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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

Harry v. University of Texas System

Justice McCollum concurs with the majority's decision to reverse and remand the case, but departs on the issue of broad form jury submission. The Appellant, Nelda Harry, complained that the trial court erred in conjunctively submitting the issues of injury and producing cause of incapacity, which placed an undue burden on her to prove incapacity for medical benefits. McCollum argues that Article 8306, section 7, entitles a worker to medical care for an injury regardless of incapacity, and the conjunctive submission was not feasible, constituting an abuse of discretion and resulting in an incomplete verdict. The opinion highlights the importance of disjunctive submission to ensure all claims for relief are properly adjudicated.

Jury SubmissionBroad Form SubmissionConjunctive SubmissionWorkers' CompensationMedical BenefitsIncapacity to LaborAbuse of DiscretionIncomplete VerdictTexas Civil ProcedureJury Charge
References
5
Case No. 01-07-01113-CV
Regular Panel Decision
Oct 17, 2008

Paul Turner v. Precision Surgical, LLC

Paul Turner, a former sales representative for Precision Surgical, L.L.C., appealed a take-nothing judgment stemming from his retaliatory-discharge and Sabine Pilot claims. Turner alleged his termination was a result of his refusal to commit insurance fraud by misrepresenting a work-related injury to claim health insurance instead of workers' compensation, and subsequently for filing a workers' compensation claim. Precision Surgical countered that Turner was terminated due to unreliability and dishonesty. The appellate court affirmed the trial court's judgment, finding no error in the disjunctive submission of jury questions because the two claims were mutually exclusive, and even if there were an error, it would have been harmless since the jury considered and rejected both theories of recovery.

Retaliatory DischargeSabine Pilot ClaimWorkers' Compensation ClaimInsurance FraudJury Charge ErrorConditional Jury SubmissionDisjunctive Jury SubmissionMutually Exclusive Legal TheoriesAbuse of DiscretionHarmless Error
References
28
Case No. MISSING
Regular Panel Decision

Turner v. Precision Surgical, L.L.C.

Paul Turner was discharged from Precision Surgical, L.L.C. and subsequently filed claims for retaliatory discharge and for refusing to perform an illegal act (insurance fraud). He alleged he was terminated after refusing to file a fraudulent health insurance claim instead of a workers' compensation claim. The trial court submitted jury questions for both claims disjunctively, requiring a 'no' answer to the insurance fraud claim before the workers' compensation claim could be answered. The jury found against Turner on both claims, leading to a take-nothing judgment. Turner appealed, arguing the conditional submission was improper. The appellate court affirmed, ruling that the two claims were mutually exclusive and that any error in the jury instruction was harmless as the jury had considered and rejected both theories of recovery.

Retaliatory dischargeWorkers compensationInsurance fraudJury instructionConditional submissionDisjunctive submissionMutually exclusive claimsHarmful errorSabine Pilot claimEmployment law
References
40
Case No. ADJ9060378
Regular
Apr 21, 2014

MELISSA OVERTON vs. THE PAPER BAG PRINCESS, HARTFORD INSURANCE COMPANY

This case concerns a dispute over applicant Melissa Overton's deposition, specifically regarding the presence of an employer representative and videotaping. A WCJ vacated a prior submission order to compel a psychiatric evaluation to assess the applicant's fitness for deposition under those conditions. The defendant sought removal, arguing the WCJ erred in vacating submission and ordering further discovery. The Appeals Board granted removal, rescinded the WCJ's order and submission order, and returned the case for reassignment to a new WCJ to resolve the discovery dispute.

Petition for RemovalOrder Vacating SubmissionFurther DiscoveryProtective OrdersDeposition LocationEmployer RepresentativePsychiatric EvaluationIndustrial InjuryCumulative TraumaWCJ Reassignment
References
0
Case No. ADJ7489572
Regular
Apr 13, 2012

Francisco Castillo vs. Duran Contracting (dba), Star Insurance Company

The Workers' Compensation Appeals Board granted reconsideration and rescinded an interim award finding applicant sustained an industrial injury to his eye. The Board found the award premature because the hearing was not concluded, evidenced by an order to take the matter off calendar for an Agreed Medical Examiner evaluation and the absence of a submission order. The case is returned to the trial level for further proceedings, clarification of evidence, and a final decision after completion of discovery and submission on all issues.

