Panel Decision
Mar 03, 2005

Hunt v. State

The claimant, arrested for grand larceny in 1998, was unable to post bail and was sexually assaulted by another inmate while in the Manhattan Detention Center. Despite a court directive for protective custody on September 18, 1998, state court officers failed to properly record this order on the securing order. Consequently, the claimant was returned to general population and assaulted again on September 21. The Court of Claims initially dismissed the claimant's action for damages against the State. However, the appellate court reversed this decision, finding that the court officers' failure to record the protective custody order was a breach of a ministerial duty, thereby establishing state liability. The case has been remanded for a trial to determine the damages for the September 21 assault.

Inmate AssaultProtective CustodyMinisterial NegligenceState LiabilityCourt Officer DutySecuring OrderDamages RemandAppellate ReversalCorrectional Facility NegligencePrisoner Safety
References
7
Case No. MISSING
Regular Panel Decision
Jan 07, 1998

People v. Hiraldo

The defendant, a 16-year-old student, struck a 66-year-old school aide during an altercation in a school locker room. The victim, who had pre-existing heart conditions, chased the defendant and subsequently collapsed, dying 17 hours later from cardiac arrest. The Grand Jury indicted the defendant for reckless manslaughter and two counts of attempted assault. The court found insufficient evidence to prove the defendant was aware of the victim's heart condition or intended to cause serious physical injury. Consequently, the charges for manslaughter in the second degree and attempted assault in the second degree were dismissed, while the motion to dismiss attempted assault in the third degree was denied.

Reckless ManslaughterCriminally Negligent HomicideAttempted AssaultCausationForeseeabilityPre-existing Medical ConditionGrand Jury ProceedingsIndictmentMotion to DismissSufficiency of Evidence
References
4
Case No. MISSING
Regular Panel Decision

In re the Claim of Marquette

Claimant, a clerical employee for New York Telephone Company (Telco) in New York City, was viciously assaulted twice in late 1982 near her workplace in the Penn Plaza complex while commuting. The Workers’ Compensation Board found her injuries compensable, ruling the assaults occurred "within the concept of the precincts of employment." Telco appealed this decision, arguing that accidents on the way to work are generally not compensable without a direct physical connection to the employer's premises. The court affirmed the Board's decision, emphasizing that injuries are compensable if they are part and parcel of the entrance to employment and there's a causal relation. The ruling highlighted that the assaults took place along a normal and reasonable route to work, within the precincts of employment, even though they occurred on a public stairway not directly controlled by the employer.

Workers' CompensationAssaultPremises LiabilityArising Out of EmploymentCourse of EmploymentPublic AccessOff-Premises InjuryAppealsEmployee SafetyNew York Law
References
6
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