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

Case No. 2000 WL 178191
Regular Panel Decision

Selby v. Principal Mutual Life Insurance

Adrian and Jill Selby sued Principal Life Insurance Company, alleging various errors in processing their health insurance claims. They challenged Principal's interpretation of an infertility treatment exclusion and its claims review procedures under ERISA. The court considered motions for class certification for four proposed classes. Class I, addressing Principal's online claims review process for altering diagnoses, was certified. Classes II and III, concerning medically necessary infertility treatments and New York Insurance Law violations respectively, were not certified for class-wide adjudication, though individual claims were permitted. Class IV, challenging the sufficiency of claim denial letters, was not certified immediately due to the named plaintiffs' lack of standing for injunctive relief, but conditional certification was offered upon identification of a new suitable plaintiff.

ERISAClass ActionHealth InsuranceClaims DenialInfertility ExclusionOnline ReviewMedical BenefitsStandingFederal Rules of Civil Procedure Rule 23Benefit Plans
References
23
Case No. MISSING
Regular Panel Decision

In Re McLean Industries, Inc.

This case concerns U.S. Lines, Inc. (now Janus Industries), along with Mclean Industries, Inc. and First Colony Farms, Inc. (collectively, the "Debtors"), and the Unsecured Creditors’ Committee (collectively, the "Movants"). They filed for Chapter 11 bankruptcy in 1986 and had a plan of reorganization confirmed in 1989, which relied on the preservation of net operating losses (NOLs). After the IRS announced proposed regulations in 1990 that could challenge the use of NOLs if a plan's principal purpose was tax evasion, the Movants sought a court order declaring that tax evasion was not the principal purpose of their plan. The Internal Revenue Service (IRS) opposed, arguing a lack of subject matter jurisdiction and the applicability of the Declaratory Judgment Act. The court denied the Movants' motion, holding that under 11 U.S.C. § 1129(d), only a governmental unit can initiate a tax avoidance motion, and the issue of tax liability based on proposed regulations was not a concrete controversy.

BankruptcyChapter 11Tax AvoidanceNet Operating Losses (NOLs)IRS RegulationsPlan ConfirmationPost-Confirmation MotionDeclaratory Judgment ActSubject Matter JurisdictionGovernmental Unit
References
4
Case No. MISSING
Regular Panel Decision

Sandiford v. City of New York Department of Education

This is a dissenting opinion concerning a school aide terminated by the New York City Department of Education (DOE) for alleged inappropriate conduct with a 16-year-old student. The plaintiff, a lesbian, claimed discrimination based on sexual orientation and retaliation for complaining about the principal. The dissent argues that the plaintiff's failure to appeal the grievance decision, which substantiated her misconduct, precludes relitigation of the facts. It asserts that the principal's decision to terminate was based on legitimate, non-discriminatory reasons supported by the DOE's investigation and recommendation. Furthermore, the dissent concludes that the retaliation claim fails because the adverse employment action predated the plaintiff's complaints. The dissenting judge would therefore modify the trial court's decision to dismiss the plaintiff's discrimination claim and affirm the dismissal of retaliation and libel claims.

DiscriminationSexual OrientationRetaliationPublic SchoolEmployee TerminationMisconductGrievanceCollateral EstoppelSummary JudgmentAppellate Review
References
30
Case No. MISSING
Regular Panel Decision
Jul 18, 2008

Felipe v. Target Corp.

The plaintiff, Thelma Felipe, sued Target Corporation and Kingsbridge in New York state court after slipping and falling in a Target store. Target removed the case to federal court based on diversity jurisdiction. Felipe moved to remand the case to state court, arguing that the amount in controversy did not exceed $75,000 and that complete diversity was lacking due to Kingsbridge, a New York corporation, being a co-defendant. The court denied Felipe's motion, finding that the amount in controversy was likely over $75,000, as conceded by plaintiff's counsel. The court also determined that Target's principal place of business is Minnesota, establishing diversity with Felipe (a New York resident), and concluded that Kingsbridge was fraudulently joined, as there was no possibility of recovery against them under New York law because they had no contractual obligation to maintain the interior of the store where the injury occurred.

Diversity JurisdictionRemovalRemandAmount in ControversyComplete DiversityFraudulent JoinderSlip and FallPersonal InjuryCorporate CitizenshipNerve Center Test
References
20
Case No. 2020 NY Slip Op 00383
Regular Panel Decision
Jan 21, 2020

U-Trend N.Y. Inv. L.P. v. US Suite LLC

This case involves an appeal concerning a judgment awarding mortgage damages to U-Trend New York Investment L.P. against US Suite LLC and Aura Investments Ltd. The Appellate Division, First Department, modified the Supreme Court's judgment by reducing the principal amount of mortgage damages awarded to U-Trend, stating that interest should be calculated at 13.5% instead of 20%. The court affirmed the judgment in other respects, including the limitation of Aura's liability for looting damages and the denial of sale damages and attorneys' fees. An appeal from a separate order denying Aura's motion to correct or vacate the judgment was dismissed as academic. The court addressed various arguments from Aura regarding liability, causation, and damages calculations, ultimately upholding liability for breach of contract but adjusting the damages amount based on the proper interest rate.

Mortgage DamagesBreach of ContractFiduciary DutyLooting DamagesInterest Rate CalculationAppellate ReviewBusiness Judgment RuleJudicial AdmissionsDerivative ClaimsAttorneys' Fees
References
20
Case No. MISSING
Regular Panel Decision

Chase Manhattan Bank, N.A. v. Nemko, Inc. (In re Nemko, Inc.)

