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

Case No. 03-09-00635-CV
Regular Panel Decision
Aug 19, 2011

Texas Racing Commission and Charla Ann King, Executive Director v. Javier Marquez D/B/A J&M Racing and Farm

Javier Marquez's racehorses were disqualified and their race purse redistributed due to inadvertently wearing incorrect saddle cloth numbers, a violation of commission rules. Marquez appealed the stewards' decision to the Texas Racing Commission, but the executive director, Charla Ann King, denied the appeal, citing a provision of the Texas Racing Act that deemed such decisions final. Marquez then filed a suit against the Commission and King, seeking declaratory relief. The trial court denied relief under the Administrative Procedure Act but granted it under the Uniform Declaratory Judgments Act, declaring that King exceeded her statutory authority by denying the appeal and by disqualifying the horses and redistributing the purse. On appeal, the Court of Appeals affirmed that the director exceeded her authority by refusing the administrative appeal, but vacated and dismissed the trial court's rulings on the disqualification and purse redistribution, holding that the trial court lacked subject matter jurisdiction until Marquez exhausted his administrative remedies. The court also affirmed a reduced award of attorney's fees.

Racing ActAdministrative LawDeclaratory JudgmentSovereign ImmunityUltra Vires ClaimAdministrative AppealHorse RacingDisqualificationPurse RedistributionSubject Matter Jurisdiction
References
20
Case No. 03-03-00435-CV
Regular Panel Decision
Jul 29, 2004

Texas Workers' Compensation Commission Richard Reynolds, in His Official Capacity as Executive Director of the Texas Workers' Compensation Commission/East Side Surgical Center Clinic for Special Surgery And Surgical and Diagnostic Center, L.P. v. East Side Surgical Center Clinic for Special Surgery/Texas Workers' Compensation Commission Richard Reynolds, in His Official Capacity as Executive Director of the Texas Workers' Compensation Commission

This case involves the Texas Workers’ Compensation Commission's failure to establish fee guidelines for ambulatory surgical centers under the Texas Workers’ Compensation Act. East Side Surgical Center, Clinic for Special Surgery, and intervenor Surgical and Diagnostic Center, L.P. (collectively "East Side") sued the Commission to invalidate certain default rules that applied when specific guidelines were absent. The district court declared one rule (133.304(i)) invalid and enjoined its enforcement, citing unlawful delegation of authority. On appeal, the Court of Appeals reversed the district court's judgment regarding the rule's invalidity and dissolved the injunction, citing a Texas Supreme Court decision finding no unlawful delegation. The court affirmed that East Side was not entitled to its usual and customary fee in the absence of specific guidelines.

Workers' CompensationAdministrative LawDelegation of AuthorityRulemakingAmbulatory Surgical CentersJudicial ReviewInsurance CarrierFee GuidelinesFair and Reasonable RatesStatutory Interpretation
References
38
Case No. 5615/89; 2643/91
Regular Panel Decision

In re the Director of the Assigned Counsel Plan

The court denies the Director of the Assigned Counsel Plan of the City of New York's request for further reconsideration of 'reasonable compensation' awarded to expert witness Hillel Bodek in People v Toe and People v Hoe. Judge Goodman reaffirmed the original compensation, emphasizing that judicial determinations of expert fees under County Law § 722-c are not subject to administrative review by the Director. The court rejected arguments regarding excessive compensation, lack of specificity in orders, and the expert's qualifications, highlighting the confidentiality of reports and the judge's sole authority in such matters. The opinion clarified the roles of judges and administrators in the assigned counsel plan. The Director was ordered, under penalty of contempt, to process the payment of $5,200 and $200 for Bodek's services.

