March 2023 | New York Workers’ Compensation Law Reporter Highlights | News Release
March 2023 New York Workers’
Compensation Law Reporter Highlights | News Release
Carrier can’t dodge medical expenses from New Jersey licensed physician
Case name: Gomez v. Cipriani Board of Managers. 123 NYWCLR 13 (N.Y. App. Div. 2023).
Ruling: In reversing, the Appellate Division held that the Board erred in finding the carrier not liable for payment of the claimant’s medical expenses by a duly-licensed physician in New Jersey, where the claimant resides.
What it means: Claimants who are inured in New York but reside in other states are entitled to receive treatment from qualified physicians in their home state.
Claimant’s financial evidence falls short of demonstrating extreme hardship
Case name: Davis v. Hutchings Children Services, 123 NYWCLR 14 (N.Y. App. Div. 2023).
Ruling: Upon review, the Appellate Division affirmed the Board’s decisions denying the claimant’s request for an extreme hardship redetermination pursuant to WCL Section 35(3).
What it means: Where the evidence shows that the claimant’s reported monthly expenses are not substantially higher than her monthly income, the claimant has not demonstrated financial hardship beyond the ordinary so as to warrant an extreme hardship redetermination.
Claimant’s false testimony at several hearings warrants permanent disqualification
Case name: Rodriguez v. American Bridge, Co. 123 NYWCLR 22 (N.Y. App. Div. 2023).
Ruling: Upon review, the Appellate Division affirmed the decision of the Board which disqualified the claimant from receiving future wage replacement benefits.
What it means: Where a claimant falsely testifies at three hearings that he had not performed any work since the accident or since the previous hearing or benefit payment, the assessment of discretionary penalty of permanent disqualifications is not disproportionate to the circumstances so as to constitute an abuse of discretion.
Evidence fails to establish prevalence of COVID-19 in workplace
Case name: Triboro Center for Rehab & Nursing, 123 NYWCLR 23 (N.Y. App. Div. 2023).
Ruling: Upon mandatory review, the Full Board held that there was insufficient evidence that COVID-19 was prevalent in claimant’s work environment to establish the claim for COVID-19.
What it means: Where there is no evidence that any of the claimant’s coworkers or patients in the facility where she worked had contracted COVID-19 prior to the claimant, the record does not support a finding that the condition was prevalent in the claimant’s workplace at the time she contracted the virus, or that the claimant had specific exposure to someone who was COVID-19 positive.