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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. ADJ11229680
Regular
Oct 13, 2025

BEATRIZ MACIAS vs. COUNTY OF LOS ANGELES SHERIFF'S DEPARTMENT, SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

Applicant Beatriz Macias (deceased) sought reconsideration of a Findings of Fact and Award (F&A) that found her 100% permanently disabled but applied credits for earnings, temporary disability, and Labor Code section 4850 benefits. The defendant argued the credit was appropriate to prevent double recovery. The Appeals Board granted reconsideration, determining that the WCJ improperly allowed credits for temporary disability indemnity, salary, or section 4850 benefits, as permanent disability compensates for physical loss and lost earning capacity, distinct from temporary disability. Consequently, the F&A was amended to permit credit solely for permanent disability paid and reasonable attorney fees, with the remainder of the F&A affirmed.

Workers' Compensation Appeals BoardDeputy SheriffMetastatic Breast CancerUlnar Nerve InjuryPermanent Total DisabilityPetition for ReconsiderationLabor Code Section 4850Temporary Total DisabilityPermanent Disability IndemnityCredit for Benefits Paid
References
7
Case No. ADJ2759696 (VNO 0492027)
Regular
Oct 11, 2010

WOON YOUNG PARK vs. FILM PAYMENT SERVICES, INC., CHARTIS INSURANCE

The Board granted reconsideration, rescinding the WCJ's decision on the defendant's credit for overpaid temporary disability. The defendant is allowed credit for temporary disability payments made from March 26, 2009, to June 3, 2009, at the temporary disability rate. Further credit is granted for payments made from June 4, 2009, to December 7, 2009, at the permanent disability rate of $185.00 per week. The Board denied further credit due to insufficient evidence regarding post-AME report overpayments.

Petition for ReconsiderationPermanent DisabilityTemporary DisabilityCreditStipulated AwardAgreed Medical ExaminationPermanent and StationarySection 4909Abuse of DiscretionDue Process
References
0
Case No. ADJ12340832
Regular
Sep 14, 2022

JOSE PEREZ vs. VILLA PARK LANDSCAPE, CALIFORNIA INSURANCE COMPANY, APPLIED RISK SERVICES

The applicant sought reconsideration of an award that found industrial injury to his back and entitled him to disability benefits, but also granted the defendant a credit for temporary disability overpayment. The Appeals Board affirmed the award of disability benefits but deferred the issue of the credit for temporary disability overpayment. This deferral is due to the defendant failing to present evidence or provide a clear explanation for the alleged overpayment, and the potential conflict between temporary and permanent disability indemnity purposes. Further proceedings are recommended to determine if the credit should be awarded.

WCABReconsiderationFindings of Fact and AwardIndustrial InjuryTree TrimmerTemporary DisabilityPermanent DisabilityCredit for OverpaymentAgreed Medical Examination (AME)Primary Treating Physician (PTP)
References
12
Case No. ADJ124002
Regular
Apr 21, 2011

RAMON RUIZ vs. DOLE FRESH VEGETABLES, SPECIALTY RISK SERVICES

The Appeals Board granted reconsideration and modified a prior award regarding temporary disability overpayments. Defendant sought credit for temporary disability paid during the applicant's off-season and after the permanent and stationary date. The Board denied credit for off-season payments, finding them inequitable. However, credit was allowed for temporary disability paid after the permanent and stationary date, recognizing these payments as advances against permanent disability.

ADJ124002Findings Order AwardPermanent DisabilityTemporary DisabilityCredit for OverpaymentOff-Season EmploymentPermanent and Stationary DateLabor Code 4909Equitable PrinciplesDouble Recovery
References
1
Case No. MON 0322465
Regular
Jan 03, 2008

AFRA CORNEJO vs. COUNTY OF LOS ANGELES

This case involved separate appeals from the applicant and defendant regarding an administrative law judge's findings on permanent disability apportionment and temporary disability overpayment. The applicant argued against apportionment of permanent disability, while the defendant sought credit for alleged overpayment of temporary disability. The Workers' Compensation Appeals Board denied both petitions, affirming the administrative law judge's decision. The Board clarified that Labor Code section 4656(b) limits temporary partial disability, not temporary total disability, thus the defendant was not entitled to a credit for overpayment.

Workers Compensation Appeals BoardAgreed Medical EvaluatorApportionmentPermanent DisabilityTemporary Disability IndemnityLabor Code Section 4656(b)Temporary Partial DisabilityTemporary Total DisabilityCreditRestitution
References
1
Case No. 2018 NY Slip Op 05652 [164 AD3d 1000]
Regular Panel Decision
Aug 02, 2018

Matter of Robinson v. Workmen's Circle Home

Barbara Robinson, a certified nurse's assistant, filed a claim for workers' compensation benefits for a work-related right shoulder injury in 2011. She received temporary disability payments totaling $133,807.48. In 2016, a Workers' Compensation Law Judge (WCLJ) awarded her a 42.50% schedule loss of use (SLU) to her right arm, amounting to $102,494.50, less prior payments. Robinson appealed the WCLJ's decision, arguing that the employer's carrier should not be credited for temporary partial disability payments against the SLU award. The Workers' Compensation Board disagreed, ruling that the carrier could credit all prior disability payments. The Appellate Division, Third Department, affirmed the Board's decision, finding no basis to differentiate between temporary total and temporary partial disability payments for credit purposes, thereby preventing an unjustifiable double recovery for the claimant.

Workers' CompensationSchedule Loss of UseTemporary Disability PaymentsCreditDouble RecoveryAppellate DivisionWork-Related InjuryRight Shoulder InjuryCarrier ReimbursementLegal Precedent
References
7
Case No. ADJ4713554
Regular
Oct 19, 2010

JULIAN ARVIZU vs. COUNTY OF FRESNO

The Appeals Board rescinded the original award due to a factual error regarding the calculation of temporary disability indemnity and its interaction with Labor Code section 4656(c)(1). The case is remanded for the WCJ to re-determine the correct amount of the third-party credit and the overpayment of temporary disability indemnity. Crucially, any credit for overpayment of temporary disability indemnity must be applied before the third-party recovery credit to avoid double recovery. The WCJ must also reconsider whether credit against future medical treatment is appropriate based on case law.

Third-party recoverycredittemporary disability indemnityoverpaymentfuture medical treatmentLabor Code section 4850Labor Code section 4656(c)(1)permanent and stationary dateAgreed Medical Examinerrescinded decision
References
17
Case No. ADJ10343251, ADJ10713340, ADJ10713342
Regular
Apr 27, 2023

JOSE CORTES vs. ST. JOHN'S REGIONAL MEDICAL CENTER, SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.

The Workers' Compensation Appeals Board denied reconsideration of a decision that awarded temporary disability benefits to Jose Cortes. The employer petitioned for reconsideration, seeking credit for alleged temporary disability payments previously made in one claim against an award in a related cumulative trauma claim. However, the Board found the employer waived this issue by failing to raise it in pre-trial statements and by not presenting evidence of the payments. The Board also noted that the employer specifically raised the issue of credit for permanent disability advances, suggesting they omitted the temporary disability credit intentionally.

WORKERS' COMPENSATION APPEALS BOARDPETITION FOR RECONSIDERATIONDENYINGADJUDICATION NUMBERSSTIPULATIONS WITH REQUEST FOR AWARDRE-OPENAPPLICATIONS FOR ADJUDICATIONINJURY ARISING OUT OF AND OCCURRING IN THE COURSE OF EMPLOYMENTEXCESSIVE AND REPETITIVE USEJOINT FINDINGS AWARD AND ORDERS
References
0
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