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

Case No. ADJ3765992 (SRO 0132531) ADJ2072207 (SRO 0140061)
Regular
Apr 29, 2009

Lorraine O'Keefe vs. Surgical Staff North, Inc., CAL COMP, In Liquidation, CIGA, Adjusted by BROADSPIRE, COMMUNITY HOSPITAL OF MONTEREY PENINSULA, Permissibly Self-Insured, Adjusted by CLAIMS MANAGEMENT, INC. (ADJ3765992), QUEEN OF THE VALLEY HOSPITAL, Permissibly Self-Insured, Adjusted by SEDGWICK CLAIMS MANAGEMENT SERVICE (ADJ2072207)

This case involves applicant Lorraine O'Keefe's workers' compensation claims for left knee injury. The Workers' Compensation Appeals Board denied reconsideration of the finding that applicant sustained an industrial injury on December 15, 1999, while employed by Community Hospital of the Monterey Peninsula (CHOMP). However, the Board granted reconsideration regarding attorney fees, rescinding the prior award against CHOMP. The issue of CHOMP's liability for applicant's attorney fees under Labor Code section 4064(c) will be returned for further proceedings due to insufficient notice.

Workers' Compensation Appeals BoardSurgical Staff NorthCal CompCIGACommunity Hospital of Monterey PeninsulaClaims Management Inc.Queen of the Valley HospitalSedgwick Claims Management ServiceFindings Award OrdersPetition for Reconsideration
References
0
Case No. ADJ3765992 (SRO 0132531)
Regular
Apr 06, 2011

LORRAINE O'KEEFE vs. SURGICAL STAFF NORTH, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, BROADSPIRE SERVICES for CAL COMP, COMMUNITY HOSPITAL OF MONTEREY PENINSULA, CLAIMS MANAGEMENT, INC.

The Workers' Compensation Appeals Board (WCAB) granted reconsideration on Community Hospital of Monterey Peninsula's (CHOMP) petition regarding a penalty assessed for delayed payment to CIGA. The WCAB amended the prior order, ruling that CHOMP is not liable for a Labor Code section 5814 penalty because this section applies only to delays in payments to injured workers, not to reimbursements between defendants. However, the WCAB affirmed the prior finding that CHOMP engaged in bad-faith litigation tactics, upholding sanctions under Labor Code section 5813. The final order also clarified the amount owed to CIGA and affirmed the attorney's fees awarded to the applicant's counsel.

Workers Compensation Appeals BoardSurgical Staff NorthCalifornia Insurance Guarantee AssociationCommunity Hospital of Monterey PeninsulaUnreasonable DelayBad Faith LitigationLabor Code Section 5814Labor Code Section 5813Labor Code Section 4064(c)Permanent Disability
References
2
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. E2009-01431-COA-R3-CV
Regular Panel Decision
May 28, 2010

James P. Griffith v. Jellico Community Hospital, Inc.

James P. Griffith, an employee of Aramark Clinical Technology Services, Inc., sustained injuries from a fall while working on the premises of Jellico Community Hospital, Inc., with whom Aramark had a contract. Griffith and his wife, Kimberly Griffith, filed a negligence action against Jellico. The trial court granted summary judgment for Jellico, ruling that it was a principal contractor under Tennessee law and, therefore, immune from tort liability under the exclusive remedy rule. The Griffiths appealed, arguing that summary judgment was inappropriate. The Court of Appeals affirmed the trial court's decision, finding that Griffith's work as a biomedical equipment technician was an essential and regular part of Jellico's business as a hospital, making Jellico a statutory employer.

Workers' CompensationPrincipal ContractorStatutory EmployerExclusive Remedy RuleSummary JudgmentNegligenceBiomedical Equipment TechnicianHospital OperationsTennessee LawAppellate Review
References
14
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. 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. 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. 13-17-00453-CV
Regular Panel Decision
Nov 14, 2017

in Re Nueces Hospitality GP, LLC and Nueces Hospitality, LP

This case involves a petition for writ of mandamus filed by Nueces Hospitality GP LLC and Nueces Hospitality LP, challenging a trial court's sanction order. The order, issued by Judge Mark H. Woerner in a personal injury suit brought by Myrtle Lee Bryant, prohibited the relators from alleging any affirmative defenses due to repeated failures to timely respond to discovery requests, specifically regarding workers' compensation coverage. Although relators eventually provided the discovery responses, the trial court imposed this severe sanction without explicitly considering lesser penalties or articulating a rationale. The Court of Appeals determined that the trial court abused its discretion by issuing such a 'death penalty' sanction without evidence of flagrant bad faith or callous disregard for discovery responsibilities. Consequently, the appellate court conditionally granted mandamus relief, instructing the trial court to vacate the sanction order.

MandamusSanctionsDiscovery AbuseAffirmative DefensesWorkers' CompensationTexas Civil ProcedureAbuse of DiscretionAppellate RemedyTrial Court OrderPrejudice
References
21
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