Expert Witness CompensationCounty Law § 722-cJudicial DiscretionAdministrative ReviewForensic Social WorkMental Health EvaluationConfidentiality of ReportsProfessional QualificationsExtraordinary CircumstancesContempt Order
References
11
Case No. 03-14-00396-CV
Regular Panel Decision
Jan 06, 2015

Texas Board of Chiropractic Examiners and Yvette Yarbrough, Executive Director v. Texas Medical Association

The Texas Board of Chiropractic Examiners (TBCE) and its Executive Director, Yvette Yarbrough, are appealing a decision from the Third Court of Appeals in Austin, Texas. They have filed a motion for panel rehearing and/or en banc rehearing. The appellants argue that the Court's previous memorandum opinion contains three fundamental errors: misstating appellate issues, resolving subject-matter jurisdiction using a prohibited method, and misstating the administrative rule at issue. They contend that the Court misunderstood their challenge to the trial court's jurisdiction regarding the Texas Medical Association's (TMA) claim to invalidate a provision of the Scope of Practice Rule (22 Tex. Admin. Code § 75.17(d)(1)) concerning chiropractors' authority to "diagnose" diseases. TBCE asserts that this claim is a collateral attack on a prior judgment in TMA I where the same issue was litigated and decided in TBCE's favor. They argue that subject-matter jurisdiction should be decided on a claim-by-claim basis and that the Court erred in its interpretation of the administrative rule number. They are requesting an opportunity for oral argument due to the significance of the issues for chiropractic practice in Texas.

Workers' CompensationChiropractic Scope of PracticeMedical AssociationCollateral AttackSubject Matter JurisdictionAdministrative LawRule InvalidationTexas LawAppellate ProcedureMotion for Rehearing
References
6
Case No. ADJ2154380
Regular
Jul 21, 2010

SPENCER DAVIS vs. CLARK & SULLIVAN, INC., LWP CLAIMS SACRAMENTO, BERKSHIRE HATHAWAY SAN FRANCISCO, BERKSHIRE HATHAWAY PASADENA

In this case, the defendant sought to disqualify a Qualified Medical Evaluator (QME) due to their alleged unavailability for deposition within 120 days as required by Administrative Director Rule 35.5(f). The Workers' Compensation Appeals Board (WCAB) denied the defendant's petition for removal. The WCAB found that Rule 31.5, which allows for replacement panels, does not apply to QME unavailability for deposition. Furthermore, the Board determined the defendant failed to demonstrate significant prejudice or irreparable harm, especially after rescheduling the deposition themselves.

Petition for RemovalQualified Medical EvaluatorDeposition UnavailabilityAdministrative Director RuleMandatory RegulationPrejudice and HarmReplacement PanelWCJ OrderUpper Extremities InjuryPsyche Injury
References
0
Case No. MISSING
Regular Panel Decision

Metropolitan Funeral Directors Ass'n v. City of New York

Plaintiffs, including the Metropolitan Funeral Directors Association, John C. Sommese, Anthony J. Martino, Hess-Miller Funeral Home, Inc., and Simonson Funeral Home, Inc., initiated an action seeking a declaratory judgment against the City of New York, the New York City Department of Consumer Affairs (DCA), and Commissioner Jules Polonetsky. The plaintiffs challenged four recently amended DCA rules (5-162, 5-164, 5-165, 5-166) pertaining to the regulation of the funeral home industry. They contended that these rules were preempted by State law, exceeded the Commissioner's authority, lacked a legitimate government purpose, were unconstitutionally vague, and were arbitrary and capricious. Additionally, plaintiffs sought a preliminary injunction to prevent the enforcement of these rules, arguing that their implementation would cause irreparable harm to their businesses. Defendants countered that the rules were consumer-protective, a rational exercise of authority, and consistent with State law, citing a February 1999 DCA investigation report titled "The High Cost of Dying." The court, presided over by Justice Richard F. Braun, denied the plaintiffs' motion for a preliminary injunction, concluding that they failed to demonstrate a likelihood of success on the merits, irreparable injury, or a favorable balance of equities. The court also noted the plaintiffs' incomplete statement as required by CPLR 6001.