Plaintiff The Chase Manhattan Bank, N.A. (Chase) filed an adversary proceeding against Defendant United Jersey Bank (UJB, later Summit Bank) and Nemko, Inc. concerning the priority of security interests in Nemko's accounts receivable. An initial court order awarded UJB priority, leading Nemko to pay UJB $649,256. This decision was later vacated by the District Court, which remanded the case to determine if Nemko's chief executive office had transferred from New Jersey to New York. The court found that Nemko's office had indeed moved, causing UJB's (Summit's) security interest to lapse due to a failure to file in New York. Chase was subsequently granted judgment on the principal amount, with the issue of prejudgment interest reserved. Following further appeals and a settlement where Summit paid the principal to Chase, Chase filed the instant motion for summary judgment to determine its entitlement to prejudgment interest for the period Summit held the funds. The court granted Chase's motion, concluding that under New York C.P.L.R. § 5001(a) and 11 U.S.C. § 105(a), an award of prejudgment interest at a rate of 5% was equitable to compensate Chase for the loss of use of the funds.

Prejudgment InterestSummary JudgmentSecurity InterestAccounts ReceivableUniform Commercial CodeBankruptcyChapter 11Lien PriorityChief Executive Office TransferCash Collateral
References
17
Case No. ADJ3164730 (LBO 0135441), ADJ3921082 (LBO 0100188), ADJ451512 (LBO 0100187)
Regular
Jan 03, 2011

SOMBOON INTRACHOOTO vs. COUNTY OF LOS ANGELES/RANCHO PRINCIPAL RECONSIDERATION Permissibly Self-Insured

This case involves a workers' compensation claim for permanent total disability and lifetime medical care awarded to an applicant who sustained industrial injuries as a registered nurse. The applicant's husband, also a lien claimant, provided 24-hour home health aide services after December 5, 2004. While the original award set the reasonable value of these services at $100 per day, the Appeals Board granted reconsideration. The Board increased the daily reimbursement rate to $200, finding it consistent with the evidence of actual care provided and more economical for the defendant than hiring external agencies or institutionalizing the applicant.

Workers' Compensation Appeals BoardSomboon IntrachootoCounty of Los AngelesJoint Supplemental Findings and Awardpermanent total disabilitylifetime medical carehome health aidereasonable value of servicespetition for reconsiderationAgreed Medical Examiner (AME)
References
5
Case No. MISSING
Regular Panel Decision

TOMUSHUNAS, DEBBIE v. DESIGNCRETE OF AMERICA, LLC

Plaintiff commenced an action against her former employer and its principal, alleging assault, intentional infliction of emotional distress, and prima facie tort. The Supreme Court granted the defendants' motion for summary judgment, dismissing the complaint. This decision was based on the fact that the plaintiff had previously accepted $40,000 in workers' compensation benefits for illnesses and injuries stemming from the same alleged misconduct by her employer. The court held that by accepting these benefits, the plaintiff forfeited her right to pursue an intentional tort action at law, citing established legal precedent. The ruling emphasized that the settlement nature of the workers' compensation award did not alter this forfeiture.

Workers' Compensation BenefitsSummary Judgment DismissalIntentional Tort ClaimsEmployer MisconductForfeiture of Legal RightsSettlement of ClaimAssault AllegationsEmotional Distress ClaimPrima Facie TortJudicial Precedent
References
4
Case No. MISSING
Regular Panel Decision

Prentice v. Levy

Plaintiff sustained a work-related cervical spine injury in 1998 and underwent surgery by defendant Dr. Walter J. Levy in 1999. After the first surgery failed and a second surgery in 2002 to remove loosened hardware, plaintiff settled a medical malpractice action against Levy for $400,000. The self-insured employer, Tops, Inc., and its administrator, MAC Risk Management, as "the carrier," asserted a workers' compensation lien against the settlement. The Supreme Court provisionally set the lien at $22,442.91 and appointed a referee to determine the final lien and offset amounts, with the carrier bearing the costs. The appellate court affirmed the order, ruling that the interim lien was "without prejudice" and the referee's hearing scope was sufficient to conduct a comprehensive evidentiary hearing, thus causing no prejudice to the carrier.

Workers' Compensation LienMedical MalpracticeSettlement LienInterim LienWorkers' Compensation LawAppellate ReviewReferee AppointmentLien EstablishmentOffset PaymentsEvidentiary Hearing
References
2
Case No. MISSING
Regular Panel Decision

Volpe v. New York City Department of Education

Cheryl Volpe, a special education teacher, sued the New York City Department of Education and Principal Olivia Francis-Webber, alleging retaliation, equal protection violations, and unlawful searches stemming from her advocacy for special needs students. The defendants filed a motion to dismiss, which the court partially granted and partially denied. The court dismissed Volpe's Fourth Amendment and equal protection claims, finding no protected class or unreasonable search. However, the court allowed her Rehabilitation Act and ADA retaliation claim to proceed, specifically regarding an incident on December 18, 2013, where she was confined after attempting to speak with a student's parent.

Special Education TeacherWorkplace RetaliationDisability DiscriminationADA Title IIRehabilitation ActPublic School SystemMotion to DismissHostile Work EnvironmentFourth Amendment ViolationEqual Protection Claim
References
68
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