X

Thank you for sharing!

Your article was successfully shared with the contacts you provided.

ADDITIONAL CASES Finger Lakes DDSO et al., Appellants. Workers’ Compensation Board, Respondent Appeal from a decision of the Workers’ Compensation Board, filed March 16, 2021, which ruled that claimant met the requirements for extreme hardship reclassification pursuant to Workers’ Compensation Law §35 (3). ELIZABETH GARRY, PRESIDING JUSTICE In May 2007, claimant was involved in a work-related accident and subsequently established a workers’ compensation claim for injuries to his right shoulder and low back. In 2009, pursuant to the parties’ stipulation, claimant was classified with a permanent partial disability and 87.5 percent loss of wage-earning capacity, entitling him to 475 weeks of indemnity benefits. In August 2018, shortly before the expiration of those indemnity benefits, claimant timely filed an extreme hardship redetermination request (C-35 form) pursuant to Workers’ Compensation Law §35 (3). Following a hearing, a Workers’ Compensation Law Judge granted claimant’s application and reclassified claimant with a permanent total disability due to factors reflecting extreme hardship. Upon administrative appeal, the Workers’ Compensation Board, in a decision filed March 16, 2021, affirmed that decision. The employer and its workers’ compensation carrier (hereinafter collectively referred to as the carrier) appeal. The carrier contends that substantial evidence does not support the Board’s decision because there was insufficient evidence — particularly with regard to the expected Social Security disability benefits claimant will receive once his workers’ compensation benefits are exhausted — for the Board to evaluate claimant’s extreme hardship application. We disagree. Workers’ Compensation Law §35 (3) provides that, “[i]n cases where the loss of wage-earning capacity is greater than [75 percent], a claimant may request, within the year prior to the scheduled exhaustion of indemnity benefits under [Workers' Compensation Law §15 (3) (w)], that the [B]oard reclassify the claimant to permanent total disability or total industrial disability due to factors reflecting extreme hardship.” This provision provides “a possible safety net” for those claimants who, having sustained a permanent partial disability and having not returned to work, face “extreme financial hardship” following the scheduled exhaustion of their indemnity benefits (Matter of Phillips v. Milbrook Distrib. Servs., 199 AD3d 1184, 1185-1186 [3d Dept 2021] [internal quotation marks and citations omitted]). In evaluating whether a claimant qualifies for the extreme hardship exception, the Board considers the claimant’s assets, monthly expenses, household income — including any spousal or family support — and any other relevant factor (see Workers’ Compensation Board Release Subject No. 046-938 [Apr. 26, 2017]; see also Matter of Phillips v. Milbrook Distrib. Servs., 199 AD3d at 1186). In determining that claimant had demonstrated extreme hardship entitling him to reclassification, the Board considered his monthly income, which included Social Security disability benefits and other imputed income derived from public assistance programs, and his detailed monthly expenses. Also considered was the income and various expenses of claimant’s fiancÉe with whom he shares a rental-assistance apartment; however, claimant testified that the two do not comingle their finances. Claimant also submitted a January 9, 2018 letter from the Social Security Administration advising that, after a deduction for his medical insurance premiums, his remaining monthly disability benefit was only $24. Claimant testified, however, that he did not receive that money because it was offset by the workers’ compensation indemnity benefits that he was receiving. Although the Board generally advises that, in connection with an extreme hardship application, a claimant “should indicate the full amount of [Social Security Disability benefits] that will be payable after the workers’ compensation benefits cease” (Workers’ Compensation Board Release Subject No. 046-938 [Apr. 26, 2017]; see generally Employer: Legacy Health Care, 2021 WL 83681, *3, 2021 NY Wrk Comp LEXIS 8, *8 [WCB No. G003 1412, Jan. 4, 2021]; Employer: Orchard Park Veterinary MC LLP, 2020 WL 1318610, *2, 2020 NY Wrk Comp LEXIS 11504, *2 [WCB No. 8080 5482, Mar. 16, 2020]), claimant did not submit such information. The circumstances here, however, reflect that the nominal amount to which claimant was entitled prior to the indemnity benefits offset would not have any appreciable impact on the difficult financial circumstances claimant will experience when his workers’ compensation indemnity benefits end. To the extent that the carrier contends that the Board did not consider certain discretionary expenses — specifically claimant’s cable/internet/telephone expenses — which the carrier suggests could be mitigated or discontinued, such contention is belied by the Board’s decision, which specifically sets forth all of claimant’s expenses in detail and concludes that such monthly obligations were modest, a characterization we consider apt. The Board, noting that the fact that claimant’s monthly expenses exceed his monthly income does not mandate a finding of extreme hardship (see Employer: Katzman Produce Fruit Div., 2022 WL 2309730, *2, 2022 NY Wrk Comp LEXIS G0326020 [WCB No. G032 6020, June 22, 2022]), also considered other relevant factors, such as claimant’s education and employment perspectives. Claimant has a high school diploma, and had an employment history prior to his injuries of working at a warehouse, doing mechanical and body/fender repair, driving a tractor trailer, operating heavy equipment and providing direct patient care. Claimant testified that his attempts at procuring employment within his current medical restrictions were unsuccessful and that, given his degree of disability, he was told he was not a candidate for vocational training. In view of the foregoing, we find that substantial evidence supports the Board’s finding that, given the notable shortfall of claimant’s financial ability to meet his monthly obligations once his workers’ compensation indemnity benefits are discontinued, and considering his inability to obtain new employment in order to produce additional income, claimant demonstrated extreme hardship warranting a reclassification pursuant to Workers’ Compensation Law §35 (3). Egan Jr., Lynch, Clark and Ceresia, JJ., concur. ORDERED that the decision is affirmed, with costs to claimant. Dated: October 6, 2022

