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

Case No. ADJ7785936
Regular
Feb 28, 2014

LISA VALDEZ vs. SAINT HELENA HOSPITAL

The Workers' Compensation Appeals Board reversed a prior order denying a lien claimant's fee, allowing payment for a psychiatric consultation. The Panel Qualified Medical Examiner (PQME) Dr. Burt reasonably requested the consultation with Dr. Goldfield under former AD Rule 32, which permitted PQMEs to obtain necessary consultations. The defendant failed to investigate the potential psychiatric component of the applicant's industrial injury as required by AD Rule 10109, despite being notified by the PQME. Therefore, the Board found that Dr. Goldfield should be compensated for services rendered in the interest of substantial justice.

AD Rule 32Panel Qualified Medical Examiner (PQME)psychiatric consultationlien claimantindustrial injuryregistered nursepermanent disabilityfuture medical treatmentreconsiderationsubstantial justice
References
0
Case No. NO. 14-13-00421-CV
Regular Panel Decision
Apr 24, 2014

Sheila Adams v. Golden Rule Service, Inc.

Sheila Adams, a nursing aide, sued her employer, Golden Rule Service, Inc., for injuries allegedly sustained while assisting a patient at Golden Rule's health care facility. The trial court dismissed the case because Adams failed to serve an expert report as required by the Texas Medical Liability Act (TMLA). Adams appealed, arguing her claims were not governed by the TMLA. The Fourteenth Court of Appeals affirmed the trial court's decision, concluding that Adams's claims were health care liability claims subject to the TMLA's expert report requirement, consistent with prior court precedents.

Health care liabilityTMLAExpert reportNegligenceEmployer liabilityMedical injuryWorkplace injuryTexas lawAppellate reviewDismissal
References
7
Case No. 03-21-00074-CV
Regular Panel Decision
Feb 28, 2023

Texas Department of Insurance, Division of Workers' Compensation// Accident Fund Insurance Company of America and Texas Cotton Ginners' Trust v. Accident Fund Insurance Company of America and Texas Cotton Ginners' Trust// Cross-Appellee, Texas Department of Insurance, Division of Workers' Compensation

This declaratory-judgment action involves a dispute between the Texas Department of Insurance, Division of Workers’ Compensation (the Division) and insurance carriers, Accident Fund Insurance Company of America and Texas Cotton Ginners’ Trust, regarding rules for workers’ compensation supplemental income benefits (SIB). The carriers challenged the validity of a Division rule, 28 Texas Administrative Code Section 130.102, which governs eligibility for SIB, specifically concerning the "work search efforts" requirement for injured employees. The district court had ruled a section of the rule (d)(1)(D) invalid and another section (f) inapplicable to independent job seekers. On appeal, the Court of Appeals reversed the district court's finding that Section (d)(1)(D) was invalid, concluding it was facially valid. However, the appellate court affirmed the district court's ruling that Section (f)'s "work search contacts" language does not qualitatively apply to independent job seekers, but only for setting a numerical standard. Additionally, the court found certain parts of the Division's preamble to the rule and its Appeals Panel Decision Manual to contain invalid ad hoc rules, reversing the district court on this point, while affirming that an Appeals Panel Decision and the SIB application form were not ad hoc rules. The court also found the exclusion of an expert witness to be harmless.

Workers’ CompensationSupplemental Income BenefitsAgency Rule ValidityAdministrative LawDeclaratory Judgment ActionStatutory InterpretationWork Search RequirementsAd Hoc RulesAppellate ProcedureTexas Government Code
References
22
Case No. MISSING
Regular Panel Decision
Mar 26, 1998

In Re Bagel Bros. Bakery & Deli, Inc.

This order addresses whether Federal Rule of Bankruptcy Procedure 1014(b) imposes an automatic stay on proceedings in a subsequently-filed bankruptcy case. The case involves three Chapter 11 cases of Bagel Bros. Maple, Inc. and Bagel Bros. Deli & Bakery, Inc. in the Western District of New York, which are related to earlier Chapter 11 cases of MBC in the District of New Jersey. MBC filed a motion in New Jersey seeking to transfer venue and requested that the New York court automatically stay its proceedings based on Rule 1014(b). Bankruptcy Judge Michael J. Kaplan ruled that Rule 1014(b) does not constitute an automatic or self-executing stay upon the mere filing of a motion. Instead, a judicial determination and order from the first-filed court (District of New Jersey) are required to impose such a stay, ensuring that substantive rights are not abridged and allowing for judicial discretion in emergency matters. Therefore, the proceedings in the Western District of New York are not automatically stayed.

Bankruptcy ProcedureAutomatic StayFederal Rule of Bankruptcy Procedure 1014(b)Venue TransferChapter 11 ReorganizationInter-district BankruptcyJudicial InterventionSubstantive RightsFranchise AgreementsCash Collateral Disputes
References
12
Case No. ADJ8608456 MF\nADJ8608504\nADJ8523009\nADJ8551858\nADJ8609068
Regular
Oct 07, 2015

HORACIO CABRERA, Deceased MARIBEL BARAJAS, Widow, Guardian Ad\nLitem for LITZY CABRERA, LESLY\nCABRERA, MARIA CABRERA AND\nKASSANDRA CABRERA; BRIANNA\nCABRERA, for herself and Guardian Ad Litem for STEFANI ARIAS, ANTONIO SOLARES, MODESTO DOMINGUEZ, JOHNATHAN ALONSO vs. MV CONTRACTING, STAR INSURANCE COMPANY

In this workers' compensation case, the employer sought reconsideration of a ruling finding a fatal motor vehicle accident and related injuries industrial. The employer argued the administrative law judge erred in admitting evidence and presuming compensability due to a failure to issue timely denial notices. The employer also contended the "going and coming rule" barred the claims as the accident occurred during a standard commute. The Board denied reconsideration, affirming the judge's findings that the injuries were industrial and not barred by the going and coming rule, largely adopting the judge's reasoning.

