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

Case No. 03-14-00726-CV
Regular Panel Decision
Oct 30, 2014

Texas San Marcos Treatment Center, L.P. D/B/A San Marcos Treatment Center v. Veronica Payton

Texas San Marcos Treatment Center appeals the trial court's denial of its motion to dismiss Veronica Payton's health care liability claim. Payton alleged negligence after being assaulted by a patient at the treatment center. The appellant argues that the expert report provided by Dr. William H. Reid is deficient, lacking factual support and specificity concerning the standard of care, its breach, and causation, as required by Chapter 74 of the Texas Civil Practices and Remedies Code. The appellant asserts the trial court abused its discretion by finding the report adequate and requests dismissal of the claims.

Medical MalpracticeExpert ReportMotion to DismissAbuse of DiscretionStandard of CareBreach of DutyCausationHealth Care Liability ClaimPsychiatric FacilityEmployee Assault
References
25
Case No. 01-12-00581-CV
Regular Panel Decision
Oct 24, 2013

Newspaper Holdings, Inc., Integracare of Texas, LLC, and Charlotte Patterson v. Crazy Hotel Assisted Living, LTD, Crazy Hotel Assisted Living GP, LLC, Leisure Life Senior Apartment Housing II, LTD, and Charles v. Miller, Jr.

This case is an appeal from the denial of motions to dismiss a defamation, business disparagement, and tortious interference lawsuit. Appellants, Newspaper Holdings, Inc., IntegraCare of Texas, LLC, and Charlotte Patterson, published articles detailing regulatory issues and investigations at Crazy Hotel Assisted Living facility and its owner, Charles Miller. They sought dismissal under the Texas Citizens’ Participation Act (TCPA), asserting their communications were protected free speech on matters of public concern. The appellate court found it had jurisdiction, reversed the trial court's decision, holding that Appellants met the TCPA burden, and that Appellees failed to provide prima facie evidence for their claims. The court also determined the commercial speech exemption to the TCPA did not apply, remanding the case for dismissal.

DefamationBusiness DisparagementTortious InterferenceTexas Citizens' Participation Act (TCPA)Free SpeechPublic ConcernAssisted Living FacilityElder AbuseMedicaid Fraud ProbeNewspaper Articles
References
29
Case No. 13-08-00269-CV
Regular Panel Decision
Oct 22, 2009

Luzelma Campos, Betty Jo Gonzalez, and Misty Valero v. Texas Department of Criminal Justice, Community Justice Assistance Division, Nueces County Substance Abuse Treatment Facility, Nueces County Community Supervision and Corrections, and Nueces County Adult Probation Department

Appellants Luzelma Campos, Betty Jo Gonzalez, and Misty Valero appealed the trial court's grant of a plea to the jurisdiction in favor of appellees, including the Texas Department of Criminal Justice and Nueces County entities. Appellants alleged federal civil rights violations and torts under the Texas Tort Claims Act, stemming from sexual harassment and assault during their incarceration. The appellate court affirmed the dismissal of the federal civil rights claims under 28 U.S.C. § 1983, determining that the appellees were state entities immune from such suits, and found claims for injunctive relief moot as appellants were no longer incarcerated. However, the court reversed the dismissal of claims under the Texas Tort Claims Act, remanding for further proceedings to allow discovery and amendment of pleadings regarding allegations of premise defect and the use of tangible personal property, consistent with prior rulings.

Plea to the JurisdictionSovereign ImmunityTexas Tort Claims ActFederal Civil RightsSection 1983Premise DefectTangible Personal PropertyNegligent Hiring and SupervisionSexual MisconductIncarceration Conditions
References
15
Case No. 2021 NY Slip Op 07401
Regular Panel Decision
Dec 23, 2021

Matter of Carola B.-M. v. New York State Off. of Temporary & Disability Assistance

Petitioners Carola B.-M. and Tiara M. challenged the denial of their supplemental nutrition assistance program (SNAP) benefits by the New York State Office of Temporary and Disability Assistance and the Orleans County Department of Social Services. The benefits were denied because they were deemed ineligible college students. The Appellate Division, Fourth Department, reversed this determination, holding that participation in the Adult Career and Continuing Education Services, Vocational Rehabilitation program (ACCES-VR) qualifies as a Job Training Partnership Act (JTPA) program. This status exempts the students from certain SNAP eligibility requirements. The court found that the original determination was based on an unreasonable interpretation of relevant regulations, annulled the decision, granted the petition, and remitted the case for a calculation of retroactive benefits.

SNAP benefitscollege student eligibilityJob Training Partnership ActACCES-VRvocational rehabilitationCPLR article 78regulatory interpretationpublic assistancefood stampsAppellate Division
References
28
Case No. E2014-00302-COA-R3-CV
Regular Panel Decision
Jan 30, 2015

American Heritage Apartments, Inc. v. The Hamilton County Water and Wastewater Treatment Authority, Hamilton County, Tennessee

The plaintiff, American Heritage Apartments, Inc., challenged a monthly flat charge imposed by the Hamilton County Water and Wastewater Treatment Authority (County WWTA) for sewer lateral repairs. The trial court granted summary judgment to the County WWTA, finding no private right of action under the Utility District Law of 1937 (UDL). On appeal, the Court of Appeals reversed the summary judgment, concluding the UDL was inapplicable as the County WWTA was formed under the Tennessee Water and Wastewater Treatment Authority Act (WWTA Act). The appellate court held that the WWTA Act implicitly provides a private right of action for ultra vires and contract claims. The court also affirmed the trial court's alternative ruling that class action certification for affected customers was appropriate.

