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

Case No. ADJ1588834
Regular
Mar 18, 2013

SOLEDAD YAP vs. MARINERS POST ACUTE NETWORK, AMERICAN HOME ASSURANCE

The Workers' Compensation Appeals Board denied the defendant's Petition for Reconsideration, affirming the judge's findings. The Board adopted the judge's report, which thoroughly addressed and refuted the defendant's arguments regarding temporary disability awards and the compensability of the applicant's urological condition. Defense counsel was admonished for mischaracterizing the record and citing evidence not in the record, with a warning of potential sanctions. The judge's findings, including the industrial causation of the applicant's cauda equina syndrome and associated permanent disability, were found to be supported by substantial evidence.

Petition for ReconsiderationAgreed Medical Examiner (AME)Qualified Medical Examiner (QME)Temporary DisabilityPermanent DisabilityCompensable ConsequenceCauda Equina SyndromeUrological ConditionBowel DysfunctionBladder Dysfunction
References
0
Case No. ADJ7148195
Regular
Jan 03, 2020

KARIN SMITH vs. MARIN GENERAL HOSPITAL, ATHENS ADMINISTRATORS

This case concerns defendant's petition for reconsideration of an award for applicant's back surgery. The Workers' Compensation Appeals Board (WCAB) granted reconsideration, affirmed the award, and corrected a clerical error in the case number. The WCAB found that while an initial surgery request was denied via Utilization Review (UR) and Independent Medical Review (IMR), the applicant's treating physician later submitted a new request supported by documented changes in material facts, including new neurological symptoms and an MRI showing critical stenosis and potential cauda equina syndrome. Because the second request indicated an imminent and serious threat to the applicant's health and was based on new medical evidence, the 12-month UR decision validity period did not apply.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardUtilization ReviewIndependent Medical ReviewLabor Code Section 4610(k)Documented Change in ConditionLumbar Spine SurgeryNurseCauda Equina Syndrome
References
0
Case No. 2-08-444-CV
Regular Panel Decision
Aug 31, 2009

Liberty Mutual Insurance Company v. Roy Burk

Roy Burk sustained a work-related back injury in 1998, which necessitated multiple surgeries, including one for cauda equina syndrome. Liberty Mutual Insurance Company, who accepted the initial injury, later contested the extent of Burk's injury, specifically arguing that his work injury did not cause his polyneuropathy and foot ulceration. Following a Contested Case Hearing and an affirmation by an appeals panel in Burk's favor, Liberty Mutual initiated judicial review. The trial court subsequently ruled that Burk's work-related injury did indeed extend to his polyneuropathy and foot ulcerations. Liberty Mutual appealed this decision, citing legal and factual insufficiency of the evidence. The Court of Appeals, Second District of Texas, affirmed the trial court's judgment, finding legally and factually sufficient evidence to support the trial court's findings, highlighting inconsistencies in the expert testimony presented by Liberty Mutual.

Workers' CompensationJudicial ReviewSufficiency of EvidenceCausationPolyneuropathyFoot UlcerationBack InjuryCauda Equina SyndromeMedical Expert TestimonyTexas Law
References
28
Case No. MISSING
Regular Panel Decision

Liberty Mutual Insurance Co. v. Burk

Liberty Mutual Insurance Company appealed a judgment finding that Roy Burk's work-related back injury caused his polyneuropathy and foot ulceration. Burk, injured in 1998, developed complications including cauda equina syndrome, leading to conditions like nerve root impairment, polyneuropathy, and foot ulcerations, which the insurer disputed were work-related, suggesting diabetes as the cause. The trial court, reviewing a Workers' Compensation Appeals Panel decision, ruled that the work injury extended to Burk's polyneuropathy and foot ulcerations, but not his diabetes. Liberty Mutual contended that the evidence was legally and factually insufficient, citing a lack of medical expert testimony from Burk and relying on their expert's opinion. The appellate court affirmed the trial court's judgment, concluding that sufficient evidence, including conflicting expert testimony and the judicial notice of the prior appeals panel decision, supported the causal link between Burk's work injury and his conditions.

Judicial ReviewPolyneuropathyFoot UlcerationCauda Equina SyndromeBack InjurySufficiency of EvidenceCausationMedical Expert TestimonyTexas Labor CodeAppeals Panel Decision
References
28
Case No. MISSING
Regular Panel Decision

Matter of Scuderi v. Mazzco Enterprises

Claimant, a union carpenter, filed a workers' compensation claim in 2010 for bilateral carpal tunnel syndrome, which was deemed an occupational disease with a disability onset of June 25, 2010. The workers’ compensation carrier for his last employer, Mazzco Enterprises, sought to apportion liability among claimant’s previous employers, including JD Consulting LLC. The Workers’ Compensation Board ultimately determined the disease was contracted on August 14, 1998, and assigned 45% of the liability to JD Consulting and its carrier. JD Consulting and its carrier appealed, contending that the Board's selection of the contraction date lacked substantial evidentiary support, as the claimant could not recall the onset of symptoms and his treating physician provided no definitive opinion on the matter. The Appellate Division concurred, reversing the Board's decision and remitting the case for further proceedings due to the insufficient evidence supporting the chosen date of contraction.

