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

Case No. 03-14-00726-CV
Regular Panel Decision
Oct 30, 2014

Texas San Marcos Treatment Center, L.P. D/B/A San Marcos Treatment Center v. Veronica Payton

Texas San Marcos Treatment Center appeals the trial court's denial of its motion to dismiss Veronica Payton's health care liability claim. Payton alleged negligence after being assaulted by a patient at the treatment center. The appellant argues that the expert report provided by Dr. William H. Reid is deficient, lacking factual support and specificity concerning the standard of care, its breach, and causation, as required by Chapter 74 of the Texas Civil Practices and Remedies Code. The appellant asserts the trial court abused its discretion by finding the report adequate and requests dismissal of the claims.

Medical MalpracticeExpert ReportMotion to DismissAbuse of DiscretionStandard of CareBreach of DutyCausationHealth Care Liability ClaimPsychiatric FacilityEmployee Assault
References
25
Case No. E2014-00302-COA-R3-CV
Regular Panel Decision
Jan 30, 2015

American Heritage Apartments, Inc. v. The Hamilton County Water and Wastewater Treatment Authority, Hamilton County, Tennessee

The plaintiff, American Heritage Apartments, Inc., challenged a monthly flat charge imposed by the Hamilton County Water and Wastewater Treatment Authority (County WWTA) for sewer lateral repairs. The trial court granted summary judgment to the County WWTA, finding no private right of action under the Utility District Law of 1937 (UDL). On appeal, the Court of Appeals reversed the summary judgment, concluding the UDL was inapplicable as the County WWTA was formed under the Tennessee Water and Wastewater Treatment Authority Act (WWTA Act). The appellate court held that the WWTA Act implicitly provides a private right of action for ultra vires and contract claims. The court also affirmed the trial court's alternative ruling that class action certification for affected customers was appropriate.

Water UtilityWastewater TreatmentFlat Rate ChargeClass Action CertificationSummary Judgment ReversalPrivate Right of ActionUltra Vires ClaimGovernmental ImmunityUtility District LawWater and Wastewater Treatment Authority Act
References
48
Case No. 08-11-00264-CV
Regular Panel Decision
Oct 08, 2014

Maria G. Thompson/Luis Marioni, D.C. v. Jaime Stolar, M.D., Alivio Medical Center, Alivio Treatment Centers, P.A. and Luis Marioni, D.C./Maria G. Thompson

This multi-party appeal originated from a medical and chiropractic malpractice lawsuit filed by Maria G. Thompson against Dr. Jaime Stolar, Dr. Luis Marioni, and Alivio Medical Center and Alivio Treatment Centers, P.A. Thompson alleged negligence resulting in severe knee injuries, including infection and fusions, following injections and treatment. A jury found Dr. Stolar and Dr. Marioni negligent, awarding damages. On appeal, the court reversed the judgment against Dr. Marioni due to insufficient evidence of causation but affirmed the judgment against Dr. Stolar. The court also upheld the denial of Thompson's claims regarding damages and apparent agency against Alivio.

Medical MalpracticeChiropractic MalpracticeKnee InjuryKnee InfectionSpontaneous FusionSurgical FusionNegligenceCausationDamages AssessmentApparent Agency
References
48
Case No. MISSING
Regular Panel Decision

John B. v. Emkes

This Memorandum Opinion addresses a class-action challenge against Tennessee officials regarding the TennCare managed care program's compliance with early and periodic screening, diagnosis and treatment (EPSDT) services for children. The lawsuit, initiated in 1998, operated under a Consent Decree. The State filed a motion to vacate the Decree, arguing substantial compliance. After an evidentiary hearing and review of extensive evidence, the Court found that the State has achieved substantial compliance with the Consent Decree's requirements concerning outreach, screening, diagnosis, treatment, and monitoring of EPSDT services. Consequently, the Court granted the State's motion to vacate the Consent Decree, dissolved all injunctive relief, and dismissed the case, while retaining jurisdiction for fee applications and contempt citations.

TennCareMedicaid ActEPSDT ProgramConsent Decree VacatedSubstantial ComplianceChild HealthcareManaged Care OrganizationsMedical ScreeningDiagnosis and TreatmentOutreach Efforts
References
4
Case No. MISSING
Regular Panel Decision

State v. Rucker

The appellant, Johnny Rucker, was convicted of aggravated rape and sentenced to twenty years. On appeal, he challenged the trial court's admission of statements made by the victim's mother to hospital personnel, including an emergency room nurse, a nurse practitioner, and a social worker. The appellate court found that while some statements to the emergency room nurse were admissible under the medical diagnosis and treatment exception, including the perpetrator's identity when part of the immediate household in child abuse cases, statements to the nurse practitioner and social worker were improperly admitted as they were not for diagnosis and treatment. The court also found portions of the statement to the emergency room nurse should have been redacted. Citing the highly prejudicial nature of the improperly admitted evidence and the recanted testimonies of the mother and victim, the appellate court reversed the trial court's judgment and remanded the case for a new trial.

