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

Case No. 03-08-00059-CV
Regular Panel Decision
Apr 16, 2010

Pacific Employers Insurance Company v. Twelve Oaks Medical Center

This document presents a concurring and dissenting opinion in an appeal before the Texas Court of Appeals, Third District, at Austin. The case involves Pacific Employers Insurance Company as the appellant and Twelve Oaks Medical Center as the appellee, appealing a district court decision regarding judicial review of a workers' compensation medical dispute resolution. The dissenting justice agrees with the majority that Twelve Oaks Medical Center failed to exercise due diligence in serving the appellant. However, the dissent argues that the majority erred in dismissing the appeal for want of jurisdiction, contending that limitations is an affirmative defense rather than a jurisdictional defect in this context. The dissenting justice would have reversed the district court's order granting remand and instead rendered judgment in favor of Pacific Employers Insurance Company, asserting that the suit was barred by limitations.

Limitations DefenseDue DiligenceAppellate ProcedureJurisdictional DefectsAffirmative DefenseWorkers' CompensationMedical Dispute ResolutionAdministrative LawService of ProcessSummary Judgment Review
References
15
Case No. MISSING
Regular Panel Decision

Healthsouth Medical Center v. Employers Insurance Co.

HealthSouth Medical Center appealed a trial court's decision that granted Employers Insurance Company of Wausau's plea to the jurisdiction, dismissing HealthSouth's breach of contract claim related to workers' compensation insurance payments. HealthSouth argued the trial court erred in concluding it lacked jurisdiction and in refusing to compel Wausau to produce contracts. The court determined that the Texas Workers’ Compensation Commission (now the Division of Workers' Compensation) has exclusive jurisdiction over medical fee disputes between healthcare providers and insurers. Because HealthSouth did not exhaust its administrative remedies after the Division dismissed its claims, the trial court correctly lacked subject matter jurisdiction. The appellate court affirmed the trial court's order, concluding that the Division has the sole authority to determine the amount to be paid in such disputes.

Workers' CompensationJurisdictionBreach of ContractAdministrative RemediesMedical Fee DisputePlea to the JurisdictionAppellate ReviewInsurance BenefitsHealthcare ProviderPreferred Provider Organization
References
8
Case No. MISSING
Regular Panel Decision

Employers Mutual Liability Insurance Co. of Wisconsin v. Parker

This is a Workmen's Compensation appeal where Employers Mutual Liability Insurance Company of Wisconsin (defendant) appealed a judgment favoring Alton A. Parker (plaintiff). Parker claimed total and permanent disability due to cancer resulting from radiation exposure during his employment. The defendant contended there was no evidence establishing a causal link between the work-incurred radiation and Parker's cancer. The court reviewed the medical expert testimonies, finding them insufficient to prove a causal connection based on reasonable medical probability. The trial court's judgment was reversed, and judgment was rendered that the plaintiff take nothing, concluding that medical opinions were speculative without accurate information on radiation exposure.

CancerRadiation ExposureCausal ConnectionMedical TestimonyExpert WitnessesTotal DisabilityPermanent DisabilityOccupational HazardLymphomaSeminoma
References
4
Case No. MISSING
Regular Panel Decision

Matter of Hill-Chapman v. Earlybird Delivery Systems, LLC

Gerald Chapman, a dispatcher, collapsed and died at work on December 25, 2011, from a pulmonary embolism of unknown cause. His estate filed a claim for death benefits, which the Workers’ Compensation Board established, applying the Workers’ Compensation Law § 21 presumption that unexplained accidents in the course of employment arise out of such employment. The employer appealed, arguing that an independent medical report by Vinay Das could not determine the cause of death and requested cross-examination of the medical examiner and access to decedent’s medical records. The Appellate Division reversed the Board's decision, remitting the matter for the Board to address the employer's contention regarding the denial of access to medical records, while upholding the Board's application of the Section 21 presumption and denial of cross-examination.

Workers' Compensation BenefitsUnexplained DeathPulmonary Embolism CausationPresumption Against EmployerMedical Evidence AdmissibilityRight to Cross-ExamineMedical Record DiscoveryAppellate Division ReviewRemand for Further ProceedingsEmployment-Related Injury
References
8
Case No. 2-06-016-CV
Regular Panel Decision
Mar 15, 2007

Shioleno Industries, Inc. AND Columbia Medical Center of Arlington Subsidiary, L.P. and Columbia North Texas Subsidiary, GP, LLC D/B/A Medical Center of Arlington v. Columbia Medical Center of Arlington Subsidiary, L.P. and Columbia North Texas Subsidiary, GP, LLC D/B/A Medical Center of Arlington AND Shioleno Industries, Inc.

Shioleno Industries, Inc. appealed a summary judgment granted in favor of Columbia Medical Center of Arlington Subsidiary, L.P. and Columbia North Texas Subsidiary, GP, LLC d/b/a Medical Center of Arlington (the Hospital). The case originated from the Hospital's alleged failure to disclose an employee's positive drug and alcohol test results to Shioleno after an on-the-job injury. Shioleno contended that this omission led to increased workers' compensation premiums and expenses in unemployment benefit disputes. The appellate court affirmed the trial court's judgment, ruling that Shioleno failed to provide a valid authorization for the disclosure of medical information. Consequently, the Hospital had no legal duty to disclose the results and could not be held liable for negligence, breach of contract, or Deceptive Trade Practices Act (DTPA) violations.

