You are here: / Workers' Compensation

Plaintiff Barred from Recovery Against Special Employer by Exclusivity Provisions of Workers’ Compensation Law

The Second Department determined plaintiff was defendant’s special employee and recovery from defendant was therefore barred by the exclusivity provisions of the Workers’ Compensation Law. Plaintiff worked for a staffing agency and was assigned to work for defendant. After plaintiff was injured working for defendant, he was paid Workers’ Compensation benefits by the staffing agency. Because of the exclusivity provisions of the Workers’ Compensation Law, plaintiff could not recover from the defendant, his special employer:

” In general, workers compensation benefits are the exclusive remedy of an employee against an employer for any damages sustained from injury or death arising out of and in the course of employment'” (…see Workers’ Compensation Law §§ 11, 29[6]). For purposes of the Workers’ Compensation Law, a person may be deemed to have more than one employer, a general employer and a special employer … . “The receipt of Workers’ Compensation benefits from a general employer precludes an employee from commencing a negligence action against a special employer” … .

A special employee is “one who is transferred for a limited time of whatever duration to the service of another” … . In determining whether a special employment relationship exists, a court should consider factors such as the right to control the employee’s work, the method of payment, the furnishing of equipment, and the right to discharge … . “A significant and weighty factor . . . is who controls and directs the manner, details and ultimate result of the employee’s work'” … .

Here, the defendant established, prima facie, that this action was barred by the exclusivity provisions of the Workers’ Compensation Law. Evidence submitted in support of the motion demonstrated, prima facie, that the defendant controlled and directed the manner, details, and ultimate result of the plaintiff’s work, and that the defendant was the plaintiff’s special employer … . Wilson v A.H. Harris & Sons, Inc., 2015 NY Slip Op 06808, 2nd Dept 9-16-15

 

, , ,

Sexual Harassment Findings Affirmed

The Third Department affirmed the State Division of Human Rights’ (SDHR’s) determination that respondent corrections officer had been subjected to sexual harassment (creating a hostile work environment) and was entitled to economic and noneconomic damages. The court noted that its review powers were “narrow” and were confined to whether the Commissioner of Human Rights’ rulings were rational in light of the evidence. The court further noted that the Commissioner should not have offset the award based upon past and future workers’ compensation benefits, and the commissioner should have considered respondent’s loss of pension benefits. In explaining its review criteria, the court wrote:

When reviewing a determination made by the Commissioner in a matter such as this one, our purview is “extremely narrow” and must focus not on whether we would have reached the same result as did the Commissioner, but instead on whether the Commissioner’s determination was rational in light of the evidence presented … . Such deference is due given SDHR’s expertise in evaluating discrimination claims … . A violation of Executive Law § 296 based on a hostile work environment must be supported by proof that the “workplace [was so] permeated [by a] discriminatory” atmosphere that it “alter[ed] the conditions of the [complainant’s] employment” … . “Where, as here, there is a finding of a hostile work environment as a result of sexual harassment, the evidence in the record must establish the pertinent elements, including proof that the discriminatory conduct occurred due to the complainant’s gender”… . Matter of Rensselaer County Sheriff’s Dept. v New York State Div. of Human Rights, 2015 NY Slip Op 06551, 3rd Dept 8-13-15

 

, , ,

Even Though the Insured Was Faultless, the “Additional Insureds” Endorsement Was Triggered—The Endorsement Covered Acts or Omissions by the Insured Which “Caused” the Underlying Injury Without Any Requirement that the “Cause” Entail Negligence—Here the Insured Was Not Negligent, but the Injury Was “Caused” by Insured’s Non-Negligent Acts—Therefore the Additional Insureds Were Covered Under the Policy

The First Department, in a full-fledged opinion by Justice Friedman, determined that the “additional insureds” endorsement in plaintiff-insurer’s policy did not have a “negligence trigger.” Therefore, even though it was demonstrated that the company insured under plaintiff-insurer’s policy was not negligent, the endorsement covered the “additional insureds” because there was a causal relationship between the insured’s acts and the underlying injury to a worker. The insured company, Breaking Solutions, was hired by the New York City Transit Authority (NYCTA) and the Metropolitan Transit Authority (MTA) to break up concrete for a subway construction project. Plaintiff-insurer, Burlington Insurance Co. insured Breaking Solutions.  The NYCTA and MTA were additional insureds under the policy. It was NYCTA’s responsibility to identify the location of electric cables and to shut off the power in the areas where Breaking Solutions was working. NYCTA failed to identify and shut off the power to a cable which was struck by Breaking Solutions’ excavation equipment resulting in an explosion. The plaintiff in the underlying personal injury action, an NYCTA employee, was injured by the explosion. The issue came down to the language of the “additional insureds” endorsement which referred only to injuries “caused” by the acts or omissions of the insured. Even though the probable intent of the drafters of the policy was to cover only “negligent” acts or omissions by the insured which “caused” the injury, the language of the endorsement could only be enforced as written. Because the worker’s injuries were “caused” by the (non-negligent) acts of the insured, the additional insureds (NYCTA and MTA) were covered under the terms of the policy:

