WC Determination Not Binding in Underlying B.I. Action (NY)

In Aqui v. Seven Thirty One Ltd. Partnership, the Court of Appeals affirmed the First Department’s determination that the defendant was not entitled to collateral estoppel on the issue of causally-related disability due to a Workers’ Compensation Administrative Hearing determination that discontinued plaintiff’s benefits.

On December 23, 2003, plaintiff was injured during the course of his employment as a food delivery person. Plaintiff received Workers’ Compensation benefits for injuries to his head, neck, back and post-traumatic stress disorder and depression.  He commenced a third party, personal injury action in 2004.

In December 2005, the workers compensation carrier moved to discontinue plaintiff’s Workers’ Compensation benefits.  The parties proceeded to a hearing before an Administrative Law Judge.  Each side introduced expert medical testimony and was subject to cross examination.  The ALJ found plaintiff had “no further treatment causally-related” to his accident and discontinued his benefits as of January 24, 2006.  Defendant in the plaintiff’s underlying personal injury action immediately moved for an order estopping plaintiff from re-litigating the issue of causally-related injuries after January 24, 2006.  The Supreme Court granted the order, the First Department reversed, and the Court of Appeals affirmed the Appellate Division.

The Court of Appeals held that the defendant was not entitled to collateral estoppel on the issue of causally-related injuries because the issue being litigated was not identical to the determination of the ALJ.  The Court explained that Workers’ Compensation benefits are meant to provide all injured employees with some compensation due to an inability to perform duties of employment.  A personal injury action, on the other hand, is broader in scope.  It is intended to make an injured party whole, by assessing the impact of an injury over the course of a plaintiff’s lifetime.  Therefore, the Court of Appeals held that the issues are not identical and collateral estoppel cannot apply.  The Court made sure to note that this decision was not a general rule about Administrative proceedings and collateral estoppel, but only applicable where there is no identity of issues in the two proceedings.

Thanks to Anne Mulcahy for her contribution to this post.   If you have any questions, please email Paul at pclark@wcmlaw.com