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

Case No. 01-22-00205-CV

Regular Panel Decision

Jun 20, 2023

Jacqueline M Mouton v. CCMSI

Jacqueline M. Mouton, a former school bus driver for Houston Independent School District (HISD), was injured in a motor vehicle collision. She received temporary workers' compensation benefits from HISD's third-party administrator, Cannon Cochran Management Services, Inc. (CCMSI), until reaching Maximum Medical Improvement (MMI). Mouton's employment was terminated by HISD after she did not return to work upon medical clearance. Mouton sued HISD for negligence, but the trial court granted HISD's plea to the jurisdiction based on governmental immunity, which the appellate court affirmed. Her claims against CCMSI for various statutory violations and negligence were also dismissed after special exceptions, a decision upheld on appeal due to Mouton's failure to state a cognizable cause of action and exhaust administrative remedies under the Texas Workers' Compensation Act.

NegligenceGovernmental ImmunityTexas Tort Claims ActPlea to JurisdictionSpecial ExceptionsAdministrative RemediesEmployment TerminationMaximum Medical ImprovementAppellate ReviewDistrict Court

References

Case No. ADJ6446675

Regular

Feb 01, 2011

ANAID AYVAZYAN vs. ST. JOHN KNITS, DISCOVER RE, Administered By CCMSI

The Workers' Compensation Appeals Board denied the defendant's Petition for Reconsideration. The Board affirmed the WCJ's decision, finding the Agreed Medical Examiner's (AME) report constituted substantial evidence despite defendant's arguments against it. The Board also addressed the defendant's contention regarding the exclusion of Dr. Uejo's testimony, clarifying it was properly admitted but afforded little weight as a rebuttal witness on rating, not as a medical expert. Consequently, the defendant's petition was denied, upholding the original findings.

Workers' Compensation Appeals BoardSt. John KnitsDiscover RECCMSIAnaid AyvazyanPetition for ReconsiderationReport and RecommendationWCJDr. Uejorating expert

References

Case No. ADJ246238 (SFO 0503079) ADJ491939 (SFO 0503081

Regular

Sep 01, 2011

JACKIE MOSELEY vs. ST. JOHNS KNITS, TRAVELERS INSURANCE COMPANY Administered By CCMSI

The Workers' Compensation Appeals Board granted reconsideration and amended a prior decision. The amendment corrected the permanent disability rating for Jackie Moseley's August 21, 2004 injury from 34% to 32%. This adjustment, equaling $31,950.00, was made after accounting for loss of earning capacity, age, occupation, and apportionment. The decision also clarified that the defendant's failure to offer modified work triggers an additional 15% permanent disability payment under Labor Code section 4658(d)(2).

WORKERS' COMPENSATION APPEALS BOARDST. JOHNS KNITSTRAVELERS INSURANCE COMPANYCCMSIADJ246238ADJ491939OPINION AND ORDER GRANTING RECONSIDERATIONDECISION AFTER RECONSIDERATIONPERMANENT DISABILITYCERVICAL SPINE

References

Case No. ADJ2571049 (OAK 0320041) ADJ6705156

Regular

Nov 16, 2011

DURRELL MARSHALL vs. RICHMOND SANITARY SERVICES/REPUBLIC SERVICES INC., Administered By CCMSI

The Workers' Compensation Appeals Board granted the defendant's petition for removal, rescinding an order that had closed discovery at a mandatory settlement conference. The defendant argued the order was unclear and prejudiced its ability to investigate the applicant's social security disability and state disability benefits in light of recent case law. The Board found significant prejudice and irreparable harm if discovery was restricted, allowing the case to return to the trial level for further proceedings and a new decision on discovery. The trial judge will now have discretion to allow or further restrict discovery as necessary.

Petition for RemovalOrder Closing DiscoveryMandatory Settlement ConferenceOgilvie IssuesExpert Witness DiscoverySocial Security DisabilityState Disability IndemnityEmployment Development DepartmentLabor Code section 5310Significant Prejudice

References

Case No. ADJ421212 (RIV 0037796)

Regular

Nov 02, 2016

GLADYS BUSTAMANTE vs. CALIFORNIA, INC., THOR CALIFORNIA COMPANY; ACE AMERICAN INSURANCE/ CCMSI

Here's a summary of the case for a lawyer, in four sentences: A lien claimant, Progressive Orthopedic Solutions, petitioned for reconsideration after their lien was dismissed with prejudice for failing to appear at a lien conference and not showing good cause for their absence. The Workers' Compensation Appeals Board denied the petition, finding the lien claimant did not establish a due process violation, as their claimed representative was not officially listed on record at the time of notice service. The Board adopted the judge's report, which noted the lien claimant failed to appear, object timely to the Notice of Intention to Dismiss, or file a notice of representation until after the dismissal. The Board also suggested the trial judge consider sanctions against the lien claimant for violating WCAB Rules and wasting board resources.

Workers' Compensation Appeals BoardPetition for ReconsiderationOrder Dismissing LienProgressive Orthopedic SolutionsMJR Management ServicesNotice of Intention to DismissLien ConferenceDue ProcessFailure to AppearBoard Rule 10562

References

Case No. ADJ9388041

Regular

May 20, 2014

LILIAN BERNABEL vs. DMS FACILITY SERVICES, TWIN CITIES FIRE INSURANCE/THE HARTFORD, administered by CCMSI

The Workers' Compensation Appeals Board denied Lilian Bernabel's petition for reconsideration of the arbitrator's finding of no injury AOE/COE. The Board adopted the arbitrator's report, which found the applicant's testimony regarding the injury and its reporting to be inconsistent and not credible. Furthermore, the petition was dismissed for lack of verification, a defect that was not cured despite notice. The arbitrator also found insufficient substantial medical evidence to support the claim of industrial injury.

ADJ9388041DMS Facility ServicesTwin Cities Fire InsuranceThe HartfordCCMSIPetition for ReconsiderationArbitrator's ReportGarza v. Workmen's Comp. Appeals Bd.Lab. Code§ 5902

References

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Jacqueline M Mouton v. CCMSI

NegligenceGovernmental ImmunityTexas Tort Claims ActPlea to JurisdictionSpecial ExceptionsAdministrative RemediesEmployment TerminationMaximum Medical ImprovementAppellate ReviewDistrict Court

ANAID AYVAZYAN vs. ST. JOHN KNITS, DISCOVER RE, Administered By CCMSI

Workers' Compensation Appeals BoardSt. John KnitsDiscover RECCMSIAnaid AyvazyanPetition for ReconsiderationReport and RecommendationWCJDr. Uejorating expert

JACKIE MOSELEY vs. ST. JOHNS KNITS, TRAVELERS INSURANCE COMPANY Administered By CCMSI

DURRELL MARSHALL vs. RICHMOND SANITARY SERVICES/REPUBLIC SERVICES INC., Administered By CCMSI

GLADYS BUSTAMANTE vs. CALIFORNIA, INC., THOR CALIFORNIA COMPANY; ACE AMERICAN INSURANCE/ CCMSI

LILIAN BERNABEL vs. DMS FACILITY SERVICES, TWIN CITIES FIRE INSURANCE/THE HARTFORD, administered by CCMSI

ADJ9388041DMS Facility ServicesTwin Cities Fire InsuranceThe HartfordCCMSIPetition for ReconsiderationArbitrator's ReportGarza v. Workmen's Comp. Appeals Bd.Lab. Code§ 5902