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Case Law Database

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

Case No. 04-15-00021-CV
Regular Panel Decision

Board of Adjustment of the City of San Antonio v. Michael and Theresa Hayes

The County Court reversed the Board of Adjustment's action regarding Appeal No. A-14-049. This reversal means that the City of San Antonio Permit No. 1951114 to construct a guardrail remains revoked. Additionally, the Board of Adjustment's action from January 13, 2014, in Case Number A-13-0732 remains final. The court also denied the Board of Adjustment's plea to the jurisdiction and their objection to the evidence.

Zoning DisputeAdministrative AppealBuilding PermitsLocal GovernmentProperty RightsJudicial ReviewTexas LawGuardrail RegulationCode EnforcementSan Antonio
References
6
Case No. ADJ9103955
Regular
Aug 25, 2014

EMMANUEL BRISENO vs. CALTRANS, Permissibly Self-Insured, Adjusted By STATE COMPENSATION INSURANCE FUND

This case concerns a workers' compensation appeal where the defendant, Caltrans, sought reconsideration of an award of temporary disability benefits. Caltrans argued the award should credit benefits already paid by the Employment Development Department (EDD) to prevent double recovery. The Appeals Board granted reconsideration, agreeing that the award needed adjustment for the EDD's potential lien. Consequently, the Board amended the award to require the parties to adjust the benefit amount, taking into account the EDD's potential lien interest.

Workers' Compensation Appeals BoardADJ9103955Emmanuel BrisenoCALTRANSPermissibly Self-InsuredState Compensation Insurance FundTemporary Disability IndemnityEmployment Development Department (EDD)EDD LienDouble Recovery
References
0
Case No. 3-92-291-CV
Regular Panel Decision
Mar 10, 1993

Ronald David Patton v. National Union Fire Insurance Company of Pittsburgh, Pennsylvania, Jean Auvenshine and American International Adjustment Company, Inc.

Ronald David Patton sued National Union Fire Insurance Company, Jean Auvenshine, and American International Adjustment Company, Inc., alleging violations of the duty of good faith and fair dealing related to his workers' compensation claim. Patton had injured his back in 1985, and his claim was formally denied by National Union in June 1987. The trial court granted a take-nothing summary judgment in favor of the appellees, ruling that Patton's suit was barred by the two-year statute of limitations. The Court of Appeals affirmed this judgment, holding that the cause of action accrued at the time of the denial of coverage in June 1987, and that the tort was not a continuous one, nor was the statute of limitations tolled by subsequent events or the involvement of an adjuster.

Workers' CompensationInsurance Bad FaithStatute of LimitationsSummary JudgmentDuty of Good Faith and Fair DealingTexas Court of AppealsDenial of CoverageAccrual of Cause of ActionContinuous TortInsurance Adjuster Liability
References
4
Case No. ADJ7978937
Regular
Aug 26, 2014

KATHERINE JAMES vs. STATE OF CALIFORNIA, CSP KINGS COUNTY AT CORCORAN, Legally Uninsured; STATE COMPENSATION INSURANCE FUND/STATE CONTRACT SERVICES, Adjusting Agency

The Appeals Board granted reconsideration and amended the original award, admitting defendant's Exhibit E and adjusting the temporary disability indemnity rate. While affirming the finding of a psychiatric injury, the Board rescinded all penalties and sanctions previously awarded. Defendant's assertion of a good faith personnel action defense was deemed reasonable, thus precluding penalties for delayed payment. Temporary disability amounts are to be adjusted by the parties, with jurisdiction reserved for future disputes.

Workers' Compensation Appeals BoardReconsiderationPsychiatric InjuryGastrointestinal SystemDepressionAnxietyPanic AttacksLoss of AppetiteTemporary DisabilityPenalties
References
14
Case No. MISSING
Regular Panel Decision

Heinsohn v. Trans-Con Adjustment Bureau

Robert Heinsohn sued his former employer, Trans-Con Adjustment Bureau, alleging wrongful termination after suffering a work-related injury, claiming the company discharged him to avoid a workers' compensation claim. The trial court granted the company's motion for a directed verdict, citing no evidence of damages. Heinsohn appealed this decision. The appellate court found sufficient evidence of damages, including lost wages and medical expenses, to overcome a directed verdict. Consequently, the court reversed the trial court's judgment and remanded the case for a new trial, asserting that a jury should have been allowed to consider the evidence.

Workers' CompensationRetaliatory DischargeEmployment LawDirected VerdictDamagesLost WagesMedical ExpensesAppellate ReviewTexas LawBurden of Proof
References
6
Case No. ADJ1755508 (SRO 0142328)
Regular
Dec 21, 2012

SOSTENES REYES vs. PROTRADES CONNECTIONS, AMERICAN HOME ASSURANCE, Adjusted By CHARTIS INSURANCE

The Workers' Compensation Appeals Board granted reconsideration to amend a prior award. While affirming most findings, the Board corrected a clerical error, changing the start date for applicant's home health care services to December 3, 2011. The Board upheld the finding that the defendant unreasonably delayed payment for these services, imposing a 25% penalty. The parties were ordered to adjust the payment amounts accordingly, with jurisdiction reserved for any disputes.

