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

Case No. NO. 09-04-368 CV
Regular Panel Decision
Apr 28, 2005

Silsbee Hospital, Inc. D/B/A Columbia Silsbee Doctors Hospital v. Lonny George

Lonny George, an employee of Silsbee Hospital, Inc., a nonsubscriber to workers' compensation, sustained injuries and sued the hospital. He had signed a waiver agreement related to an employee benefit plan, which the hospital contended released them from liability for personal injuries. The Court of Appeals examined the waiver agreement's language, applying contract construction rules and the express negligence doctrine, and found it only applied to the parent company, Columbia/HCA Healthcare Corporation, not the subsidiary Hospital, as George's injuries arose from employment with the Hospital. The court also rejected the Hospital's affirmative defenses of ratification, release, waiver, and estoppel. However, the appellate court determined there was harmful error in jury selection due to the trial court's failure to strike two unequivocally biased veniremembers. Consequently, the judgment was reversed and the case remanded for a new trial.

NonsubscriberWorkers' Compensation WaiverEmployee InjuryExpress Negligence RuleJury BiasAppellate ReversalRemand for New TrialContract InterpretationAffirmative DefensesTexas Law
References
38
Case No. 01-02-00286-CV
Regular Panel Decision
Aug 15, 2002

in Re: Tenet Healthcare, Ltd., D/B/A Park Plaza Hospital

This opinion addresses a petition for writ of mandamus filed by Tenet Healthcare, Ltd. d/b/a Park Plaza Hospital, challenging the trial court's denial of its motion to compel arbitration against Vonessa Valyan. Valyan, a former employee, sued Tenet for retaliatory discharge after being terminated, alleging a violation of the Texas Labor Code. The Court of Appeals for the First District of Texas determined that the Federal Arbitration Act (FAA) applied to the dispute due to its relation to interstate commerce. The court found a valid and enforceable arbitration agreement existed between Tenet and Valyan, supported by mutual promises to arbitrate, and that Valyan's retaliatory discharge claim fell within the scope of this agreement. The court rejected Valyan's arguments regarding the Texas General Arbitration Act and Texas public policy. Consequently, the court conditionally granted the writ of mandamus, concluding the trial court abused its discretion.

ArbitrationFederal Arbitration ActTexas General Arbitration ActEmployment LawRetaliatory DischargeWorker's CompensationMandamusContract LawAt-Will EmploymentConsideration
References
17
Case No. ADJ656822 (RIV 0015821)
Regular
May 08, 2012

WILLIAM WEBB vs. SID STONE CONSTRUCTION COMPANY, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION For CALIFORNIA COMPENSATION INSURANCE COMPANY, In Liquidation

This case concerns CIGA's liability for lien claims from Coast Plaza Doctors Hospital and Valley Plaza Doctors Hospital. CIGA argued it was not obligated to pay because the hospitals "assigned" their claims to Innovative Medical Management for collection, which CIGA contends is an excluded claim under Insurance Code section 1063.1(c)(9)(B). The Board affirmed the WCJ's finding that no true legal assignment occurred, as Innovative was merely hired for collection services and the hospitals retained ownership and control. Therefore, the lien claims were not excluded from coverage as assignee claims.

CIGAassigned claimlien claimantchose in actionlegal titleInnovative Medical ManagementWCABcompromise and releaseworkers compensationsubrogation
References
1
Case No. MISSING
Regular Panel Decision

Huntington Hospital v. Huntington Hospital Nurses' Ass'n

Huntington Hospital initiated an action under the Federal Arbitration Act to partially vacate an arbitration award, while the Huntington Hospital Nurses’ Association cross-petitioned to confirm it. The dispute originated from the Hospital unilaterally granting two nurses, Betty Evans and Lynn Meyer, longevity pay credits exceeding the ten-year cap stipulated in their collective bargaining agreement (CBA). The arbitrator found the Hospital violated the CBA's sections on pay and exclusive bargaining rights. The arbitrator mandated the Hospital roll back excess credits and recover overpayments. The District Court denied the Hospital's petition, dismissing arguments regarding public policy, manifest disregard for law, and lack of award finality, ultimately confirming the arbitration award.

Arbitration AwardCollective Bargaining AgreementLabor LawFederal Arbitration ActWage DisputesLongevity PayUnion RightsPublic Policy ExceptionManifest Disregard of LawContract Interpretation
References
22
Case No. 03-02-00429-CV
Regular Panel Decision
May 30, 2003

Hospitals and Hospital Systems v. Continental Casualty Company

Hospitals and Hospital Systems appealed a declaratory judgment favoring Continental Casualty Company and other insurers, concerning the application of a one-year statute of limitations (rule 133.305(a)) for workers' compensation medical claims. The claims arose after the 1992 Acute Care Hospital Fee Guideline was invalidated. Hospitals argued the limitations period should be tolled due to prior litigation challenging the guideline and that the Commission waived the rule through a settlement agreement. The Texas Court of Appeals, Third District, Austin, found no basis for tolling, noting hospitals were not prevented from filing claims earlier. It also ruled that the Commission's executive director lacked authority to waive the rule, and that any waiver could not revive time-barred claims. The court affirmed the trial court's judgment, upholding the applicability of rule 133.305(a) and barring the Hospitals' claims.

