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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
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. 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
Case No. 2014-2225 K C
Regular Panel Decision
Oct 27, 2017

Acupuncture Approach, P.C. v. NY Cent. Mut. Fire Ins. Co.

This case concerns an appeal from an order of the Civil Court of the City of New York, Kings County, relating to assigned first-party no-fault benefits. Acupuncture Approach, P.C., as assignee, sought to recover sums from NY Central Mutual Fire Ins. Co. The defendant moved for summary judgment, arguing timely payment according to the workers' compensation fee schedule for some claims, and lack of medical necessity for others. The plaintiff cross-moved for summary judgment. The Appellate Term modified the Civil Court's order, denying the defendant's motion for summary judgment on claims totaling $3,495, $2,695, and $1,965, due to the defendant's failure to demonstrate timely denial. The Appellate Term affirmed the reduction of the amount in controversy for other claims and the denial of the plaintiff's cross-motion.

No-Fault BenefitsSummary JudgmentAppellate ReviewInsurance ClaimsWorkers' Compensation Fee ScheduleMedical NecessityTimely DenialCivil Court OrderAssignee ClaimsPreclusion
References
4
Case No. 2015-1563 K C
Regular Panel Decision
Dec 22, 2017

Z. M. S. & Y Acupuncture, P.C. v. GEICO Gen. Ins. Co.

This case involves an appeal by GEICO General Insurance Company from an order of the Civil Court that denied branches of its cross-motion for summary judgment. The plaintiff, Z. M. S. & Y Acupuncture, P.C., sought to recover assigned first-party no-fault benefits for services billed under CPT codes 97811, 97813, and 97814. The Appellate Term, Second Department, reversed the lower court's order, granting GEICO's cross-motion for summary judgment. The court found that GEICO had fully paid the plaintiff for services in accordance with the workers' compensation fee schedule for acupuncture, and since the services were rendered after April 1, 2013, the defense regarding the fee schedule was not subject to preclusion. Plaintiff failed to rebut this showing.

No-fault benefitsAcupuncture servicesWorkers' compensation fee scheduleSummary judgmentCPT codesAppellate reviewInsurance disputeMedical billingFee dispute
References
2
Case No. 2013-2706 Q C
Regular Panel Decision
Sep 19, 2016

NYS Acupuncture, P.C. v. State Farm Mut. Auto. Ins. Co.

This case, NYS Acupuncture, P.C. v State Farm Mut. Auto. Ins. Co., concerned an appeal from an order of the Civil Court of the City of New York, Queens County. The plaintiff, NYS Acupuncture, P.C., sought assigned first-party no-fault benefits from State Farm, which had moved for summary judgment arguing full payment according to the workers' compensation fee schedule. The Civil Court initially granted State Farm's motion. On appeal, NYS Acupuncture, P.C. contended that the fee schedule reductions were improper. The Appellate Term, Second Department, affirmed the prior ruling, finding that State Farm adequately demonstrated it had fully compensated the plaintiff for acupuncture services based on the applicable workers' compensation fee schedule for services performed by chiropractors, referencing Great Wall Acupuncture, P.C. v Geico Ins. Co.

Workers' Compensation Fee ScheduleNo-Fault BenefitsAcupuncture ServicesChiropractorsSummary JudgmentAppellate ReviewInsurance DisputeFee Schedule ReductionAssigned BenefitsMedical Billing
References
1
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