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

Case No. 14-11-00902-CV
Regular Panel Decision
Jul 19, 2012

Deandrew Price v. Uni-Form Components Company

Deandrew Price, a temporary employee provided by AGL Elite Business Solutions, appealed a summary judgment granted in favor of Uni-Form Components Company (UCC) in his negligence suit. Price sustained a severe foot injury while working as a machine operator at UCC. UCC asserted the affirmative defense of exclusive remedy under the Texas Workers’ Compensation Act (TWCA), claiming Price was a temporary employee covered by its workers' compensation insurance and presented a certificate of insurance. Price challenged the coverage, arguing UCC failed to produce the full policy and that his personal affidavit indicated no workers' compensation involvement from UCC. The appellate court affirmed the trial court's decision, finding UCC sufficiently established coverage through the certificate and affidavit, noting that an employer cannot split its workforce regarding workers' compensation coverage and that premium payment issues do not affect an employee's coverage.

Workers' CompensationSummary JudgmentExclusive Remedy ProvisionTemporary EmployeeBorrowed Servant DoctrineNegligenceInsurance CoverageTexas Labor CodeAppellate ReviewEmployer Liability
References
17
Case No. AD.J9949974, AD.J9950384
Regular
Apr 21, 2016

KAREN HERCULES vs. BODEGA LATINA CORPORATION dba EI SUPER, YORK RISK SERVICES GROUP

This case involves Karen Hercules' workers' compensation claim against Bodega Latina Corporation. The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration. The denial was based on the employer's failure to reject the claim within 90 days of filing, creating a presumption of compensability under Labor Code section 5402(b). The employer's subsequent denial on June 18, 2015, was untimely as it occurred 132 days after the claim form dated February 5, 2015. Therefore, the injury is presumed compensable, and the employer failed to rebut this presumption.

Workers' Compensation Appeals BoardBodega Latina CorporationYork Risk Services GroupPetition for ReconsiderationLabor Code section 5402presumption of compensabilityclaim formdenial of claimadministrative law judgespecific injury
References
0
Case No. MISSING
Regular Panel Decision

Goodyear Dunlop Tires North America, Ltd. v. Gamez

This case involves an appeal by Goodyear Dunlop Tires North America, Ltd. challenging a trial court's award of approximately $400,000 in guardian ad litem fees and an additional $30,000 in appellate fees. The underlying litigation was a products liability case involving multiple minor plaintiffs, for whom the guardians ad litem were appointed. Goodyear contested the fees, arguing they were excessive, covered work outside the guardians' scope of duties, included work performed after the case settlement, and featured inappropriate billing practices. The appellate court found insufficient evidence to support the reasonableness of the ad litem fees, noting issues like billing for non-essential tasks, duplicate work, and unreasonable time entries (e.g., billing for sleeping or over 24 hours a day). Consequently, the court reversed the award of appellate fees, finding the trial court lacked plenary jurisdiction to modify the judgment. The aggregate ad litem fees portion of the judgment was reversed and remanded for recalculation consistent with the appellate court's opinion.

Guardian Ad LitemAttorney FeesAppellate FeesProducts LiabilityMinor PlaintiffsFee CalculationScope of DutiesExcessive BillingPlenary JurisdictionAbuse of Discretion
References
35
Case No. MISSING
Regular Panel Decision

Shelton v. ADS Environmental Services

This is a workers' compensation case on interlocutory appeal, considered a companion to McCall v. National Health Corp. The central issue is the trial court's authority to initiate temporary workers' compensation benefits before a trial. The appellee, William Roger Shelton, an employee of ADS Environmental Services, claimed to have contracted Hepatitis C during his employment. After ADS denied his claim, the trial court ordered ADS to pay Shelton's medical expenses and temporary total disability benefits, finding a likely causal relationship. Following the precedent set in McCall, the appellate court affirmed the trial court's authority to issue such preliminary orders, applying the 'likely to succeed on the merits' standard, and remanded the case for further proceedings.

Workers' CompensationInterlocutory AppealTemporary BenefitsHepatitis CCausal RelationshipMedical EvidenceTrial Court AuthorityScope of EmploymentTennessee LawPrecedent
References
3
Case No. MISSING
Regular Panel Decision

In re the Adoption of J.

The case concerns an adoption proceeding initiated by a same-sex couple. The court addresses whether to appoint a guardian ad litem for the adoptive infant, a practice previously common in same-sex adoptions due to their novelty. Citing Matter of Dana, which affirmed the legality of same-sex and heterosexual unmarried couple adoptions, the court found no legal basis to treat same-sex adoptions differently from those by married couples, where a guardian ad litem is not automatically appointed if statutory requirements and social worker reports are favorable. The court concluded that denying equal treatment could violate federal and state equal protection clauses, deciding against appointing a guardian ad litem unless special circumstances are present.

AdoptionSame-sex coupleGuardian ad litemBest interest of childEqual protectionDomestic Relations LawStatutory interpretationCourt of AppealsSurrogate's CourtFamily Law
References
2
Case No. MISSING
Regular Panel Decision

Claim of Velji v. Rural Farms Workers Opportunity

The employer and its carrier appealed a Workers’ Compensation Board decision from June 9, 1982, which denied their request for reimbursement of wages paid to a claimant during a disability period. The carrier had filed C-9 forms indicating lost time, full wages paid, and specifically requested reimbursement. The Board denied this, asserting that a C-9 form could not be used for a reimbursement claim, thereby adding an unauthorized limitation to Section 25 (subd 4, par [a]) of the Workers’ Compensation Law. The court found the Board’s rationale irrational, especially since the C-9 forms explicitly requested reimbursement. The court reversed the Board’s decision and remitted the matter for further proceedings.

