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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

Bopp v. Wiest

This is a case of first impression concerning the application of a workers' compensation lien to a wrongful death settlement involving beneficiaries who are not statutory dependents. The decedent's estate received $50,000 in workers' compensation benefits under Workers' Compensation Law § 16 (4-b) following a workplace death, as there were no dependents. The estate's coexecutrices secured a $60,000 wrongful death settlement on behalf of the decedent's adult children. Liberty Mutual, the workers' compensation carrier, asserted a lien against this settlement. The court, presided over by Justice Andrew V. Siracuse, ruled that the 1990 amendment to Workers' Compensation Law § 16 (4-b) made the distinction between dependents and distributees irrelevant in this context. Consequently, the court approved the settlement but confirmed that the proceeds are subject to Liberty Mutual's workers' compensation lien, ensuring that adult children receiving benefits through the estate do not have a superior position to minor dependents receiving direct benefits.

wrongful deathworkers' compensationliensettlementstatutory interpretationdependentsdistributeesNew York lawfirst impressionsubrogation
References
7
Case No. MISSING
Regular Panel Decision

Kesick v. Ulster County Self Insurance Plan

Paul Kesick, a police officer, was involved in two automobile accidents, leading to workers' compensation claims for knee injuries. Kesick and his wife settled a personal injury action against the drivers for $50,000 and $75,000 without the consent of the Ulster County Self Insurance Plan, their workers' compensation carrier. The Supreme Court granted their application for a nunc pro tunc order approving the settlement but denied the carrier's request for a workers' compensation lien against the settlement proceeds. The carrier appealed, arguing it was entitled to a lien for amounts exceeding $50,000, which are not considered first-party benefits. The appellate court agreed, modifying the order by granting the carrier a lien of $5,969.49 to be held in escrow, preventing an impermissible double recovery for the petitioners.

Workers' Compensation LawLienSettlementThird-Party ActionFirst-Party BenefitsNo-Fault Insurance LawDouble RecoveryAutomobile AccidentAppellate CourtStatutory Interpretation
References
3
Case No. MISSING
Regular Panel Decision

DeRosa v. Petrylak

This case concerns an appeal and cross-appeal regarding a third-party personal injury settlement and an insurance lien. The plaintiff, DeRosa's widow, initially received workers' compensation death benefits after her husband's work-related automobile accident. She subsequently settled a third-party claim against Petrylak's estate, the driver of the vehicle, without the workers' compensation carrier's (Aetna) prior consent or court approval. This led Aetna to refuse further death benefits. The Supreme Court granted nunc pro tunc approval of the third-party settlement, finding the delay justified by the plaintiff's belief of no lien due to the fellow-employee rule and the initial uncertainty of benefit entitlement. However, the Supreme Court declined to reduce Aetna's insurance lien. The Appellate Division affirmed both orders, concluding that the Supreme Court properly exercised its discretion in granting nunc pro tunc approval.

Workers' Compensation Law § 29Nunc Pro Tunc ApprovalThird-Party SettlementInsurance LienFellow Employee DoctrineAutomobile Accident DeathWorkers' Compensation Death BenefitsAppellate ReviewCarrier ConsentStatutory Interpretation
References
3
Case No. MISSING
Regular Panel Decision

In re Settlement Capital Corp.

Settlement Capital Corporation (SCC) sought court approval, under New York's Structured Settlement Protection Act (SSPA), to acquire $125,000 of a $225,000 annuity payment due to Richard C. Ballos on October 1, 2010. Ballos, a totally disabled father of two, agreed to transfer these rights for a net advance of $36,500, reflecting a 15.591% annual discount rate. The court, presided over by Justice Patricia E. Satterfield, denied the petition after a hearing on April 23, 2003. The decision hinged on a two-pronged test: whether the transfer was in Ballos's 'best interest' and if the transaction terms were 'fair and reasonable.' The court found that Ballos did not demonstrate 'true hardship' given his other income sources and previous transfer of structured settlement payments, concluding it was not in his or his dependents' best interest. Furthermore, the court deemed the 15.591% discount rate, resulting in Ballos receiving only 29% of the transferred amount, unconscionable and not 'fair and reasonable.'

Structured SettlementStructured Settlement Protection Act (SSPA)Annuity TransferDiscount RateBest Interest StandardFair and Reasonable StandardPayee ProtectionFinancial HardshipCourt ApprovalGeneral Obligations Law
References
12
Case No. MISSING
Regular Panel Decision

Klem v. Special Response Corp.

This case involves an appeal from an order regarding the distribution of settlement proceeds and a workers' compensation lien. The plaintiff sustained an ankle injury during employment and subsequently settled a personal injury action against Special Response Corporation. Zurich Insurance Company, the workers' compensation insurer for the plaintiff's employer, had paid over $114,000 in benefits and claimed a lien against the $70,000 settlement proceeds. The Supreme Court initially ruled that Zurich was not entitled to assert a lien. However, the appellate court reversed this decision, affirming Zurich's right to a lien, but remitted the matter to the Supreme Court for further proceedings to properly calculate the lien amount, taking into account statutory reductions for benefits paid in lieu of first-party benefits and an equitable apportionment of litigation costs, including attorneys' fees.