WCABProtrades ConnectionsAmerican Home AssuranceChartis InsuranceSosthenes Reyesindustrial injurycognitive impairmentmemory impairmentpost-traumatic stress disorderpermanent total disability
References
0
Case No. ADJ4025440 (VNO 0557895)
Regular
Mar 12, 2012

CHARLES B. HANLON vs. WYLE HOLDINGS, INC., AIG adjusted by CHARTIS CLAIMS, INC.

The Workers' Compensation Appeals Board granted reconsideration to clarify an ambiguous award for temporary disability benefits. The applicant sustained a cumulative injury resulting in temporary and permanent disability. The defendant argued the award was unclear regarding the coordination of temporary disability payments with benefits already paid by the Employment Development Department (EDD). The Board clarified that the applicant is to be compensated for temporary disability, less amounts paid by EDD, with adjustments potentially needed to match the agreed-upon temporary disability rate. Furthermore, the Board clarified that EDD's overpayments of unemployment benefits made after the applicant's permanent and stationary date are to be reimbursed from the applicant's permanent disability benefits.

Cumulative industrial injuryTemporary disability indemnityPermanent disability benefitsPetition for ReconsiderationFindings and AwardAmbiguous awardEDD benefitsLabor Code §4904Agreed Medical ExaminerTemporary total disability
References
0
Case No. ADJ25889773 (SRO 0125150) ADJ2310836 (SRO 0125151) ADJ 4628741 (SRO 0127006)
Regular
Nov 24, 2008

JOSE SANCHEZ vs. AMY'S KITCHEN, ZURICH NORTH AMERICA, SECURITY INSURANCE, COMPANY OF HARTFORD SUCCESSOR TO CONNECTICUT INDEMNITY, Adjusted by CAMBRIDGE AND MAJESTIC INSURANCE COMPANY

This Workers' Compensation Appeals Board case concerns a dispute over the distribution of $75,000 in attorney's fees awarded in a compromise and release agreement. The applicant's former counsel, Kneisler Law Firm, filed a lien for fees, but the original approval order did not specify how these fees would be divided with the applicant's current counsel. The Board granted reconsideration to amend the order, clarifying that the prior attorney's lien shall be paid out of the $75,000 award, with the exact amount to be adjusted by the parties. Jurisdiction is reserved for further proceedings if the parties cannot agree on the division.

Workers' Compensation Appeals BoardAmy's KitchenZurich North AmericaSecurity Insurance Company of HartfordConnecticut IndemnityCambridge Insurance CompanyMajestic Insurance CompanyPetition for ReconsiderationCompromise and ReleaseAttorneys' Fees
References
0
Case No. MISSING
Regular Panel Decision

Greece Support Service Employees Ass'n v. Public Employment Relations Board

This case concerns an appeal regarding the proper application of Civil Service Law § 209-a (1) (e) to salary provisions in an expired collective bargaining agreement between an unnamed petitioner and the Greece Central School District. The agreement, from July 1992 to June 1995, included cost-of-living adjustments for salary schedules during its term. After the agreement expired, the District continued existing salary schedules but ceased further cost-of-living adjustments for 1995-1996, prompting the petitioner to file an improper practice charge. The Public Employment Relations Board (PERB) reversed an Administrative Law Judge's decision, concluding that the agreement did not mandate continued cost-of-living adjustments post-expiration. The Supreme Court dismissed the petitioner's subsequent CPLR article 78 petition seeking annulment of PERB's determination. The Appellate Division affirmed the Supreme Court's judgment, deferring to PERB's expertise and finding its interpretation that the adjustments were limited to the agreement's term to be reasonable and legally permissible.

Collective Bargaining AgreementSalary AdjustmentCost-of-Living AdjustmentPublic EmployerImproper Practice ChargeCivil Service LawPublic Employment Relations BoardJudicial ReviewCPLR Article 78Statutory Interpretation
References
6
Case No. MISSING
Regular Panel Decision

Claim of Bruzzese v. Guardsman Elevator Co.

In 1994, the claimant sustained head, neck, and back injuries at work, leading to an award for permanent partial disability, which included a wage expectancy adjustment under Workers’ Compensation Law § 14 (5). Following back surgery in 1998, the case was reopened, and the claimant was found to be temporarily totally disabled. Benefits for this temporary total disability were calculated based on the claimant's average weekly wage at the time of injury, without applying the wage expectancy adjustment. The claimant appealed, arguing that since the permanent partial disability preceded the temporary total disability, the wage expectancy adjustment should also apply to the latter period. The court disagreed, affirming the Workers’ Compensation Board's decision, citing established case law that Workers’ Compensation Law § 14 (5) is applicable only to awards for permanent partial disability and not temporary disability.

Wage expectancyTemporary total disabilityPermanent partial disabilityWorkers' Compensation benefitsBack injuryAppellate reviewDisability calculationWorkers' Compensation BoardAverage weekly wage
References
1
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