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

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. ADJ7924562
Regular
Sep 19, 2014

RAUL HERNANDEZ vs. LOS ANGELES UNIFIED SCHOOL DISTRICT

The applicant sought reconsideration of a WCJ decision that found an industrial injury to the low back but not the cervical spine or left ankle, with no permanent disability or further medical treatment. The applicant argued the QME's reports were insubstantial and that prior permanent disability was not considered. The Appeals Board granted reconsideration to amend the original award to include injury to the cervical spine, affirming the remainder of the decision. Therefore, the applicant sustained injury to his low back and cervical spine.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardIndustrial InjuryLow Back InjuryCervical Spine InjuryPermanent DisabilityFurther Medical TreatmentPanel Qualified Medical EvaluatorLabor Code Section 4664(b)
References
0
Case No. ADJ1337074 (GRO 0034564) ADJ1286218 (GRO 0034565)
Regular
Jun 24, 2009

Dave Gerletti vs. SANTA MARIA AIRPORT DISTRICT, GREGORY BRAGG STOCKTON

The Workers' Compensation Appeals Board denied Dave Gerletti's petition for reconsideration of an award for a cumulative trauma injury to his cervical spine and lungs. The original award found 35% permanent disability, apportioning 50% of the cervical spine disability to non-industrial factors based on a Qualified Medical Evaluator's opinion of degenerative changes. The majority affirmed the WCJ's reliance on this opinion, finding it adequately explained. A dissenting opinion argued the QME's apportionment was speculative and improperly based on age and genetics, recommending an unapportioned award for the cervical spine injury.

Workers' Compensation Appeals Boardcumulative traumacervical spinelungspermanent disabilityapportionmentQualified Medical EvaluatorAgreed Medical Examinerarthritic degenerationnon-industrial factors
References
1
Case No. 2024 NY Slip Op 00599 [224 AD3d 428]
Regular Panel Decision
Feb 06, 2024

Matter of New Millennium Pain & Spine Medicine, P.C. v. Garrison Prop. & Cas. Ins. Co.

This case involves two appeals by New Millennium Pain & Spine Medicine, P.C. against Garrison Property & Casualty Insurance Company and GEICO Casualty Company. New Millennium sought to vacate master arbitration awards that denied its claims for no-fault benefits for medical services. The Supreme Court denied these applications. The Appellate Division, First Department, affirmed the Supreme Court's decisions, stating that an arbitrator's award will not be set aside unless it is irrational. The court also addressed the argument regarding a 20% wage offset in no-fault benefits, finding it unavailing under Insurance Law § 5102 (b). Ultimately, New Millennium was not entitled to attorneys' fees as it was not the prevailing party.

No-fault benefitsarbitration awardvacaturinsurance lawwage offsetappellate reviewmedical servicesno-fault policy exhaustionattorneys' feesCPLR Article 75
References
8
Case No. ADJ7288330
Regular
Oct 03, 2016

GLORIA BENITEZ vs. NEWPORT SUBACUTE HEALTH CARE CENTER, ALASKA NATIONAL INSURANCE COMPANY

The applicant, Gloria Benitez, sought to reopen her workers' compensation claim to include injury to additional body parts beyond her cervical spine and psyche. The original award found injury only to the cervical spine and psyche, with a 19% permanent disability rating for the cervical spine. While the WCJ's initial decision denied injury to additional body parts, the Board granted reconsideration. The Board amended the original findings to defer the issue of injury to the alleged additional body parts, while affirming other aspects of the WCJ's order, including the appointment of a regular physician to evaluate new and further disability.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderNew and Further DisabilityAgreed Medical ExaminerRegular PhysicianLabor Code Section 5410Petition to ReopenIndustrial InjuryCervical Spine
References
4
Case No. 526688
Regular Panel Decision
Dec 27, 2018

Matter of Bufearon v. City of Rochester Bur. of Empl. Relations

Claimant Kamren Bufearon sustained work-related injuries in a motor vehicle collision on March 4, 2016, for which his workers' compensation claim was established for injuries to his left shoulder, left hip, and lower back. Subsequently, he sought to amend his claim to include a causally-related cervical spine injury, which was initially approved by a Workers' Compensation Law Judge. However, the Workers' Compensation Board reversed this decision, finding that the claimant failed to sufficiently demonstrate a causal relationship between his cervical spine condition and the March 4, 2016 incident. The Appellate Division affirmed the Board's decision, noting that the medical testimony from two physicians contained conflicting findings and equivocal narratives regarding causation. The court concluded that the Board was entitled to reject the physicians' opinions as speculative, particularly since neither physician had reviewed the claimant's prior medical records for a pre-existing cervical spine fusion surgery.

