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

Case No. 01-21-00008-CV
Regular Panel Decision
Aug 29, 2024

Sealy Emergency Room, L.L.C. and Kannappan Krishnaswamy, M.D. v. Dr. Atul Dhingra, Dr. Swapan Dubey and Dr. Sanjeev Dubey

Appellants Sealy Emergency Room, L.L.C., and Dr. Kannappan Krishnaswamy appealed a trial court's summary judgment in favor of appellees Free Standing Emergency Room Managers of America, L.L.C., Dr. Atul Dhingra, Dr. Swapan Dubey, and Dr. Sanjeev Dubey. The dispute arose from a management agreement for an emergency room, with appellants bringing counterclaims and third-party claims for breach of contract, fraud, fraudulent inducement, and negligence. After a previous dismissal for lack of appellate jurisdiction was reversed by the Texas Supreme Court, the First District of Texas Court of Appeals reviewed the merits. The court found that the appellants failed to raise a genuine issue of material fact on any of their claims, concluding that the alleged breaches of contract were not supported by the agreement's plain language or that the best-efforts clause was unenforceable. Furthermore, claims of fraud and negligence were not substantiated or were barred by the economic loss rule. Therefore, the appellate court affirmed the trial court's summary judgment.

Contract DisputeSummary JudgmentAppellate ReviewBreach of ContractFraudFraudulent InducementNegligenceEconomic Loss RuleTexas LawHealthcare Management
References
45
Case No. 03-10-00019-CV
Regular Panel Decision
Oct 12, 2011

Dr. Don Brantley, Belinda Castillo, Dr. Corinne Alvarez-Sanders and Patricia Logterman// Texas Youth Commission Cherrie Townsend in Her Official Capacity as Executive Director v. Texas Youth Commission Cherrie Townsend in Her Official Capacity as Executive Director// Dr. Don Brantley, Belinda Castillo, Dr. Corinne Alvarez-Sanders

This case concerns challenges by current and former employees of the Texas Youth Commission (TYC) against the constitutionality of Senate Bill 103, which converted TYC employment from 'for-cause' to 'at-will.' The plaintiffs, including Dr. Don Brantley, Belinda Castillo, Dr. Corinne Alvarez-Sanders, and Patricia Logterman, sought declaratory, injunctive, and monetary relief based on alleged wrongful termination, due process violations, defamation, and unconstitutional takings. The district court partially granted and denied TYC's plea to the jurisdiction. The appellate court affirmed the dismissal of Castillo's claims for lack of ripeness and the defamation and takings claims for all plaintiffs due to sovereign immunity. It reversed in part, allowing Alvarez-Sanders and Logterman to replead their wrongful-termination/due-process claims for equitable relief against a proper state official, and similarly reversed in part Brantley's wrongful-termination/due-process claim.

Employment LawPublic EmployeesAt-Will EmploymentFor-Cause EmploymentDue ProcessConstitutional LawRetroactive LegislationEx Post Facto LawBill of AttainderSovereign Immunity
References
37
Case No. ADJ251564 (SAC 0318113)
Regular
Jan 05, 2012

JASMELITA ASPER vs. HILTON, AMERICAN PROTECTION INSURANCE COMPANY

The Workers' Compensation Appeals Board rescinded a prior order that found Dr. Mata's treatment reasonable and necessary. The Board found that Dr. Mata, as the lien claimant, failed to meet his burden of proof by not submitting sufficient evidence, such as itemized bills, to demonstrate the reasonableness and necessity of his services. Therefore, Dr. Mata's lien claim was disallowed. One commissioner dissented, agreeing with the original administrative judge that Dr. Mata's reporting was sufficient given the admitted injury and lack of contrary evidence from the defendant.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings of Fact and OrderCompromise and ReleaseIndustrial InjuryRight ShoulderNeckRight ElbowHeadachesDr. Mata's Lien
References
0
Case No. ADJ2506742
Regular
Apr 18, 2011

SAUL FUENTES ARGUETA, SAUL ARGUETA vs. PRO CASES INC., STATE COMPENSATION INSURANCE FUND

This case involves a lien claimant, Dr. Konstat, seeking reconsideration of a Compromise and Release (C&R) agreement. Dr. Konstat contends the C&R improperly dismisses the applicant's psychiatric injury claim, which had been previously established by earlier WCAB orders. However, the Board found the C&R did not explicitly stipulate the applicant *did not* sustain a psychiatric injury, but rather agreed to withdraw that specific claim. Therefore, the C&R was not a final order regarding the lien claimant's rights, and the petition for reconsideration was dismissed, allowing the lien claimant to pursue her claim separately.

Lien claimantCompromise and ReleasePetition for ReconsiderationIndustrial injuryPsycheStipulationFindings and AwardLabor CodeWorkers' Compensation Appeals BoardWCJ
References
7
Case No. LAO 0837305, LAO 0837306
Regular
Apr 29, 2008

IRMA ALEJANDRA VILLAMAN vs. CALIFORNIA CLEANING SERVICE, CLARENDON NATIONAL INSURANCE COMPANY c/o AMERICAN ALL RISK LOSS ADMINISTRATORS

The Workers' Compensation Appeals Board denied the defendant's petition to reconsider the allowance of Dr. Kan's lien for medical treatment related to the applicant's industrial injuries. However, the Board granted the lien claimant's petition to clarify the award. Upon reconsideration, the Board amended the original award to disallow reimbursement for "work conditioning" services, reducing Dr. Kan's lien from $7,998.35 to $7,858.35.

