Matter of Scheiber v. I. Simon Co.

6 Citing cases

  1. Sopko v. C R Transfer Co., Inc.

    1998 S.D. 8 (S.D. 1998)   Cited 79 times
    Holding that SDCL 62-7-33 is "South Dakota's statutory exception to the finality rule"

    Padilla v. Indus. Com'n of Colorado, 696 P.2d 273, 276 (Colo. 1985) (full release with waiver of right to reopen unenforceable); Scheiber v. I. Simon Co., 25 A.D.2d 588, 267 N.Y.S.2d 44 (1966) (change in condition and degree of disability not contemplated at the time of lump sum approval). Padilla cites our holding in Novak in illustration of this rule.

  2. Claim of Cordell v. City of Oneida Youth Division

    146 A.D.2d 362 (N.Y. App. Div. 1989)   Cited 5 times

    While these definitional differences are not easily reconciled, we find the comprehensive nature of a Workers' Compensation Law § 15 (5-b) settlement forecloses the payment of additional medical expenses absent a proper reopening of the case. This conclusion is consistent with previous applications of the statute in which medical expenses were allowed only for uncontemplated changes in the claimant's medical condition (see, Matter of Scheiber v Simon Co., 25 A.D.2d 588, affd 19 N.Y.2d 619; cf., Elting v Will Baumer Candle Co., 86 A.D.2d 709, lv denied 57 N.Y.2d 602). Further support may be found in the Final Report of the Temporary State Commission on Workers' Compensation and Disability Benefits, depicting necessary changes in the Workers' Compensation Law (see, L 1983, ch 415). This report recommended an amendment to Workers' Compensation Law § 15 (5-b) expressly providing that lump-sum settlements not impair a claimant's right to medical benefits, as was presently the case.

  3. Matter of Avila v. St. Francis Hospital

    140 A.D.2d 769 (N.Y. App. Div. 1988)   Cited 1 times

    This appeal by the Special Fund for Reopened Cases ensued. The provisions of Workers' Compensation Law § 15 (5-b) have been interpreted to permit a reopening where there is a change based upon an uncontemplated medical condition, new or increased symptoms, or an over-all worsening of the claimant's disability (see, Matter of Scheiber v Simon Co., 25 A.D.2d 588, affd 19 N.Y.2d 619). Here, claimant's medical examination in 1969 found only low back pain, mild flattening of the lumbar lordosis with mild restriction in squatting and mildly restricted trunk motion.

  4. Matter of Parietti v. Dellwood Country Club

    91 A.D.2d 806 (N.Y. App. Div. 1982)   Cited 2 times

    In any event, the record reveals that the carrier was aware of claimant's neck condition shortly after it manifested itself, and, therefore, there is substantial evidence to support the board's finding of no prejudice to the carrier. The evidence supports the carrier's argument that claimant's neck condition was considered in the lump-sum award, but in view of the medical evidence that subsequent to the award, which was based upon a permanent partial disability, claimant's condition rendered her permanently totally disabled, there is a rational basis for the board's finding of a change in her condition not contemplated in the lump-sum award (see Matter of Scheiber v Simon Co., 25 A.D.2d 588, affd 19 N.Y.2d 619). It should be noted that the carrier has never contested the causal relationship between claimant's neck condition and the industrial accident. Decisions affirmed, with costs to the Workers' Compensation Board. Mahoney, P.J., Sweeney, Main, Casey and Weiss, JJ., concur.

  5. Elting v. Will Baumer Candle Co., Inc.

    86 A.D.2d 709 (N.Y. App. Div. 1982)   Cited 2 times

    Under these circumstances, plaintiff's only recourse is to seek payment directly from Drake for the services he rendered to him (cf. Ellis Hosp. v. Symonds, 96 Misc.2d 643). In so ruling, we lastly cite our decision in Matter of Scheiber v. Simon Co. ( 25 A.D.2d 588, affd 19 N.Y.2d 619), a case involving a claim against a carrier for medical expenses occurring some years after the case in question was closed upon approval of a nonschedule adjustment. Significantly, we held the carrier liable for the medical expenses in that case only after determining that there was substantial evidence of a change in the claimant's condition so as to permit the reopening of the case for the payment of the medical bills at issue.

  6. Matter of Rizzo v. Glenwood Clothes, Inc.

    33 A.D.2d 611 (N.Y. App. Div. 1969)   Cited 2 times

    5-b; Matter of Lawton v. General Motors Corp., Chevrolet-Tonawanda Div., 13 A.D.2d 587, mod. 13 A.D.2d 607, mot. for lv. to app. den. 9 N.Y.2d 613) and, despite contrary testimony, there was substantial evidence to support the board's finding that the statutory test had been met (cf. Matter of Scheiber v. Simon Co., 25 A.D.2d 588, affd. 19 N.Y.2d 619; Matter of Goldbard v. Dixie Lake Hotel Country Club, 11 A.D.2d 858). In cases such as this, subdivision 1 of section 25-a Work. Comp. of the Workmen's Compensation Law provides that the liability of the Special Fund for Reopened Cases attaches only when the reopening is "after a lapse of seven years from the date of the injury * * * and also a lapse of three years from the date of the last payment of compensation" ( Matter of Sayres v. Feine Sons Co., 283 App. Div. 547, 549) and subdivision 7 requires that "where the case is disposed of by the payment of a lump sum, the date of last payment * * * shall be considered as the date to which the amount paid in the lump sum settlement would extend if the award had been made on the date the lump sum payment was approved at the maximum compensation rate which is warranted by the employee's earning capacity as determined by the board" under section 15 of said law (see Matter of Weyzk v. Town of Stafford, 7 N.Y.2d 121,