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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

Donaldson v. Texas Department of Aging & Disability Services

David Donaldson appealed a trial court's summary judgment in favor of the Texas Department of Aging and Disability Services (DADS) on claims of race and disability discrimination, retaliation, and hostile work environment under the TCHRA and Title VII. Donaldson, an African-American employee diagnosed with multiple conditions including prostate cancer and PTSD, alleged DADS failed to accommodate his disabilities and discriminated against him through various adverse actions, culminating in his termination. The appellate court affirmed the summary judgment for DADS on the race discrimination, retaliation, and hostile work environment claims, finding insufficient evidence of discriminatory intent or materially adverse actions in those areas. However, the court reversed and remanded the reasonable accommodation claim, concluding that Donaldson presented a fact issue regarding DADS's failure to provide continued assistance for his disabilities despite initial accommodations. This decision partially reverses the trial court's judgment, necessitating further proceedings on the reasonable accommodation aspect of the disability discrimination claim.

DiscriminationRetaliationHostile Work EnvironmentDisability DiscriminationRace DiscriminationReasonable AccommodationSummary JudgmentTexas Commission on Human Rights ActTitle VIIEmployment Law
References
83
Case No. MISSING
Regular Panel Decision

Claim of Fonda v. Norton Co.

Claimant suffered serious injuries to his right leg, hip, and spine in February 1988, necessitating two laminectomies for a herniated disc. The employer and its insurer challenged the Workers’ Compensation Board's determination that the claimant's permanent disability resulted solely from his back injury, arguing that a preexisting dormant heart condition contributed. The court affirmed the Board's decision, finding substantial evidence that the claimant's disability was not materially or substantially greater due to the heart condition. The Board's prerogative to resolve conflicting medical opinions was upheld. Furthermore, the court found the employer's argument regarding a contractually based reimbursement claim could not be raised for the first time on appeal, as it was not addressed administratively.

Workers' CompensationBack InjuryPreexisting ConditionHeart ConditionDisabilityLaminectomyCausationMedical EvidenceFactual DisputeAppellate Review
References
2
Case No. MISSING
Regular Panel Decision
Nov 30, 2015

Claim of Gramza v. Buffalo Board of Education

Claimant, a teacher, sustained a work-related injury to his left shoulder and neck in 2005 and was subsequently classified with a permanent partial disability. The employer sought reimbursement from the Special Disability Fund, citing the claimant's preexisting medical conditions, including rheumatoid arthritis and hypertension. The Workers' Compensation Board granted this application, prompting an appeal from the Fund. The court affirmed the Board's decision, finding substantial evidence that the claimant's rheumatoid arthritis was a permanent condition restricting hand use and hindering general employability. An independent medical reviewer's opinion further supported that the claimant's overall disability was significantly greater due to the combined effect of both conditions.

Workers' CompensationSpecial Disability FundReimbursementPreexisting ImpairmentRheumatoid ArthritisPermanent Partial DisabilityMaterially and Substantially Greater DisabilityGeneral EmployabilityIndependent Medical ReviewerAppellate Division
References
6
Case No. MISSING
Regular Panel Decision
Sep 17, 1980

Bass v. Westchester Concrete, Inc.

This case involves an appeal from a Workers’ Compensation Board decision, which was initially filed on March 14, 1980, and later amended on September 17, 1980. The employer's insurance carrier sought reimbursement from the Special Disability Fund under Workers’ Compensation Law § 15(8), claiming a known prior physical impairment of bilateral deafness in the claimant. The record established that the claimant's total disability stemmed from a severe psychoneurotic disorder, with a pre-existing psychiatric condition materially and substantially exacerbating the present disability due to a compensable accident. However, the appeal found no substantial evidence that the employer had prior knowledge of this psychiatric condition; only the bilateral deafness was known, which was deemed incidental to the current disability. Consequently, the Board's decision, which presumably denied reimbursement, was affirmed, with costs awarded to the Special Disability Fund.

Workers' CompensationSpecial Disability FundReimbursement ClaimPrior Physical ImpairmentBilateral DeafnessPsychoneurotic DisorderPre-existing ConditionEmployer KnowledgeTotal DisabilityCompensable Accident
References
0
Case No. 2016-01-0035 / 67325-2014
Regular Panel Decision
Aug 07, 2017

Findley, Jack v. Volswagen Group of America, Inc.

This case involves an employee, Jack Keith Findley, who sustained a back injury while working for Volkswagen. He sought temporary and additional permanent partial disability benefits, leading to a dispute over his impairment rating, maximum medical improvement date, and the compensability of his condition. The Court of Workers' Compensation Claims sided with Mr. Findley, awarding him the requested disability benefits and future medical care under Dr. Jolley, based on Dr. Hodges' medical opinion regarding his work-related injury and functional limitations. The court also allowed Volkswagen to offset short-term disability payments.