Workers' CompensationLien RightsSettlement ProceedsPersonal InjuryAppellate ReviewInsurance LawEquitable ApportionmentLitigation CostsFirst-Party BenefitsNo-Fault Law
References
6
Case No. MISSING
Regular Panel Decision

Stair v. Calhoun

Plaintiffs' counsel, Ballon Stoll Bader & Nadler, P.C., moved to withdraw from representing plaintiffs and sought a charging and retaining lien due to plaintiff Theodore Stair's substantial unpaid legal fees. Stair opposed the withdrawal, citing a pending settlement. The court granted counsel's motion to withdraw, finding Stair's prolonged failure to pay constituted deliberate disregard of his financial obligations. The court also granted a charging lien for $37,546.87, representing adjusted reasonable hours and expenses, but denied the motion for a retaining lien to prevent prejudice to the ongoing litigation and due to Stair's alleged indigence.

Withdrawal of CounselCharging LienRetaining LienUnpaid Legal FeesAttorney-Client RelationshipDeliberate DisregardQuantum MeruitShareholder DilutionMotion PracticeFee Dispute
References
86
Case No. MISSING
Regular Panel Decision
May 05, 2011

Spadaro v. Meza

The plaintiffs appealed an order from the Supreme Court, Kings County, which denied their motion to determine that nonparty respondents Pacific Employers Insurance Company, c/o Gallagher Bassett, and the Special Funds Conservation Committee had no enforceable workers’ compensation lien on settlement proceeds. The injured plaintiff had two workers' compensation claims from accidents in 1998 and 2004. An agreement from 2008 allowed Gallagher Bassett and Special Funds to reserve their right to assert liens on settlement proceeds from the 2004 claim. Plaintiffs argued the lien amounts could not be accurately established due to a lack of apportionment between the claims. The Supreme Court correctly denied the motion, as Gallagher Bassett only made benefit payments related to the 2004 accident, making the lien amount ascertainable. The order was affirmed.

Workers' Compensation LienSettlement ProceedsPersonal InjuriesApportionment of ClaimsInsurance CarrierSpecial Funds Conservation CommitteeLump Sum AwardWaiver of BenefitsSupreme Court AppealCivil Procedure
References
3
Case No. MISSING
Regular Panel Decision
Dec 27, 2004

McComber v. Lehrer McGovern Bovis, Inc.

This case involves an appeal of an order from the Supreme Court, New York County, which fixed a nonparty-appellant workers’ compensation carrier’s lien at $23,355.68. The original action was for personal injuries at a work site, resulting in a $14.5 million recovery for the plaintiff through a high-low settlement. The carrier had paid $228,605.18 in past compensation benefits and was assessed to have a present value of $387,143.30 in future compensation benefits that it would have paid. The appellate court affirmed the lower court's decision, which applied the Kelly formula to reduce the carrier's lien by its equitable share of litigation costs, encompassing both past and future benefits. The court also rejected the carrier's argument that the plaintiff violated Workers’ Compensation Law § 29 (5) by not obtaining consent for the settlement, clarifying that such consent is only required for settlements less than the statutory benefits, which was not the case here. Furthermore, any required judicial approval was deemed properly granted nunc pro tunc.

Lien ReductionKelly FormulaFuture Benefits ValuationHigh-Low SettlementJudicial DiscretionNunc Pro Tunc ApprovalWorkers' Compensation Law § 29 (5)Equitable ApportionmentSubrogation RightsPersonal Injury Recovery
References
7
Case No. ADJ426447 (RDG 0129495)
Regular
Jul 16, 2010

Shane Guest vs. Barrett Business Services

The Appeals Board dismissed the applicant's petition for reconsideration as he was not aggrieved by a final order. The applicant sought to set aside a settlement concerning the Employment Development Department's (EDD) lien, arguing it was made in error. However, the Board found that the WCJ had not yet made a final determination on the EDD lien, which is a prerequisite for the Board to have jurisdiction to approve or disapprove such a settlement. Therefore, the matter is returned to the trial level for a final determination of the EDD's lien.

WCABPetition for ReconsiderationDismissalEDD LienTrial LevelFinal DeterminationTemporary DisabilityEmployment Development DepartmentStipulationDeferred Lien
References
1
Case No. MISSING
Regular Panel Decision

Venner v. Grimm

The Supreme Court, Erie County's order regarding the settlement of an action and a workers' compensation lien has been unanimously affirmed with costs. The appellate panel included Justices Simons, Callahan, Doerr, Boomer, and Moule. The decision refers to the case of Vinson v Berkowitz, 83 AD2d 531, and the original order was presided over by Justice Mintz.

Workers' Compensation LienAppealSettlement of ActionOrder AffirmedSupreme CourtAppellate DivisionJudicial PanelCosts
References
1
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