Water UtilityWastewater TreatmentFlat Rate ChargeClass Action CertificationSummary Judgment ReversalPrivate Right of ActionUltra Vires ClaimGovernmental ImmunityUtility District LawWater and Wastewater Treatment Authority Act
References
48
Case No. 2018-06-2365
Regular Panel Decision
Mar 07, 2019

Bauknecht, Bauknecht, v Five Star Quality Care, Inc., d/b/a Morningside Assisted Living

Barbara Bauknecht, an employee of Five Star Quality Care, Inc., sustained a work injury to her low back on July 4, 2018, while assisting a patient. Her authorized treating physician, Dr. Edward Mackey, diagnosed sciatica and disc degeneration and recommended decompressive laminectomy and fusion surgery after non-operative treatments proved unsuccessful. The employer's carrier, Safety National Casualty Corp., initially denied the surgery. At an expedited hearing, the Court found Ms. Bauknecht met her burden to prove the medical necessity of the surgery, noting the presumption of necessity for treatment recommended by an authorized physician. Consequently, the Court granted the requested relief, ordering Five Star Quality Care to immediately authorize the recommended surgery.

Workers' Compensation ClaimsExpedited HearingMedical BenefitsBack SurgerySpinal FusionLaminectomySciaticaDisc DegenerationMedical NecessityAuthorized Treating Physician
References
1
Case No. 08-11-00264-CV
Regular Panel Decision
Oct 08, 2014

Maria G. Thompson/Luis Marioni, D.C. v. Jaime Stolar, M.D., Alivio Medical Center, Alivio Treatment Centers, P.A. and Luis Marioni, D.C./Maria G. Thompson

This multi-party appeal originated from a medical and chiropractic malpractice lawsuit filed by Maria G. Thompson against Dr. Jaime Stolar, Dr. Luis Marioni, and Alivio Medical Center and Alivio Treatment Centers, P.A. Thompson alleged negligence resulting in severe knee injuries, including infection and fusions, following injections and treatment. A jury found Dr. Stolar and Dr. Marioni negligent, awarding damages. On appeal, the court reversed the judgment against Dr. Marioni due to insufficient evidence of causation but affirmed the judgment against Dr. Stolar. The court also upheld the denial of Thompson's claims regarding damages and apparent agency against Alivio.

Medical MalpracticeChiropractic MalpracticeKnee InjuryKnee InfectionSpontaneous FusionSurgical FusionNegligenceCausationDamages AssessmentApparent Agency
References
48
Case No. MISSING
Regular Panel Decision

In re Dolan

This contested special proceeding, commenced under Mental Hygiene Law § 9.60, sought the continuation of an assisted outpatient treatment (AOT) order for respondent Joan W. The court addressed three primary issues: the admissibility of hearsay statements from non-parties in hospital records, a motion to quash a subpoena for the respondent’s expert witness's notes, and the continuation of the AOT plan. The court ruled that hearsay statements relevant to diagnosis and treatment are admissible under the business records exception, extending the People v Ortega holding to Mental Hygiene Law hearings. Additionally, the motion to quash the subpoena for the expert’s notes was denied, as the respondent waived privilege by placing her condition in controversy. Ultimately, with the respondent's consent, the court granted the continuation of the AOT order for one year, retroactive to September 23, 2011.

Assisted Outpatient TreatmentMental Hygiene LawHearsay AdmissibilityBusiness Records ExceptionHospital RecordsMedical Diagnosis and TreatmentSocial Worker-Client PrivilegeWaiver of PrivilegeSubpoena QuashalKendra's Law
References
8
Case No. MISSING
Regular Panel Decision
Jun 23, 1981

Claim of Sanginario v. County of Monroe Pure Waters Division

The Workers' Compensation Board denied medical fee payments to an intervenor-appellant for treatment provided to a claimant. The initial treatment for a right arm and shoulder injury was performed by a physician’s assistant not under the supervision of an authorized physician. Although the claimant received compensation benefits for disability, the Board refused to pay medical bills submitted by Dr. Choi, an orthopedic specialist associated with the intervenor. The court affirmed the Board's decision, emphasizing that the Workers' Compensation Law requires authorization for treatment providers and does not permit unsupervised care by physician's assistants. This ruling underscored the importance of statutory compliance regarding medical services reimbursement in workers' compensation cases.

Medical Fees DenialPhysician's Assistant SupervisionAuthorization for TreatmentWorkers' Compensation LawMedical Provider QualificationsStatutory ComplianceAppellate ReviewBoard Decision AffirmedMedical Service ReimbursementOrthopedic Injury
References
1
Case No. ADJ4157637
Regular
Mar 18, 2010

BEATRICE WEISS vs. TECHNOLOGY FUNDING, LUMBERMEN'S MUTUAL CASUALTY COMPANY, BROADSPIRE, a CRAWFORD COMPANY

This case involves an applicant who sustained a spinal injury in 2000 and was awarded permanent total disability and ongoing medical treatment, including assisted living. The Workers' Compensation Appeals Board (WCAB) clarified that the applicant is entitled to full reimbursement for assisted living costs incurred after exhausting long-term care insurance, as medical treatment for industrial injuries is not apportionable, even if concurrent non-industrial conditions exist. However, the WCAB reversed an award for personal duty aides, finding insufficient evidence of their necessity due to the industrial injury, and denied claims for interest on unpaid bills and guardianship costs. The WCAB affirmed reimbursement for dental expenses necessitated by medication for the industrial injury, while excluding attorney fees for enforcing treatment denials.

Workers' Compensation Appeals BoardBeatrice WeissTechnology FundingLumbermen's Mutual Casualty CompanyBroadspireCrawford CompanyADJ4157637SFO 0445495Opinion and Decision After Reconsiderationpermanent total disability
References
5
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