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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

Singletary v. Apfel

Plaintiff Sylvester M. Singletary appealed the Commissioner of Social Security's denial of disability insurance benefits, leading to this action under 42 U.S.C. § 405(g). The Court reviewed the final determination, including an Administrative Law Judge's decision, which the Appeals Council upheld. The central issue revolved around the ALJ's rejection of Singletary's treating physician's opinion of total disability, which the ALJ deemed unsupported by objective evidence, specifically the absence of disc herniation. The Court found that the ALJ arbitrarily substituted his lay opinion for competent medical evidence and ignored other objective findings like degenerative disc disease and disc bulging. Consequently, the Commissioner’s decision was not supported by substantial evidence, and the case was remanded solely for the calculation of benefits, with the plaintiff's motion for judgment on the pleadings granted.

Disability BenefitsSocial Security ActTreating Physician RuleSubstantial Evidence ReviewDegenerative Disc DiseaseChronic PainSpinal ImpairmentALJ ErrorRemandFederal Court Review
References
13
Case No. MISSING
Regular Panel Decision

Claim of Scalzo v. St. Joseph's Hospital

The claimant, a patient account representative, suffered a back injury (herniated L5-S1 disc and bulging discs) on May 18, 2000, after abruptly rising from her chair to avoid an object at work. Her claim for workers' compensation benefits was controverted by her employer and its carrier, arguing the injury was idiopathic. However, both a Workers' Compensation Law Judge and the Workers' Compensation Board found the accident established, relying on medical evidence, lay testimony, and the presumption under Workers’ Compensation Law § 21 (1). The employer appealed this decision. The appellate court affirmed the Board's decision, concluding that substantial evidence supported the finding that the injury arose out of and in the course of employment, and that credibility issues were for the Board to resolve.

Workplace InjuryBack InjuryHerniated DiscBulging DiscWorkers' Compensation BenefitsAccident Arising Out of EmploymentCourse of EmploymentPresumption of Arising Out of EmploymentCredibility IssueSubstantial Evidence
References
6
Case No. 05-21-00303-CV
Regular Panel Decision
Nov 28, 2022

Amanda McGee v. Ladonna Tatum

Amanda McGee appealed the trial court's judgment finding her liable for Ladonna Tatum's damages from an automobile accident. McGee contended the evidence was legally and factually insufficient to support the jury's verdict that Tatum's injuries were caused by the accident. The appellate court found no expert medical evidence to support causation for Tatum's medical expenses, which included diagnoses like bulging discs and herniated discs, thus reversing and rendering judgment that Tatum take nothing on her claim for medical expenses. However, the court affirmed the awards for past and future pain and suffering and physical impairment, finding lay testimony sufficient for these damages and that McGee failed to adequately brief why expert testimony was required for these specific awards. The case was also remanded for recalculation of prejudgment interest.

Automobile AccidentPersonal InjuryNegligenceCausationMedical ExpensesPain and SufferingPhysical ImpairmentLegal SufficiencyFactual SufficiencyAppellate Review
References
28
Case No. 2017-05-0892
Regular Panel Decision
Apr 02, 2018

Hunt, Michele v. Amazon.com

Michelle Hunt, an employee of Amazon.com, sustained injuries including her right ankle, wrist, and low back after a slip and fall incident in 2015. Amazon provided a panel of physicians, and Ms. Hunt chose Dr. Jeffrey Hazlewood. Despite conservative treatment, Ms. Hunt's low back pain persisted and worsened, showing a diffuse disc bulge and mild central disc extrusion at L5-S1 on an MRI. Dr. Hazlewood concluded the back pain did not warrant a specialist referral. Ms. Hunt sought an expedited hearing to request a panel of orthopedists for her low back complaints, arguing Dr. Hazlewood's care failed to improve her symptoms. The Court, however, denied her request, finding her testimony alone insufficient to overcome the presumption of medical necessity accorded to Dr. Hazlewood's opinion.

Workers' CompensationMedical BenefitsExpedited HearingLow Back PainOrthopedistsPanel of PhysiciansTreating PhysicianMRIDisc BulgeDegenerative Disc Disease
References
2
Case No. MISSING
Regular Panel Decision

Blankenship v. American Ordnance Systems, LLS

Gatha Blankenship, an employee of American Ordnance Systems, LLC, was temporarily laid off in February 2002. She voluntarily took an upper body strength test on the employer's premises on March 7, 2002, for new job openings, despite not being compensated or required to do so. Immediately after the test, she experienced back pain, later diagnosed as a bulging disc. The trial court denied workers' compensation benefits, ruling the injury did not arise out of her employment. The Supreme Court affirmed this decision, concluding that her injury was not compensable as it did not arise out of or occur in the course of her employment, given her voluntary participation and lack of compensation for the test.

