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

Case No. ADJ8469531, ADJ9267403
Regular
May 02, 2019

KAREN DOUGLAS vs. STATE OF CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a prior decision that barred the applicant's psychiatric claim under Labor Code section 4660.1(c)(1). The WCAB rescinded the original Findings and Award for both consolidated cases. The matters are returned to the trial level for further proceedings and a new decision, guided by a subsequent WCAB en banc opinion addressing section 4660.1(c). The WCAB did not address other issues raised in the applicant's petition.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardPsychiatric claimLabor Code section 4660.1(c)(1)Permanent total disabilityInjury to body partsReport and RecommendationPetition for ReconsiderationSupplemental pleading
References
1
Case No. ADJ9914916
Regular
Feb 22, 2017

RUSSELL MADSON vs. MICHAEL J. CAVALETTO RANCHES, ZENITH INSURANCE COMPANY

This case concerns an applicant who sustained a psychological injury after a severe truck rollover accident. The Workers' Compensation Appeals Board (WCAB) overturned a prior ruling that denied permanent disability for the psychological injury. The WCAB found that Labor Code section 4660.1(c), which limits psychiatric disability awards arising from physical injuries, did not apply because the psychiatric injury was directly caused by the traumatic events of employment. Furthermore, the Board determined the accident itself constituted a "violent act," qualifying for an exception to section 4660.1(c) and entitling the applicant to compensation for his psychiatric impairment, ultimately awarding 60% permanent disability.

AOE/COELabor Code section 4660.1(c)violent actreconsiderationpsychiatric permanent disabilitymotor vehicle accidentcatastrophic injuryPTSDGAF scoreQME
References
6
Case No. MISSING
Regular Panel Decision
Jul 10, 2013

Christopher C. v. Bonnie C.

This divorce action between Christopher C. and Bonnie C. addresses equitable distribution, spousal maintenance, and counsel fees. The defendant, Bonnie C., who has a court-appointed guardian due to mental and emotional difficulties, had separated from the plaintiff in 2003 and informally divided marital assets. The court ratified this prior asset division, noting the defendant had dissipated her share. Finding the defendant unable to work and self-support, and the plaintiff capable of employment despite his claims of disability, the court awarded the defendant non-durational permanent maintenance of $2,500 per month and substantial attorney's fees. The plaintiff's motion to suspend or refund temporary maintenance was denied.

DivorceSpousal MaintenanceEquitable DistributionGuardianshipMental Health IssuesAsset DissipationAttorney's FeesFinancial CapacityPermanent MaintenanceMarital Property
References
12
Case No. 2016-910 K C
Regular Panel Decision
Jan 12, 2018

Precious Acupuncture Care, P.C. v. Hereford Ins. Co.

This case concerns an action by Precious Acupuncture Care, P.C., as assignee of James Hough, against Hereford Insurance Company to recover assigned first-party no-fault benefits. Plaintiff sought the unpaid balance of five claims for services rendered between December 2013 and April 2014. Defendant cross-moved for summary judgment, asserting that the amounts claimed exceeded the workers' compensation fee schedule. The Civil Court initially granted plaintiff's motion, ruling that defendant was precluded from the defense due to untimely denial. However, the Appellate Term reversed this decision, clarifying that under 11 NYCRR 65-3.8 (g) (1) (ii); (2), for services rendered after April 1, 2013, payment is not due for fees exceeding permissible charges, irrespective of timely denial. Consequently, the Appellate Term vacated the prior order, denied plaintiff's motion, and granted defendant's cross-motion for summary judgment dismissing the complaint.

No-Fault BenefitsSummary JudgmentFee Schedule DefenseAppellate ReviewTimely DenialWorkers' Compensation Fee ScheduleMedical BillingInsurance LawCivil CourtAppellate Term
References
5
Case No. MISSING
Regular Panel Decision
Jul 09, 2002

Saunders v. New York City Health & Hospitals Corp.

This case involves an order and judgment from the Supreme Court, New York County, concerning a proceeding under CPLR article 78. The petition was granted to the extent of enjoining the respondent from appointing temporary employees in disregard of Civil Service Law § 64 (1) and directing an amendment to its policy regarding Civil Service Law § 75 (1) (c) to include part-time employees. However, the application for lost wages and benefits on behalf of petitioner Patino was denied. The court unanimously affirmed the decision, stating that the injunctive relief was properly granted as the respondent failed to articulate an important need for open-ended temporary employment consistent with Civil Service Law. The court also rejected the argument that Civil Service Law § 75 (1) (c) applies only to full-time employees, affirming that no hearing was required for Patino's termination under the applicable collective bargaining agreements.

Temporary EmployeesCivil Service LawInjunctive ReliefPart-time EmployeesLost WagesCollective Bargaining AgreementsTerminationPublic PolicyJudicial ReviewAdministrative Law
References
4
Case No. MISSING
Regular Panel Decision
Jul 19, 2001

LaBarbera v. C. Volante Corp.

