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Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. 13-13-00463-CV
Regular Panel Decision
Oct 10, 2013

the Corporation of the President of the Church of Jesus Christ of Latter-Day Saints, the Church of Jesus Christ of Latter-Day Saints, and the Corporation of the Presiding Bishop of the Church of Jesus Christ of Latter-Day Saints v. John Doe

John Doe sued the Church of Jesus Christ of Latter-day Saints, alleging sexual assault by Eustacio Munioz and seeking damages based on vicarious and direct liability theories. The Church moved for summary judgment, asserting the claims were time-barred. The trial court denied the motion without stating its reasons. The Church petitioned the Court of Appeals for a permissive interlocutory appeal, arguing controlling questions of law regarding the statute of limitations and tolling doctrines like duress and continuing tort. The appellate court denied the petition, finding that the absence of a substantive ruling by the trial court prevented the identification of a clear controlling question of law, thus failing to meet the requirements for a permissive appeal.

Permissive appealInterlocutory orderSummary judgmentStatute of limitationsTollingDuressContinuing tort doctrineControlling question of lawAppellate procedureTexas law
References
12
Case No. MISSING
Regular Panel Decision

Toney v. Mueller Co.

This is a workers' compensation appeal concerning the denial of an employee's (Mr. Toney) motion to set aside a judgment, filed under Rule 60.02, Tenn.R.Civ.P., alleging a mistake regarding the extent of his injury. Mr. Toney had been awarded benefits based on a 15% permanent partial disability, but later underwent a spinal fusion, leading him to argue the original assessment was mistaken. The trial court denied his motion, reasoning that the conditions for which he was later treated already existed at the time of the original trial. The appellate court affirmed, emphasizing that Rule 60.02 serves as an "escape valve" for inequity, not merely for changed circumstances or dissatisfaction, and found no abuse of discretion in the trial judge's ruling.

Rule 60.02Post-Judgment MotionPermanent Partial DisabilitySpinal FusionPercutaneous Lumbar DiskectomyMedical Impairment RatingJudicial DiscretionFinality PrincipleMistake of FactRadiculopathy
References
3
Case No. No. 10-02-155-CV
Regular Panel Decision
Dec 31, 2003

TIG Premier Insurance Company v. John Pemberton and Texas Workers' Compensation Commission

John Pemberton, an injured worker, received an impairment rating that included deep vein thrombosis (DVT). TIG Premier Insurance, his employer's insurer, later disputed the compensability of the DVT, arguing it was not work-related and that the 60-day rule for contesting an injury did not apply to 'extent of injury' matters. A TWCC hearings officer found no causal link but ruled TIG waived its right to contest due to the 60-day rule, a decision affirmed by an appeals panel. The district court granted summary judgment for TWCC. The Tenth Court of Appeals reversed, holding that Labor Code § 409.021(c)'s 60-day rule applies solely to the initial contest of an injury's compensability, not to subsequent disputes regarding the extent of an injury. The court rendered judgment for TIG, confirming the absence of a causal connection between Pemberton's fall and the DVT.

Workers' CompensationImpairment RatingDeep Vein ThrombosisStatutory ConstructionSummary JudgmentTexas Labor CodeWaiverCompensabilityExtent of InjuryJudicial Review
References
15
Case No. MISSING
Regular Panel Decision

TIG Premier Insurance Co. v. Pemberton

John Pemberton was injured on the job in 1996 and was later diagnosed with deep vein thrombosis (DVT). His employer's worker's compensation insurer, TIG Premier Insurance, did not initially dispute the overall injury but later challenged the compensability of the DVT, arguing it was not work-related. A TWCC hearings officer found no causal relationship between the fall and the DVT but ruled that TIG waived its right to contest the DVT's compensability by not doing so within 60 days of learning of it. TIG appealed this decision to the district court, where its motion for summary judgment was denied, and TWCC's motion was granted, affirming the 60-day rule's application. The appellate court reversed the lower court's judgment, concluding that the 60-day rule in Tex. Lab.Code Ann. § 409.021(c) applies only to the initial response to a notice of injury, not to later disputes regarding the extent of an injury, and rendered judgment in favor of TIG based on the lack of causal connection.

Workers' CompensationDeep Vein ThrombosisImpairment RatingSixty-Day RuleStatutory ConstructionSummary JudgmentCausal RelationshipCompensability DisputeWaiver DefenseAppellate Review
References
16
Case No. Docket No. 406
Regular Panel Decision
Jun 15, 2005

Frew v. Hawkins

This civil action, initiated in 1993, addresses the alleged failure of the State of Texas to implement a Medicaid program, specifically the Early Periodic Screening, Diagnosis and Treatment (EPSDT) program, for indigent children. A Consent Decree was approved in 1996 to ensure compliance, with the court retaining jurisdiction. Defendants subsequently filed a Rule 60(b) motion in November 2004, seeking either complete dissolution of the Consent Decree or its partial dissolution for urban areas, citing compliance with federal law and changed circumstances. Following a June 2005 hearing, the Court evaluated evidence concerning medical checkups, dental services, outreach efforts, and case management. The Court concluded that Defendants failed to demonstrate significant changed factual circumstances, that the proposed relief was suitably tailored, or that reasonable efforts were made to comply with the decree's obligations. Consequently, Defendants' Rule 60(b) Motion for Relief From Judgment was DENIED, affirming the continued prospective application of the Consent Decree.

