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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

Claim of Zobel v. Chemung County

Claimant, a correction officer, sustained a torn medial meniscus in his right knee when turning to enter an elevator while completing his shift. He applied for workers’ compensation benefits, which the employer controverted, arguing the injury was idiopathic. A Workers’ Compensation Law Judge and the Board found the injury work-related, awarding benefits. The Appellate Division affirmed this decision, citing substantial evidence. They noted the claimant’s testimony, corroborated by an independent medical examiner, supported the finding that the injury resulted from a workplace accident.

Work-Related InjuryMedial Meniscus TearCorrection OfficerCourse of EmploymentIdiopathic DefenseSubstantial EvidenceAppellate AffirmationMedical Examiner ReportKnee InjuryElevator Accident
References
6
Case No. MISSING
Regular Panel Decision

Claim of Thompson v. New York Telephone Co.

A chauffeur's helper sustained a knee injury while descending stairs to exit her employer's premises after changing clothes. She was diagnosed with a torn medial meniscus. The Workers’ Compensation Board ruled the injury compensable as an accident arising out of and in the course of employment. The employer appealed, arguing the injury was not compensable because the claimant was not engaged in actual labor and the injury lacked a direct employment connection. The court affirmed the Board's decision, citing that the course of employment includes a reasonable amount of time for an employee to leave the premises after work. Furthermore, accidents occurring in the course of employment are presumed to arise out of employment, a presumption the employer failed to rebut with substantial evidence.

Knee InjuryCompensable InjuryCourse of EmploymentArising Out of EmploymentPresumptionAffirmationAppellate DivisionWorkers' Compensation BoardChauffeur's HelperPremises Liability
References
2
Case No. MISSING
Regular Panel Decision

Liebman v. New Jersey Manufacturers Insurance

A physician, acting as plaintiff, brought a jury trial action against an insurance company, the defendant, under the New York State No-Fault Law to recover fees for surgical procedures and subsequent hospital visits, as well as attorneys' fees. The core dispute revolved around whether certain surgical procedures (arthroscopy, arthrotomy, excision of torn medial meniscus) were separate and distinct for billing purposes, and if post-operative hospital visits constituted reimbursable care or included follow-up care under the Workers’ Compensation Board medical fee schedule. The jury found arthroscopy and arthrotomy to be separate procedures, but arthrotomy and excision were not. They also determined the hospital visits were follow-up care. The court, finding the issues novel and unique, awarded the plaintiff $4,425 plus interest in attorneys' fees, exceeding the statutory maximum.

No-Fault LawInsurance ClaimMedical Billing DisputeAttorneys' FeesJury TrialSurgical ProceduresWorkers' Compensation ScheduleNovel and Unique IssuesOrthopedic SurgeryArthroscopy
References
7
Case No. ADJ10958168
Regular
Apr 09, 2019

LYN SAMUEL JEFFERS vs. GLENDALE ADVENTIST MEDICAL CENTER, ADVENTIST HEALTH

This case involves a worker's compensation applicant who claimed her left knee injury occurred when she fainted at work on February 8, 2017. Medical reports from her treating physicians documented acute left knee pain, a torn lateral meniscus, degenerative changes, and temporary total disability following the incident. The Workers' Compensation Appeals Board found the applicant's testimony credible, supported by medical evidence, and determined the injury arose out of and occurred in the course of employment. Therefore, the employer's petition for reconsideration was denied.

AOE/COEPrimary Treating PhysicianTemporary Total DisabilityPreponderance of the EvidenceSubstantial EvidenceWCJ CredibilityPetition for ReconsiderationLateral Meniscus TearDegenerative ChangesChondromalacia
References
1
Case No. 2017 NY Slip Op 04529 [151 AD3d 1262]
Regular Panel Decision
Jun 08, 2017

Matter of Kranick v. Niskayuna Cent. Sch. Dist.

Petitioner Matthew R. Kranick sought leave to file a late notice of claim against Niskayuna Central School District after injuring his knee on school property in July 2015. He reported the injury and later an MRI revealed a torn meniscus, leading to surgery in January 2016. The Supreme Court denied his application, citing a reasonable excuse for the delay but prejudice to the respondent. The Appellate Division, Third Department, reversed this decision, finding that the Supreme Court's conclusion of substantial prejudice was based on speculation and not supported by evidence in the record, and the respondent failed to present particularized evidence to rebut the petitioner's showing.