WCABPetition for ReconsiderationDenying PetitionRulings and Order Admitting EvidenceFindings of FactMotor Vehicle AccidentIndustrial InjuriesFatal Industrial InjuryDependentsNotice of Denial
References
0
Case No. ADJ10348591 ADJ10349019
Regular
Jan 07, 2019

MIGUEL VELAZQUEZ, SERVANDO VELAZQUEZ vs. ARTEMIO ARCE, SOLOMON MARTINEZ

The Workers' Compensation Appeals Board denied a defendant's petition for reconsideration, upholding a prior finding that liens for interpreting services were not barred by AD rule 9792.5.5. This rule, requiring a second review request for fee schedule disputes, did not apply because the interpreter services were not subject to an applicable fee schedule at the time of service. Therefore, the lien claimant's failure to request a second review did not preclude the WCAB from adjudicating the lien dispute. The Board reasoned that AD rule 9792.5.5 and associated statutes only mandate the second review process for disputes concerning amounts under an "applicable fee schedule."

Workers' Compensation Appeals BoardAD Rule 9792.5.5Official Medical Fee ScheduleIndependent Bill ReviewExplanation of ReviewLabor Code section 4603.2Senate Bill 863Threshold IssueFee Schedule DisputeInterpreter Services
References
0
Case No. MISSING
Regular Panel Decision

Cameron Appraisal District v. Rourk

The Cameron Appraisal District assessed ad valorem taxes against the owners of 34 travel trailers. Some owners did not exhaust administrative remedies, while others did. The district court dismissed claims for those who failed to exhaust remedies, granted summary judgment against the others, and refused class certification. The court of appeals reversed these rulings. The Supreme Court reversed the court of appeals' decision, holding that exhaustion of administrative remedies is mandatory and courts lack jurisdiction without it. The court also stated that a class action cannot bypass these statutory prerequisites for taxpayer recovery. However, the court agreed that fact issues prevent determining whether the remaining trailers are taxable as a matter of law, remanding that issue for further proceedings.

Ad Valorem TaxesProperty TaxAdministrative RemediesExhaustion DoctrineJurisdictionClass ActionTax CodeTravel TrailersManufactured HomesRecreational Vehicles
References
8
Case No. MISSING
Regular Panel Decision

TXU Generation Co. v. Public Utility Commission

The Texas Court of Appeals, Austin, reviewed a direct appeal challenging the Public Utility Commission's Wholesale Market Oversight (WMO) Rule. Appellants, a group of market participants, argued the rule exceeded the Commission's statutory authority, was unconstitutionally vague, constituted an unconstitutional taking, and violated the Administrative Procedure Act (APA) regarding notice and concise statement of authority. The court, led by Justice Bea Ann Smith, affirmed the validity of the WMO Rule. It held that the Commission possessed broad authority under PURA to regulate the wholesale electricity market to protect public interest, consumers, and ensure reasonably priced ancillary services, even if some prohibited conduct was unintentional. The court also found the rule provided sufficient notice and did not invite arbitrary enforcement, nor did it constitute an unconstitutional taking or violate APA procedures. Ultimately, the court affirmed the validity of the WMO Rule, concluding that it reasonably promotes competition and fulfills legislative goals for the electricity market.

Electricity RegulationWholesale Energy MarketPublic Utility CommissionAdministrative LawStatutory InterpretationConstitutional ChallengesMarket Power AbuseConsumer ProtectionTexas LawDirect Appeal
References
38
Case No. ADJ9346293
En Banc
Jan 13, 2020

ANTHONY DENNIS vs. STATE OF CALIFORNIA – DEPARTMENT OF CORRECTIONS AND REHABILITATION INMATE CLAIMS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) issued a Notice of Intention to hold that Administrative Director (AD) Rule 10133.54 is invalid. The WCAB reasoned that the rule exceeds the AD's statutory authority and improperly restricts the WCAB's exclusive jurisdiction to adjudicate disputes over supplemental job displacement benefits (SJDB). The board also intends to affirm its prior decision that an employer must make a bona fide offer of work to an injured employee to be exempt from providing an SJDB voucher.

AD Rule 10133.54Supplemental Job Displacement BenefitBona Fide OfferExclusive JurisdictionAdministrative DirectorWorkers' Compensation Appeals BoardInmate LaborerStatutory AuthorityEn Banc DecisionReconsideration
References
31
Case No. ADJ8543406
Regular
Jun 01, 2018

JOSE HERNANDEZ vs. ALBA CONSTRUCTION COMPANY, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration of a WCJ's denial of sanctions for delayed payment of interpreter services. The Board found that the interpreter services for the Compromise and Release were reasonable and necessary under AD Rule 9795.3. Defendant received the invoice on February 24, 2016, but did not pay it until August 2, 2017, exceeding the 60-day payment requirement of AD Rule 9795.4. Therefore, the Board rescinded the prior findings and returned the matter for further proceedings on the petitions for costs and sanctions.

WCABJoyce Altman InterpretersAD Rule 9795.4AD Rule 9795.3Labor Code Section 5813Petition for ReconsiderationFindings of FactCompromise and ReleaseInterpreter ServicesClaims Administrator
References
8
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