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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
May 01, 2005

In Re Balderas

This decision addresses post-confirmation attorneys' fees in Chapter 13 bankruptcy cases, using the Balderas case as a factual background. The debtors in the Balderas case sought modification of their plan due to payment defaults and requested $350 in attorney's fees for the motion. The court outlines the history of the Balderas' numerous modifications, moratoriums, and associated attorney fee awards, totaling $3,495, highlighting how these fees were paid out of plan distributions at the expense of creditors. The court analyzes sections 1326(b)(1) and 330(a)(4)(B) of the Bankruptcy Code to determine the reasonableness and payment method of such fees. Ultimately, the court establishes new rules for post-confirmation attorney fee awards in the Western District of Texas, San Antonio Division, including a $2,500 prima facie base fee, a $100 per month payment rate for additional fees, and specific guidelines for various types of motions. The current $350 fee request for the Balderas case's moratorium is approved but with caution against future similar requests.

BankruptcyChapter 13Attorneys' FeesPost-Confirmation FeesPlan ModificationCreditor DistributionsSecured ClaimsAdministrative ExpensesDebtor RepresentationFeasibility
References
26
Case No. MISSING
Regular Panel Decision

Texas Workers' Compensation Commission v. East Side Surgical Center

This case addresses the Texas Workers’ Compensation Commission's failure to establish fee guidelines for ambulatory surgical centers under the Texas Workers’ Compensation Act. East Side Surgical Center and related entities sued the Commission, seeking to invalidate default rules that applied in the absence of specific fee guidelines, arguing an unlawful delegation of fee-setting authority to insurance carriers. The district court initially declared rule 133.304® invalid, but the appellate court reversed this decision, holding that the rule did not constitute an unlawful delegation of the Commission’s authority. The court further clarified that providers are entitled to fair and reasonable reimbursement, not a statutory right to fee guidelines established by rule, and affirmed that East Side was not entitled to its usual and customary fee.

Workers' CompensationFee GuidelinesAdministrative LawStatutory InterpretationDelegation of AuthorityInsurance CarriersAmbulatory Surgical CentersJudicial ReviewDeclaratory ReliefInjunctive Relief
References
19
Case No. 2022 NY Slip Op 05964 [209 AD3d 596]
Regular Panel Decision
Oct 25, 2022

Pirozzo v. Laight St. Fee Owner LLC

Plaintiff Paul Pirozzo sought summary judgment on his Labor Law § 240 (1) claim against defendants Laight Street Fee Owner LLC, Laight Street Fee Owner II LLC, and Sciame Construction, LLC, which was granted by the Supreme Court. The Appellate Division, First Department, affirmed this decision. The plaintiff established a prima facie case by demonstrating that the scaffold he was working on collapsed without an apparent reason. The defendants' arguments that the plaintiff was the sole proximate cause, either by failing to lock scaffold pins or remaining on the scaffold while it was moved, were deemed unavailing. The court noted that these actions, even if proven, would amount to comparative negligence, which is not a defense to a Labor Law § 240 (1) claim, and there was no evidence of specific instructions to the plaintiff that were disobeyed.

Summary judgmentLabor Law § 240 (1)Scaffold collapseSole proximate causeComparative negligenceWorkers' compensation Form C-2Hearsay objectionPersonal knowledgeRecalcitranceAppellate Division
References
9
Case No. 04-MD-1596
Regular Panel Decision
Mar 20, 2006

In Re Zyprexa Products Liability Litigation

This order by Senior District Judge Weinstein addresses legal fee allocation in a coordinated multi-district litigation against Eli Lilly & Company concerning the prescription drug Zyprexa. Following a partial settlement covering approximately 8,000 individual plaintiffs, the court adopted a proposal from special settlement masters regarding fee caps. The court modified the proposed cap, reducing it from 37.5% to 35% for most recoveries, while maintaining a 20% cap for "Track A" settlements. The special masters are granted discretionary authority to adjust fees within a range of 30% to 37.5% based on individual case circumstances, with appeal rights to the court. The decision emphasizes the court's inherent authority to supervise attorney fees, particularly in quasi-class actions and mass litigations, to ensure fairness and prevent excessive charges to clients, drawing parallels to class action rules and state laws limiting contingent fees.

