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Case Law Database

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

Case No. ADJ7825020
Regular
Aug 31, 2015

MILTON LEWIS vs. BARLOW RESPIRATORY HOSPITAL, ZENITH INSURANCE COMPANY

This case concerns a lien claimant's petition for reconsideration of a stipulation and order where they agreed to accept \$1,000.00 in full satisfaction of their lien. The lien claimant argued the stipulation was entered into by unilateral mistake as their representative lacked authorization. The Workers' Compensation Appeals Board denied reconsideration, finding the claimant failed to present evidence of unilateral mistake or to properly seek to set aside the stipulation. Furthermore, the claimant did not plead sufficient facts to support a unilateral mistake claim, such as the opposing party's knowledge and advantage, nor did they demonstrate they fulfilled their legal duty of reasonable inquiry.

Workers' Compensation Appeals BoardLien claimantPetition for ReconsiderationStipulation and OrderUnilateral mistakeAffirmative defenseGood causeRescinding contractMaterial factLegal duty
References
5
Case No. ADJ10514440 (SFO 0282615)
Regular
Dec 27, 2017

RICHARD MERLO vs. CITY OF DALY CITY, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied the City of Daly City's petition for reconsideration of an order approving a stipulation. The stipulation, agreed to by co-defendant State Compensation Insurance Fund, settled future medical expenses for $25,000.00. The City argued the stipulation improperly circumvented joint and several liability and alleged unilateral mistake. The Board affirmed the WCJ's report, finding no good cause to vacate the stipulation based on the presented arguments or unilateral mistake.

Workers' Compensation Appeals BoardStipulationJoint and Several LiabilityPetition for ReconsiderationWCJInnovative Claim SolutionsState Compensation Insurance FundFuture Medical ExpensesUnilateral MistakeGood Cause
References
4
Case No. VNO 466077, VNO 466078
Regular
Apr 10, 2008

PABLO GONZALEZ vs. CHECK MATE STAFFING, UEBTF DEPENDABLE HIGHWAY EXPRESS, COMMERCE & INDUSTRY INSURANCE COMPANY C/O AIG DOMESTIC CLAIMS

This case involves a defendant's petition for reconsideration regarding a Notice of Intention (NIT) to approve a settlement that unilaterally added a reimbursement obligation to the Uninsured Employers Benefits Trust Fund (UEBTF). The Appeals Board granted reconsideration, rescinding the NIT due to procedural defects, including improper service and a violation of the defendant's due process rights by unilaterally altering the settlement terms. The Board allowed the underlying Compromise and Release agreement to stand, as it was properly executed and did not contain the disputed reimbursement clause.

UEBTFAdelson Testan Brundo & JimenezNotice of IntentionApproval OrderReimbursementGeneral Special EmploymentThomas WaiverCompromise and ReleaseLabor Code sections 3715(e)3717
References
3
Case No. ADJ2353136 (STK 0213635)
Regular
Dec 19, 2016

AHMED SHOAIB vs. CAMBELL SOUP COMPANY

This case concerns a dispute over the payment of a workers' compensation settlement. The applicant, Ahmed Shoaib, settled a discrimination claim against Campbell Soup Company for $55,000. Campbell Soup unilaterally withheld over $19,000 from the applicant's share of the settlement for alleged payroll taxes. The Workers' Compensation Appeals Board denied Campbell Soup's petition for reconsideration, finding that the company unreasonably delayed payment by taking a unilateral credit. The Board affirmed the WCJ's decision and the awarded 25% penalty for the delayed payment.

Workers' Compensation Appeals BoardPetition for ReconsiderationStipulation and AwardLabor Code Section 132aAmended Petition for PenaltyDelayed PaymentLabor Code Section 5814Labor Code Section 5814.5Contract EnforcementUnilateral Credit
References
8
Case No. MISSING
Regular Panel Decision
Dec 24, 2012

Port Authority v. Local Union No. 3, International Brotherhood of Electrical Workers

The Supreme Court, New York County, affirmed an arbitration award on December 24, 2012. The award confirmed that the Port Authority could not unilaterally eliminate the 'E-ZPass' benefit for its retirees. This decision was based on a memorandum of agreement which stipulated the continued eligibility for employee commutation passes and personal passes for covered membership, including retired employees, as per current practice. The court found the arbitrator's conclusion that the Port Authority could not unilaterally eliminate this benefit was not irrational and did not remake the contract, thus upholding the union's position.

Arbitration AwardE-ZPass BenefitsRetiree BenefitsMemorandum of AgreementUnilateral Termination of BenefitsContract InterpretationAppellate ReviewLabor RelationsCollective Bargaining AgreementEmployee Benefits
References
1
Case No. ADJ6778732
Regular
Dec 19, 2012

GLORIA PARRIS vs. TIME WARNER CABLE, NEW HAMPSHIRE INSURANCE COMPANY

This case concerns a worker injured by industrial injury, who sought to settle her claim for $24,500. The administrative law judge unilaterally added a note to the approval order, withholding proceeds due to an issue with the Medical Provider Network (MPN) and the defendant's refusal to pay non-MPN liens. The Appeals Board rescinded the judge's order, finding it inappropriate to unilaterally modify the settlement. The case was returned for further proceedings to address the lien claims and ensure the applicant understands any potential personal liability for self-procured medical treatment.