Child Sexual AbuseHearsay ExceptionMedical DiagnosisVictim RecantationExcited UtteranceForensic ExaminationJudicial DiscretionPrejudicial ErrorEvidence AdmissibilityFamilial Abuse
References
23
Case No. ADJ7507504; ADJ7507542
Regular
Jun 13, 2012

MARIA CARRILLO vs. HELP N TIME BBSI, CORVEL

The Workers' Compensation Appeals Board denied reconsideration of a decision allowing treatment outside the Medical Provider Network (MPN). The Board found that the defendant's MPN physician failed to provide reports, justifying the applicant's treatment elsewhere under Labor Code sections 4605 and 5402(c). The Board also noted that statutory provisions for second opinions or independent medical review were inapplicable as the applicant wasn't disputing diagnosis or treatment, but rather the MPN physician's inaction. The defendant's argument regarding treatment for unpled body parts was dismissed as pleadings could be conformed to proof.

Workers' Compensation Appeals BoardPetition for ReconsiderationMedical Provider Network (MPN)Independent Medical ReviewLabor Code Section 4616.6Labor Code Section 4605Labor Code Section 5402(c)Treating PhysicianSecond OpinionThird Opinion
References
1
Case No. MISSING
Regular Panel Decision

Peeples v. Home Indemnity Co.

Billy R. Peeples, an injured worker, appealed a trial court's decision regarding psychiatric treatment expenses for a knee injury sustained while employed by Friedrich Refrigeration. Peeples, the claimant, sought compensation from Home Indemnity Company, the carrier. The trial jury awarded workers' compensation but denied payment for psychiatric treatment, finding it was not reasonably required as a result of the leg injury. The appellate court found that the trial court erred in excluding testimony from Dr. George Schlagenhauf, the treating psychiatrist, concerning the diagnosis and necessity of the treatment. Furthermore, the jury's finding against the necessity of psychiatric care was deemed against the great weight and preponderance of the evidence, as Dr. Schlagenhauf's testimony on necessity was uncontradicted. The appellate court reversed and remanded the case for a new trial.

Workers' CompensationPsychiatric TreatmentMedical ExpensesAdmissibility of EvidenceSufficiency of EvidenceKnee InjuryDepressionMedical NecessityAppellate ReviewTexas Law
References
7
Case No. MISSING
Regular Panel Decision
Jan 22, 2004

Mete v. New York State Office of Mental Retardation

This class action alleged age discrimination in employment against the New York State Office of Mental Retardation and Development Disabilities (OMRDD). Plaintiffs, former Chiefs of Developmental Center Treatment Services, claimed disparate treatment and disparate impact arising from a 1989 reduction in force (RIF) that eliminated their positions. All 46 Chiefs, who were over 40, were either demoted or retired, and statistical evidence showed a disproportionate impact on employees over 40. The Supreme Court granted defendants’ motion for summary judgment, dismissing all causes of action. The appellate court affirmed, finding that while plaintiffs established a prima facie case, OMRDD provided a legitimate, nondiscriminatory reason for the RIF (economic conditions and long-standing concerns about the position's utility), which plaintiffs failed to adequately prove was a pretext for discrimination.

Age DiscriminationClass ActionSummary JudgmentDisparate TreatmentDisparate ImpactReduction in ForceEmployment LawPretextPrima Facie CaseStatistical Evidence
References
11
Case No. MISSING
Regular Panel Decision

Claim of Evevsky v. Liberty Mutual Group

This case involves an appeal from a Workers’ Compensation Board decision regarding a claimant's unauthorized medical treatment. The claimant, who sustained neck and shoulder injuries in 1993, had her case reopened in 2001 after the employer's carrier objected to her request for authorized massage therapy. Both the Workers’ Compensation Law Judge and the Board determined that the treatment was not authorized under Workers’ Compensation Law § 13-b, as the massage therapist was not Board-authorized nor supervised by an authorized physician. The appellate court reviewed the Board's decision, affirming that there was no legal basis to overturn the finding. The court also considered and dismissed the claimant's constitutional arguments as being without merit.

Workers' CompensationMedical TreatmentMassage TherapyAuthorizationBoard DecisionAppellate ReviewStatutory InterpretationPhysician SupervisionConstitutionalityPermanent Partial Disability
References
3
Case No. 2016-06-0841
Regular Panel Decision
Dec 29, 2016

Petty, Thomas v. Convention Production Rigging

Thomas Petty, an employee, sustained head and shoulder injuries after an object fell on him at work. While the claim was initially accepted, subsequent medical evaluations led authorized physicians to conclude no further treatment was needed, prompting the employer to deny additional requests. The trial court upheld this denial, citing insufficient evidence from Petty to prove the necessity of further treatment. The Appeals Board affirmed the trial court's decision, finding no error in denying medical benefits for alleged foot, knee, head, neck, or shoulder injuries. The Board also clarified the statutory interpretation regarding second opinions on surgery and diagnosis, emphasizing the requirement of a prior recommendation for surgery.

Workers' Compensation AppealsExpedited HearingHead InjuryShoulder InjuryMalingeringMaximum Medical ImprovementCausationMedical NecessitySecond Opinion StatuteLabral Tear
References
4
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