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

Case No. 2021 NY Slip Op 07401
Regular Panel Decision
Dec 23, 2021

Matter of Carola B.-M. v. New York State Off. of Temporary & Disability Assistance

Petitioners Carola B.-M. and Tiara M. challenged the denial of their supplemental nutrition assistance program (SNAP) benefits by the New York State Office of Temporary and Disability Assistance and the Orleans County Department of Social Services. The benefits were denied because they were deemed ineligible college students. The Appellate Division, Fourth Department, reversed this determination, holding that participation in the Adult Career and Continuing Education Services, Vocational Rehabilitation program (ACCES-VR) qualifies as a Job Training Partnership Act (JTPA) program. This status exempts the students from certain SNAP eligibility requirements. The court found that the original determination was based on an unreasonable interpretation of relevant regulations, annulled the decision, granted the petition, and remitted the case for a calculation of retroactive benefits.

SNAP benefitscollege student eligibilityJob Training Partnership ActACCES-VRvocational rehabilitationCPLR article 78regulatory interpretationpublic assistancefood stampsAppellate Division
References
28
Case No. MISSING
Regular Panel Decision

Claim of Bruzzese v. Guardsman Elevator Co.

In 1994, the claimant sustained head, neck, and back injuries at work, leading to an award for permanent partial disability, which included a wage expectancy adjustment under Workers’ Compensation Law § 14 (5). Following back surgery in 1998, the case was reopened, and the claimant was found to be temporarily totally disabled. Benefits for this temporary total disability were calculated based on the claimant's average weekly wage at the time of injury, without applying the wage expectancy adjustment. The claimant appealed, arguing that since the permanent partial disability preceded the temporary total disability, the wage expectancy adjustment should also apply to the latter period. The court disagreed, affirming the Workers’ Compensation Board's decision, citing established case law that Workers’ Compensation Law § 14 (5) is applicable only to awards for permanent partial disability and not temporary disability.

Wage expectancyTemporary total disabilityPermanent partial disabilityWorkers' Compensation benefitsBack injuryAppellate reviewDisability calculationWorkers' Compensation BoardAverage weekly wage
References
1
Case No. 2022 NY Slip Op 06531
Regular Panel Decision
Nov 17, 2022

Matter of Jennings v. Stop & Shop

Claimant, Hope J. Jennings, a supermarket clerk, suffered a work-related shoulder injury in 2007, leading to a classification of nonschedule permanent partial disability with a 50% loss of wage-earning capacity in 2012, subject to a 300-week durational cap for benefits. Following further causally-related surgeries in 2017 (shoulder) and 2019 (cervical fusion), claimant sought temporary total disability benefits after the durational cap on her permanent partial disability benefits had expired. The Workers' Compensation Board (WCB) ultimately ruled that the expiration of the durational cap on permanent partial disability benefits does not preclude a claimant from seeking temporary total disability benefits following a causally-related surgery. The Appellate Division, Third Department, affirmed the Board's decision, emphasizing that Workers' Compensation Law § 15 (2) (temporary total disability) and § 15 (3) (w) (permanent partial disability) operate under distinct statutory provisions, and the durational cap applies only to benefits payable under the latter paragraph.

Workers' Compensation Law § 15Temporary Total DisabilityPermanent Partial DisabilityDurational CapWage Loss BenefitsCervical Fusion SurgeryShoulder InjuryReclassification of DisabilityStatutory InterpretationAppellate Review
References
4
Case No. 535144
Regular Panel Decision
Nov 17, 2022

In the Matter of the Claim of Hope Jennings

Hope J. Jennings, a supermarket clerk, sustained a work-related shoulder injury in 2007, leading to established workers' compensation benefits. She was classified with a nonschedule permanent partial disability in 2012, subject to a durational cap for wage loss benefits, which expired in November 2018. Following a causally-related cervical fusion surgery in July 2019, claimant sought temporary total disability benefits, arguing these should not count towards the permanent partial disability cap. The Workers' Compensation Board, on full Board review, rescinded an earlier decision and ruled that the expiration of the durational cap did not preclude claimant from seeking temporary total disability benefits after subsequent surgeries. The Appellate Division affirmed the Board's decision, clarifying that temporary total disability benefits under Workers' Compensation Law § 15 (2) are distinct from permanent partial disability benefits under § 15 (3) (w) and are not subject to the latter's durational caps.

Workers' CompensationTemporary Total DisabilityPermanent Partial DisabilityDurational CapWage Loss BenefitsCervical Fusion SurgeryShoulder InjuryAppellate ReviewStatutory InterpretationWorkers' Compensation Law § 15
References
4
Case No. 2021 NY Slip Op 04073
Regular Panel Decision
Jun 24, 2021

Matter of Jagiello v. Air Tech Lab, Inc.

Czeslaw Jagiello had an established workers' compensation claim for an occupational disease that became disabling in 2017, in addition to a prior claim for World Trade Center site injuries, under which he received $400 weekly in temporary partial disability benefits. The dispute revolved around the amount of additional benefits for the occupational disease claim, with the Workers' Compensation Board (WCB) initially determining $480.71 weekly but capping the concurrent award at $801.32 weekly, leading to an award of $401.32 weekly for the occupational disease. Jagiello argued the statutory cap should be $870.61 weekly, thus seeking $470.61 weekly. The Appellate Division affirmed the WCB's decision, clarifying that while the combined weekly benefit was statutorily capped at $870.61 under Workers' Compensation Law § 15 (6), the appropriate temporary partial disability award, being two-thirds of the difference between pre- and post-accident average weekly wages, was correctly limited to $801.32, which was two-thirds of his average weekly wages at the date of disablement.

