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

Case No. MISSING
Regular Panel Decision

Claim of Umanzor v. General Telecom

This case involves an appeal from decisions of the Workers’ Compensation Board concerning death benefits following a decedent's death in the 9/11 World Trade Center attacks. The decedent's mother (claimant) sought workers’ compensation death benefits for herself and the decedent's minor half-siblings, asserting financial dependency. A Workers’ Compensation Law Judge initially found dependency and awarded benefits, but the Board reversed this finding, concluding that the record did not support the claim of dependency under Workers’ Compensation Law § 16 (4-a), while still awarding some benefits under § 16 (4-b). The appellate court affirmed the Board's decision, citing numerous discrepancies and inconsistencies in the claimant's evidence regarding household expenses and the decedent's financial contributions, which made it impossible to determine if the loss had a detrimental effect, thus upholding the Board's finding of no dependency under § 16 (4-a).

Workers’ CompensationDeath BenefitsDependencyWorld Trade Center Attack9/11Financial ContributionSubstantial EvidenceAppellate ReviewHousehold ExpensesFactual Finding
References
6
Case No. 04-24-00516-CV & 04-24-00521-CV
Regular Panel Decision
Aug 13, 2025

B&T Dependable Services, LLC and Bernell Gardener v. Edward Santos

Edward Santos, performing work for B&T Dependable Services, LLC, was injured in a truck accident. B&T had workers' compensation coverage, and Texas Mutual Insurance Company provided Santos benefits. Santos subsequently sued B&T and Bernell Gardener for negligence, disputing his employment status. An administrative law judge (ALJ) previously ruled Santos was an employee, and Santos did not appeal this decision. Appellants filed a plea to the jurisdiction and a motion for summary judgment, arguing that the exclusive remedy provision of the Texas Labor Code and the doctrine of election of remedies barred Santos's lawsuit. The appellate court affirmed the trial court's denial of the plea to the jurisdiction, citing recent Supreme Court precedent that the Division of Workers' Compensation does not hold exclusive jurisdiction over negligence claims not predicated on entitlement to benefits. The court also affirmed the denial of the motion for summary judgment, concluding that appellants failed to conclusively prove every element of their affirmative defense of election of remedies.

Workers' Compensation LawNegligence ClaimExclusive Remedy DoctrineElection of RemediesSubject Matter JurisdictionAppellate Court ReviewSummary Judgment DenialTexas Labor CodeEmployment Status DisputeAdministrative Remedies Exhaustion
References
19
Case No. ADJ9440770 ADJ8897603
Regular
Nov 02, 2016

LEE WOOLEVER (Deceased); PENNY WOOLEVER; DEPARTMENT OF INDUSTRIAL RELATIONS DEATH WITHOUT DEPENDENTS UNIT vs. CITY OF LONG BEACH

This case concerns a claim for workers' compensation death benefits by Penny Woolever, the ex-wife of deceased employee Lee Woolever. Ms. Woolever argued she was a total dependent despite their divorce due to ongoing financial support and a close relationship. The Workers' Compensation Appeals Board affirmed the finding that she was not a dependent, as their divorce was final and they never resumed cohabitation. The Board distinguished this case from precedent allowing dependency claims based on reconciliation. Consequently, the death benefit was awarded to the Department of Industrial Relations, Death Without Dependents Unit.

Esophageal cancerDeath benefitsDependency claimLabor Code section 3502Reconciliation of marriageSpousal supportTotal dependentDivorce decreeWCJ ReportLloyd Corporation
References
5
Case No. MISSING
Regular Panel Decision

Claim of Smolicz v. Fitzgerald

Decedent, Frank Koestner, died in the September 11, 2001 attacks while working at the World Trade Center. His former wife, the claimant, filed for workers' compensation death benefits for their daughter, which were initially awarded. Michelle Stabile subsequently claimed entitlement to a portion of these benefits as the decedent's domestic partner, a claim initially denied by a workers' compensation law judge but reversed by the Workers’ Compensation Board, which awarded Stabile benefits. The claimant appealed this decision, arguing that Stabile did not meet the statutory definition of a domestic partner, specifically lacking dependence on the decedent for support. The court found insufficient evidence to establish Stabile's dependence or mutual interdependence with the decedent, despite their engagement and plans to marry. Consequently, the court reversed the Board's decision and remitted the matter for further proceedings.

Death benefitsDomestic partnershipWorkers' Compensation LawDependency for supportStatutory interpretationAppellate reviewFactual questionSubstantial evidenceRemandSeptember 11, 2001 attacks
References
4
Case No. ADJ3872772 (VNO 0546594) ADJ310152 (MON 0351415)
Regular
Nov 05, 2015

HIRAN EDIRIWEERA (Deceased); DEPARTMENT OF INDUSTRIAL RELATIONS, DEATH WITHOUT DEPENDENTS UNIT vs. SRR, LLC; STATE COMPENSATION INSURANCE FUND

Petitioners, alleged partial dependents of a deceased worker, sought to overturn a 2007 Compromise and Release agreement where the insurer paid death benefits to the State's Death Without Dependents Unit, asserting they received no notice. The Board dismissed their petition for reconsideration of the 2007 order due to untimeliness and failure to meet reopening criteria. However, the Board removed the separate, pending death benefit claim (ADJ3872772) to address the petitioners' potential claims for partial dependency, acknowledging prior notification of their existence to the insurer.