Workers' Compensation Appeals BoardInterim Findings and AwardAgreed Medical Examinerindustrial injuryleft eyeleft foreheadfarm laborerapplicant's testimonycontradictory evidenceapplicant's credibility
References
3
Case No. ADJ2820557 (RDG 0106325), ADJ3301737 (RDG 0110776)
Regular
Oct 18, 2011

DEAN LAGOE vs. GRASS VALLEY FORD by RISK ENTERPRISE MANAGEMENT

The defendant, Grass Valley Ford, petitioned for removal to vacate an order vacating submission, arguing irreparable harm from ongoing temporary disability payments. The WCJ vacated submission due to an insufficient evidentiary record lacking stipulations on temporary disability payments and claimant's claims. The Appeals Board denied the petition, finding the WCJ was correct that a sufficient record was needed for a proper decision. The case is remanded for further proceedings to develop the record.

Petition for RemovalVacating SubmissionInsufficient EvidenceTemporary Disability IndemnityIrreparable HarmStipulated AwardsEAMSCumulative TraumaAmended Minutes of HearingStipulation
References
1
Case No. ADJ9398564
Regular
Jun 12, 2018

JEROME POLAND vs. COUNTY OF SAN BERNARDINO

The applicant, Jerome Poland, filed a Petition for Reconsideration without his attorney in response to a notice of intention to disallow his claim. The Workers' Compensation Judge (WCJ) subsequently issued an "Order Vacating Submission" in response to this petition. Citing WCAB Rule 10859, which allows a WCJ to amend or rescind a decision within fifteen days of a reconsideration petition, the Board dismissed the applicant's petition. This dismissal was based on the WCJ's action in vacating submission within the allowable timeframe.

Workers' Compensation Appeals BoardPetition for ReconsiderationNotice of Intention to DisallowWorkers' Compensation Administrative Law JudgeOrder Vacating SubmissionWCAB Rule 10859Amend or ModifyRescindFurther ProceedingsDismissed Petition
References
1
Case No. ADJ8040191
Regular
Sep 18, 2013

JOEL GOODEN vs. HILLS PET NUTRITION, INC., ACE AMERICAN INSURANCE COMPANY

The defendant petitioned for removal, seeking to overturn an order vacating submission of the case for further medical record development. The administrative law judge (WCJ) had vacated submission to review PQME reports from Dr. Georgis and Dr. Francisco. The WCJ subsequently took the matter off calendar to allow parties to obtain a supplemental report from the PQME reviewing Dr. Francisco's report. As the issue raised by the defendant's petition is now moot due to the subsequent order, the Appeals Board dismissed the Petition for Removal.

Petition for RemovalVacating SubmissionPQMESupplemental ReportWCJOff CalendarMootAppeals BoardWorkers' CompensationCase Development
References
0
Case No. ADJ11225851
Regular
Oct 18, 2019

SUZAN ELSHAMI vs. C & A RESTAURANTS INC.; SAFETY NATIONAL CASUALTY CORPORATION, administered by BROADSPIRE

This case involves an applicant challenging a WCJ's decision regarding a Medical Provider Network (MPN) issue. The Appeals Board granted reconsideration solely to amend the order vacating submission, instructing further record development without vacating submission. The Board affirmed the WCJ's finding of injury AOE/COE, a threshold issue, while deeming the MPN development order interlocutory. The Board clarified that for MPN compliance, the network only needs at least three available primary treating physicians of an appropriate specialty within access standards.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalVacating SubmissionFurther Development of RecordThreshold IssueFinal DecisionInterlocutory IssueInjury Arising Out of and in the Course of Employment (AOE/COE)Medical Provider Network (MPN)
References
7
Case No. ADJ892953 (LAO 0863530) ADJ4178497 (POM 0234792)
Regular
Jul 02, 2012

FELICIDAD MCINTOSH vs. GOLDEN STATE FOODS, LIBERTY MUTUAL INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) dismissed the applicant's Petition for Reconsideration because it was filed against a non-final order vacating the Order of Submission. The WCAB also denied the applicant's Petition for Removal, finding no evidence of significant prejudice or irreparable harm. The WCJ vacated the submission to allow for the development of the record regarding apportionment, which was inadequately addressed in the agreed medical examiner reports. The WCAB clarified that reconsideration is only available for final orders, and removal is an extraordinary remedy reserved for cases demonstrating substantial prejudice or irreparable injury.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalOrder Vacating Order of SubmissionAgreed Medical Evaluator (AME)CausationApportionmentBurden of ProofFinal OrderSubstantive Rights
References
5
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