| Matter of Howard v Stature Elec., Inc. |
| 2010 NY Slip Op 02703 [72 AD3d 1167] |
| April 1, 2010 |
| Appellate Division, Third Department |
| In the Matter of the Claim of David W. Howard, Appellant, vStature Electric, Inc., et al., Respondents. Workers' Compensation Board,Respondent. |
—[*1] Gregory J. Allen, State Insurance Fund, Liverpool (Susan B. Marris of counsel), for StatureElectric, Inc. and another, respondents.
Garry, J. Appeal from a decision of the Workers' Compensation Board, filed October 6,2008, which determined that claimant violated Workers' Compensation Law § 114-a.
Claimant suffered a work-related injury in March 2003 and submitted a claim for workers'compensation benefits. After a hearing, the Workers' Compensation Law Judge (hereinafterWCLJ) established the injury, awarded benefits, and authorized surgery to be covered by theworkers' compensation carrier, the State Insurance Fund (hereinafter SIF). Claimant wassubsequently indicted on charges of insurance fraud in the third degree, grand larceny in the thirddegree, offering a false instrument for filing in the first degree, and violating Workers'Compensation Law § 114. These charges arose from evidence collected by SIF allegedlyrevealing that claimant was employed while collecting benefits.[FN1] In June 2007, claimant entered an Alford plea to the charge of insurance fraud in thefourth degree. He was convicted and sentenced in accordance with this plea agreement to aconditional discharge upon [*2]payment of restitution, and acertificate of relief from disabilities was issued.
At a subsequent hearing, SIF asked the WCLJ to find that claimant's plea and convictiondisqualified him from receiving benefits pursuant to Workers' Compensation Law § 114-a.Claimant requested a hearing. After affording the parties an opportunity to brief the issue, theWCLJ determined that the criminal proceedings did not involve a full hearing on the merits and,thus, claimant was entitled to a hearing. SIF sought review. The Workers' Compensation Boardfound that a violation of Workers' Compensation Law § 114-a had occurred, based uponclaimant's criminal conviction.[FN2] The Board modified the WCLJ's decision and returned the case for the determination ofappropriate penalties. Claimant appeals.
Initially, we disagree with the SIF's claim that this appeal was improperly taken from aninterlocutory decision. The question posed, i.e., whether claimant violated Workers'Compensation Law § 114-a, is a potentially dispositive threshold legal issue (see Matter of Michaels v Towne Ford,9 AD3d 733, 733 n [2004]). "[O]ur policy to discourage piecemeal review of the mainissues in a compensation claim . . . should not be applied in such a manner as topreclude, as in this case, the prompt review of threshold legal issues which may be dispositive"(Matter of McDowell v LaVoy, 59 AD2d 995 [1977]; see Matter of Pisarek v Utica Cutlery,26 AD3d 619, 619 [2006]).
The Board relied upon the equitable doctrine of collateral estoppel in rendering itsdetermination. This doctrine is based on the concept that it is unfair to permit a party to relitigatean issue that has previously been decided against it (see Kaufman v Eli Lilly & Co., 65NY2d 449, 455 [1985]). There are two fundamental requirements: " '[f]irst, the identical issuenecessarily must have been decided in the prior action and be decisive of the present action, andsecond, the party to be precluded from relitigating the issue must have had a full and fairopportunity to contest the prior determination' " (Matter of Juan C. v Cortines, 89 NY2d659, 667 [1997], quoting Kaufman v Eli Lilly & Co., 65 NY2d at 455; accord Alaimo v McGeorge, 69 AD3d1032, 1033 [2010]). Here, SIF did not meet its burden of demonstrating the identity ofissues (see Kaufman v Eli Lilly & Co., 65 NY2d at 456). To satisfy this requirement, theissue in question must have been "actually litigated and resolved in the prior proceeding"(Matter of Halyalkar v Board of Regents of State of N.Y., 72 NY2d 261, 267 [1988]).
Here, the determinative issue was not whether claimant had been convicted of a crime(contrast Matter of Hopfl, 48 NY2d 859, 860 [1979]; Matter of Feuereisen vAxelrod, 100 AD2d 675, 675-676 [1984], lv denied 62 NY2d 605 [1984]), butwhether he "knowingly ma[de] a false statement or representation as to a material fact"(Workers' Compensation Law § 114-a) for the purpose of obtaining workers'compensation benefits or influencing a payment determination. An Alford plea, by itsvery nature, is accepted on the explicit basis that the person making the plea does not admithaving committed the charged acts (see North Carolina v Alford, 400 US 25, [*3]37 [1970]; People v Miller, 239 AD2d 787, 788 [1997],affd 91 NY2d 372 [1998]). When claimant entered his Alford plea, he "was notrequired to and did not admit his participation in the acts constituting the crime" (People vGreen, 249 AD2d 691, 693 [1998]). On the contrary, he made no factual admissions, hiscounsel specified that he was pleading guilty "without an admission of wrongdoing," and thetranscript of the plea proceeding includes no discussion of the factual basis for the charge. Thequestion of whether claimant committed the charged conduct, though decisive in determiningwhether he violated Workers' Compensation Law § 114-a, was not determined in thecriminal action.[FN3] Thus, the requirement of identicality was not met, and collateral estoppel does not apply (seeMatter of Halyalkar v Board of Regents of State of N.Y., 72 NY2d at 267; Kaufman vEli Lilly & Co., 65 NY2d at 456).[FN4] Claimant must be provided an "ample opportunity to address the issue of whether he knowinglymisrepresented material facts" sufficient to establish the charged violation (Matter of Robbins v Mesivtha TiferethJerusalem, 60 AD3d 1166, 1167 [2009]).
Peters, J.P., Spain, Lahtinen and Stein, JJ., concur. Ordered that the decision is reversed,without costs, and matter remitted to the Workers' Compensation Board for further proceedingsnot inconsistent with this Court's decision.
Footnote 1: This evidence is not part of therecord.
Footnote 2: The Board incorrectly statedthat claimant pleaded guilty to a violation of Workers' Compensation Law § 114, ratherthan insurance fraud in the fourth degree. However, this error is immaterial; it does not affect theissue of whether collateral estoppel operates to render claimant's conviction legally sufficient toestablish the violation of Workers' Compensation Law § 114-a.
Footnote 3: The Board has previously foundviolations of Workers' Compensation Law § 114-a based upon guilty pleas (see e.g.Europa Tile & Masonary, 2007 WL 2923176, *3, 2007 NY Wrk Comp LEXIS 6740, *6[WCB No. 0921 8601, Aug. 7, 2007]; Lewis County Dairy, 2006 WL 3927451, *3, 2006NY Wrk Comp LEXIS 10675, *6-7 [WCB No. 6000 2515, Nov. 29, 2006]). In these cases,however, the pleas included admissions to the acts constituting the crime.
Footnote 4: Given this determination, weneed not reach the question whether claimant had a full and fair opportunity to litigate the issuein the prior action (see Matter of Halyalkar v Board of Regents of State of N.Y., 72NY2d at 266).