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Case Law Database

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

Case No. MISSING
Regular Panel Decision
Jun 27, 1975

Nelson v. Dumpson

The court annulled the determination by the State Commissioner of Social Services, which had affirmed the New York City commissioner's decision to recoup an overpayment of public assistance from the petitioner. The overpayment was due to the inclusion of the petitioner's son, Frank, in the budget while he was outside the household. The initial determination was based on section 348.4 of the regulations of the State Department of Social Services (18 NYCRR 348.4), concerning 'suspected fraud' requiring evidence of willful withholding of information. However, the record from the fair hearing lacked substantial evidence to establish willful withholding or fraud. The petitioner testified to disclosing Frank's absence, and respondent's records did not contradict this. This annulment does not preclude the respondent from seeking relief for overpayment due to honest mistake.

public assistanceoverpaymentrecoupmentwillful withholdingfraudfair hearingsocial services regulationssubstantial evidenceannulmentremand
References
0
Case No. MISSING
Regular Panel Decision
May 09, 1974

Russell v. Dumpson

Petitioner (Mrs. Russell) initiated an Article 78 proceeding to challenge a May 9, 1974 decision by the New York State Department of Social Services, which affirmed the denial of retroactive public assistance by the New York City Department of Social Services. The petitioner and her husband had taken two children, Harry and Kennedy Drayton, into their home based on assurances from a social services employee that assistance would be provided. Despite filing an application and making numerous inquiries, assistance for the period the children resided with them was denied, and only later partially granted for one child. The respondents denied retroactive assistance, citing regulations that assistance meets current needs and the petitioner's alleged failure to request a fair hearing within 60 days. The court found errors of law in the respondents' decision, ruling that the Department could not penalize the petitioners for its own inaction and that the 60-day period did not commence without written notification. Consequently, the court annulled the decision and directed respondents to issue a retroactive grant of assistance to the petitioner.

Public AssistanceRetroactive GrantArticle 78 ProceedingSocial Services LawFair HearingAdministrative ReviewDue ProcessAgency InactionChildren's WelfareState Regulations
References
6
Case No. 03-04-00050-CV
Regular Panel Decision
Jul 29, 2004

Al Boenker Insurance Agency, Inc. v. the Texas FAIR Plan Association The Texas Department of Insurance And Jose Montemayor, Commissioner of Insurance

Appellant Al Boenker Insurance Agency, Inc. appealed a summary judgment ruling in favor of the Texas FAIR Plan Association (FAIR Plan). Al Boenker had challenged a bulletin issued by FAIR Plan, which restricted fees insurance agencies could charge for homeowners insurance applications and allowed for termination of agencies violating the contract. Al Boenker argued that FAIR Plan violated the separation-of-powers doctrine and exceeded its statutory authority. The Court of Appeals affirmed the district court's judgment, concluding that FAIR Plan is not a state agency subject to the Texas Administrative Procedure Act's rulemaking provisions and acted within its authority derived from the FAIR Plan Act and its Plan of Operation by contractually limiting agent compensation and establishing conditions for agent termination.

Administrative LawInsurance LawContract LawSummary JudgmentDeclaratory JudgmentInjunctionAgency AuthoritySeparation of PowersStatutory ConstructionTexas Court of Appeals
References
16
Case No. E2011-00831-COA-R3-CV
Regular Panel Decision
Mar 30, 2012

Cristy Irene Fair v. Stephen Lynn Cochran

The case of Cristy Irene Fair v. Stephen Lynn Cochran involved an appeal from the Circuit Court for Knox County. The Trial Court dismissed Fair's motor vehicle accident claim because proof of service for her summons was not returned to the clerk until 412 days after issuance, failing to comply promptly with Tenn. R. Civ. P. 4.03(1). Consequently, Fair could not rely on Tenn. R. Civ. P. 3 to toll the statute of limitations. The Court of Appeals affirmed the dismissal, emphasizing the necessity of strict compliance with procedural rules for service of process.

Statute of LimitationsService of ProcessMotion to DismissCivil Procedure RulesAppellate ReviewJudgment AffirmedTennessee LawMotor Vehicle AccidentProof of ServiceTimeliness
References
25
Case No. MISSING
Regular Panel Decision

Galveston County Fair & Rodeo v. Kauffman

Travis Kauffman entered his steer "Reebok" in The Galveston County Fair and Rodeo steer show. After winning a class, the steer was later disqualified due to allegations of "airing," an unethical fitting practice. Daniel S. Kauffman, Jr., Travis's father, sued the Fair alleging violations of the Deceptive Trade Practices-Consumer Protection Act (DTPA), breach of contract, negligence, and gross negligence. A jury found in favor of Kauffman on all claims, with recovery elected under the DTPA. The Fair appealed, challenging aspects of the jury charge, evidence sufficiency, damages, consumer status under DTPA, and attorney's fees. The appellate court affirmed the judgment but modified it by deleting a $1,500 damage award related to negligence.