While it is true that, because NYCTA had not warned the Breaking Solutions’ operator of the cable’s presence, Breaking Solutions’ “act[]” did not constitute negligence, this does not change the fact that the act of triggering the explosion, faultless though it was on Breaking Solutions’ part, was a cause of [the worker’s] injury. The language of the relevant endorsement, on its face, defines the additional insured coverage afforded in terms of whether the loss was “caused by” the named insured’s “acts or omissions,” without regard to whether those “acts or omissions” constituted negligence or were otherwise actionable. Burlington Ins. Co. v NYC Tr. Auth., 2015 NY Slip Op 06481, 1st Dept 8-11-15

 

Petition for Late Approval (Eight Years Late) of a Settlement of a Third-Party Tort Action Nunc Pro Tunc Should Have Been Granted

The First Department determined the Court of Claims abused its discretion when it denied claimant’s late petition to approve a settlement of a third-party tort action nunc pro tunc. The carrier had been aware of the settlement for eight years and had continued to pay benefits to the claimant throughout, the carrier would suffer no prejudice from the approval, and the amount of the settlement was fair and reasonable:

The Court of Claims erroneously denied claimant’s request for the application for a nunc pro tunc order. “‘A judicial order may be obtained nunc pro tunc approving a previously agreed-upon settlement, even in cases where the approval is sought more than three months after the date of the settlement, provided that the petitioner can establish that (1) the amount of the settlement is reasonable, (2) the delay in applying for a judicial order of approval was not caused by the petitioner’s fault or neglect, and (3) the carrier was not prejudiced by the delay'” … . Amacio v State of New York, 2015 NY Slip Op 06298, 1st Dept 7-28-15

 

,

Plaintiff’s Recovery for On-the-Job Injury Against “Alter Ego” of Plaintiff’s Employer Limited to Workers’ Compensation

The Second Department determined that defendant’s status as the “alter ego” of plaintiff’s employer limited plaintiff’s recovery for job-related injury to Workers’ Compensation:

“The protection against lawsuits brought by injured workers which is afforded to employers by Workers’ Compensation Law §§ 11 and 29(6) also extends to entities which are alter egos of the entity which employs the plaintiff” … . “A defendant moving for summary judgment based on the exclusivity defense of the Workers’ Compensation Law under this theory must show, prima facie, that it was the alter ego of the plaintiff’s employer” … . “A defendant may establish itself as the alter ego of a plaintiff’s employer by demonstrating that one of the entities controls the other or that the two operate as a single integrated entity” … .

Here, the defendant demonstrated its prima facie entitlement to judgment as a matter of law by establishing that it was the alter ego of the plaintiff’s employer, since the two companies operated as a single integrated entity … . Haines v Verazzano of Dutchess, LLC, 2015 NY Slip Op 06214, 2nd Dept 7-22-15

 

Claim for Psychological Injury Should Have Been Upheld—Retail Employee Was Directed to Submit False Reserve Orders for a Product to Deceive Manufacturer

The Workers’ Compensation Law Judge (WCLJ) found a retail employee suffered compensable psychological injury because he was directed by a supervisor to submit false reserve orders for a product in order to deceive the manufacturer.  The Workers’ Compensation Board disagreed and disallowed the claim. The Third Department reinstated the claim, finding the Board’s conclusion was not supported by substantial evidence:

The WCLJ found claimant’s testimony to be credible and determined, among other things, that he had been directed by a supervisor to submit false reserve orders in order to deceive the manufacturer and that credit card numbers were included in the reserve orders. The WCLJ concluded that claimant sustained a mental injury as a result of “the stress of being directed to engage in deceptive business practices” and that this stress was greater than that experienced in the normal work environment because “[p]ressure to engage in unethical and illegal practices . . . cannot be considered a normal work environment.” The Board subsequently disallowed the claim, finding that, because all of the employees in claimant’s department were pressured to place reserve orders and were given the same instruction, claimant’s stress was not greater than that of similarly situated workers.