Workers' Compensation LawReimbursement ClaimWage PaymentStatutory InterpretationC-9 FormAppellate ReviewBoard Decision ReversalEmployer RightsCarrier ReimbursementDisability Benefits
References
5
Case No. 13-11-00198-CV
Regular Panel Decision
Aug 29, 2011

in Re: New Hampshire Insurance Company, Chartis Claims, Inc., and Stephanie Stark

This case involves a petition for writ of mandamus filed by New Hampshire Insurance Company, Chartis Claims, Inc., and Stephanie Stark (relators) seeking to overturn a trial court's order denying their motion to dismiss. The underlying lawsuit was brought by Rosalinda Torres, who sued New Hampshire for bad faith, alleging a delay in providing workers' compensation death benefits after her husband, Lazaro Torres, died. New Hampshire argued that the trial court lacked subject matter jurisdiction because Torres had not exhausted her administrative remedies by failing to obtain a formal determination from the Texas Department of Insurance, Division of Workers’ Compensation (DWC) that her claim was compensable and benefits were owed. The Court of Appeals denied the petition for writ of mandamus, concluding that a DWC form signed by Torres, New Hampshire, and a DWC representative, authorizing the purchase of an annuity for death benefits, constituted an agreement that benefits were due, thus establishing the trial court's subject matter jurisdiction.

Workers' CompensationBad FaithMandamusSubject Matter JurisdictionExhaustion of Administrative RemediesTexas LawDeath BenefitsInsurance DisputeAdministrative ProcessAppellate Review
References
32
Case No. 2019-08-0191
Regular Panel Decision
Apr 28, 2021

Russell, Frederick v. Aluma Form, Inc.

Frederick Russell, an assembly technician for Aluma Form, Inc., suffered a left shoulder and neck injury in January 2018. The employer accepted a shoulder sprain but contested a labral tear and impingement. The Court reviewed conflicting medical testimony from Dr. Jones and Dr. Dalal regarding causation and impairment. The Court ruled that Mr. Russell successfully proved causation for his shoulder injury and that he was justified in seeking unauthorized treatment due to the employer's actions. Consequently, Aluma Form was ordered to pay permanent partial disability benefits of $11,879.49, temporary disability benefits of $9,308.86, and Mr. Russell's medical bills from Dr. Dalal and Memphis Surgery Center. Dr. Dalal was designated as the authorized treating physician for future medical benefits.

Shoulder InjuryLabral TearImpingement SyndromeMedical CausationPermanent Partial DisabilityTemporary Total DisabilityUnauthorized Medical TreatmentOrthopedic SurgeryWorkers' Compensation ClaimsRange of Motion Impairment
References
5
Case No. AD.J9352393, AD.J9352398, AD.J9531390
Regular
Apr 11, 2016

NORMAN WESEMAN vs. CITY OF CATHEDRAL CITY, Permissibly Self-Insured, SUPERIOR READY MIX, Permissibly Self-Insured

This case involves a petition for reconsideration filed by the defendants, City of Cathedral City and Superior Ready Mix. The Workers' Compensation Appeals Board (WCAB) has granted this petition. Reconsideration was granted due to statutory time constraints and the need for further study of the factual and legal issues. The WCAB aims to thoroughly understand the record to issue a just decision. All future correspondence related to the petition must be filed directly with the WCAB Commissioners, not district offices or e-filed.

PETITION FOR RECONSIDERATIONWORKERS' COMPENSATION APPEALS BOARDCITY OF CATHEDRAL CITYSUPERIOR READY MIXPERMISSIBLY SELF-INSUREDADJUDICATION MANAGEMENT SYSTEMEAMSJUDICIAL ATTORNEY'S FEESCOMPROMISE AND RELEASE AGREEMENTSSTIPULATIONS WITH REQUEST FOR AWARD
References
0
Case No. ADJ8608456 MF ADJ8608504 ADJ8523009 ADJ8551858 ADJ8609068
Regular
Oct 07, 2015

HORACIO CABRERA, Deceased MARIBEL BARAJAS, Widow, Guardian Ad Litem for LITZY CABRERA, LESLY CABRERA, MARIA CABRERA AND KASSANDRA CABRERA; BRIANNA CABRERA, for herself and Guardian Ad Litem for STEFANI ARIAS,, ANTONIO SOLARES, MODESTO DOMINGUEZ, JOHNATHAN ALONSO vs. MV CONTRACTING, STAR INSURANCE COMPANY

This case involves a petition for reconsideration by MV Contracting regarding a prior WCJ decision finding industrial injuries and a fatal injury due to a motor vehicle accident. The WCJ excluded the defendant's evidence of a timely denial, presuming the claims compensable and finding the "going and coming rule" inapplicable. The Board affirmed the WCJ's decision, denying the petition for reconsideration. The Board agreed that the employer's submission of a claim form acted as the applicant dependents' agent, satisfying their obligation.

Workers' Compensation Appeals BoardIndustrial InjuriesMotor Vehicle AccidentFatal Industrial InjuryDependentsPetition for ReconsiderationRulings and Order Admitting EvidenceFindings of FactNotice of DenialPresumed Compensable
References
0
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