Cervical spine injuryCausal relationshipMedical evidenceSubstantial evidence reviewAppellate DivisionWorkers' Compensation BoardPre-existing conditionCredibility of physiciansBurden of proofMotor vehicle accident
References
13
Case No. 2022-07-0138
Regular Panel Decision
Feb 12, 2024

Hepner, Charles v. MC Produce, LLC, d/b/a McCartney Produce

Mr. Charles Hepner, an employee, sought permanent disability benefits for neck and low back injuries sustained in February 2021 while working for MC Produce, LLC. He initially claimed permanent total disability or extraordinary benefits, but the Court denied these claims. The case involved conflicting impairment ratings from three physicians: Dr. Kyle Stephens (orthopedic surgeon, 2%), Dr. Jacob Schwarz (neurosurgeon, 25% for cervical spine), and Dr. James Wiesman (orthopedic surgeon, 3% for lumbar spine). The Court accredited Dr. Schwarz's 25% rating for the cervical spine and Dr. Wiesman's 3% rating for the lumbar spine, totaling a 27% permanent partial disability. Applying multipliers for not returning to work and age, Mr. Hepner was awarded $91,250.39 in benefits. The Court denied the education multiplier and dismissed the claim against the Subsequent Injury Fund. Future medical benefits were granted with Dr. Stephens designated as the treating physician.

Workers' CompensationPermanent Partial DisabilityCervical Spine InjuryLumbar Spine InjuryImpairment RatingMedical Expert TestimonyTennessee LawIncreased BenefitsNeurosurgeon EvaluationOrthopedic Surgeon Evaluation
References
5
Case No. ADJ7969168; ADJ9330687
Regular
Mar 23, 2016

Mario Alcantar vs. Alfredo Melchor, Zenith Insurance Company

This case involves applicant Mario Alcantar's petition for reconsideration of a Workers' Compensation Appeals Board (WCAB) decision. The WCAB previously rescinded a joint finding and substituted a new one finding applicant sustained a lumbar spine injury but not a cervical spine injury during specified employment periods. Alcantar sought reconsideration to include a cervical spine injury during a different, unspecified period. The WCAB denied the petition, affirming its prior decision and incorporating it by reference.

Petition for ReconsiderationDecision After ReconsiderationJoint Findings of Factcumulative periodlumbar spinecervical spineindustrial injuryarising out of and occurring in the course of employmentWorkers' Compensation Appeals BoardZenith Insurance Company
References
0
Case No. 13-99-746-CV
Regular Panel Decision
Aug 31, 2001

Colonial Casualty Insurance Company v. Garcia, Osler G.

Osler G. Garcia, an employee, sustained a compensable injury to his cervical spine and back while working. His workers' compensation claim resulted in a dispute over his impairment rating. The hearing officer and TWCC Appeals Panel found his impairment rating to be seventeen percent as determined by the designated doctor, Dr. Rodney Simonsen. Colonial Casualty Insurance Company, the employer's insurer, sought judicial review, challenging the finding of a cervical spine injury and the seventeen percent impairment rating. The trial court affirmed the commission's findings, and on appeal, the Court of Appeals affirmed the trial court's judgment, finding sufficient evidence to support both the cervical injury and the impairment rating based on Dr. Simonsen's reports.

Workers' CompensationImpairment RatingCervical Spine InjuryBench TrialMedical EvidenceAMA GuidesAppellate ReviewSubstantial EvidenceTrial Court AffirmanceDesignated Doctor
References
7
Case No. 14-07-00887-CV
Regular Panel Decision
Jun 02, 2009

Tanya E. Dowell v. Theken Spine, L.L.C

Tanya E. Dowell appealed the trial court's grant of summary judgment in favor of Theken Spine, LLC, arguing lack of proper notice for the summary judgment motion and hearing. Dowell's motion for summary judgment was granted after her certified mail for the notice was returned "unclaimed." The appellate court affirmed the trial court's judgment, finding that Dowell failed to provide verified proof at the time of the summary judgment ruling to rebut the presumption of actual notice. The court also upheld the denial of Dowell's motion for new trial, stating that a complete record of the hearing on the motion was not presented by the appellant, thus precluding a finding of abuse of discretion by the trial court.

Summary JudgmentNoticeDue ProcessCertified MailUnclaimed MailPresumption of ReceiptMotion for New TrialAbuse of DiscretionAppellate ProcedureTexas Rules of Civil Procedure
References
21
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