Funeral Home RegulationConsumer ProtectionDeclaratory JudgmentPreliminary InjunctionState PreemptionLocal OrdinancesAdministrative LawStatutory AuthorityUnconstitutionally VagueArbitrary and Capricious
References
21
Case No. MISSING
Regular Panel Decision

Director of the Assigned Counsel Plan v. Townsend

This case involves an appeal by the Director of the Assigned Counsel Plan from orders of the Supreme Court, New York County. The Director's applications sought to reduce vouchers for compensation for services other than counsel in multiple criminal cases. The Supreme Court denied these applications and, upon reconsideration, adhered to its decisions directing the processing of the vouchers. The Appellate Division unanimously affirmed these orders, finding no basis to disturb the lower court's determinations of "reasonable compensation" and "extraordinary circumstances" under County Law § 722-c. The court further ruled that such determinations are not reviewable by the Appellate Division, emphasizing that fiscal concerns regarding compensation should be addressed through administrative review processes.

Assigned Counsel PlanVoucher CompensationCriminal Defense ServicesAttorney CompensationSocial Worker CompensationCounty Law 722-cExtraordinary CircumstancesAppellate ReviewJudicial DiscretionAdministrative Review
References
4
Case No. ADJ9772365 (MF) ADJ10082338
Regular
Dec 06, 2016

Leonel Hidalgo vs. Hilbert Property Management, Technology Insurance Company

The Workers' Compensation Appeals Board (WCAB) dismissed the applicant's Petition for Reconsideration, treating it instead as a Petition for Removal. The WCAB granted removal, rescinded the Joint Findings of Fact, and returned the matter for further proceedings. This action was based on the Medical Director applying the incorrect standard when determining that an orthopedic QME panel was in the applicant's medical interest. The WCAB found that the Medical Director should have first determined if the applicant's chosen chiropractic specialty was medically or otherwise inappropriate, as required by Administrative Director Rule 31.5(a)(10).

Workers' Compensation Appeals BoardQualified Medical EvaluatorQME panelspecialty determinationorthopedicschiropracticMedical DirectorAdministrative Director RuleLabor CodePetition for Reconsideration
References
9
Case No. 03-01-00631-CV
Regular Panel Decision
Jun 21, 2002

Everest National Insurance Company v. Texas Workers' Compensation Commission Subsequent Injury Fund Leonard W. Riley, Jr., in His Official Capacity as Director of Texas Workers' Compensation Commission And John Casseb, in His Official Capacity as Administrator of Subsequent Injury Fund

Everest National Insurance Company (Everest) sought reimbursement from the Subsequent Injury Fund for overpaid workers' compensation benefits after district court judgments reversed prior agency decisions. The Fund denied a portion of the requested amount, leading Everest to file a declaratory judgment suit in district court. The district court dismissed the suit, citing lack of subject-matter jurisdiction due to Everest's alleged failure to exhaust administrative remedies. The Texas Court of Appeals reversed this decision, holding that Everest was not required to exhaust administrative remedies because the Fund had previously stated no such remedies existed. The appellate court found Everest was authorized to bring a direct suit for declaratory relief under the Uniform Declaratory Judgments Act to enforce the Fund's statutory obligation, remanding the case for a decision on the merits.

Workers' CompensationInsurance ReimbursementSubsequent Injury FundAdministrative Procedure ActDeclaratory JudgmentExhaustion of Administrative RemediesSubject-Matter JurisdictionStatutory InterpretationTexas Court of AppealsJudicial Review
References
8
Case No. 03-97-00124-CV
Regular Panel Decision
Sep 18, 1997

Director, Workers' Compensation Division v. Belinda J. Pampell

This case addresses the timely filing of a petition by the Workers' Compensation Division with the Lee County district clerk, appealing an adverse ruling from the Texas Workers' Compensation Commission. The district court dismissed the appeal, citing a lack of jurisdiction due to the late filing. The Division argued its petition was timely under Texas Rules of Civil Procedure 4 and 5, having been mailed on August 14, 1996, the last day for filing. The Court of Appeals reversed the dismissal, concluding that the petition was timely mailed and effectively received by the district clerk's office on August 26, 1996, fulfilling the requirements of Rule 5. The cause was remanded to the district court for further proceedings.

Timely FilingWorkers' CompensationAppellate ProcedureTexas Rules of Civil Procedure 5JurisdictionMailbox RuleStatutory InterpretationCourt of AppealsLee CountyDismissal Reversal
References
6
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