Workers' CompensationBack InjuryStrength TestVoluntary ParticipationCourse of EmploymentArising Out of EmploymentLayoffCausationCompensabilityAppeal
References
9
Case No. MISSING
Regular Panel Decision

Knight v. Astrue

Plaintiff Llewelyn M. Knight applied for disability insurance benefits (DIB), which were denied by the Commissioner of Social Security. Plaintiff sought judicial review, alleging disability due to herniated and bulging discs and cervical spondylosis. The Administrative Law Judge (ALJ) initially denied the claim, finding Plaintiff not disabled and able to perform sedentary work. This court reviewed the ALJ's decision, addressing Plaintiff's arguments regarding impairment listings, residual functional capacity, the need for a vocational expert, credibility, and an independent medical examiner's opinion. Ultimately, the court found substantial evidence supporting the Commissioner's decision, granted the Commissioner's motion for judgment on the pleadings, and denied Plaintiff's motion, dismissing the case.

Disability BenefitsSocial Security ActSedentary WorkResidual Functional CapacityAdministrative Law JudgeMedical-Vocational GuidelinesCredibility AssessmentSpinal DisordersNerve Root CompressionMotor Loss
References
41
Case No. MISSING
Regular Panel Decision

Bennett v. Secretary of United States Depatment of Health & Human Services

Charles Bennett ("plaintiff") is appealing a final decision by the Secretary of the United States Department of Health and Human Services, which denied his application for disability insurance and supplemental security income benefits. Bennett, a 41-year-old with a history of heart issues and a December 1986 back injury, claims disability, which was initially denied by an Administrative Law Judge and upheld by the Appeals Council. The court's review examines whether the Secretary's decision is supported by substantial evidence, specifically evaluating the "treating physician rule" concerning the opinions of Dr. Blum and Dr. Gold versus consulting physicians like Dr. Massoff. While objective tests confirm a bulging disc and treating physicians noted decreased range of motion, the court found their cursory "total disability" conclusion for Workers' Compensation purposes insufficient under the Act. Consequently, the court remands the case to the Secretary, requiring further information on Bennett's current residual functional capacity for sedentary or light work.

Social Security ActDisability Insurance BenefitsSupplemental Security IncomeResidual Functional CapacityLumbosacral Spine StrainBulging DiscTreating Physician RuleRemandAdministrative Law JudgeAppeals Council
References
11
Case No. MISSING
Regular Panel Decision

Lay v. Scott County Sheriff's Department

Jerry Brandon Lay, a deputy sheriff for Scott County Sheriff's Department, was injured in an automobile accident in October 2000, sustaining neck, shoulder, arm, and back injuries. He underwent surgery for a bulging disc and was rated with a 13% whole body disability, reaching maximum medical improvement in January 2002. After initially returning to the Sheriff's Department at the same pay, Lay voluntarily resigned for a higher-paying job, only to be rehired by the Sheriff's Department at a lower wage after his surgery. The trial court awarded Lay 60% permanent partial disability, believing the 2.5 times impairment rating statutory cap did not apply as he was not returned to the same position at the same wage. The Supreme Court reversed this decision, asserting that the 2.5 times cap applies when an employee has a meaningful return to work and resigns for reasons unrelated to the injury, regardless of later returning at a lower wage. Consequently, Lay's award was modified to 32.5% permanent partial disability, which is 2.5 times his 13% impairment rating.

Workers' CompensationPermanent Partial DisabilityMeaningful Return to WorkStatutory CapsVoluntary ResignationWage DiscrepancySpinal InjuryMedical Impairment RatingAppellate ReviewTennessee Law
References
11
Case No. 2016-03-0298
Regular Panel Decision
Sep 13, 2018

Hollis, Aleceia v. Komyo America

Ms. Hollis, a material handler for Komyo America, sustained a work injury in January 2016, leading to a lumbar sprain and later a herniated disc. She sought various benefits, including temporary and permanent disability, and medical expenses for the herniated disc. The Court found that Ms. Hollis failed to establish by a preponderance of the evidence that her herniated disc arose primarily out of and in the course and scope of her employment. This decision was largely based on the authorized treating physician's opinion, Dr. Sanabria, which was presumed correct and deemed unrebutted by other medical experts' testimony. Consequently, the Court denied benefits related to the herniated disc but ordered Komyo America to provide ongoing reasonable and necessary medical care for her work-related lumbar strain.

Workers' CompensationLumbar StrainHerniated DiscCausation DisputePre-existing ConditionMedical Expert TestimonyPreponderance of EvidenceMaximum Medical ImprovementAuthorized PhysicianUnauthorized Treatment
References
1
Case No. 2023-08-6277
Regular Panel Decision
Apr 17, 2024

OLGUIN, MIGUEL v. AZTEC MASONRY, INC.

Mr. Miguel Olguin, an employee of Aztec Masonry, Inc., sustained a back injury on November 15, 2021. Following initial treatments, Dr. Glen Crosby, a spine surgeon, recommended a total disc replacement surgery after an MRI revealed a collapsed and ruptured disc. This surgery was subsequently denied by utilization review. Mr. Olguin requested temporary total disability benefits, an earlier pain management appointment, and a second opinion on the denied surgery. The Court of Workers’ Compensation Claims at Memphis, presided over by Judge Shaterra R. Marion, denied the request for temporary benefits and an earlier pain management appointment, but granted Mr. Olguin's request for a second opinion on the total disc replacement surgery.

back injuryruptured discdisc replacement surgerytemporary total disability benefitspain managementsecond medical opinionutilization review denialmedical treatment authorizationworkers' compensation law
References
3
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