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

Case No. ADJ6776516
Regular
May 30, 2017

FRANCIS HARGREAVES vs. SOUTHWEST AIRLINES, ACE USA INSURANCE CO.

This case involves an applicant seeking workers' compensation benefits for injuries sustained on the job, including to his back, left shoulder, left wrist, and psyche, as well as complex regional pain syndrome, coronary artery disease, and a sleep disorder. The defendant sought reconsideration of the initial award, arguing that the medical evidence did not support the $90\%$ permanent disability finding. The Appeals Board granted reconsideration, affirming the findings of injury and treatment for Complex Regional Pain Syndrome but reducing the permanent disability to $88\%$ by excluding the sleep disorder impairment due to insufficient objective evidence. The applicant's permanent disability payments were recalculated and ordered to commence from January 21, 2011.

Workers' Compensation Appeals BoardFrancis HargreavesSouthwest AirlinesACE USA Insurance Co.Sedgwick CMSADJ6776516Opinion and Order Granting Petition for ReconsiderationFindings Award and OrderAOE/COEback injury
References
1
Case No. 524271
Regular Panel Decision
Sep 06, 2018

Matter of Kemraj v. Garelick Farms

Claimant Balram Kemraj sustained a work-related injury to his left shoulder in 2005. He was initially awarded workers' compensation benefits, but his schedule loss of use was later rescinded, and the claim was amended to include complex regional pain syndrome. A Workers' Compensation Law Judge found no further causally-related disability after September 16, 2013, a decision affirmed by the Workers' Compensation Board. On appeal, the Appellate Division affirmed the Board's decision, finding substantial evidence to support it. The court relied on the opinion of neurologist Sheldon Staunton, who conducted an independent medical examination and concluded that the claimant had no objective neurological problems, was exaggerating symptoms, exhibited no signs of complex regional pain syndrome, and could return to work immediately.

Workers' Compensation BenefitsCausally-Related DisabilityIndependent Medical Examination (IME)Complex Regional Pain SyndromeSchedule Loss of UseSubstantial EvidenceAppellate ReviewMedical CredibilityShoulder InjuryReturn to Work
References
7
Case No. 2020-08-0198
Regular Panel Decision
Jun 03, 2020

Gray, Katie v. Conagra Foods Packaged Foods Co., Inc.

The case involves an employee, Katie Gray, who suffered a work-related hand injury and was diagnosed with complex regional pain syndrome. After her authorized treating physician, Dr. Dan Fletcher, assigned a 13% permanent medical impairment rating based on a therapist's report using the range-of-motion model, her employer, Conagra Foods, retained Dr. David West for a medical records review. Dr. West disagreed with the methodology, concluding a 4% impairment rating for complex regional pain syndrome. Due to this discrepancy, the employer requested an evaluation through the Medical Impairment Rating Registry (MIRR), which the employee moved to quash, arguing that a medical records review was an insufficient basis for a dispute. The trial court denied the motion, and the Appeals Board affirmed, holding that the statute and regulations allow either party to obtain a second opinion, even based on a medical records review, to establish a dispute for an MIRR evaluation.

Workers' CompensationMedical Impairment Rating Registry (MIRR)Permanent Medical ImpairmentComplex Regional Pain SyndromeMedical Records ReviewSecond Medical OpinionDispute ResolutionAppeals Board DecisionTennessee LawTrial Court Affirmation
References
1
Case No. MISSING
Regular Panel Decision

City of Laredo v. Garza

Juan Garza Jr., a groundskeeper for the City of Laredo, suffered an on-the-job injury, sustaining a broken kneecap and ankle. The core dispute centered on whether additional injuries, including L4-L5 and L5-S1 herniated discs, L5-S1 radiculopathy, and complex regional pain syndrome, were compensable, with administrative and district court decisions differing. The City of Laredo appealed the district court's finding for Garza, arguing a lack of legally sufficient expert medical evidence to establish causation for the complex back and pain conditions. The appellate court ruled that expert medical testimony was necessary for these conditions, especially given the delayed reporting of symptoms and conflicting medical opinions. Consequently, the court reversed the trial court's judgment, determining that Garza's compensable injuries do not include the disputed back and pain syndrome conditions due to insufficient causation evidence.

CausationExpert Medical TestimonyLay TestimonyHerniated DiscsRadiculopathyComplex Regional Pain SyndromeOn-the-job InjuryTemporal ProximitySufficiency of EvidenceDegenerative Injury
References
11
Case No. No. M2018-01696-COA-R3-CV; No. 15-4-IV
Regular Panel Decision
Dec 07, 2020

American Board of Craniofacial Pain v. American Board Of Orofacial Pain

This case involves an appeal concerning a failed merger between two professional dental associations, American Board of Craniofacial Pain (ABCP) and American Board of Orofacial Pain (ABOP). ABCP sued ABOP, alleging a breach of an agreement to merge formed through email exchanges and seeking specific performance and damages. The Chancery Court for Davidson County granted summary judgment to ABOP, finding no meeting of the minds and thus no enforceable contract. The Court of Appeals of Tennessee affirmed this decision, concluding that the parties’ objective manifestations showed a lack of mutual assent because an essential term (disposition of intellectual property) was not agreed upon and they intended to reduce the agreement to a formal Memorandum of Understanding, which was never finalized. The court also agreed that specific performance was not an available remedy due to the incompleteness of the purported contract.

Contract DisputeMerger NegotiationsCorporate MergerDental ProfessionMutual AssentSpecific Performance DenialSummary Judgment AffirmationTennessee Court of AppealsContract FormationLack of Agreement
References
26
Case No. 04-08-00504-CV
Regular Panel Decision
May 13, 2009

City of Laredo v. Juan Garza, Jr.

