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

Case No. 532932
Regular Panel Decision
Jan 06, 2022

Matter of Lazalee v. Wegman's Food Mkts., Inc.

Claimant Thomas Lazalee, a truck driver, established claims for work-related occupational diseases in both hands, undergoing multiple surgeries. The employer, Wegman's Food Markets, Inc., initially paid temporary total disability benefits but later sought to cross-examine treating physician Raymond Stefanich regarding the degree of disability following a 2019 surgery. A Workers' Compensation Law Judge and the Board denied the employer's request as untimely, noting the employer had accepted liability and paid benefits for months without challenging the disability status. The Appellate Division, Third Department, affirmed the Board's decision, finding no basis to disturb the finding that the request for cross-examination was untimely, thereby waiving the employer's right.

Workers' Compensation Board DecisionOccupational Disease ClaimCarpal Tunnel SyndromeTrigger ThumbTemporary Total Disability BenefitsEmployer's Right to Cross-ExamineTimeliness of RequestMedical ReportsWaiver of RightsAppellate Review of Board Decision
References
7
Case No. ADJ6669630
Regular
Jul 23, 2018

ROBERT SAXTON vs. SELECT A SERVICE RETAIL, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a prior decision regarding a lien claim by Western Imaging Services for copying services. The WCAB found that for most invoices, the defendant waived objections to reasonableness due to untimely and invalid objections. However, the WCAB noted potential issues with two specific invoices (82003-7 and 82003-8) and deferred the final determination of reimbursement for these and other contested invoices. The matter was returned to the administrative law judge for further proceedings on the validity of those specific invoices.

Workers' Compensation Appeals BoardLien ClaimantPetition for ReconsiderationFindings and AwardWorkers' Compensation Administrative Law JudgeReimbursementFee ScheduleObjectionsInvoicesReasonable and Necessary
References
5
Case No. MISSING
Regular Panel Decision

Claim of Wilkinson v. Bendix Friction Corp.

Claimant filed a workers' compensation claim after being diagnosed with a lung condition, which a Workers' Compensation Law Judge (WCLJ) determined in August 2003 was an occupational disease causally related to 1969 asbestos exposure while working for the employer, though not currently disabling. The claimant sought review. The Workers' Compensation Board, in January 2004, found the employer's rebuttals to be untimely. Subsequently, the employer and its third-party administrator filed an application for Board review in February 2004, which the Board denied as untimely in October 2004. The employer appealed this denial. The appellate court affirmed the Board's decision, finding no abuse of discretion in denying the application as untimely, given that the employer had received proper notice of the WCLJ decision.

Workers' CompensationUntimely ApplicationBoard ReviewOccupational DiseaseAsbestos ExposureCausal RelationDisability ClaimAppellate Decision
References
4
Case No. MISSING
Regular Panel Decision
Apr 17, 1990

Claim of Rogers v. Evans Plumbing & Heating

The claimant appealed a decision from the Workers’ Compensation Board, filed on April 17, 1990, which ruled his application untimely. The claimant had applied on August 31, 1988, to review two Workers’ Compensation Law Judge decisions from August 5, 1985, and October 1, 1985, denying compensation benefits for a period between February 7, 1983, and September 23, 1985. The Board correctly determined that the claimant's application was untimely as it was filed more than 30 days after the original decisions, citing Workers’ Compensation Law § 23 and 12 NYCRR 300.13 (a). The Board's decision to not entertain the untimely application was found to be neither arbitrary nor capricious. The higher court subsequently affirmed the Board's decision.

Untimely ApplicationWorkers' Compensation LawAppellate ReviewBoard DecisionProcedural TimelinessJudicial ReviewAppealSection 23NYCRR 300.13Claimant Benefits
References
1
Case No. ADJ1952983
Regular
Mar 15, 2018

JUAN RIVERA vs. IMPORT EXPORT CACTUS, STATE COMPENSAITON INSURANCE FUND

In this workers' compensation case, the defendant sought reconsideration of a prior ruling that deemed them to have waived objections to a specific invoice from lien claimant Scandoc Imaging. The WCAB denied reconsideration, finding that the defendant's objection, if any, was untimely, having been filed approximately four years after the invoice was submitted. California regulations require objections to medical-legal billings within 60 days to avoid waiver. Therefore, the defendant waived their objections to the reasonableness of the services and charges for invoice #234447-3.