Partial dependentsDeath benefitsCompromise and Release AgreementPetition for ReconsiderationOrder Approving Compromise and ReleaseReopeningTimelinessNoticeOpportunity to objectIndustrial injury
References
0
Case No. MISSING
Regular Panel Decision
Jun 16, 2006

Fortis Benefits v. Cantu

Vanessa Cantu suffered severe injuries in a car accident and sued multiple parties. Her medical insurer, Fortis Benefits, intervened, seeking subrogation for medical benefits paid under the policy. After Cantu settled with the defendants, Fortis pursued recovery from Cantu. Cantu argued that the equitable "made whole" doctrine barred Fortis's claim because her total losses exceeded the settlement amount plus the benefits Fortis paid. The trial court and court of appeals sided with Cantu. The Texas Supreme Court reversed, holding that the "made whole" doctrine does not override an insurer's clear contractual subrogation rights. The Court affirmed the dismissal of Fortis's claims against Ford due to a pretrial agreement.

Insurance SubrogationMade Whole DoctrineContractual SubrogationEquitable SubrogationERISATexas LawInsurance Policy InterpretationPersonal InjuryAutomobile AccidentSettlement Proceeds
References
28
Case No. 2020-05-0875
Regular Panel Decision
Aug 09, 2021

Summers, Sonney v. RTR Trans Services

Sonney Summers, as the surviving spouse of Christine Summers, filed a Petition for Benefit Determination after RTR Transportation initially denied his claim for death benefits. Christine Summers died tragically while working for RTR. After mediation, RTR accepted the claim and paid funeral expenses, but Mr. Summers sought a lump-sum commutation of death benefits. The Court denied the lump-sum request, citing that benefits for a sole dependent spouse cannot be commuted due to uncertainties like remarriage or death, and that Mr. Summers failed to demonstrate exceptional circumstances or a wise management plan. However, the Court awarded periodic death benefits of $558.23 weekly and granted attorneys' fees of twenty percent on the total award, excluding funeral expenses, to be paid periodically.

Death BenefitsSurviving SpouseLump Sum CommutationAttorney's FeesWorkers' Compensation ActStatutory InterpretationDependencyFuneral ExpensesPeriodic PaymentsTennessee Law
References
12
Case No. 2017-04-0093 / 13763-2017
Regular Panel Decision
Oct 15, 2025

JEFFREY MOLANDS, Administrator, THE ESTATE OF MARSHA MOLANDS v. ACCESS PROGRAM

Marsha Molands, a home health nurse for Access Program, suffered low-back and left-shoulder injuries in 2017. She underwent two back surgeries in 2019 and 2023. Following the second surgery, she developed a wound infection, sepsis, and related complications, leading to her death in April 2024. Her husband, Jeffrey Molands, as Administrator of her estate and sole dependent, sought death benefits, additional temporary total disability (TTD) benefits, medical expenses, and funeral expenses. The Court found that Ms. Molands’s death arose primarily out of her 2017 work injury, largely based on the medical examiner’s testimony that infections from her surgeries caused a "death spiral." Consequently, the Court granted death benefits to Mr. Molands at a rate of 50% of Ms. Molands’s average weekly wage, along with reimbursement for medical and funeral expenses. However, the Court denied Mr. Molands’s request for a lump-sum payment of future death benefits, citing statutory limitations and a lack of "exceptional circumstances." It also denied additional TTD benefits from August 2020 to July 2023, determining that Ms. Molands had reached maximum medical improvement in August 2020. Attorney's fees were awarded to Mr. Molands' counsel.

Death BenefitsWorkers' CompensationMedical CausationSpinal InjurySepsisInfectionLaminectomyFusion SurgeryMaximum Medical ImprovementTemporary Total Disability
References
9
Case No. MISSING
Regular Panel Decision
Oct 14, 1982

Claim of Rodriguez v. Vogue Metalcraft, Inc.

This case concerns an appeal from a Workers' Compensation Board decision that awarded death benefits to the parents of a deceased employee. The employee died in a factory explosion. While the employer and carrier conceded compensability, they contested the parents' claim of dependency. The Board found the parents were partially dependent, based on evidence of the decedent's financial contributions to household expenses. The Appellate Division affirmed the Board's decision, concluding that it was supported by substantial evidence, thereby upholding the award of death benefits.

Death BenefitsDependency ClaimFactory AccidentWorkers' Compensation AppealPartial DependencySubstantial Evidence ReviewHousehold ContributionsAppellate DivisionEmployer LiabilityInsurance Carrier Responsibility
References
2
Case No. ADJ1298520
Regular
Dec 24, 2010

CLUSEGUN AFOLAYAN (DECEASED), OLUWASEUN AFOLAYAN, et al vs. STATE OF CALIFORNIA CDCR, CALIFORNIA REHABILITATION CENTER, Legally Uninsured, SCIF/STATE CONTRACTS

In this workers' compensation case, the Appeals Board reconsidered a WCJ's award of dependency benefits to three adult children of a deceased worker. The WCJ had awarded $192,000 total, based on the children being total dependents despite the widow electing CalPERS benefits which typically bar other death benefits. The Board agreed that the adult children are entitled to benefits under Labor Code section 4702, as the widow's CalPERS election does not necessarily exclude other dependents with good cause. However, the Board disagreed with the WCJ's calculation method and remanded the case for a new decision, directing the adult children to divide the difference between the maximum benefit for a widow with dependents and the benefit for a widow without dependents.

Workers' Compensation Appeals BoardDependency benefitsLabor Code Section 4702Adult childrenDeath benefitsLabor Code Section 4707CalPERS special death benefitGood causeTotal dependentsWidow's benefits
References
1
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