Workers' CompensationOccupational DiseaseCarpal Tunnel SyndromeApportionment of LiabilityEmployer LiabilitySubstantial EvidenceAppellate ReviewReversalRemittalNew York Law
References
8
Case No. MISSING
Regular Panel Decision
Oct 04, 2006

Claim of McKenzie v. UJA-FED

Claimant, employed in data entry, developed bilateral carpal tunnel syndrome and sought workers' compensation benefits. The Workers' Compensation Law Judge initially dismissed the claim, but the Workers' Compensation Board reversed, finding the condition to be an occupational disease causally related to employment, based on agreement between the treating physician and an independent medical examiner, and the carrier's failure to request cross-examination. The carrier appealed, arguing the Board erred in its finding regarding cross-examination and mischaracterized medical evidence. The appellate court affirmed the Board's decision, ruling that the carrier waived its right to cross-examination by not making a timely request and finding no basis to disturb the Board's assessment of the medical evidence.

Occupational DiseaseCarpal Tunnel SyndromeWorkers' CompensationMedical EvidenceCross-Examination WaiverAppellate ReviewCausationEmployment-Related InjuryMedical Expert TestimonyBoard Decision Appeal
References
6
Case No. MISSING
Regular Panel Decision

Henry v. Dillard Department Stores, Inc.

Carol Ann Henry and James S. Henry appealed a summary judgment in favor of Dillard Department Store, Inc., and its adjuster, Pulaski Adjustment Company. Mrs. Henry sustained a back injury during employment in February 1994 and sued Dillard for alleged unreasonable denial or delay of workers’ compensation benefits, asserting claims for breach of good faith, Texas Insurance Code violations, and breach of contract. Dillard initially denied coverage, leading to delayed testing and surgery for Mrs. Henry's cauda equina diagnosis. The key legal question was whether the Henrys needed to exhaust administrative remedies with the Texas Workers Compensation Commission (TWCC) before bringing their bad faith suit. The appellate court affirmed the trial court's judgment, ruling that exhaustion of administrative remedies was required given no evidence of Dillard's misconduct causing an independent injury.

Workers' Compensation Benefits DenialAdministrative Remedies ExhaustionBad Faith Insurance ClaimSummary Judgment AppealTexas Insurance Code ViolationsBreach of Contract ClaimDuty of Good Faith and Fair DealingSpinal Injury CaseCauda Equina DiagnosisWorkers' Compensation Act Litigation
References
14
Case No. 02-23-00220-CV
Regular Panel Decision
Apr 17, 2025

Bianco Brain and Spine, PLLC and Nikhil Kanti Patel, M.D. v. Larry Jones and Shelley Jones

This case concerns a medical malpractice claim brought by Larry and Shelley Jones against Bianco Brain and Spine, PLLC and Dr. Nikhil Kanti Patel. Mr. Jones suffered a cauda equina injury during spine surgery performed by Dr. Patel. The jury found Dr. Patel negligent, and his negligence proximately caused Mr. Jones's injury. On appeal, Dr. Patel challenged the legal and factual sufficiency of the evidence. The Court affirmed the judgment against Dr. Patel, finding sufficient evidence to support the jury's finding that Dr. Patel's intraoperative surgical technique (removing existing hardware before stabilizing the L3-L4 junction) breached the standard of care and caused the injury. Bianco Brain and Spine, PLLC was sued under a theory of respondeat superior. The Court reversed the judgment imposing liability on Bianco, holding that the Joneses waived their independent ground of recovery for respondeat superior by failing to submit a jury question on this claim, and the evidence of Dr. Patel's employment status was not conclusive.

Medical MalpracticeMedical NegligenceSpine SurgeryCauda Equina InjuryRespondeat SuperiorVicarious LiabilityLegal SufficiencyFactual SufficiencyExpert TestimonyProximate Cause
References
87
Case No. MISSING
Regular Panel Decision

People v. Yates

The People moved for a Frye hearing to determine the scientific acceptance of expert testimony on male rape trauma syndrome, which the defendant sought to introduce. The defendant, charged with grand larceny, claimed he was sexually assaulted and that the syndrome explained his failure to report the incident. The court reviewed existing New York case law on rape trauma syndrome for female and child victims, and scientific literature on male sexual assault. It found that male victims exhibit similar post-traumatic stress symptoms to female victims, concluding that male rape trauma syndrome is generally accepted in the scientific community. Therefore, the court denied the People's motion, ruling that a Frye hearing was not necessary.

Male Rape Trauma SyndromeFrye HearingExpert Testimony AdmissibilitySexual AssaultPosttraumatic Stress DisorderScientific AcceptanceGender Neutral LawEvidence LawCriminal ProcedureSodomy
References
26
Case No. ADJ1088522 (RIV 0015524)
Regular
Jan 03, 2013

SAMANTHA VAN DUINHOVEN vs. SPA HOTEL & CASINO, CALIFORNIA CASUALTY, Administered by GAB ROBINS NORTH AMERICA

This case involved an applicant who claimed industrial injury to her neck, back, left shoulder, psyche, and associated chronic pain syndrome, resulting in a finding of permanent total disability. The defendant sought reconsideration, arguing the medical evidence did not support injury to the low back or a diagnosis of chronic pain syndrome. The Appeals Board reversed the findings on the low back and chronic pain syndrome, finding no substantial evidence to support them. Consequently, the applicant's permanent disability award was amended to 70%, based on ratings for her neck, left shoulder, and psyche.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardPermanent Total DisabilityChronic Pain SyndromeAgreed Medical EvaluatorQualified Medical EvaluatorMedical Record ReviewIndustrial InjuryPermanent Disability Indemnity
References
0
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