The City of Laredo appealed a trial court's judgment that found Juan Garza Jr.'s compensable injuries included L4-L5 and L5-S1 herniated discs, L5-S1 radiculopathy, and complex regional pain syndrome. The City argued a lack of expert medical evidence to establish causation, while Garza contended his lay testimony was sufficient. The appellate court examined whether expert medical testimony was necessary for these specific conditions, especially considering the delayed reporting of back pain and conflicting medical reports. It concluded that lay testimony was insufficient under the circumstances to prove causation for such complex medical conditions. Therefore, the appellate court reversed the trial court's judgment, finding legally insufficient evidence of causation.

Workers' CompensationCausationExpert Medical TestimonyLay TestimonySufficiency of EvidenceHerniated DiscsRadiculopathyComplex Regional Pain SyndromeAppellate ReviewTexas Law
References
11
Case No. 2022-08-1051
Regular Panel Decision
Jan 31, 2023

Foulks, Barbara v. ABM Industry Groups, LLC

Ms. Barbara Foulks suffered a compensable injury and was initially treated by Dr. John Lochemes, who deemed her at maximum medical improvement. She subsequently received treatment from Dr. Michael Cody Scarbrough for chronic pain and complex regional pain syndrome symptoms. The employer argued Ms. Foulks was conclusively at maximum medical improvement, as her treatment was for pain only. However, the Court found Dr. Scarbrough's treatment to be active, involving physical therapy and other interventions aimed at functional improvement, not solely pain management. Consequently, the Court ruled that Ms. Foulks was not at maximum medical improvement under Tennessee Code Annotated section 50-6-207(1)(E) and reinstated her temporary total disability benefits, applying an overpayment credit.

Temporary Total DisabilityMaximum Medical ImprovementComplex Regional Pain SyndromePain ManagementActive Medical TreatmentFunctional ImprovementPhysical TherapyNerve BlockGait InstabilityOverpayment Credit
References
3
Case No. 2016-05-1050
Regular Panel Decision
Oct 19, 2017

Tapley, Shane v. Transport National

This is an interlocutory appeal where the employer contested the trial court's decision regarding the designation of an authorized treating physician and the acknowledgment of a pain management referral under Tennessee Code Annotated sections 50-6-204(a)(3)(A)(ii) or 50-6-204(j). The employee, Shane Tapley, suffered a left knee injury and received treatment, including surgery, from Dr. Martin Fiala. Dr. Fiala later recommended a consult with Dr. Jeffrey Hazlewood concerning Complex Regional Pain Syndrome (CRPS) and potential pain management. The trial court concluded that Dr. Fiala's request for a consult did not constitute a statutory referral for pain management or a direct referral transferring care. The Appeals Board affirmed the trial court's decision, emphasizing that the statutory language for referrals implies treatment rather than just an opinion or consultation, and remanded the case for further proceedings.

Workers' CompensationMedical BenefitsPhysician ReferralPain ManagementAuthorized Treating PhysicianInterlocutory AppealStatutory InterpretationComplex Regional Pain SyndromeKnee InjuryMedical Consult
References
8
Case No. 13-03-427-CV
Regular Panel Decision
Mar 23, 2006

Columbia Rio Grande Regional Healthcare, L.P. D/B/A Rio Grande Regional Hospital v. Alice H. Hawley and James A. Hawley

This case involves an appeal by Columbia Rio Grande Regional Healthcare, L.P., d/b/a Rio Grande Regional Hospital, from a jury verdict in favor of Alice H. Hawley and James A. Hawley. The Hawleys sued the Hospital for negligence in failing to timely communicate Alice H. Hawley's colon cancer diagnosis, which led to a significant delay in treatment and the cancer becoming inoperable. The central issue revolved around the sufficiency of evidence regarding causation, specifically whether Mrs. Hawley had a greater than 50% chance of survival at the time of the Hospital's alleged negligence. The Court of Appeals affirmed the trial court's judgment, overruling all of the Hospital's ten issues on appeal, which included challenges to evidentiary rulings, jury instructions, and damages.

Medical MalpracticeHospital NegligenceCancer MisdiagnosisColon CancerLoss of Chance DoctrineProximate CauseExpert Testimony AdmissibilitySufficiency of Medical EvidenceJury Charge ErrorDamage Caps
References
63
Case No. MISSING
Regular Panel Decision

Ley v. Rochester Regional Joint Board, Local 14A

Rhonda P. Ley, Regional Director of the National Labor Relations Board, filed a petition against the Rochester Regional Joint Board, Local 14A (Union) seeking a preliminary injunction. Ley alleged that Article XXII of the collective bargaining agreement between the Union and Xerox Corporation (Employer) constituted an unlawful 'union signatory' agreement under Section 8(e) of the National Labor Relations Act. Furthermore, Ley claimed that the Union's continued attempts to enforce Article XXII violated Sections 8(b)(4)(ii)(A) and (B) of the Act. The Union argued that Article XXII was a lawful work preservation provision. The Court found reasonable cause to believe the Union was violating the Act and that a preliminary injunction was just and proper to prevent further statutory violations and maintain public interest. Consequently, the preliminary injunction was granted, enjoining the Union from enforcing Article XXII.

Labor LawPreliminary InjunctionUnfair Labor PracticeNational Labor Relations ActUnion Signatory AgreementWork PreservationCollective Bargaining AgreementSubcontractingArbitrationDistrict Court
References
11
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