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Claim of Ash v. Native Laces & Textiles Co.

Citations: 85 A.D.2d 822; 445 N.Y.S.2d 646; 1981 N.Y. App. Div. LEXIS 16642

Court: Appellate Division of the Supreme Court of the State of New York; December 16, 1981; New York; State Appellate Court

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An appeal was made regarding a decision by the Workers’ Compensation Board from December 31, 1980, which determined that the employer's insurance carrier was liable for workers' compensation benefits and released the Special Fund for Reopened Cases. The claimant sustained a compensable knee injury in 1971 while employed by Native Laces Textiles Co. He underwent knee surgery in 1974, leading to additional compensation, and informed the board of further surgery scheduled for September 1974. 

In July 1975, a board hearing resulted in a closed case. Dissatisfied with the outcome, the claimant appealed, prompting the board to reopen the case. On April 8, 1976, the board closed the case again but required the carrier to review the file and settle unpaid bills. The claimant subsequently appealed the April 1976 decision, citing inadequate compensation and further treatment needs. The board responded by instructing the claimant to submit future medical bills.

In 1976, the board received medical reports from the claimant's doctor about the knee condition. In May 1979, the board reopened the case, attributing liability to the special fund under section 25-a of the Workers' Compensation Law. Upon appeal, the board reversed this finding, discharging the special fund from liability.

The court affirmed the board’s decision stating that the claimant's application for compensation was made within the required seven-year period from the injury and three years from the last payment. The claimant's April 1976 letter, which sought further compensation, was deemed adequate despite not following a specific form. The reopening of the case was justified based on the claimant's timely correspondence, not solely on later medical reports. The court found substantial evidence supporting the board’s decision to discharge the special fund, affirming the ruling with costs awarded to the Special Fund for Reopened Cases against the employer and its insurance carrier. Judges Mahoney, Sweeney, Kane, Yesawich, Jr., and Weiss concurred.