This action, brought under the Labor Management Relations Act and ERISA, sought recovery of delinquent pension fund contributions from October 1, 1993, to June 30, 1997. The court previously granted default judgment against C. Volante Corp. and C. Volante Trucking Corp. Plaintiffs, trustees of Local 282 Funds, moved for summary judgment against the remaining defendant, Vital Trucking Corp. The court found C. Volante Corp. liable for contributions based on its course of conduct, adopting collective bargaining agreements. C. Volante Trucking Corp. was found jointly liable under the 'single employer' theory due to shared operations, management, and ownership with C. Volante Corp. Vital Trucking Corp. was found jointly and severally liable under the 'alter ego' theory, as it was formed shortly after Volante/Trucking ceased operations, sharing substantially identical business purpose, equipment, customers, and management with the Volante family, indicating an attempt to avoid CBA obligations. The court denied Vital's motion for summary judgment and granted plaintiffs' motion, adopting the Magistrate Judge's recommendation for damages.

Labor Management Relations ActEmployee Retirement Income Security ActPension Fund ContributionsDelinquent ContributionsSummary JudgmentDefault JudgmentSingle Employer DoctrineAlter Ego DoctrineCollective Bargaining AgreementUnion Labor
References
16
Case No. 2017 NY Slip Op 06050 [154 AD3d 1]
Regular Panel Decision
Aug 08, 2017

Matter of Leenasia C. (Lamarriea C.--Maxie B.)

The Administration for Children's Services (ACS) appealed a Family Court order that retroactively granted a suspended judgment to Lamarriea C., vacated a neglect finding, and dismissed a child neglect proceeding. The mother had initially consented to a neglect finding due to drug presence and unsanitary home conditions. After successfully completing the conditions of a dispositional order for 12 months, the mother moved to modify it. The Family Court granted her motion, reasoning that it was in the children's best interest, especially to remove barriers to the mother's employment opportunities. The Appellate Division, First Department, affirmed this decision, asserting that the Family Court possesses broad discretion under Family Court Act § 1061 to modify orders for good cause and that the mother's compliance and the children's welfare supported the vacatur of the neglect finding.

Child NeglectFamily Court ActSuspended JudgmentVacatur of Neglect FindingBest Interests of the ChildParental RightsAppellate ReviewChild Protective ProceedingsDispositional OrderGood Cause
References
42
Case No. 2021 NY Slip Op 00133 [190 AD3d 505]
Regular Panel Decision
Jan 12, 2021

Santana v. MMF 1212 Assoc L.L.C.

Plaintiff, Juan C. Santana, was injured during demolition work when a ceiling fell and struck him. He brought claims under Labor Law §§ 241 (6) and 200, alleging violations of Industrial Code (12 NYCRR) §§ 23-1.8 (c) and 23-3.3 (c). The Appellate Division affirmed the denial of Richard Mishkin Contracting Inc.'s motion for summary judgment on the Labor Law § 241 (6) claim, finding issues of fact regarding the provision of safety hats and ongoing inspections. The court also affirmed the dismissal of the Labor Law § 200 claim against MMF 1212 Assoc L.L.C. and Finkelstein Timberger East Real Estate LLC, as plaintiff did not oppose and they lacked control over the work. Finally, Mishkin's cross-claims for common-law contribution and indemnification were not dismissed due to conflicting expert opinions on the gravity of plaintiff's brain injury under Workers' Compensation Law § 11.

Demolition AccidentFalling ObjectsConstruction SafetyLabor LawIndustrial CodeSummary JudgmentContribution ClaimIndemnification ClaimWorkers' CompensationAppellate Review
References
4
Case No. MISSING
Regular Panel Decision

Schultz v. Texaco Inc.

Plaintiffs, former employees of Texaco and TEPI, alleged ERISA violations due to their reclassification as independent contractors, which excluded them from benefits plans. They filed a class action asserting claims for breach of fiduciary duties (Section 502(a)(3)), improper denial of benefits (Section 502(a)(1)(B)), refusal to supply benefit information (Section 502(c)), and interference with benefit rights (Section 510). Defendants moved to dismiss these claims, arguing they were time-barred or legally insufficient. The court granted the dismissal of claims under ERISA Sections 510 and 502(a)(1)(B) as time-barred. Additionally, Gladys Criddle's 502(c) claim and all 502(c) and 502(a)(3) claims against defendants other than Janet Stoner were granted dismissal. However, the motion to dismiss Harold Weber's 502(c) claim and the 502(a)(3) claim against Janet Stoner was denied.

ERISAEmployee BenefitsIndependent ContractorFiduciary DutyStatute of LimitationsEquitable EstoppelContinuing ViolationPlan AdministratorClass ActionMisclassification
References
32
Case No. 2016-2075 K C
Regular Panel Decision
Nov 16, 2018

UGP Acupuncture, P.C. v. 21st Century Ins. Co.

UGP Acupuncture, P.C., as the assignee of Santana, Nicole, appealed an order from the Civil Court that granted summary judgment to 21st Century Insurance Company. The action sought to recover first-party no-fault benefits. The defendant had dismissed the complaint, arguing that the amounts claimed for acupuncture services after April 1, 2013, exceeded the workers' compensation fee schedule. The Appellate Term affirmed the Civil Court's decision, reiterating its prior holding that insurers may lawfully use the workers' compensation fee schedule for acupuncture services, even if performed by a licensed acupuncturist rather than a chiropractor. Therefore, the order granting summary judgment to the insurer was affirmed.

No-fault benefitsacupuncture servicesworkers' compensation fee schedulesummary judgmentappellate reviewinsurance lawmedical billingfee reduction
References
1
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