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

Case No. MISSING
Regular Panel Decision

United Spinal Ass'n v. Board of Elections in the City of New York

Plaintiffs United Spinal Association and Disabled in Action brought an action against the Board of Elections in the City of New York (BOE) under Title II of the Americans with Disabilities Act and Section 504 of the Rehabilitation Act, alleging pervasive access barriers at poll sites. The Court previously denied a preliminary injunction. Both parties subsequently moved for summary judgment. The Court found no genuine dispute of material fact regarding the existence of pervasive and recurring accessibility barriers and deemed the BOE's accommodation methods insufficient. Consequently, the Court granted the plaintiffs' motion for summary judgment on liability and denied the defendants' cross-motion. The case is now referred to a Magistrate Judge for the determination of the appropriate remedy.

AccessibilityVoting RightsAmericans with Disabilities ActRehabilitation ActPoll SitesSummary JudgmentDisability DiscriminationBoard of ElectionsMeaningful AccessReasonable Accommodation
References
26
Case No. SAL 0107786
Regular
Oct 16, 2007

MOLLY KIRKPATRICK vs. DOMINICAN SANTA CRUZ HOSPITAL, PSI ADMINISTERED BY OCTAGON RISK SERVICES

This case concerns an injured worker who had cervical spine surgery involving diskectomy, vertebrectomy, decompression, and fusion. The defendant sought reconsideration of an award granting temporary disability benefits beyond the statutory 104-week limit, arguing the surgery was not an amputation. The Appeals Board rescinded the prior award and returned the matter for further proceedings, as the definition of "amputation" in precedent excludes internal body parts like those removed during spinal fusion.

Workers' Compensation Appeals BoardDominican Santa Cruz HospitalOctagon Risk ServicesMolly KirkpatrickIndustrial InjuryCervical Spine SurgeryTemporary Disability IndemnityLabor Code Section 4656(c)AmputationDiskectomy
References
1
Case No. 2021 NY Slip Op 00608 [191 AD3d 1078]
Regular Panel Decision
Feb 04, 2021

Matter of Peck v. The Donaldson Org.

Harry Peck, a carpenter, sustained a work-related back injury in 2013 and received workers' compensation benefits. After spinal fusion surgery, he was deemed medically unable to return to work. Following authorization for a spinal cord simulator trial in 2018, the employer's carrier alleged that Peck violated Workers' Compensation Law § 114-a, citing surveillance footage inconsistent with his claimed disability. Although a Workers' Compensation Law Judge initially found no misrepresentation, the Workers' Compensation Board reversed, finding a violation and imposing mandatory and discretionary penalties, including disqualification from future wage replacement benefits. The Appellate Division, Third Department, affirmed the Board's decision, concluding that substantial evidence supported the finding that Peck made willful misrepresentations regarding the extent of his disability to physicians.

Workers' Compensation FraudDisability MisrepresentationSurveillance EvidencePenalty ImpositionWage Replacement DisqualificationSpinal Cord InjuryBack PainClaimant CredibilityAppellate Review of Board DecisionMaterial False Statement
References
10
Case No. ADJ7951527
Regular
Oct 03, 2016

RONALD COYLE vs. DANE COYLE CUSTOM HOMES, INC.

The defendant sought reconsideration of an award for an applicant's industrial back injury, challenging the timeliness of the utilization review (UR) denial and the necessity of proposed spinal surgery. The Board denied reconsideration, affirming that the defendant failed to prove timely communication of the UR denial as required by law. Furthermore, substantial evidence, including reports from the treating physician and Agreed Medical Evaluator, supported the necessity of the lumbar fusion surgery. The Board found the defendant's arguments insufficient to rebut the expert medical opinions presented.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardIndustrial InjuryUtilization Review (UR) DenialTimelinessFurther Medical TreatmentSpinal SurgeryLumbar FusionRequest for Authorization (RFA)
References
2
Case No. FRE 191206
Regular
Nov 20, 2007

MARY SEPEDA vs. SEPEDA BROTHERS DAIRY, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION on behalf of FREMONT INDEMNITY, in liquidation, REPUBLIC INDEMNITY

This case involves an applicant seeking reconsideration of a workers' compensation award concerning a low back injury sustained through July 13, 1995. The applicant, supported by her treating physician, argued for additional disc replacement surgery at the L4-5 level beyond the previously awarded L5-S1 spinal fusion. The Workers' Compensation Appeals Board granted reconsideration and amended the award to include the L4-5 disc replacement surgery, finding it reasonably required to cure or relieve the applicant's injury based on the treating physician's opinion.

