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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 Simpson v. Glen Aubrey Fire Co.

A volunteer fireman suffered an acute lumbosacral strain requiring frequent hospital and doctor visits. He sought reimbursement for 290 miles of travel expenses. The Workers' Compensation Board approved reimbursement at 20 cents per mile, leading to this appeal. The court examined whether travel expenses for medical treatment are reimbursable under the Volunteer Firemen’s Benefit Law and Workers’ Compensation Law. It concluded that access to medical treatment implies the financial means to obtain it, upholding the humanitarian goals of the legislation.

Volunteer FiremanLumbosacral StrainMileage ReimbursementTravel ExpensesMedical TreatmentWorkers' Compensation LawVolunteer Firemen's Benefit LawStatutory InterpretationRemedial LawLiberal Construction
References
2
Case No. MISSING
Regular Panel Decision

Claim of Vanostrand v. Felchar Manufacturing Corp.

The case involves an appeal from a Workers’ Compensation Board decision concerning a claimant found to have defrauded employers and carriers by overstating mileage and making false statements about her physical condition. The Board ruled that Workers’ Compensation Law § 114-a, which bars future wage replacement benefits for such violations, does not preclude the claimant from receiving future mileage expenses or medical coverage. The Appellate Division, Third Department, affirmed this decision, citing its previous ruling in Matter of Rodriguez v Burn-Brite Metals Co., which established that the penalties under Workers’ Compensation Law § 114-a are limited to wage replacement benefits and do not extend to medical benefits. The court also found no error in the Board's tacit refusal to require the claimant to directly repay the mileage overpayments to the subject carriers.

Workers' Compensation Law § 114-aMedical BenefitsMileage ExpensesFraudulent MisrepresentationStatutory InterpretationAppellate DecisionWage Replacement BenefitsBoard Decision ReviewAffirmative RulingLegal Precedent
References
2
Case No. ADJ1323942
Regular
Jan 25, 2010

JANN WASHINGTON vs. DAVIS COMPANIES, FIREMAN'S FUND

The Workers' Compensation Appeals Board granted reconsideration to address the applicant's medical mileage reimbursement. The Board amended the prior award to allow reimbursement for travel between the applicant's Nevada residence and her California treating physician. The employer failed to prove that equally effective treatment was available closer to the applicant's residence, thus their objection to the extended mileage was denied. The specific amount of reimbursement is to be determined by the parties, with jurisdiction reserved for dispute resolution.

Workers' Compensation Appeals BoardIndustrial InjuryUpper ExtremitiesMedical TreatmentMedical MileageReconsiderationResidenceGeographic AreaTreating PhysicianEmployer Burden
References
1
Case No. MISSING
Regular Panel Decision

Civil Service Employees Ass'n v. County of Steuben

CSEA appealed an order that denied confirmation of an arbitrator's award and granted the County's cross-petition to vacate it. The dispute stemmed from a public employment contract concerning mileage reimbursement between CSEA and the County. The County changed its mileage policy, prompting CSEA to file a grievance, arguing that a 'past practice' had effectively modified the contract's terms. The arbitrator agreed with CSEA, but the Special Term vacated the award, ruling that the contract's language on mileage reimbursement was clear and unambiguous, rendering any past practice irrelevant. The appellate court affirmed the Special Term's decision, concluding that the arbitrator exceeded his authority by relying on matters outside the explicit contractual agreement, thereby creating a new contract for the parties.

ArbitrationPublic Employment ContractMileage ReimbursementPast PracticeContract InterpretationArbitrator's PowerVacatur of AwardCPLR Article 75Collective Bargaining AgreementUnambiguous Contract Terms
References
6
Case No. MISSING
Regular Panel Decision
Oct 26, 2015

Matter of Newbill v. Town of Hempstead

Claimant, a sanitation crew chief, injured his right ankle and foot at work and was awarded disability benefits. His self-insured employer paid his full weekly wages during a period of disability and timely sought reimbursement for these advanced payments. A Workers’ Compensation Law Judge granted the employer's reimbursement request against a 20% schedule loss of use award for the right foot. The Board affirmed this decision, and the claimant appealed, arguing that reimbursement should not cover periods where no compensation awards were initially made. The court affirmed the Board's decision, reiterating that an employer is entitled to full reimbursement from a schedule loss of use award for advanced wages paid during disability, as schedule awards are not allocable to specific periods of lost work.

