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

Case No. 03-99-00846-CV
Regular Panel Decision
Sep 13, 2001

Antonio Cortez v. Progressive County Mutual Insurance Company

Antonio Cortez appealed a summary judgment against him in an insurance discrimination case, alleging that Progressive County Mutual Insurance Co.'s variable commission program violated Texas Insurance Code article 21.21-8 by charging consumers of the same risk different rates based on agent commission levels. The trial court had granted summary judgment for Progressive, concluding that 'unfair discrimination' was defined by article 21.21-6 and that Cortez had not shown evidence of discrimination or economic damages. The appellate court reversed, holding that article 21.21-8 contains its own definition of unfair discrimination, distinct from article 21.21-6, and that Cortez had presented more than a scintilla of probative evidence to create a genuine issue of material fact regarding unfair discrimination and economic damages. The case was remanded for further proceedings.

Insurance discriminationVariable commission programSummary judgment appealStatutory interpretationTexas Insurance CodeUnfair discrimination definitionEconomic damagesAppellate court decisionRemand for further proceedingsAgent commission rates
References
21
Case No. MISSING
Regular Panel Decision

Cortez v. Alutech, Inc.

This case involves an appeal stemming from an employment contract dispute between Appellants ACPC, Inc. and Alfredo Riviere, and Appellees Oswaldo Antonio Cortez and his family. Cortez alleged breach of contract, fraudulent misrepresentation, negligent misrepresentation, and promissory estoppel after his employment with ACPC was terminated prematurely, despite promises of a three-year term and assistance with permanent residency. A jury found mixed verdicts, ultimately awarding the Appellees $50,000 in damages against ACPC and Riviere for fraudulent misrepresentation in their corporate capacities. On appeal, the Appellants challenged the denial of their summary judgment motion and directed verdict. The appellate court affirmed the trial court's judgment, concluding that the Appellants' failure to file a timely post-trial motion for judgment notwithstanding the verdict precluded a review of the directed verdict issue.

Employment Contract BreachFraudulent MisrepresentationNegligent MisrepresentationPromissory EstoppelSummary Judgment DenialDirected Verdict MotionPost-Trial ProcedureAppellate Review WaiverTennessee Appellate RulesJury Verdict Challenge
References
10
Case No. MISSING
Regular Panel Decision

Cortez v. Soloco, Inc.

This case concerns an appeal from a summary judgment in favor of Soloco, Inc. The appellants, parents and the temporary administrator of Guadalupe Z. Cortez's estate, sought exemplary damages alleging gross negligence caused his death during employment. The parents had already received workers' compensation benefits. The central legal issue was whether the estate of an employee, deceased in the course of employment with a subscribing employer, has a cause of action for exemplary damages against the employer under the Texas Workers' Compensation Act. The court affirmed the trial court's judgment, holding that the Act provides the exclusive remedy for work-related injuries, and only a specific class of individuals, which does not include parents, can sue for exemplary damages under Article 8306 § 5, mirroring Tex. Const, art. 16, § 26.

Workers' CompensationExemplary DamagesGross NegligenceSurvival ActionExclusive RemedyEmployment LawAutomobile CollisionDeceased EmployeeSummary Judgment AppealConstitutional Law
References
7
Case No. 03-98-00707-CV
Regular Panel Decision
Jan 06, 2000

Richard Martinez and Rachel Perez v. Melanie Vela, Individually and as Next Friend of Tiffany Michelle Cortez and Jessica Kaye Riojas, Minors

Appellants Richard Martinez and Rachel Perez challenged a trial court's judgment affirming jury awards for personal injuries to Melanie Vela and her daughters, Tiffany Michelle Cortez and Jessica Kaye Riojas, resulting from a car accident caused by Martinez. The appellants raised issues concerning the sufficiency of evidence for causation and medical expenses, the trial court's refusal to allow impeachment of Vela regarding Medicaid benefits, and the exclusion of Vela's mental health history. The Texas Court of Appeals, Third District, affirmed the trial court's judgment, finding the evidence legally and factually sufficient for the jury's damage awards. The court also upheld the trial court's discretionary rulings, applying the collateral source rule to exclude Medicaid benefits for impeachment and finding Vela's prior mental condition irrelevant to her mental anguish claim as presented.

Car accidentNegligenceNegligent entrustmentPersonal injuryDamagesExemplary damagesSufficiency of evidenceCausationMedical expensesCollateral source rule
References
19
Case No. MISSING
Regular Panel Decision

Cortez v. Liberty Mutual Fire Insurance Co.

Martin Cortez appealed a summary judgment granted in favor of Liberty Mutual Fire Insurance Co. in a case alleging breach of the duty of good faith and fair dealing. Cortez, a machine operator, sustained a repetitious trauma injury and received weekly worker's compensation benefits from Liberty Mutual, which were later suspended based on an independent medical examination (IME) by Dr. David Capen. Dr. Capen opined that Cortez had reached maximum medical improvement and could return to work without restrictions. Cortez argued that the IME was not a sufficient basis to suspend benefits as it wasn't a release from his treating physician. The appellate court affirmed the summary judgment, finding that Dr. Capen's uncontroverted opinion constituted a reasonable basis for suspending benefits. Additionally, the court found that collateral estoppel and judicial admission, stemming from a prior agreed judgment in the worker's compensation lawsuit, also barred the bad faith claim.