Medicaid Program EnforcementEPSDT ServicesConsent Decree ModificationRule 60(b) MotionHealth Care AccessIndigent Children's HealthManaged Care PerformanceState Compliance IssuesOutreach EffectivenessDental Care Access
References
27
Case No. 13-06-471-CV
Regular Panel Decision
Apr 17, 2008

Day Cruises Maritime, L.L.C. and Corpus Christi Day Cruise, L.L.C. v. Christus Spohn Health System D/B/A Christus Spohn Hospital Memorial

This case involves an appeal from summary judgments. Appellants (Day Cruises Maritime, L.L.C. and Corpus Christi Day Cruise, L.L.C., collectively "Texas Treasure") contested the trial court's decision in favor of appellee (Christus Spohn Health System d/b/a Christus Spohn Hospital Memorial, "Christus"). The dispute arose from medical expenses incurred by a seaman, Judy Ann Lanado, employed by Texas Treasure, who suffered severe brain damage after surgery at Christus. Texas Treasure sought to avoid liability for the entire hospital bill and claimed equitable subrogation. The appellate court affirmed the denial of Texas Treasure's motion for summary judgment on its plea in intervention but reversed the granting of Christus's motions for summary judgment on its counterclaim and Texas Treasure's plea in intervention, remanding for further proceedings to determine negligence and attributable expenses.

Summary JudgmentAppellate ReviewSworn AccountVerified DenialDue ProcessEquitable SubrogationMaintenance and CureMaritime LawAlien CrewmanHospital Expenses
References
52
Case No. MISSING
Regular Panel Decision

Local 205, Community and Social Agency Employees'union v. Day Care Council of Ny Inc.

Local 205, Community and Social Agency Employees’ Union petitioned for confirmation and enforcement of an arbitration award against the Day Care Council of New York, Inc. (DCC). The award arose from employee grievances against the now-closed Georgia-Livonia Day Care Center. The Union argued that the award should be interpreted as binding upon DCC, a multi-employer bargaining association, despite not explicitly naming DCC for relief. DCC contended it was not a party to the arbitration agreement in the collective bargaining agreement (CBA) and therefore not obligated to arbitrate disputes involving itself. The court, after reviewing the CBA's language and the parties' past conduct, found no agreement by DCC to arbitrate. It also ruled that DCC's defenses were not time-barred by either the Federal Arbitration Act or New York C.P.L.R. § 7511, as these limitations do not apply to arguments challenging the existence of an arbitration agreement itself. Consequently, the Union's petition for confirmation and enforcement of the award against DCC was denied.

Arbitration AwardCollective Bargaining AgreementGrievance ProcedureMulti-Employer AssociationAgreement to ArbitrateFederal Arbitration ActLabor Management Relations ActConfirmation of AwardEnforcement of AwardSouthern District of New York
References
25
Case No. MISSING
Regular Panel Decision

State Office of Risk Management v. Lawton

Mary Lawton sustained a knee contusion during her employment. The State Office of Risk Management (SORM) initially paid benefits but later disputed additional knee conditions diagnosed by Dr. Mario Bertoni, claiming these were not part of the compensable injury. SORM argued that the 60-day waiver rule under Texas Labor Code § 409.021 did not apply to "extent of injury" disputes. However, the Division of Worker’s Compensation and the appeals panel found that SORM had waived its right to contest compensability because it had received notice of the additional conditions within the statutory 60-day period. The trial court granted Lawton's motion for summary judgment, and the appellate court affirmed this decision, reinforcing that the waiver rule applied where information about the extent of the injury was reasonably discoverable within the initial period.

Summary Judgment AppealWaiver of CompensabilityExtent of Injury DisputeTexas Labor Code Section 409.021Workers' CompensationMedical BenefitsKnee InjuryOsteochondritis DissecansChondromalaciaInsurance Carrier Liability
References
12
Case No. 04-09-00401-CV
Regular Panel Decision
Jul 21, 2010

Texas Mutual Insurance Company v. Sarah Ochoa

Sarah Ochoa sustained a lumbar sprain injury at work and filed a workers' compensation claim. Texas Mutual Insurance Company, the carrier, initially accepted the lumbar sprain but disputed later claims of extensive lumbar disc pathology as an ordinary disease of life. The hearing officer found a sprain/strain injury superimposed on pre-existing degenerative conditions but also ruled that Texas Mutual waived its right to contest the extent of injury by not timely disputing it within 60 days, making the degenerative conditions compensable. Texas Mutual appealed to the state district court, which granted Ochoa's no-evidence motion for summary judgment. This appellate court reverses and remands the trial court's judgment, holding that the 60-day waiver rule in the Texas Labor Code does not apply to extent-of-injury disputes, citing Texas Supreme Court precedent.

Workers' CompensationSummary JudgmentWaiver RuleExtent of Injury DisputeLumbar SprainDegenerative Disc DiseasePre-existing ConditionAppellate ReviewTexas Labor CodeJudicial Precedent
References
7
Case No. MISSING
Regular Panel Decision

Jaco v. Department of Health, Bureau of Medecaid

This case involves a judicial review of an administrative decision by the Department of Health, Bureau of Medicaid, which denied John Jaco's application for medicaid benefits. The trial court initially dismissed Jaco's petition for judicial review, ruling that the failure to issue a summons within 60 days of the administrative decision deprived the court of jurisdiction, despite the petition itself being filed and served within that timeframe. The Court of Appeals reversed this decision, asserting that the issuance of a summons is not a prerequisite to initiating proceedings for judicial review of an administrative decision in chancery court. The Supreme Court of Tennessee affirmed the Court of Appeals' judgment, holding that under the Uniform Administrative Procedures Act (Tenn.Code Ann. § 4-5-322(b)), proceedings for review are instituted by filing a petition within 60 days, and the reference to the Tennessee Rules of Civil Procedure applies only to the method of service of the petition, not to a requirement for a summons to commence the action.

Judicial reviewAdministrative lawMedicaid benefitsSummonsService of processUniform Administrative Procedures ActTennessee Supreme CourtCourt jurisdictionStatutory interpretationPetition for review
References
5
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