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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

Bopp v. Wiest

This is a case of first impression concerning the application of a workers' compensation lien to a wrongful death settlement involving beneficiaries who are not statutory dependents. The decedent's estate received $50,000 in workers' compensation benefits under Workers' Compensation Law § 16 (4-b) following a workplace death, as there were no dependents. The estate's coexecutrices secured a $60,000 wrongful death settlement on behalf of the decedent's adult children. Liberty Mutual, the workers' compensation carrier, asserted a lien against this settlement. The court, presided over by Justice Andrew V. Siracuse, ruled that the 1990 amendment to Workers' Compensation Law § 16 (4-b) made the distinction between dependents and distributees irrelevant in this context. Consequently, the court approved the settlement but confirmed that the proceeds are subject to Liberty Mutual's workers' compensation lien, ensuring that adult children receiving benefits through the estate do not have a superior position to minor dependents receiving direct benefits.

wrongful deathworkers' compensationliensettlementstatutory interpretationdependentsdistributeesNew York lawfirst impressionsubrogation
References
7
Case No. 2018 NY Slip Op 08227
Regular Panel Decision
Nov 29, 2018

Matter of Kelly v. New York State Workers' Compensation Bd.

In 2006, claimant Grace Kelly established a workers' compensation claim for an occupational disease. The State Insurance Fund (SIF) repeatedly sought to transfer liability to the Special Fund for Reopened Cases, which was denied by Workers' Compensation Law Judges. The Workers' Compensation Board affirmed these denials and assessed $500 penalties against both SIF and its counsel, Walsh and Hacker, for filing an application for review without reasonable grounds. Walsh and Hacker appealed the penalty imposed against them to the Appellate Division, Third Department. The Appellate Division found insufficient evidence to support the Board's finding that Walsh and Hacker's application lacked reasonable grounds, and therefore reversed the penalty against them, modifying and affirming the Board's decision.

PenaltiesAppellate ReviewSpecial Fund for Reopened CasesWorkers' Compensation Law § 25-aWorkers' Compensation Law § 114-aAttorney SanctionsAdministrative LawBoard DecisionJudiciary Law § 431
References
4
Case No. MISSING
Regular Panel Decision
Jan 27, 1984

Stedman v. City of New York

This case concerns an appeal regarding a workers' compensation lien. The plaintiff, a cab driver, was injured in an automobile accident and received workers' compensation benefits from the State Insurance Fund and no-fault benefits from Eagle Insurance Co. Plaintiff settled a personal injury action against Walther and the City of New York for $30,000, with Welsbach and Alfo Cab Co. as third-party defendants. The trial court initially granted a motion to vacate the workers' compensation lien but later reversed this decision. The appellate court unanimously reversed the vacatur, denied the motion to vacate the lien, and reinstated the lien, holding that the Fund's lien attaches to recoveries from non-covered persons (City of New York and Welsbach) for both economic and non-economic loss under Insurance Law § 673, subd 2.

Workers' Compensation LienNo-Fault BenefitsAutomobile AccidentThird-Party ActionSubrogationInsurance LawEconomic LossNoneconomic LossSettlement ProceedsStatutory Interpretation
References
2
Case No. MISSING
Regular Panel Decision

Kesick v. Ulster County Self Insurance Plan

Paul Kesick, a police officer, was involved in two automobile accidents, leading to workers' compensation claims for knee injuries. Kesick and his wife settled a personal injury action against the drivers for $50,000 and $75,000 without the consent of the Ulster County Self Insurance Plan, their workers' compensation carrier. The Supreme Court granted their application for a nunc pro tunc order approving the settlement but denied the carrier's request for a workers' compensation lien against the settlement proceeds. The carrier appealed, arguing it was entitled to a lien for amounts exceeding $50,000, which are not considered first-party benefits. The appellate court agreed, modifying the order by granting the carrier a lien of $5,969.49 to be held in escrow, preventing an impermissible double recovery for the petitioners.

Workers' Compensation LawLienSettlementThird-Party ActionFirst-Party BenefitsNo-Fault Insurance LawDouble RecoveryAutomobile AccidentAppellate CourtStatutory Interpretation
References
3
Case No. MISSING
Regular Panel Decision
Feb 05, 1980

In re the Claim of Ross v. Standard Milling Co.

This case concerns an appeal from a Workers’ Compensation Board decision, filed on February 5, 1980, which approved a $50 attorney’s fee as a lien upon an award made to the claimant. The claimant had sustained a back injury in March 1978 and received compensation payments from the carrier. After retaining an attorney, a hearing in May 1979 established accident, notice, and causal relationship, formalizing the award already paid by the carrier. The carrier contested the attorney's fee as a lien, arguing the claimant had already received the full award. The Board affirmed the lien, citing relevant case law and Section 24 of the Workers’ Compensation Law. The court ultimately affirmed the Board's decision, with costs to the Workers’ Compensation Board.