We reject this analysis. The Board neither contradicted nor commented upon the findings of the WCLJ that claimant’s supervisors directed him to engage in a deceptive business practice by submitting falsified reserve orders, and it did not exercise its power to reject the underlying credibility determinations … . Thus, the remaining basis for the Board’s conclusion that claimant was not subjected to stress greater than that experienced in a normal workplace is that other employees were similarly directed to engage in wrongful conduct. This analysis is untenable; the imprimatur of “normal” cannot be placed upon a workplace where an employee is directed to carry out a deceptive, unethical or potentially illegal practice because an employer also gave that direction to other employees … . The mere fact that other employees may have received the same instruction cannot support this conclusion. Here, there was no other evidence from which it may be concluded that directions to place false reserve orders constituted part of a normal work environment for similarly situated employees. The employer’s witnesses testified that corrective action — including termination — had been taken when similar practices occurred at the store in the past, and claimant testified that he would have been fired for such conduct in other upscale department stores where he had previously worked. Accordingly, we find that the Board’s determination is not supported by substantial evidence … . Matter of Cox v Saks Fifth Ave., 2015 NY Slip Op 06003, 3rd Dept 7-9-15

 

, ,

Lien for Attorney’s Fees (Re: Workers’ Compensation Award) Can Be Satisfied Before Reimbursing Municipality for Benefits Paid by the Municipality to the Injured Corrections Officer Pursuant the General Municipal Law

The Third Department determined that a lien for attorney’s fees could be attached to Workers’ Compensation benefits prior to reimbursing a municipality for benefits paid to the municipal employee pursuant to the General Municipal Law. Claimant corrections officer was injured on the job. Under General Municipal Law 207-c municipal employers are required to pay full wages to corrections officers injured in the performance of their duties.  Workers’ Compensation Law 30 (3) provides that the amount of the payments made under the General Municipal Law shall be credited against any award of compensation pursuant to the Workers Compensation Law. The municipality argued it was entitled to the entire amount paid to the employee and the amount should not be reduced by the attorney’s fees (a lien on the Workers’ Compensation award).  The Third Department disagreed:

General Municipal Law § 207-c requires municipal employers to pay full wages to correction officers who are injured in the performance of their duties. Workers’ Compensation Law § 30 (3) provides that the amount of such payments “shall be credited against any award of compensation” that may also be made to such an officer. The employer contends that the mandatory language of the Workers’ Compensation Law provision entitles employers to full credit for such payments and, thus, precludes the attachment of a lien for counsel fees. However, Workers’ Compensation Law § 24 likewise uses mandatory language in providing that, when approved by the Board, counsel fees “shall become a lien upon the compensation awarded . . . [and] shall be paid therefrom only in the manner fixed by the [B]oard” (emphasis added). The lien attaches when the compensation is awarded “and takes precedence over the employer’s right to reimbursement of funds previously paid to the claimant-employee” … . The purpose of enacting Workers’ Compensation Law § 30 (3) was not to preclude counsel fees, but “to avoid duplicate benefits to an injured [officer], the combined total of which might exceed the salary [the officer] would have received for the period” if the injury had not occurred … . Workers’ Compensation Law § 30 (3) must be harmoniously interpreted with the Workers’ Compensation Law as a whole and with General Municipal Law § 207-c … . We find nothing in the statutory language indicating a legislative intent to treat employees who receive benefits under General Municipal Law § 207-c differently from other injured employees by departing from the statutory scheme for payment of counsel fees set forth in Workers’ Compensation Law § 24. Matter of McCabe v Albany County Sheriff’s Dept., 2015 NY Slip Op 05236, 3rd Dept 6-18-15

 

Approval of an MRI Within Seven Years of Closure of Claimant’s Case Effectively Reopened the Case—Transfer to the Special Fund for Closed Cases Was Error

The Third Department determined the fact that an MRI had been approved demonstrated that the claimant’s case had not been closed for the requisite seven years. Liability therefore was not shifted to the Special Fund for closed cases:

Pursuant to Workers’ Compensation Law § 25-a, the Special Fund becomes liable for claims that are reopened more than seven years from the date of the injury and three years after the last payment of compensation … . There is no dispute that this case was initially closed as of June 20, 2005. In its amended decision, the Board determined that the case was first reopened in April 2012 when the MRI was requested, but closed once that application was approved. Finding that the case was again reopened when surgery was requested on June 26, 2012, the Board determined that the requisite seven-year time period had passed, shifting liability to the Special Fund.