Late Notice of ClaimGeneral Municipal Law § 50-eEducation Law § 3813Appellate ReviewJudicial DiscretionPrejudice to RespondentActual KnowledgeTorn MeniscusKnee InjuryBus Garage Parking Lot
References
8
Case No. 534152
Regular Panel Decision
Jun 02, 2022

In the Matter of the Claim of Maurice Blue

Claimant Maurice Blue sustained a right leg injury in 2016, leading to a workers' compensation claim for his right knee. His physician diagnosed a medial meniscus tear and chondromalacia patella, initially recommending a 50% schedule loss of use (SLU) but later limiting it to 10% based on the 2018 Workers' Compensation Guidelines for Determining Impairment. The Workers' Compensation Law Judge (WCLJ) awarded 50% SLU, but the Workers' Compensation Board modified this to 10%, strictly applying a special consideration for chondromalacia patella and disregarding the meniscal tear. The Appellate Division found the Board's interpretation irrational, stating it leads to inequitable outcomes where greater injury results in lesser compensation. Consequently, the court modified the Board's decision, reversing the restrictive interpretation of the guidelines and remitting the matter for a proper assessment of the evidence.

Schedule Loss of UseKnee InjuryChondromalacia PatellaMeniscus TearMedical Impairment GuidelinesAppellate ReviewStatutory InterpretationEquity in CompensationRange of Motion DeficitsWorkers' Compensation Law
References
33
Case No. 2022 NY Slip Op 03565
Regular Panel Decision
Jun 02, 2022

Matter of Blue v. New York State Off. of Children & Family Servs.

Claimant Maurice Blue sustained a work-related right leg injury in December 2016, with his claim for workers' compensation benefits established for a right knee injury including a medial meniscus tear and chondromalacia patella. His physician initially assessed a 50% schedule loss of use (SLU) based on range of motion deficits but, applying a special consideration in the 2018 Workers' Compensation Guidelines for chondromalacia patella, limited his opinion to 10% SLU. The Workers' Compensation Board (WCB) adopted this 10% SLU, reversing a Workers' Compensation Law Judge's (WCLJ) award of 50%. On appeal, the Appellate Division, Third Department, found the WCB's interpretation of the guidelines irrational and inconsistent with the Workers' Compensation Law, as it resulted in claimants with more severe injuries receiving lesser compensation. The court reversed the WCB's decision regarding the preclusion of additional SLU for other knee impairments and remitted the matter for a proper assessment.

Workers' CompensationSchedule Loss of UseKnee InjuryChondromalacia PatellaMeniscus TearMedical Impairment GuidelinesAppellate ReviewStatutory InterpretationEquitable ApplicationJudicial Precedent
References
35
Case No. ADJ11834433
Regular
Feb 05, 2020

DIETRICK TURNER vs. SUTTER AUBURN FAITH HOSPITAL

The Workers' Compensation Appeals Board granted the applicant's Petition for Reconsideration to amend a Finding of Fact and the order regarding record development. The Board affirmed the original Findings and Award but clarified that there is insufficient medical evidence to establish causation for the applicant's torn scapholunate ligament. The case is remanded for further development of the record specifically on the issue of causation for this injury.

Scapholunate ligamentWorkers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardMedical evidenceCausationAggravationJob dutiesPre-existing conditionDevelopment of the record
References
0
Case No. ADJ6639764
Regular
Sep 23, 2010

DENNIS MUSKRAT vs. CALIFORNIA MEN'S COLONY, SCIF STATE EMPLOYEES OXNARD

The Workers' Compensation Appeals Board granted reconsideration to eliminate a 25% penalty previously awarded. The penalty was based on the employer's denial of medial branch blocks, but the Board found the employer's request for clarification from the Agreed Medical Evaluator was reasonable. The AME had failed to cite evidence supporting the treatment recommendation, and the employer's inquiry was justified given this lack of basis. Therefore, the penalty was rescinded, and the employer was ordered to provide the necessary medical treatment.

Workers' Compensation Appeals BoardIndustrial InjuryLumbar SpineTemporary DisabilityMedical Branch BlocksUtilization ReviewAgreed Medical Evaluator (AME)Labor Code Section 5814PenaltyUnreasonable Delay
References
3
Case No. ADJ6801375
Regular
Jul 13, 2010

MICHAEL DAVID HERNANDEZ vs. VINCE'S ITALIAN TO GO, PREFERRED EMPLOYERS

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded a prior award. The WCAB found that the applicant was not entitled to medical treatment outside the employer's Medical Provider Network (MPN) for a meniscus transplant or graft. The applicant failed to follow the required procedures for obtaining a second and third opinion within the MPN before seeking treatment from an out-of-network physician. Therefore, the WCAB concluded there was no showing that treatment outside the MPN was justified under the relevant rules.

Workers' Compensation Appeals BoardMedical Provider NetworkMPNFurther Medical TreatmentSports Medicine DoctorMedical Meniscus TransplantGraft ProcedureDr. Patrick O'MearaDr. John DeSantisSubspecialist
References
2
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