Workers' CompensationAdministrative LawDeclaratory JudgmentStatute of LimitationsTollingWaiverTexas Court of AppealsFee GuidelinesMedical Dispute ResolutionAgency Rules
References
10
Case No. MISSING
Regular Panel Decision

Eye Clinic, P.C. v. Jackson-Madison County General Hospital

This case concerns a challenge by eye doctors (The Eye Clinic, P.C. and individual doctors) against the Jackson-Madison County General Hospital District and its affiliated entities (Health Partners, Inc., and West Tennessee Alliance for Healthcare, Inc.). The plaintiffs alleged that the hospital district's business activities, specifically its joint ownership of provider networks and operation of Preferred Provider Organizations (PPOs), violated Article II, §§ 29 and 31 of the Tennessee Constitution, as well as their due process and equal protection rights. The trial court had granted summary judgment and injunctive relief to the plaintiffs. However, the appellate court reversed this decision, ruling that the hospital district does not fall under the constitutional definitions of 'county, city or town' or 'the State' as per the relevant articles. The court also found no merit in the plaintiffs' claims of due process or equal protection violations, citing a lack of vested rights and a rational basis for the defendants' actions. Therefore, summary judgment was granted in favor of the defendants.

Constitutional LawHospital DistrictProvider NetworkPreferred Provider Organization (PPO)Physician-Hospital Organization (PHO)Summary JudgmentDue ProcessEqual ProtectionQuasi-Municipal CorporationState Constitution
References
66
Case No. 2-05-303-CV
Regular Panel Decision
Mar 30, 2006

Sally Downs v. Triad-Denton Hospital, L.P. D/B/A Denton Community Hospital

Sally Downs, a licensed vocational nurse employed by Advantage Nursing Services, Inc., sustained injuries after slipping and falling on a wet floor at Triad-Denton Hospital, where she was temporarily assigned. Downs received workers' compensation benefits through her employer's policy. She subsequently sued the Hospital for her injuries. The Hospital moved for summary judgment, asserting the affirmative defense of the Texas Workers’ Compensation Act’s exclusive remedy provision, arguing Downs was a borrowed servant. The trial court granted summary judgment in favor of the Hospital. The Court of Appeals reversed and remanded the case, holding that the trial court erred because the Hospital failed to specially plead the affirmative defense as required by Texas Rule of Civil Procedure 94, and Downs had properly objected to this omission.

Workers' CompensationBorrowed Servant DoctrineSummary JudgmentAffirmative DefenseExclusive RemedyTexas Labor CodeAppellate ProcedureProcedural ErrorPersonal InjuryPremises Liability
References
2
Case No. 03-21-00242-CV
Regular Panel Decision
Dec 28, 2022

Vista Medical Center Hospital, Surgery Specialty Hospital of America, Southeast Houston and Vista Hospital of Dallas v. Texas Mutual Insurance Company

This appeal stems from a dispute over workers' compensation medical benefits reimbursement between multiple hospitals (Vista Parties) and numerous insurance carriers (Carriers) in Texas. The core issue revolves around the application of a "stop-loss exception" under Former Rule 134.401, designed for unusually costly or lengthy hospital stays, which the Vista Parties sought for 542 injured workers. After the State Office of Administrative Hearings (SOAH) largely denied additional reimbursement, the district court affirmed SOAH's order. The Court of Appeals, Third District, affirmed the district court's judgment, rejecting the Vista Parties' arguments that the SOAH order was arbitrary and capricious or lacked substantial evidence. The court found that SOAH properly conducted a case-by-case inquiry into whether services were "unusually costly and unusually extensive" and did not err in its application of the rule or in its findings.

Workers' CompensationMedical ReimbursementStop-Loss ExceptionAdministrative LawAppellate CourtTexas Court of AppealsSubstantial Evidence ReviewArbitrary and CapriciousFee GuidelinesHospital Reimbursement
References
51
Case No. MISSING
Regular Panel Decision

League of Voluntary Hospitals & Homes v. Local 1199, Drug, Hospital & Health Care Workers Union

The court addresses an application for a preliminary injunction against Local 1199, a union planning a three-day strike. The League of Voluntary Hospitals and Homes of N. Y. sought the injunction following a previous temporary restraining order concerning a one-day strike. The union argued that each planned strike required a new legal proceeding, but the court deemed the strikes "episodic and organically connected." Citing concerns about blocked ingress/egress to hospitals and the union president's threats to "shut down" facilities, the judge found a preliminary injunction necessary under Labor Law § 807 to protect public health and safety. The injunction restrains the union from unlawfully interfering with hospital operations, blocking access, and picketing within certain distances of hospital entrances and emergency rooms.

Labor DisputePreliminary InjunctionStrike ActionUnion ActivityHospital AccessPicketing RegulationsCollective BargainingCivil Disobedience ThreatPublic Health and SafetyIngress Egress Interference
References
1
Case No. 02S01-9511-CV-00112
Regular Panel Decision
Dec 04, 2000

Debra Michelle Lambert v. Famous Hospitality, Inc. A/K/A A.S. Hospitality A/K/A M W M Dexter, Inc. and American Motorist Insurance Company

In this workers' compensation case, Debra Lambert sustained a work-related shoulder injury while employed by Famous Hospitality, Inc. The employer failed to provide a list of physicians as required by statute, leading Lambert to seek her own medical treatment. The trial court initially awarded 60% permanent vocational disability and covered past medical expenses but denied future treatment by Lambert's chosen physicians. The Supreme Court of Tennessee, reviewing the Special Workers' Compensation Appeals Panel's decision, affirmed in part and reversed in part. The Court held that the employer is liable for Lambert's post-trial medical expenses for continued treatment by Doctors Rizk and Rosensweig, due to the employer's failure to comply with the statutory requirement to provide a list of physicians.

Workers' CompensationShoulder InjuryThoracic Outlet SyndromePermanent ImpairmentMedical TreatmentPhysician SelectionEmployer LiabilityStatutory ComplianceAppellate ReviewTennessee Law
References
2
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