Workers' CompensationAttorney's FeesLienAwardAffirmed DecisionStatutory InterpretationNew York LawBoard DecisionInsurance CarrierLegal Services
References
3
Case No. 2017 NY Slip Op 27428
Regular Panel Decision
Dec 14, 2017

New York State Workers' Compensation Bd. v. Compensation Risk Mgrs., LLC

This action was brought by the New York State Workers' Compensation Board (WCB), as an assignee of former members of the Healthcare Industry Trust of New York (HITNY), against Compensation Risk Managers, LLC (CRM), HITNY trustees, and auditing firm UHY LLP. The WCB alleged mismanagement, breach of fiduciary duty, and negligent auditing, leading to the Trust's insolvency. Defendants moved to dismiss on grounds of standing, statute of limitations, and pleading particularity. The court dismissed certain derivative claims and negligent misrepresentation claims against some trustees due to standing issues and statute of limitations. All claims against UHY LLP were dismissed for lack of a near-privity relationship or prior precedent. An implied indemnity claim against the trustees was sustained. The WCB's cross-motion to consolidate related actions was denied.

Workers' Compensation LawGroup Self-Insured Trust (GSIT)Fiduciary DutyNegligenceNegligent MisrepresentationStatute of LimitationsStandingDerivative ActionImplied IndemnityAuditing Firm Liability
References
46
Case No. 532391
Regular Panel Decision
Nov 18, 2021

Matter of Richman v. New York State Workers' Compensation Bd.

Claimant, Rebecca Richman, appealed three decisions from the Workers' Compensation Board regarding her claim for a work-related right shoulder injury. She alleged a fall at work on January 19, 2018, but did not seek medical treatment for 19 months. A Workers' Compensation Law Judge initially established the claim, but the Board reversed, finding that Richman failed to submit sufficient, credible medical evidence to demonstrate a causally-related injury and denied her claim. The Board subsequently denied her application for reconsideration and/or full Board review. The Appellate Division affirmed the Board's decisions, concluding that the Board's finding of no causally-related injury was supported by substantial evidence and that the Board did not abuse its discretion in denying reconsideration.

Workers' Compensation ClaimCausation (Medical)Shoulder InjuryMedical Evidence SufficiencyBoard ReversalAppellate Division ReviewBurden of ProofCredibility of EvidenceOsteoarthritis DiagnosisDelayed Medical Treatment
References
8
Case No. MISSING
Regular Panel Decision
Dec 27, 2004

McComber v. Lehrer McGovern Bovis, Inc.

This case involves an appeal of an order from the Supreme Court, New York County, which fixed a nonparty-appellant workers’ compensation carrier’s lien at $23,355.68. The original action was for personal injuries at a work site, resulting in a $14.5 million recovery for the plaintiff through a high-low settlement. The carrier had paid $228,605.18 in past compensation benefits and was assessed to have a present value of $387,143.30 in future compensation benefits that it would have paid. The appellate court affirmed the lower court's decision, which applied the Kelly formula to reduce the carrier's lien by its equitable share of litigation costs, encompassing both past and future benefits. The court also rejected the carrier's argument that the plaintiff violated Workers’ Compensation Law § 29 (5) by not obtaining consent for the settlement, clarifying that such consent is only required for settlements less than the statutory benefits, which was not the case here. Furthermore, any required judicial approval was deemed properly granted nunc pro tunc.

Lien ReductionKelly FormulaFuture Benefits ValuationHigh-Low SettlementJudicial DiscretionNunc Pro Tunc ApprovalWorkers' Compensation Law § 29 (5)Equitable ApportionmentSubrogation RightsPersonal Injury Recovery
References
7
Case No. MISSING
Regular Panel Decision

Matter of Saratoga Skydiving Adventures v. Workers' Compensation Board

Saratoga Skydiving Adventures appealed a Workers’ Compensation Board decision upholding a stop-work order. The initial order was issued after an investigation revealed the company lacked workers' compensation coverage, with owner Bob Rawlins asserting his workers were independent contractors. Following a hearing, a Workers’ Compensation Law Judge denied Saratoga Skydiving's application to lift the order. The appellate court affirmed this denial, determining that substantial evidence supported the finding of an employer-employee relationship for pilots and jump instructors, given their integral role in the business and Rawlins' control over their work. Consequently, Saratoga Skydiving was required to maintain workers' compensation coverage for these individuals.

Workers' CompensationStop-Work OrderEmployer-Employee RelationshipIndependent ContractorSkydiving BusinessHazardous EmploymentUninsured Employers’ FundAppellate ReviewSubstantial EvidenceLabor Law
References
7
Case No. MISSING
Regular Panel Decision
May 05, 2011

Spadaro v. Meza

The plaintiffs appealed an order from the Supreme Court, Kings County, which denied their motion to determine that nonparty respondents Pacific Employers Insurance Company, c/o Gallagher Bassett, and the Special Funds Conservation Committee had no enforceable workers’ compensation lien on settlement proceeds. The injured plaintiff had two workers' compensation claims from accidents in 1998 and 2004. An agreement from 2008 allowed Gallagher Bassett and Special Funds to reserve their right to assert liens on settlement proceeds from the 2004 claim. Plaintiffs argued the lien amounts could not be accurately established due to a lack of apportionment between the claims. The Supreme Court correctly denied the motion, as Gallagher Bassett only made benefit payments related to the 2004 accident, making the lien amount ascertainable. The order was affirmed.

Workers' Compensation LienSettlement ProceedsPersonal InjuriesApportionment of ClaimsInsurance CarrierSpecial Funds Conservation CommitteeLump Sum AwardWaiver of BenefitsSupreme Court AppealCivil Procedure
References
3
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