Summary JudgmentGood Faith and Fair DealingWorker's CompensationIndependent Medical ExaminationMaximum Medical ImprovementBenefits SuspensionCollateral EstoppelJudicial AdmissionAppellate Court DecisionInsurance Law
References
16
Case No. 30 AD3d 876
Regular Panel Decision

Sandra M. v. St. Luke's Roosevelt Hospital Center

The plaintiffs, Sandra M. and her husband, appealed a Supreme Court order granting summary judgment to St. Luke's Roosevelt Hospital Center, dismissing their complaint. Sandra M. was allegedly sexually assaulted by a nursing assistant, Ricardo Cortez, supplied by United Staffing System, Inc., while on suicide watch at the Hospital. The plaintiffs sued the Hospital, United, and Cortez, alleging the Hospital was negligent in its suicide watch policies and its failure to independently evaluate staff provided by United. The Appellate Division dismissed the appeal from the intermediate order and affirmed the judgment dismissing the complaint against the Hospital. The court found the Hospital was not vicariously liable for Cortez's personal tortious acts and had no duty to independently screen employees supplied by United, as it had no prior knowledge of Cortez's propensity for misconduct.

Personal InjurySexual AssaultNegligenceHospital LiabilityVicarious LiabilityIndependent ContractorNegligent HiringSummary JudgmentAppellate ReviewSuicide Watch
References
20
Case No. ADJ8969860
Regular
Jul 28, 2016

Miguel Cortez vs. American Security Force, Inc., The Hartford

This case involves an applicant, Miguel Cortez, who sought workers' compensation benefits for an alleged injury to his left shoulder sustained on May 28, 2013. The Workers' Compensation Appeals Board denied his Petition for Reconsideration, upholding the administrative law judge's finding. The Board found Cortez failed to meet his burden of proof for a compensable injury arising out of and occurring in the course of employment. This decision was based heavily on the judge's credibility determination regarding Cortez's inconsistent testimony about the incident and conflicting accounts of the injury provided to medical providers.

AOE/COEPetition for ReconsiderationCredibility determinationBurden of proofLabor Code § 3600(a)(10)Industrial injuryCompensable injuryWCJ reportWitness demeanorTerminated employee
References
1
Case No. MISSING
Regular Panel Decision

Twin City Fire Insurance Co. v. Cortez

Twin City Fire Insurance Company appealed a judgment that matured a workers' compensation death benefit award. The company had failed to make timely weekly payments to Anita Cortez, the surviving widow, and her minor children, after an initial 18 March 1975 award from the Industrial Accident Board. The lawsuit, initiated by Anita Cortez, sought to mature the entire claim into a lump sum, along with a twelve percent penalty and attorney's fees, citing the company's failure to make prompt payments without justifiable cause. The trial court found no justifiable cause for the payment cessation, ruled in favor of the beneficiaries, and awarded a lump sum without discount, plus penalties and attorney's fees. The appellate court affirmed the trial court's judgment, rejecting the insurance company's arguments regarding justifiable cause, the lump sum prohibition, discounting, and attorney's fees computation.

Workers' CompensationDeath BenefitsLump Sum PaymentPenaltyAttorney's FeesJustifiable CauseClerical OversightStatutory InterpretationAppellate ReviewInsurance Carrier Liability
References
7
Case No. ADJ9843354, ADJ9340113
Regular
Feb 02, 2017

SANDRA CORTEZ vs. EMPLOYMENT RESOURCES GROUP, INC.; CLAIMS R.M.

This case involves an applicant, Sandra Cortez, and defendants Employment Resources Group, Inc. and Claims R.M. The Workers' Compensation Appeals Board dismissed Cortez's petition for reconsideration and denied her petition for removal. The Board found that the WCJ's decision addressed an interlocutory procedural or evidentiary issue, not a final determination of substantive rights or liabilities. Removal was denied because there was no showing of substantial prejudice or irreparable harm, and reconsideration would be an adequate remedy. The Board also clarified that a letter to an AME copied to the applicant's attorney was not an ex parte communication.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalFinal OrderSubstantive RightThreshold IssueInterlocutory DecisionProcedural IssueEvidentiary IssueExtraordinary Remedy
References
9
Case No. ADJ9100288
Regular
May 17, 2018

GILBERT CORTEZ (Deceased), NOHEMA CORTEZ (Surviving Spouse & Guardian Ad Litem), et al. vs. CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION, Legally Uninsured, CALIFORNIA PUBLIC EMPLOYEES RETIREMENT SYSTEM, STATE COMPENSATION INSURANCE FUND (Claims Administrator)

The Workers' Compensation Appeals Board (WCAB) rescinded a prior decision concerning death benefits for the deceased employee's children, Andres and Marisa Cortez. The WCAB remanded the case to the administrative law judge to properly join the California Public Employees' Retirement System (CalPERS) and determine the entitlement to and coordination of workers' compensation death benefits with CalPERS special death benefits. The WCAB clarified that the "good cause" standard under *Antrim* applies and that CalPERS benefits may offset workers' compensation benefits to avoid duplicate payments. Further proceedings are required to consider the specific claims of dependency and the impact of CalPERS payments.

Workers' Compensation Appeals BoardCDCRSCIFCalPERSdeath benefitsdependent childrenspecial death benefitsoffsetAntrim standardLabor Code section 4707
References
7
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