Summary JudgmentMedical RecordsDisclosure AuthorizationHealth & Safety CodeNegligenceBreach of ContractDTPADrug TestingAlcohol TestingEmployer Liability
References
13
Case No. 03-97-00567-CV
Regular Panel Decision
Jul 30, 1998

Memorial Medical Center of East Texas v. James A. Howard, Special Deputy Receiver of Texas Employers' Insurance Association and Texas Property and Casualty Insurance Guaranty Association

Memorial Medical Center of East Texas appealed a summary judgment granted in favor of James A. Howard, Special Deputy Receiver of Texas Employers' Insurance Association, and Texas Property and Casualty Insurance Guaranty Association. Memorial sought a declaration that the appellees were obligated to reimburse defense costs incurred in a separate suit brought by its employees. The trial court granted the appellees' motions for summary judgment without specifying the grounds. The appellate court affirmed the trial court's judgment, holding that both the Receiver and the Association were statutorily precluded from defending Memorial or reimbursing its defense costs under relevant provisions of the Texas Insurance Code.

Summary judgmentInsurance CodeDuty to defendReimbursementImpaired insurerReceivershipGuaranty AssociationAppellate reviewStatutory interpretationWorkers' compensation insurance
References
11
Case No. MISSING
Regular Panel Decision

Texas Employers' Insurance Ass'n v. Lee

This worker's compensation case concerns Franklin N. Lee, a carpenter employed by Sabine Consolidated, Inc., who sustained severe injuries on June 28, 1975. The injury occurred after his work shift, within his employer's designated parking area on the construction site, while he was attempting to clear a path for his car by moving a company compressor. The defendant, Texas Employers’ Insurance Association, appealed a jury verdict that found Lee's injury occurred in the course of his employment, challenging the application of the 'access doctrine.' The 'access doctrine' posits that employment includes a reasonable margin of time and space for an employee to pass to and from work, extending to injuries sustained on premises owned or controlled by the employer or closely related thereto. The appellate court affirmed the judgment, concluding that there was sufficient factual evidence to support the jury's finding under the access doctrine.

Worker's CompensationAccess DoctrineCourse of EmploymentEmployer LiabilityPremises InjuryJury VerdictAppellate AffirmationStatutory InterpretationIngress EgressTexas Civil Statute
References
16
Case No. 13-17-00346-CV
Regular Panel Decision
May 09, 2019

Audrey Nickerson v. Julio Pineda and Unique Employment, LLC, Unique Employment Services, Unique Employment I, LTD, D/B/A Unique Employment Services

Audrey Nickerson, an employee of the City of Corpus Christi, sued Julio Pineda, a temporary worker, and Unique Employment Services for negligence after Pineda, operating a City-owned backhoe, caused an injury. Appellees filed a plea to the jurisdiction, which the trial court granted. The appellate court affirmed the dismissal of claims against Pineda, determining he qualified as a government employee under the Texas Tort Claims Act and was therefore immune from suit. However, the court reversed the dismissal of claims against Unique Employment Services, concluding that the borrowed-employee doctrine, on which Unique relied, is an affirmative defense to liability and not a jurisdictional matter properly addressed in a plea to the jurisdiction. The case against Unique was remanded for further proceedings.

Plea to the JurisdictionGovernmental ImmunityTexas Tort Claims ActElection of RemediesBorrowed Employee DoctrineNegligenceTemporary StaffingVicarious LiabilityAppellate ReviewSubject Matter Jurisdiction
References
35
Case No. 2015-02-0316
Regular Panel Decision
Nov 16, 2016

Dugger, Brandon v. Employment Solutions, LLC

Brandon Dugger, an employee of Employment Solutions, LLC, sustained a left arm injury on March 19, 2016, while working at Gardner Paint and subsequently falling at a hotel parking lot. He reported the injury, but Employment Solutions disputed its work-related nature and the timeliness of the notice. Mr. Dugger sought medical benefits and temporary disability. The Court determined that Mr. Dugger's injury occurred within the course of employment, applying the traveling employee doctrine, and that he provided timely actual notice. Therefore, the Court ordered Employment Solutions to provide Mr. Dugger with an appropriate panel of physicians, while reserving issues concerning temporary disability benefits and reimbursement for past medical expenses.

Workers' CompensationMedical BenefitsExpedited HearingTimely NoticeTraveling Employee DoctrineLeft Arm InjuryUlnar Styloid FracturePost-traumatic OsteoarthritisCausationPanel of Physicians
References
4
Case No. MISSING
Regular Panel Decision

Blocker v. Regional Medical Center at Memphis

Carolyn Blocker appealed the trial court's dismissal of her worker's compensation claim based on the statute of limitations. Blocker sustained an arm injury in April 1982, aggravated in October 1983, alleging continuous treatment by an employer-designated physician. Defendants, Regional Medical Center at Memphis and U.S. Security Fire & Casualty Insurance Companies, argued the claim was time-barred as the last voluntary payment was made in January 1983 or January 1984. The Supreme Court found that genuine issues of material fact existed regarding the dates of last voluntary compensation, the connection between the two injuries, and whether the plaintiff was adequately informed that payments for her medical treatment had shifted from worker's compensation to Blue Cross-Blue Shield. Consequently, the court reversed the summary judgment and remanded the case for further proceedings, emphasizing the need for full development of facts in such cases.

Worker's CompensationStatute of LimitationsSummary Judgment AppealLast Voluntary PaymentMedical BenefitsContinuous TreatmentAggravated InjuryEmployer-Designated PhysicianInsurance Coverage DisputeGenuine Issues of Material Fact
References
21
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