« November 2008 | Main | June 2009 »

May 2009 Archives

May 5, 2009

Appellate Division Limits Amount of Workers' Compensation Benefits Payable

The Appellate Division – Third Department limited the amount of benefits that a claimant can receive in any one week to the maximum allowed by the Workers' Compensation Law. The Appellate Division had previously indicated that there may have been a way for an injured worker to actually collect over the maximum rate allowed by law. The court reached its decision in the case of Lamantia v. Midland Elevator Company, 2009 NY Slip Op 01379 (February 26, 2009)

Mr. Lamantia stopped working when he sustained a back injury. As a result of that injury the claimant never returned to work. When he stopped working he also realized that he had developed carpal tunnel syndrome and filed a separate claim for that condition.

On the day that the claimant was classified as having a permanent partial disability he was also awarded a scheduled loss of use for his hands. The State Insurance Fund objected to paying the scheduled loss of use since for the “weeks it covered” the claimant was already paid the maximum rate of $400.00 per week in the back case.

The Workers' Compensation Board affirmed the Law Judge and the State Insurance Fund took the case up to the Third Department. This was a full frontal attack on the Miller v. North Syracuse Central School District, 1 A.D. 3d 691 (2003) case. The Court of Appeals had already questioned the viability of Miller in the LaCroix v. Syracuse Executive Air Service, Inc., 8 N.Y. 3d 348 (2007) case.

The Third Department was able to read the tea leaves from the Court of Appeal and all but overruled Miller. The Third Department now indicates that a person’s benefits are limited to the maximum rate in §15(6) of the Workers' Compensation Law for the date of accident and that it is an overall limit of money that is paid every week. No longer can a claimant collect benefits for temporary and permanent disability for the same week and have the benefits exceed the maximum rate for the date of accident and/or disability.

As a result of this case there will be the end of awarding full benefits for a hearing loss where the worker eventually stops working because of an accident as in this case or from an OD such as asbestosis.

Currently there is legislation pending in both houses of the Legislature to attempt to resolve this matter. The “Same As” bill numbers are A2021 sponsored by Assemblywoman Susan John and S2776 sponsored by State Senator George Onorato.

Undocumented Workers Entitled to Workers' Compensation Benefits

The Appellate Division decided one of the most important cases in years recently involving the rights of undocumented workers to receive workers' compensation benefits. The case is Amoah v. Mallah Management, LLC.

In this case the claimant used phony documents to get his job. The claimant entered the country legally but was not permitted to work. He then stayed longer in the country than his visa permitted him stay. After he was injured he filed a workers' compensation claim and filed a PI case under his roommate’s name, whose name and Social Security number he used. The roommate eventually demanded a piece of the workers' compensation benefits and the negligence recovery. The claimant balked at this. The claimant eventually told this story to the workers' compensation carrier on a voluntary basis.

After this the workers' compensation carrier sought to suspend his benefits because of the use of fraudulent documents used to get the job. After development of the record the Law Judge ruled that the claimant was still entitled to workers' compensation benefits. On appeal within the Workers' Compensation Board a Board Panel affirmed the Law Judge and the workers' compensation carrier appealed to the Appellate Division. The employer and workers' compensation carrier contended that the Immigration Reform and Control Act of 1986 (see 8 USC § 1324a et seq.) (hereinafter IRCA), as interpreted by the United States Supreme Court in Hoffman Plastic Compounds v National Labor Relations Bd. (535 US 137 [2002]).*

The court analyzed the potential conflict between the New York State Workers' Compensation Law and IRCA. The analysis led it to be of the opinion that IRCA did not preempt the New York State Workers' Compensation Law under the Supremacy Clause of the United Constitution. Part the basis for this was that occupational health and safety is historically an exercise of state police powers and that Congress did not intend to supplant state law in this area. Also the Court of Appeals had already ruled in Balabuena v. IDR Realty, LLC, 6 N.Y. 3d 338 (2006) that IRCA did not take away an undocumented worker’s right to collect damages in a personal injury case.

The court also indicated that the mere fact that a person is an undocumented worker is not a bar to receiving basis workers' compensation benefits based upon the decision of the Court of Appeals in Ramroop v. Flexo-Craft Printing, 11 N.Y. 3d 160 (2008) and Testa v Sorrento Rest., 10 AD 2d 133, 135, lv denied 8 NY2d 705 (1960)

The court went on to say that IRCA was intended to deter employers from hiring undocumented workers. The court then reasoned that to allow employers who hire undocumented workers to avoid having their workers' compensation carriers pay indemnity for lost time would encourage the hiring of undocumented workers and to defeat the purpose of IRCA. It should also be noted that in this case the court found no evidence that the employer tried in any way to confirm the eligibility of the injured worker to work in the United States.

Hoffman Plastics was then distinguished in that Hoffman Plastics involved a claim for unpaid wages and for personal injury. The court then considered that the payment of workers' compensation benefits was a contractual right as a form of consideration that was part of the contract for services already performed. The court then stated that since the claimant was totally disabled and under no obligation under New York law to look for work he should not be barred from continuing to receive workers' compensation benefits. Had the claimant had a partial disability and would therefore, have been required to look for work the result may have been different. If the claimant had a partial disability New York law requires him to remain attached to the labor market. Since it would have been illegal for him to obtain employment the court may have denied his claim for ongoing benefits, which he would have been able to collect if he returned to his home country and produced medical evidence of a disability and attachment to the labor market in his home country.

The decision of the Appellate Division was a unanimous affirmance of the Workers' Compensation Board. Therefore, there is no appeal of right to the New York State Court of Appeals, New York’s highest court. The next step in this case can be either a motion to the Court of Appeal for permission to appeal to the court or an appeal directly to the United States Supreme if the workers' compensation carrier seeks to continue their fight.

* Justice Bryer wrote a dissent in Hoffman Plastics.

About May 2009

This page contains all entries posted to Torts, Insurance and Compensation Law Weblog in May 2009. They are listed from oldest to newest.

November 2008 is the previous archive.

June 2009 is the next archive.

Many more can be found on the main index page or by looking through the archives.