Workers' CompensationOccupational DiseaseTemporary Partial DisabilityConcurrent AwardsStatutory Maximum RatesAverage Weekly WageWorld Trade Center ClaimAppellate ReviewDisability BenefitsBenefit Calculation
References
7
Case No. MISSING
Regular Panel Decision

Claim of Sciame v. Airborne Express, Inc.

This case addresses the application of Workers’ Compensation Law § 15 (6) (a) concerning the maximum weekly benefits a claimant can receive for concurrent schedule and nonschedule awards. The court reaffirms its established precedent that these concurrent payments cannot exceed the statutory cap of $400 per week for 2004 injuries, irrespective of whether the nonschedule award stems from a permanent disability. This principle was also extended to include periodic payments for a schedule loss of use award and nonschedule award payments for temporary disability. The court concluded that the 2009 amendments to Workers’ Compensation Law §§ 15 and 25 did not indicate legislative intent to overturn this longstanding cap. Consequently, the Board's decision, which held that the claimant's receipt of maximum weekly benefits from a nonschedule award precluded additional benefits from a schedule loss of use award, was affirmed.

Workers' Compensation BenefitsBenefit MaximumsConcurrent AwardsSchedule Loss of Use AwardNonschedule AwardStatutory CapJudicial Precedent AffirmationWorkers' Compensation Law Interpretation2009 Amendments AnalysisPermanent Disability Benefits
References
11
Case No. 5674395Z
Regular Panel Decision
Dec 01, 2011

Baines v. Berlin

Mashon Baines, a homeless and disabled mother of three, initiated a CPLR article 78 proceeding to challenge the New York State Office of Temporary and Disability Assistance's August 31, 2011 decision to discontinue her temporary housing assistance. This decision stemmed from an alleged altercation with a shelter director, Marilyn Gonzalez, during a fire drill, leading to Baines's arrest. Baines argued that her due process rights were violated because the discontinuance notice cited only the assault on Ms. Gonzalez, while the administrative decision was based on multiple uncharged wrongdoings and failed to adequately consider video evidence. The court found that respondents failed to adequately apprise Baines of all charges, thereby violating her due process rights, and consequently annulled the August 31, 2011 fair hearing decision. The court also granted Baines's request for attorneys' fees, costs, and disbursements.

Due ProcessAdministrative HearingHomeless AssistanceShelter BenefitsDiscontinuance of BenefitsNotice RequirementsCPLR Article 78Judicial ReviewAttorneys' FeesSelf-Incrimination
References
8
Case No. ADJ4492292
Regular
Mar 29, 2010

WELDON PITTS vs. LOS ANGELES METROPOLITAN TRANSIT AUTHORITY

This case involves a dispute over temporary disability payments for an applicant who sustained a cumulative industrial injury. The applicant contended the WCJ erred by finding payments were made in this case and by incorrectly calculating the 104-week temporary disability cap. The defendant argued against awarding benefits due to an EDD lien and the applicant's voluntary removal from the labor market. The Board granted the applicant's petition, amended the findings to clarify that temporary disability payments were made in a separate case (ADJ6875920), and revised the commencement date for the 104-week cap in this case (ADJ4492292) to the first actual payment.

ADJ4492292ADJ6875920cumulative industrial injuryneckbackbilateral shouldershandsright kneetemporary disabilityreconsideration
References
2
Case No. SAC 345456
Regular
Jun 05, 2008

CONNIE SOTOLONGO vs. STATE OF CALIFORNIA / EMPLOYMENT DEVELOPMENT DEPARTMENT, STATE COMPENSATION INSURANCE FUND, STATE CONTRACT SERVICES

This case clarifies that Labor Code section 4656(c)(1) imposes an aggregate 104-week limit on temporary disability indemnity payments within a two-year period for any single injury. The Workers' Compensation Appeals Board held that this limit applies to both temporary total and temporary partial disability payments, regardless of the specific type of temporary disability. This interpretation aligns with the statutory language and the Legislature's intent to create a broad, time-based cap on temporary disability benefits.

Labor Code section 4656(c)(1)temporary total disabilitytemporary partial disabilityaggregate limitcompensable weekstwo-year periodIndustrial Disability LeaveSB 899legislative intentstatutory construction
References
10
Case No. ADJ769732 (SAL 0120813) ADJ4662339 (SAL 0083272) ADJ705266 (SAL 0094125) ADJ2433088 (SAL 0094126)
Regular
Jan 28, 2011

, Applicant, HENRY VEGA, vs. , Defendant(s). DEPARTMENT OF CORRECTIONS; STATE COMPENSATION INSURANCE FUND,

The Appeals Board rescinded a prior award finding the applicant not yet permanent and stationary and ordered temporary disability indefinitely. This was because the applicant had multiple injuries with different application dates for the 104-week temporary disability cap under Labor Code section 4656(c)(2). The Board returned the case to the trial level to determine which specific injury or injuries caused the applicant's temporary disability. This clarification is necessary to correctly apply the statutory limitations on temporary disability payments.

Workers' Compensation Appeals BoardReconsiderationFindings Award and OrdersTemporary DisabilityMaximum Medical ImprovementLabor Code section 4656(c)(2)104-week capAggregate disability paymentsDate of injuryTrial level
References
0
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