 
Reprints & Licensing
Mentioned in a Law.com story?

License our industry-leading legal content to extend your thought leadership and build your brand.

More From ALM

With this subscription you will receive unlimited access to high quality, online, on-demand premium content from well-respected faculty in the legal industry. This is perfect for attorneys licensed in multiple jurisdictions or for attorneys that have fulfilled their CLE requirement but need to access resourceful information for their practice areas.
View Now
Our Team Account subscription service is for legal teams of four or more attorneys. Each attorney is granted unlimited access to high quality, on-demand premium content from well-respected faculty in the legal industry along with administrative access to easily manage CLE for the entire team.
View Now
Gain access to some of the most knowledgeable and experienced attorneys with our 2 bundle options! Our Compliance bundles are curated by CLE Counselors and include current legal topics and challenges within the industry. Our second option allows you to build your bundle and strategically select the content that pertains to your needs. Both options are priced the same.
View Now
September 05, 2024
New York, NY

The New York Law Journal honors attorneys and judges who have made a remarkable difference in the legal profession in New York.


Learn More
July 22, 2024 - July 24, 2024
Lake Tahoe, CA

GlobeSt. Women of Influence Conference celebrates the women who drive the commercial real estate industry forward.


Learn More
September 06, 2024
Johannesburg

The African Legal Awards recognise exceptional achievement within Africa s legal community during a period of rapid change.


Learn More

Be the game-changer at a pioneering Queens/Brooklyn law collective, making strides in Commercial and Real Estate Disputes. Immerse yourself ...


Apply Now ›

White Plains Insurance Defense Firm of 60+ years is looking for an entry level or pending admission to NYS Bar attorney.The Firm focus is on...


Apply Now ›

Description: Fox Rothschild LLP has an opening in multiple offices in our Entertainment and Sports Law Department for an Associate with Corp...


Apply Now ›
06/27/2024
The American Lawyer

Professional Announcement


View Announcement ›
06/21/2024
Daily Business Review

Full Page Announcement


View Announcement ›
06/14/2024
New Jersey Law Journal

Professional Announcement


View Announcement ›