WCABPetition for ReconsiderationFindings and Orderslien claimantinvoice objectionwaiver of objectionreasonableness of servicesLabor Code section 4622Scandoc ImagingImport Export Cactus
References
2
Case No. ADJ4269777 (SJO 0238464) ADJ1887256 (SJO 0247242)
Regular
Nov 13, 2008

DOLORES WALLACE-McLEAN vs. CUPERTINO UNIFIED SCHOOL DISTRICT, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for RELIANCE NATIONAL INSURANCE COMPANY

The Workers' Compensation Appeals Board affirmed an arbitrator's award requiring Cupertino Unified School District (District) to reimburse CIGA for benefits paid to an applicant following the liquidation of the District's insurer, Reliance National. The District argued CIGA had no legal basis for reimbursement and its claim was untimely and procedurally flawed. The Board found CIGA was entitled to reimbursement for temporary disability and medical treatment paid post-liquidation, and 75% of benefits paid prior to liquidation, based on prior arbitration and settlement agreements.

CIGAReliance National Insurance Companyliquidationreimbursementspecific injurycumulative traumacompromise and releasepermanent disabilityfuture medical careself-insured
References
0
Case No. ADJ9120523
Regular
Jan 25, 2018

Guillermo Reyes Perez vs. Colorama Wholesale Nursery, Zenith Insurance Company

This Workers' Compensation Appeals Board case concerns disputed payments for copying services provided by lien claimant Citywide Scanning Services, Inc. The Board granted reconsideration to amend the original decision based on the WCJ's report. While most of the lien claimant's invoices were deemed satisfied due to failure to request a second review after receiving Explanations of Review (EORs), two invoices were specifically addressed. The Board found the defendant failed to provide valid EORs for services related to Colorama Wholesale Nursery and the California Secretary of State. Therefore, the lien claimant is entitled to full payment for these two invoices, less any amounts already paid by the defendant.

EORLabor Code section 4622WCAB Rule 9794(c)Petition for ReconsiderationLien claimantCopying servicesSecond reviewInvoicesDefendant's answerReport and Recommendation
References
0
Case No. MISSING
Regular Panel Decision
Feb 03, 2017

Building Service 32bJ Health Fund v. GCA Services Group, Inc.

This case involves five multi-employer employee benefit plans, collectively known as the Benefits Funds, suing GCA Services Group, Inc. for unpaid contributions under two collective bargaining agreements (CBAs). The Benefits Funds argued that GCA should have paid contributions based on "hours worked and/or paid for," while GCA contended payments should only be for "hours worked." The Court granted summary judgment for the Benefits Funds on their claims and denied GCA's counterclaims for overpayments, ruling that GCA was required to pay for "hours worked and/or paid for" under both CBAs. However, the Court also found that the Benefits Funds' claims for contributions that accrued before August 4, 2009, were untimely due to a six-year statute of limitations.

ERISATaft-Hartley ActCollective Bargaining AgreementEmployee BenefitsPension FundHealth FundUnpaid ContributionsSummary JudgmentStatute of LimitationsOverpayments
References
21
Case No. 78107628
Regular Panel Decision

Stojanov v. Eastman Kodak Co.

Claimant appealed two decisions by the Workers' Compensation Board, filed July 10, 2008, which ruled that his applications for review were untimely. These claims stemmed from 1981 work-related accidents, reopened in 2008 with liability transferred to the Special Fund for Reopened Cases. A Workers’ Compensation Law Judge denied compensation in May 2008, citing Workers’ Compensation Law § 123. The Board found claimant's applications for review, mailed on the 30th day but received later, were untimely. The Appellate Division affirmed the Board’s decision, emphasizing that Workers’ Compensation Law § 23 requires filing within 30 days, not just mailing.

timelinessSpecial FundBoard reviewappealWCLJ decisionfiling deadlinemailed applicationamended decisionstatutory interpretationadministrative review
References
5
Case No. MISSING
Regular Panel Decision

Claim of Jones v. Chevrolet-Tonawanda Division, GMC

This case involves appeals from two decisions by the Workers’ Compensation Board concerning a self-insured employer’s entitlement to credit for holiday wages paid to disabled employees. Claimants Hanks and Jones were injured during employment, resulting in lost time, including holidays. The employer paid them compensation for lost time but also provided full wages for holidays as per collective bargaining agreements, subsequently seeking reimbursement under Workers’ Compensation Law § 25 (4)(a). The Board denied these reimbursement requests, stating that holiday pay was a contractual right and not intended to be in lieu of compensation. The appellate court reversed the Board’s decisions, ruling that denying reimbursement would lead to claimants receiving both full wages and compensation for the holidays, creating an imbalance. Therefore, the employer is entitled to reimbursement, and the matters are remitted to the Workers’ Compensation Board for further proceedings consistent with this decision.

Workers' CompensationHoliday PayReimbursementCollective Bargaining AgreementDisabled EmployeesLost WagesSelf-Insured EmployerAppellate ReviewBoard Decision ReversalStatutory Interpretation
References
2
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