Workers' CompensationPermanent Partial DisabilityTemporary Partial DisabilityMedical BenefitsImpairment RatingMaximum Medical ImprovementVoluntary ResignationMedical Opinion ConflictBack InjuryLumbar Disc Herniation
References
5
Case No. MISSING
Regular Panel Decision
Jan 09, 1991

Claim of Ingham v. Oswego County

The claimant, a nursing assistant for Oswego County, sustained multiple injuries, including to the knee, back, wrist, and head, in an August 1979 accident while assisting a client. Over time, the claimant's condition deteriorated, leading to permanent total disability. A Workers’ Compensation Law Judge initially found a causally related disability for the knee and wrist, later amending it to include the low back and consequential obesity. The self-insured employer, Oswego County, appealed this decision, arguing the back injury claim was untimely and that the disability should be apportioned due to the claimant's prior back history and obesity. The Workers’ Compensation Board affirmed the WCLJ's decision, rejecting the County’s arguments by finding a waiver of the timeliness objection and substantial evidence supporting the aggravation of preexisting conditions as causally related to the 1979 accident, leading to total disability.

Permanent Total DisabilityCausally Related DisabilityAggravation of Preexisting ConditionWaiver of Section 28 DefenseTimeliness of Claim ObjectionConflicting Medical EvidenceSpinal InjuryObesity-Related DisabilityJoint InjuryEmployer Self-Insured
References
3
Case No. 2018-01-0702
Regular Panel Decision
Dec 16, 2019

Mollica, Gena M. v. EHHI Holdings, Inc. DBA Advanced Home Care Management, Inc. DBA Encompass Home Health

Ms. Mollica requested medical and temporary disability benefits from EHHI Holdings, Inc., which had accepted her back injury but failed to provide orthopedist treatment and denied her claim that the medication Lyrica aggravated a pre-existing mental condition. The Court found Ms. Mollica entitled to the requested benefits. It ordered EHHI to authorize psychiatric evaluation with Dr. Sandvi and orthopedic treatment with Dr. Caputo, reimburse out-of-pocket medical expenses incurred for her mental condition, and pay past and ongoing temporary total disability benefits. Additionally, EHHI was required to respond regarding a potential twenty-five percent penalty for non-payment of temporary disability benefits.

Temporary Total DisabilityMedical Treatment AuthorizationPre-existing Mental Health ConditionDrug AggravationLyrica Side EffectsPsychiatric EvaluationOrthopedic ReferralCausation StandardPhysician Opinion PresumptionPenalty for Non-payment
References
2
Case No. 2017-08-0024
Regular Panel Decision
Feb 19, 2020

Thomas, Alisha v. Federal Express Corp.

Alisha Thomas filed a Petition for Benefit Determination (PBD) seeking permanent total disability benefits or additional permanent partial benefits, which Federal Express Corp. disputed. The Court ruled that Ms. Thomas is entitled to increased permanent partial disability benefits under Tennessee Code Annotated section 50-6-207(3)(B) because she had not returned to work by the expiration of her initial compensation period, and her treating physician, Dr. Melvin Goldin, attributed her condition to the work injury at that time. However, the Court denied claims for additional benefits under section 50-6-242 and permanent total disability, as Dr. Goldin's later testimony revealed Ms. Thomas's condition had evolved beyond the initial somatic symptom disorder, and he could not definitively connect her advanced symptoms to the work injury at the time of the award. The awarded increased benefits totaled $3,379.01.

Permanent Partial DisabilitySomatic Symptom DisorderImpairment RatingRes JudicataMental Injury CompensabilityIncreased BenefitsSocial Security DisabilityTreating Physician TestimonyCausation StandardSettlement Agreement
References
5
Case No. 2018 NY Slip Op 08980
Regular Panel Decision
Dec 27, 2018

Matter of Ricci v. Maria Regina Residence

This case involves an appeal by the Special Disability Fund from a Workers' Compensation Board decision. The Board had ruled that the workers' compensation carrier for Maria Regina Residence was entitled to reimbursement from the Special Disability Fund for a claim related to Cyndia Ricci's work-related knee injury, asserting Ricci had pre-existing heart and arthritis conditions. The Appellate Division, Third Department, found that the record lacked substantial evidence to support the Board's finding that Ricci's preexisting conditions hindered her employment potential. The court concluded that the medical opinion relied upon was based on generalities and speculation, and that conditions controlled by medication do not, without more, constitute a hindrance to employability. Consequently, the Board's decision was reversed, and the matter was remitted for further proceedings.

Workers' CompensationSpecial Disability FundReimbursement ClaimPreexisting ImpairmentEmployabilityMaterially and Substantially Greater DisabilityMedical OpinionOrthopedic SurgeonAppellate ReviewSubstantial Evidence
References
11
Case No. MISSING
Regular Panel Decision

Claim of Russo v. M & M Transportation

The claimant, employed by M & M Transportation, sustained back and knee injuries in 1976. The employer's insurance carrier sought reimbursement from the Special Disability Fund, alleging various preexisting conditions under Workers’ Compensation Law § 15 (8). However, the carrier failed to produce medical proof to support its claim of preexisting conditions, even after being directed to do so by the Hearing Officer. Consequently, the Hearing Officer discharged the Special Fund, a decision affirmed by the Workers’ Compensation Board. The appellate court affirmed the Board's decision, citing the carrier's failure to provide clarifying medical proof and finding the Board's denial of reconsideration was neither arbitrary nor capricious. The court emphasized that the existence of a previous disability must be established before addressing the employer's knowledge of such a condition.

Workers' CompensationSpecial Disability FundReimbursement ClaimPreexisting Medical ConditionMedical EvidenceCarrier ObligationsBoard DiscretionDenial of ReconsiderationAppellate ReviewSufficiency of Evidence
References
3
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