CIGAFremont IndemnityRepublic Indemnitylow back injurypermanent disabilityfurther medical treatmentspinal surgeryL5-S1 fusionL4-5 disc replacementtreating physician
References
2
Case No. ADJ10034122
Regular
Dec 22, 2017

CRYSTAL WYANT vs. AMERICAN MEDICAL RESPONSE, ACE AMERICAN INSURANCE COMPANY

This case concerns an applicant's industrial back injury requiring lumbar spinal fusion. Defendants sought to overturn a prior award granting ongoing medical treatment, arguing a subsequent Utilization Review (UR) certification was invalid. The Appeals Board denied reconsideration, finding the UR process was correctly followed. A second Request for Authorization (RFA) submitted by the applicant's physician included "Change in Material Facts," triggering a new review. This second UR decision, dated September 11, 2017, authorized the surgery as medically necessary, superseding the earlier denial.

Utilization ReviewIndependent Medical ReviewReconsiderationFindings and AwardAdministrative Law JudgeLabor Code Section 4610Request for AuthorizationLumbar Spinal FusionMedical TreatmentChange in Material Facts
References
4
Case No. 242 AD3d 1455
Regular Panel Decision
Oct 30, 2025

Matter of Jover v. Alba Demolition

Carlos Jover, the claimant, appealed a decision by the Workers' Compensation Board, which ruled he was not entitled to permanent partial disability benefits. The Board affirmed a finding that Jover failed to demonstrate attachment to the labor market. Jover, who sustained work-related injuries in 2015 and underwent spinal fusion surgery in 2019, had been classified with a 75% loss of wage-earning capacity. His job search efforts were deemed insufficient because many applied positions required English proficiency or specialized qualifications he lacked. The Appellate Division, Third Department, affirmed the Board's decision, concluding that substantial evidence supported the determination that Jover had not diligently sought employment within his medical restrictions.

Permanent Partial DisabilityLabor Market AttachmentWage-Earning CapacityJob Search EffortsMedical RestrictionsEnglish Proficiency BarrierVocational Data FormSpinal Fusion SurgeryWorkers' Compensation Board DecisionAppellate Review Standard
References
13
Case No. MISSING
Regular Panel Decision

Claim of Kendle v. Colonie Masonry Corp.

The claimant, a laborer, fell 15 to 20 feet from a scaffold in 1990, sustaining a burst fracture at L-1 vertebra requiring spinal fusion. The employer acknowledged the accident and injuries but sought to apportion responsibility with injuries from a 1985 automobile accident. The Workers’ Compensation Board found that the claimant had fully recovered from the 1985 injuries and had returned to full-time work as a laborer, making apportionment inappropriate. The employer appealed, arguing lack of substantial evidence. The court affirmed the Board's decision, finding no error in the Workers’ Compensation Law Judge's refusal to allow the employer to introduce further evidence, as the employer failed to produce readily available records or supervisor testimony to support their claim that the claimant remained symptomatic or had not fully resumed previous employment.

Workers' CompensationScaffold FallSpinal InjuryApportionmentPrior InjuryAutomobile AccidentFull-time EmploymentSubstantial EvidenceAbuse of DiscretionEvidence Admissibility
References
5
Case No. MISSING
Regular Panel Decision
Jan 17, 2014

Scottsdale Insurance v. Indian Harbor Insurance

Scottsdale Insurance Company, an excess insurer, sued Indian Harbor Insurance Company, a primary insurer, alleging bad faith and gross disregard for failing to settle an underlying personal injury lawsuit involving Linzy Dickson within the primary policy limits. Dickson, a construction worker, sustained severe injuries and underwent spinal fusion surgery, leading to a $2.5 million settlement which required Scottsdale to pay $1.5 million. Both parties filed cross-motions for summary judgment. The court denied both motions, finding material disputed facts regarding Indian Harbor's alleged gross disregard and whether it caused the loss of an opportunity to settle the case for $1 million or less, thus necessitating a jury trial.

Insurance DisputeBad Faith ClaimExcess InsurancePrimary InsuranceSettlement NegotiationsSummary Judgment MotionPersonal Injury LawsuitConstruction AccidentSpinal Fusion SurgeryDamages Assessment
References
22
Case No. MISSING
Regular Panel Decision
Jan 22, 2013

Matter of Dacey v. Sweeteners Plus, Inc.

This case concerns an appeal from a Workers' Compensation Board decision that found a claimant did not violate Workers' Compensation Law § 114-a. The claimant sustained a work-related back injury in 2000, was classified as permanently partially disabled, and continued to receive benefits. Following spinal fusion surgery, his benefits became permanent. The employer's workers' compensation carrier alleged a violation of § 114-a based on video surveillance showing the claimant performing light wood-cutting. While a Workers' Compensation Law Judge initially found a violation, the Board reversed this determination, characterizing the activity as 'de minimis' and not inconsistent with the claimant's partial disability. The Appellate Division affirmed the Board's decision, concluding that it was supported by substantial evidence and reiterating the Board's authority as the sole arbiter of witness credibility.

Workers' CompensationPermanent Partial DisabilityFraud AllegationVideo SurveillanceFalse StatementBenefit DisqualificationSpinal Fusion SurgeryDe Minimis ActivitySubstantial EvidenceAppellate Review
References
5
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