DTPA ViolationUnconscionable ActNegligenceBreach of ContractSteer DisqualificationAnimal Show EthicsConsumer ProtectionAppellate ReviewDamagesMental Anguish
References
18
Case No. ADJ1941485 (VNO 0263845) ADJ4137418 (VNO 0270976) ADJ1018222 (MON 0140131)
Regular
Dec 15, 2008

GERTRUDE CHISM vs. K-MART/SEARS HOLDING CORPORATION, Permissibly Self-Insured Administered by SEDGWICK CLAIMS MANAGEMENT SERVICES

The Appeals Board dismissed the defendant's petition to remove WCJ Zarett as moot due to his retirement, and denied the request for a commissioner's hearing on sanctions as premature. The Board remanded the case to the trial level for a full evidentiary hearing on the defendant's allegations regarding the applicant's attorneys, as these factual issues are best addressed by a new Workers' Compensation Judge. The defendant's numerous petitions for removal, vacating hearings, and stays were largely dismissed or denied.

Workers' Compensation Appeals BoardGertrude ChismK-Mart/Sears Holding CorporationSedgwick Claims Management ServicesPetition for Commissioner's HearingRemoval of Judge ZarettVacate HearingStay ProceedingsImposition of SanctionsGuardian Ad Litem
References
1
Case No. MISSING
Regular Panel Decision

Brown v. Lavine

This case addresses whether an indigent recipient of public assistance is constitutionally entitled to assigned counsel at a statutory fair hearing concerning the discontinuance of aid. The petitioner, whose aid was to be discontinued, was denied assigned counsel after Queens Legal Services declined representation. The court affirmed the lower court's decision, holding that while due process requires notice and an opportunity to be heard, it does not extend to the right to assigned counsel in such administrative hearings. The court emphasized that existing regulations provide ample safeguards and that the purpose of the hearing is factual ascertainment, not criminal prosecution. It distinguished this from child neglect cases where fundamental liberty interests mandate assigned counsel, concluding that if assigned counsel is to be provided, it is a legislative, not a constitutional, mandate. The court also rejected the equal protection claim, noting that fair hearing procedures are available to all.

Public AssistanceFair HearingAssigned CounselDue ProcessEqual ProtectionIndigencySocial Services LawWelfare FraudAdministrative HearingsConstitutional Law
References
13
Case No. MISSING
Regular Panel Decision

Hearring v. Sliwowski

Melissa Hearring, as next friend of a minor, B.H., filed a § 1983 action against school nurse Karen Sliwowski and the Metropolitan Government of Nashville Davidson County, Tennessee, alleging a Fourth Amendment violation for an intrusive visual search of B.H.'s labia without consent or emergency. The Magistrate Judge recommended granting summary judgment for defendants, citing qualified immunity for Sliwowski and insufficient evidence against Metro. However, the District Judge set aside this recommendation, concluding that B.H.'s Fourth Amendment right was clearly established at the time of the search. The Court denied the defendants' motion for summary judgment, finding that Metro could be liable for deliberate indifference to the need for clear policies regarding student searches.

Fourth AmendmentQualified ImmunitySchool SearchStrip SearchMinor's RightsDeliberate IndifferenceMunicipal LiabilitySchool Nurse ConductParental ConsentMedical Examination
References
79
Case No. MISSING
Regular Panel Decision

Kenton v. Wyman

Petitioner, a 35-year-old father of five, was enrolled full-time in the SEEK program at college. His public assistance grant was reduced, and housekeeping services discontinued, because he refused to seek employment that interfered with his schooling. The court examined whether the hearing officer should have disqualified herself (found she was qualified), whether the petitioner was entitled to public assistance while in the SEEK program (found he was not as he wasn't a minor or in an approved vocational program), and whether he required notice for discontinuance of housekeeping services (found he did, but he had a fair hearing). The court ultimately directed that the petitioner be reimbursed for welfare allowances deducted during the period leading up to the State's fair hearing decision, acknowledging a new regulation requiring continued payments during that time, but upheld the other decisions.

Public AssistanceWelfareSEEK ProgramFull-Time StudentEmployabilityFair HearingHousekeeping ServicesGrant ReductionArticle 78 ProceedingSocial Services Law
References
4
Case No. 2015-02-0155, 2015-02-0156, 40357-2015, 31700-2015
Regular Panel Decision
Apr 13, 2018

Muse, Estel Blackie v. Campbell County

Estel "Blackie" Muse, an employee of Campbell County, filed claims for multiple injuries, including his back, hearing loss, right shoulder, bilateral upper extremities, and occupational lung disease. The employer accepted the back and hearing-loss claims but denied the others. The Court of Workers’ Compensation Claims at Knoxville, presided by Judge Lisa A. Lowe, denied Mr. Muse's claims for his right shoulder, bilateral upper extremity, and occupational lung disease, finding he failed to establish compensability. However, the court granted permanent partial disability benefits for his back and hearing loss based on accepted medical opinions, incorporating increased benefits and applying a social security offset. The total award for permanent partial disability benefits was $79,073.37, and future medical benefits for his back and hearing loss were also awarded.

Workers' CompensationPermanent Partial DisabilityBack InjuryHearing LossOccupational Lung DiseaseRight Shoulder InjuryBilateral Upper Extremities InjuryMedical CausationPreponderance of EvidenceIndependent Medical Evaluation (IME)
References
5
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