Workers' Compensation Appeals BoardPetition for ReconsiderationLien ClaimantFindings and AwardIndustrial InjuryCompensableCompromise and ReleaseMedical TreatmentChiropractic VisitsWork Conditioning
References
1
Case No. 14-12-00531-CV
Regular Panel Decision
Sep 12, 2013

Denise Zimmerman v. Dr. Leslie Farias, D.D.S., P.A. F/K/A Dr. Leslie Farias, D.D.S., P.C. and Leslie Farias, Individually

Denise Zimmerman, a dental hygienist, sued Dr. Leslie Farias, D.D.S., P.A., and Leslie Farias individually for negligence after breaking her hip in a workplace fall due to alleged tripping hazards from computer cords. Neither Farias nor her Professional Association subscribed to Texas workers’ compensation insurance. Zimmerman's claims included unsafe working environment and an attempt to pierce the corporate veil against Farias. The trial court granted summary judgment in favor of the appellees. The appellate court affirmed, concluding that Zimmerman did not provide sufficient evidence to support her claims of sham to perpetrate fraud or an unreasonable risk of harm in her premises liability claim.

Workplace personal injurySummary judgmentNegligencePremises liabilityCorporate veil piercingAlter egoDental office accidentAppellate reviewTexas lawNo-evidence summary judgment
References
36
Case No. 03-18-00282-CV
Regular Panel Decision
Apr 17, 2019

Yvette Mata v. Capitol Wright Distributing, LLC Dalton Marek And Wright Distributing Co., Inc.

Yvette Mata appealed the district court's dismissal of her personal injury suit against Capitol Wright Distributing, LLC, Dalton Marek, and Wright Distributing Co., Inc. for want of prosecution. She contended that the district court provided inadequate notice of its intent to dismiss and erred in denying her motion to reinstate the case. The appellate court found that Mata was presumed to know Williamson County's local rules requiring a motion to retain, thus deeming the dismissal notice adequate. Furthermore, the court determined that any potential due process issues were rectified by the post-dismissal hearing on Mata's motion to reinstate. Ultimately, the appellate court affirmed the district court's judgment, concluding that Mata failed to demonstrate reasonable diligence in prosecuting her case.

Personal injurydismissal for want of prosecutionmotion to reinstateappellate reviewdue diligenceinadequate noticeabuse of discretionTexas Rules of Civil Procedurelocal court rulesappellate procedure
References
19
Case No. MISSING
Regular Panel Decision

Prentice v. Levy

Plaintiff sustained a work-related cervical spine injury in 1998 and underwent surgery by defendant Dr. Walter J. Levy in 1999. After the first surgery failed and a second surgery in 2002 to remove loosened hardware, plaintiff settled a medical malpractice action against Levy for $400,000. The self-insured employer, Tops, Inc., and its administrator, MAC Risk Management, as "the carrier," asserted a workers' compensation lien against the settlement. The Supreme Court provisionally set the lien at $22,442.91 and appointed a referee to determine the final lien and offset amounts, with the carrier bearing the costs. The appellate court affirmed the order, ruling that the interim lien was "without prejudice" and the referee's hearing scope was sufficient to conduct a comprehensive evidentiary hearing, thus causing no prejudice to the carrier.

Workers' Compensation LienMedical MalpracticeSettlement LienInterim LienWorkers' Compensation LawAppellate ReviewReferee AppointmentLien EstablishmentOffset PaymentsEvidentiary Hearing
References
2
Case No. ADJ1085807 (BAK 0154474) ADJ6601730
Regular
Sep 15, 2015

MARIA CORTEZ vs. KIRSCHENMAN ENTERPRISES, WAUSAU UNDERWRITERS INSURANCE COMPANY

The Workers' Compensation Appeals Board denied Dr. Moelleken's petition for reconsideration, affirming the disallowance of his lien. However, they granted Associated Reproduction Services' (ARS) petition, deferring their lien claim due to an ongoing federal injunction affecting lien dismissals for unpaid activation fees. The Ninth Circuit's decision vacating the injunction was not yet final, thus the injunction remained in effect. ARS's lien will be decided on its merits pending further developments.

Workers' Compensation Appeals BoardLien ClaimantsPetition for ReconsiderationFindings and OrdersAdministrative Law JudgeActivation FeeInjunctionMandateJudicial NoticeFederal Court
References
3
Case No. MISSING
Regular Panel Decision

Simon Ramirez and Cynthia Ramirez v. Dr. Jose Carreras

Simon Ramirez sustained a lower back injury while working, leading to a spinal fusion. K-Mart's worker's compensation carrier hired Dr. Jose Carreras to conduct a range-of-motion examination for disability rating. Simon and Cynthia Ramirez alleged Dr. Carreras caused further injury by forcefully bending Simon during the examination. The trial court directed a verdict on assault and battery but presented the common law negligence claim to the jury, which found no negligence. The appellate court affirmed the trial court's judgment, upholding the jury's verdict. It also ruled that the Texas Medical Liability and Insurance Improvement Act was not applicable due to the absence of a physician-patient relationship between Dr. Carreras and Simon Ramirez, reaffirming its prior decision on this matter as the law of the case.

NegligenceMedical ExaminationDuty Not To InjureWorker's CompensationPhysician-Patient RelationshipCommon Law NegligenceDirected VerdictAppellate ReviewSufficiency of EvidenceMedical Malpractice Act Inapplicability
References
5
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