Workers' Compensation Appeals BoardCompromise and ReleaseMedical Provider Network (MPN)Self-procured medical treatmentLien claimsLabor Code Section 4600Labor Code Section 4605WCJ OrderReconsiderationTrial level proceedings
References
9
Case No. ADJ3905924 (ANA 0339374)
Regular
Jul 24, 2014

JENNIFER PATTERSON vs. THE OAKS FARM, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for CALIFORNIA COMPENSATION INSURANCE COMPANY, in liquidation

This case concerns the unilateral termination of nurse case manager services by an employer, which the Workers' Compensation Appeals Board affirmed as a form of medical treatment. The Board held that employers cannot unilaterally cease approved nurse case manager services without substantial medical evidence showing they are no longer necessary. Additionally, the Board clarified that an injured worker does not need to obtain a Request for Authorization to challenge such a termination, and expedited hearings are appropriate for these disputes. Ultimately, the employer failed to meet its burden of proving a change in the applicant's condition justifying the discontinuation of services.

Nurse Case ManagerLabor Code 4600Expedited HearingUnilateral TerminationMedical TreatmentRequest For AuthorizationAgreed Medical EvaluatorUtilization ReviewIndependent Medical ReviewSubstantial Medical Evidence
References
11
Case No. MISSING
Regular Panel Decision

In re the Arbitration between Tarpon Cove, Ltd. & Taylor Woodrow Blitman Property Corp. of Florida

Tarpon, a Florida property owner, entered a management and development agreement with Taylor, which included a New York arbitration clause. After Tarpon unilaterally terminated the agreement, a dispute arose over termination and reimbursement costs. Tarpon initiated an action in Florida, prompting Taylor to demand arbitration for both parties' claims. Special Term initially granted Tarpon's motion to stay arbitration, ruling the clause was nullified by termination. The appellate court reversed, holding that a unilateral termination does not extinguish a broad arbitration clause and that issues regarding the agreement's termination and alleged breaches are matters for arbitration. The court also ordered a stay of the related Florida action pending arbitration.

Arbitration AgreementContract TerminationStay of ArbitrationCompelling ArbitrationCross-MotionFlorida LitigationNew York LawUnilateral TerminationBreach of ContractAppellate Review
References
6
Case No. MISSING
Regular Panel Decision
May 08, 1984

Gotbaum v. Lewis

This case concerns a dispute over the regulatory authority of the New York State Superintendent of Insurance regarding employee welfare funds administered unilaterally by municipal unions but financed by the City of New York. Plaintiffs, trustees of these funds, sought a declaration that they were not bound by Insurance Law article III-A, citing decades of legislative intent and administrative practice that excluded unilaterally administered funds from its scope. Despite a history of failed legislative attempts to expand jurisdiction, the Superintendent of Insurance moved to compel registration. The court ultimately modified a prior order, denying the plaintiffs' motion and granting the defendant's cross-motion for summary judgment, thereby declaring that the Insurance Department possesses regulatory jurisdiction over these funds under Insurance Law article III-A, § 37-a.

Employee welfare fundsRegulatory jurisdictionInsurance Law Article III-AUnilaterally administered fundsCollective bargainingMunicipal unionsLegislative intentStatutory interpretationAdministrative overreachSummary judgment
References
7
Case No. MISSING
Regular Panel Decision

City of Syracuse v. Public Employment Relations Board

This case involves the City of Syracuse's unilateral implementation of procedures to terminate General Municipal Law § 207-a benefits for firefighters. Two firefighters were injured and receiving benefits; one reported late and left early for light duty, the other refused to report. The City held hearings and terminated their benefits, prompting the Syracuse Fire Fighters Association (Union) to file an improper practice charge with the Public Employment Relations Board (PERB), alleging a violation of the Taylor Law. The Administrative Law Judge initially dismissed the charge, but PERB reversed this decision, finding that the procedures for terminating such benefits are a subject of mandatory bargaining. The City then commenced a CPLR article 78 proceeding to annul PERB's determination. The court confirmed PERB's determination, holding that the City's unilateral implementation of benefit termination procedures constituted an improper practice and that a City Charter's notice of claim provision did not apply to improper practice charges filed with PERB.

Taylor LawCivil Service LawGeneral Municipal Law § 207-aImproper Practice ChargeMandatory BargainingCollective Bargaining AgreementDue ProcessLight Duty AssignmentNotice of ClaimCPLR Article 78 Proceeding
References
23
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