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

Case No. ADJ3857516 (VNO 0505788)
Regular
Sep 20, 2013

ALBERTO ALCAZAR vs. PACTIV CORPORATION

This case involves a worker's compensation claim where the employer, Pactiv Corporation, was found to have unreasonably delayed necessary medical treatment, including transportation and home care. The Appeals Board modified a prior decision, finding the unreasonable delay occurred from December 20, 2010, to March 2, 2011, and reduced the penalty from 25% to 15% of the delayed benefits. The Board reversed the penalty for two instances of transportation failure by a hired company, deeming it not the employer's unreasonable conduct. Finally, attorney fees were reduced as some services were deemed unnecessary for the period of unreasonable delay.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of FactAward and OrderUnreasonable DelayMedical TreatmentTransportationHome Care AssistanceLabor Code section 5814Penalty
References
1
Case No. ADJ954867 (SFO 0497953)
Regular
Dec 29, 2008

HERBERT BARRIOS vs. DEEP VAC, INC., STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board partially granted reconsideration, rescinding the award of attorney's fees for frivolous tactics but affirming the award for expert witness costs and a penalty for unreasonable refusal to pay. The Board found that while SCIF's refusal to pay for the diminished future earnings capacity expert was unreasonable, their actions did not rise to the level of bad faith or frivolous conduct required for sanctions. A dissenting opinion argued to affirm the original award of sanctions, finding SCIF's actions to be unreasonable and in bad faith based on prior unfavorable decisions and testimony from SCIF's claims adjustor.

Diminished Future Earnings CapacityVocational RehabilitationLabor Code section 5811Labor Code section 5814Labor Code section 5813Expert Witness FeesReconsiderationFindings and AwardSanctionsBad Faith Tactics
References
3
Case No. ADJ9489540
Regular
Jun 03, 2019

KEN JENSEN vs. COUNTY OF SANTA BARBARA, DEPARTMENT OF SOCIAL SERVICES, Permissibly Self-Insured, CORVEL CORPORATION (Claims Administrator)

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration of an award. The applicant sought multiple penalties for the defendant's alleged continuous unreasonable denial and delay of benefits. However, the Board found that the defendant's conduct constituted a single unreasonable act, not multiple distinct acts required for separate penalties under Labor Code section 5814. The applicant is entitled to only one penalty.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and AwardLabor Code section 5813Labor Code section 5814unreasonable denial of benefitsfrivolous delaysanctionsattorney's feespenalty
References
2
Case No. MISSING
Regular Panel Decision

Maher v. NYS Division of Budget

Claimant, a budget examiner, sought workers' compensation benefits after falling from a second-story hotel roof while attending a work training conference. The Workers’ Compensation Board reversed a prior decision, determining that her actions of climbing onto the roof constituted a deviation from employment and were unreasonable, thus denying her claim. The Appellate Division affirmed the Board's decision, finding that the Board did not err in concluding that the claimant's conduct of accessing the hotel roof via a bathroom window was unreasonable under the circumstances, and therefore her injury did not arise out of and in the course of her employment.

Workers' CompensationEmployment DeviationHotel AccidentTraining ConferenceUnreasonable ConductAppellate ReviewInjury ClaimSaratoga CountyBenefits DenialNew York Law
References
7
Case No. ADJ2855152
Regular
Apr 23, 2009

KAM PING CHU vs. WESTIN ST. FRANCIS HOTEL/STARWOOD HOTELS & RESORTS, ZURICH INSURANCE INSURANCE

This case involves an applicant's petition for reconsideration of a workers' compensation award. The Workers' Compensation Appeals Board (WCAB) denied reconsideration, upholding the judge's finding that the applicant sustained industrial injuries to her lower extremities. The judge awarded a $16\%$ permanent disability and also found that the defendant unreasonably delayed paying an interpreter's fees, leading to a $25\%$ penalty. However, the judge found no unreasonable delay in other areas, no frivolous conduct, and therefore no additional attorney fees or sanctions. The applicant argued the initial claim denial was untimely, precluding claims of genuine doubt, but the WCAB adopted the judge's reasoning in denying the petition.