Schedule Loss of UseReimbursementAdvanced Wage PaymentsDisability BenefitsEmployer RightsAppellate ReviewWorkers’ Compensation BoardStatutory InterpretationPermanent Partial DisabilityTimely Claim
References
10
Case No. MISSING
Regular Panel Decision

Heroux v. Ingrassio

Plaintiff Bernard R. Heroux, Sr. filed a pro se complaint against his former employer CQC Prosthodontics and two employees, alleging national origin discrimination under Title VII, denial of Workers’ Compensation benefits, denial of 401(k) participation under ERISA, and failure to reimburse mileage. The defendants moved to dismiss all claims. The court dismissed the Title VII claims against individual defendants, and against CQC Prosthodontics for failure to exhaust administrative remedies. The Workers’ Compensation claim was dismissed due to res judicata and exclusive remedy provisions. The mileage reimbursement claim was dismissed as neither federal nor New York law requires it. Finally, the ERISA claim was dismissed as untimely, as the plaintiff had actual knowledge of the alleged breach more than three years before filing. Therefore, the court granted the defendants' motion to dismiss in its entirety.

Employment DiscriminationNational Origin DiscriminationTitle VIIWorkers' CompensationERISAMotion to DismissPro SeAdministrative RemediesStatute of LimitationsRes Judicata
References
22
Case No. MISSING
Regular Panel Decision

Claim of Guarascio v. Spargo Wire Co.

The claimant, a truck driver, suffered work-related back and shoulder injuries in October 1995. The employer’s workers’ compensation carrier paid benefits. In 2000, the carrier sought reimbursement from the Special Disability Fund under Workers’ Compensation Law § 15 (8) (d) for these payments. A Workers’ Compensation Law Judge (WCLJ) established the claim in 2002 and later found the claimant permanently partially disabled, ruling on apportionment but deferring the reimbursement issue. The WCLJ subsequently found the carrier’s request for reimbursement timely. The Workers’ Compensation Board affirmed this decision. This appeal concerns the Board’s ruling that the carrier’s C-250 claim for reimbursement was timely filed within the statutory 52-week period, despite the underlying claim documents being posted by the Board in 2000.

ReimbursementSpecial Disability FundTimeliness of ClaimPermanent Partial DisabilityWorkers' Compensation LawPreexisting ImpairmentWork-related InjuryC-250 ClaimStatute of LimitationsAppellate Review
References
3
Case No. MISSING
Regular Panel Decision

Poupard v. Mohonasen Central School District

The claimant, a librarian, sustained an employment-related injury. Following her injury, she received full salary for 27 weeks under a collective bargaining agreement, and then used 23 days of accumulated sick leave. The employer sought reimbursement for these advance payments. The referee and the Workers’ Compensation Board initially granted the full reimbursement. On appeal, the court modified the decision, holding that wages paid from accumulated sick leave, acquired through a collective bargaining agreement, are compulsory payments and thus not reimbursable under Workers’ Compensation Law § 25 (subd 4, par [a]). The matter was remitted for further proceedings consistent with this ruling, with costs awarded to the claimant.

Workers' CompensationReimbursementSick LeaveCollective Bargaining AgreementAdvance PaymentsOccupational DisabilityStatutory LimitationsAppellate ReviewEmployment InjuryReferee Decision
References
5
Case No. MISSING
Regular Panel Decision

Claim of Domanico v. Woodmere Fire District

This case involves an appeal from a decision by the Workers’ Compensation Board, filed April 4, 2005, which denied an employer's request for reimbursement of wages paid to a claimant during a period of disability. The court examined whether a June 24, 2004 notice, issued by the self-insured employer, Woodmere Fire District, containing language about reimbursement, was sufficient as a request under Workers’ Compensation Law § 25 (4) (a). The court found the notice to be sufficient in form. However, a critical issue remained regarding the timeliness of this request; specifically, whether it was filed prior to the compensation award made at the January 7, 2005 hearing. Due to this unresolved issue, the court reversed the Board's decision and remitted the matter for further proceedings to determine the timeliness of the reimbursement request.

Workers' Compensation ReimbursementEmployer Wage ReimbursementDisability WagesTimeliness of Reimbursement RequestWorkers' Compensation LawBoard Decision AppealJudicial ReversalRemittal for Further ProceedingsNew York Workers' CompensationStatutory Interpretation
References
5
Case No. MISSING
Regular Panel Decision

Claim of Perrin v. Builders Resource, Inc.

The case concerns an appeal from a Workers' Compensation Board decision regarding the reimbursement rate for home health aide services provided to a claimant by their sister. Initially, the carrier denied payment but was later directed to pay. The Workers’ Compensation Law Judge set the reimbursement rate at $12 per hour for services starting in 2011, which the Board affirmed. The claimant appealed, solely challenging this rate. The court dismissed the appeal, ruling that the claimant was not an aggrieved party concerning the reimbursement rate, as the dispute was between the care provider (the sister) and the carrier. The court affirmed that the claimant received the care sought and could not raise issues on behalf of the care provider.

Workers' CompensationHome Health Aide ServicesReimbursement RateAppeal DismissalAggrieved PartyCare ProviderWorkers' Compensation BoardAppellate ProcedureNew York LawCarrier Liability
References
4
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