This sequence calls into question whether the case was “truly closed” when the MRI request was approved. We have previously recognized that a “decision authorizing [an] MRI [does] not constitute a true closing of the case as [the] claimant’s future treatment depended upon the results of the MRI and, thus, further action was contemplated although not planned at that time” … . The same holds true here. As such, we conclude that the Board erred in concluding that the case was closed when the MRI was authorized. Correspondingly, since the case was reopened when the MRI was requested in April 2012, within the statutory seven-year period, liability does not shift to the Special Fund. Matter of Bank v Village of Tuckahoe, 2015 NY Slip Op 04894, 3rd Dept 6-11-15

 

Even When the Injured Worker, Who Had Received Workers’ Compensation Benefits, Successfully Sues His Employer (As Opposed to a “Stranger”) for His Injuries, the Workers’ Compensation Carrier Has a Lien Against the Recovery Pursuant to Workers’ Compensation Law 29(1)

The Third Department noted that, even though the worker who had received workers’ compensation benefits successfully sued his employer (as opposed to a third party) for his injuries, the workers’ compensation carrier still had a lien against the recovery (Workers’ Compensation Law 29(1)):

“When a claimant obtains recovery in a civil action for the same injuries that were the predicate for workers’ compensation benefits, the carrier has a lien against any recovery (see Workers’ Compensation Law § 29 [1]), even where the action is brought against an employer” … . Indeed, as the Court of Appeals has recently reaffirmed, “‘[Workers’ Compensation Law § ] 29, read in its entirety and in context, clearly reveals a legislative design to provide for reimbursement of the compensation carrier whenever a recovery is obtained in tort for the same injury that was a predicate for the payment of compensation benefits'” … . The Court reasoned that “[i]t would be unreasonable to read the statute as mandating a different result merely because the recovery came out of the pockets of a coemployee [or the employer] and not from the resources of a stranger” … . Ronkese v Tilcon N.Y., Inc., 2015 NY Slip Op 04908, 3rd Dept 6-11-15

 

Lump Sum Settlement with Third Party Barred Transfer of Employer’s Liability for Future Medical Payments to the Special Fund

The Third Department, in a full-fledged opinion by Justice Stein, determined that a lump sum payment from a third party, to which the employer agreed in return for the worker’s forebearance re: future indemnity payments by the employer, barred the transfer of the employer’s liability for future medical payments to the Special Fund:

Pursuant to Workers’ Compensation Law § 25-a, liability for a claim will be transferred to the Special Fund when an application is made to reopen a closed case after a lapse of seven years from the date of the injury and three years from the date of the last payment of compensation … . The issue here distills to when the last payment of compensation was made in light of the settlement agreement between claimant and the employer. …

Pursuant to Workers’ Compensation Law § 25-a (7), where a case is “disposed of by the payment of a lump sum,” the date of the last payment of compensation is established by calculating the date to which the amount paid in the settlement would have extended had the award of indemnity benefits been made at the maximum compensation rate warranted on the date the lump-sum payment was approved … . Here, the employer entered into an agreement with claimant on December 30, 2008 that permitted claimant to retain the proceeds of the third-party action in exchange for, among other things, his forebearance of future indemnity benefits. In our view, these proceeds constituted a lump-sum payment for purposes of the statute. Contrary to the employer’s contention that the statute only applies where the employer itself makes a lump-sum payment to the claimant, we note that the plain language of the statute indicates that it applies “where the case is disposed of by the payment of a lump sum,” without reference to the source of such payment (Workers’ Compensation Law § 25-a [7]). Thus, because the settlement agreement effectively “disposed” of the employer’s obligation to pay future indemnity benefits in exchange for claimant’s retention of a lump-sum payment from the third-party action, application of the statute is appropriate to bar transfer of liability for future medical benefits to the Special Fund. Matter of Nicpon v Zelasko Constr Inc, 2014 NY Slip Op 04102, 3rd Dept 6-5-14

 

Categories

Sign Up for the Mailing List to Be Notified When the Site Is Updated.

  • This field is for validation purposes and should be left unchanged.

Copyright © 2026 New York Appellate Digest, Inc.
Site by CurlyHost | Privacy Policy