Workers' Compensation Appeals BoardIndustrial InjuriesLower ExtremitiesFeetHousekeeperZurich InsuranceUnreasonably DelayedInterpreter's FeesLabor Code Section 5814Permanent Disability
References
0
Case No. MISSING
Regular Panel Decision

Adams v. Chicago Insurance

Eric R. Adams, an attorney, sued Chicago Insurance Company for breach of its professional liability insurance policy, seeking a declaration that Chicago had a duty to defend and indemnify him in an underlying professional malpractice lawsuit brought by Patricia E. Novak. Chicago disclaimed coverage, asserting Adams failed to provide timely notice of the potential malpractice claim as required by the policy's terms. The court initially found that Adams, despite his claims of a good faith belief in non-liability, unreasonably delayed notifying Chicago of the potential claim. However, the court ultimately concluded that Chicago was equitably estopped from denying coverage due to its own unreasonable eight-month delay in formally disclaiming coverage after receiving initial notice from Adams and for engaging in conduct that gave the appearance of defending Adams. Consequently, the court denied Chicago's motion for summary judgment and granted Adams' motion, compelling Chicago to defend and indemnify Adams in the malpractice action.

Professional LiabilityInsurance CoverageDuty to DefendDuty to IndemnifyLegal MalpracticeSummary JudgmentEquitable EstoppelTimeliness of NoticeDisclaimer of CoverageFederal Rules of Civil Procedure
References
22
Case No. 2010 NY Slip Op 51549(U)
Regular Panel Decision

Milosevic v. O'Donnell

The motion court properly dismissed the fourth and fifth causes of action against Joost, which alleged negligence and intentional/wanton conduct. These claims failed under the theory of respondeat superior, as there was no evidence the coworker's alleged assault was within the scope of employment or condoned by Joost. Furthermore, the claims based on common-law negligence for sponsoring an event were also dismissed. The court found no allegations that Joost controlled the premises or was aware of the CFO's violent propensities when intoxicated. The decision highlighted that speculation about discovery would not prevent dismissal, and thus, the court did not need to address whether the claims were barred by the Workers' Compensation Law.

NegligenceRespondeat SuperiorAssaultEmployer LiabilityVicarious LiabilityCommon-Law NegligencePremises LiabilityWorkers' Compensation LawAppellate ReviewDismissal
References
4
Case No. MISSING
Regular Panel Decision
Jun 04, 2007

FCI Group, Inc. v. City of New York

This case involves an action brought by a contractor against the City of New York and the Department of Citywide Administrative Services (DCAS) for the balance due on a construction contract. The defendants contended that the plaintiff forfeited its right to further payment due to the attempted bribery of two city employees by the plaintiff's president. The Supreme Court initially denied the defendants' motion for summary judgment, but this Court reversed that decision. It found that the contract's narrow alternative dispute resolution clause was inapplicable to the dispute. Crucially, the Court concluded that the plaintiff was bound by the contract’s forfeiture provision and that its enforcement did not offend public policy, as the unlawful conduct was central to the performance of the contract, thereby barring recovery.

Construction ContractContract ForfeitureBriberyPublic PolicyAlternative Dispute Resolution (ADR)Summary JudgmentUnlawful GratuitiesEthical ConductContract InterpretationNew York City Charter
References
28
Case No. MISSING
Regular Panel Decision

Addei v. State Board for Professional Medical Conduct

A surgeon's medical license was revoked by the State Board for Professional Medical Conduct due to findings of moral unfitness from sexual harassment of co-workers and fraudulent practice on employment applications. The petitioner challenged this determination via a CPLR article 78 proceeding. The court upheld the Committee's jurisdiction and the findings of moral unfitness and fraud, dismissing claims of statutory vagueness. However, the court deemed the penalty of license revocation excessively harsh and "shocking to one’s sense of fairness" given mitigating factors, equivocal findings on the fraud charge, and no impact on patient care. Consequently, the court indicated that the severe penalty should not stand.

Professional MisconductLicense RevocationMoral UnfitnessFraudulent PracticeSexual HarassmentEmployment ApplicationsDue ProcessVague StatuteDisproportionate PenaltyCPLR Article 78
References
10
Case No. MISSING
Regular Panel Decision
Mar 02, 2009

People v. Andrus

Defendant appealed a judgment convicting him of attempted course of sexual conduct against a child. He argued his Miranda rights were violated, but the court found a knowing, voluntary, and intelligent waiver. The court also rejected his claim that a social worker acted as a law enforcement agent without issuing Miranda warnings, noting the interview's timing and continuous custody. Furthermore, police deception regarding a polygraph did not coerce his statement or deny due process. His challenge to his Alford plea was unpreserved, and the sentence was deemed appropriate.

Miranda rightsWaiver of rightsRight to counselPolice interrogationSocial worker interviewLaw enforcement agencyVoluntariness of confessionPolice deceptionPolygraph examinationDue process
References
12
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