Mass TortMulti-District LitigationFee AllocationContingency FeesAttorney FeesEthical SupervisionSettlementZyprexa LitigationQuasi-Class ActionJudicial Discretion
References
23
Case No. MISSING
Regular Panel Decision

Texas Medical Ass'n v. Texas Workers Compensation Commission

The Texas Medical Association, Texas AFL-CIO, Patient Advocates of Texas, and Doctors Meril and Richey challenged the Texas Workers Compensation Commission's 2002 medical fee guidelines (Rule 134.202). Appellants argued the Commission unlawfully delegated its authority to a federal agency (CMS), acted arbitrarily and capriciously, and violated procedural requirements regarding the Medical Advisory Committee and public notice. The district court upheld the guidelines' validity. This appellate court affirmed, finding no unlawful delegation or arbitrary action, and concluded that the Commission substantially complied with the Administrative Procedure Act's requirements for reasoned justification and public comment, thereby validating the fee guidelines and denying a permanent injunction.

Workers' CompensationMedical Fee GuidelinesAdministrative LawRulemaking ValidityDelegation of PowerArbitrary and Capricious ReviewReasoned JustificationPublic Notice RequirementsTexas Labor CodeCMS Reimbursement
References
40
Case No. 03-01-00215-CV
Regular Panel Decision
Apr 25, 2002

Patient Advocates of Texas and Allen J. Meril, M.D. v. Texas Workers Compensation Commission Leonard Riley, Executive Director And State of Texas

This case concerns a challenge brought by Patient Advocates of Texas and Allen J. Meril, M.D., against the Texas Workers' Compensation Commission and the State of Texas. The challenge targeted the validity and enforcement of Commission rules, specifically the Medical Fee Guideline (Rule 134.201) and the Dispute and Audit Rules (Rules 133.300-.305). Advocates contended that the Guideline was procedurally and substantively invalid, and that the Dispute and Audit Rules improperly delegated auditing powers to private insurance carriers and imposed an unlawful statute of limitations. The appellate court affirmed the Guideline's fee caps and the one-year statute of limitations but reversed the trial court's judgment, declaring the delegation of auditing powers to private insurance carriers invalid.

Workers' Compensation ActMedical Fee GuidelinesAdministrative Procedure Act (APA)Rule-making proceduresDelegation of authorityPrivate insurance carriersAuditing powersStatute of limitationsConstitutional challengeDue process
References
15
Case No. MISSING
Regular Panel Decision

In re Currency Conversion Fee Antitrust Litigation

This Memorandum and Order addresses plaintiffs' motion for reconsideration of a prior decision concerning a class action alleging an antitrust price-fixing conspiracy by VISA, MasterCard, and their member banks related to foreign currency conversion fees. The Court denied the plaintiffs' motion for reconsideration, upholding its earlier finding that network defendants did not waive their right to arbitration because compelling arbitration would have been futile under then-existing law. Additionally, the Court denied reconsideration on several other procedural matters, including the creation of subclasses, membership of specific cardholder subclasses, representation of Diners Club and Providian cardholders, and a request for further discovery, citing the untimeliness of new arguments and the plaintiffs' failure to meet the burden of proof for class certification requirements.

Antitrust LitigationClass Action ProcedureArbitration AgreementsWaiver of ArbitrationEquitable EstoppelForeign Currency Conversion FeesReconsideration MotionSherman ActTruth in Lending ActDeceptive Trade Practices
References
43
Case No. 03-03-00436-CV
Regular Panel Decision
May 20, 2004

Texas Medical Association Texas AFL-CLO Patient Advocates of Texas Allen J. Meril, M.D. And L. E. Richey v. Texas Workers Compensation Commission Richard F. Reynolds, Executive Director And Texas Association of Business

The Texas Court of Appeals, Third District, at Austin, affirmed a district court's judgment upholding the validity of the 2002 medical fee guidelines promulgated by the Texas Workers' Compensation Commission. Appellants, including the Texas Medical Association and Texas AFL-CIO, challenged the guidelines on substantive grounds (unlawful delegation of power to CMS and arbitrary/capricious rulemaking) and procedural grounds (failure to consult the Medical Advisory Committee and inadequate reasoned justification/public notice). The appellate court found no unlawful delegation of power, that the Commission's decision was not arbitrary and capricious, and that the Commission substantially complied with the reasoned-justification requirement of the APA. The court also found no requirement to consult the Medical Advisory Committee for initial fee guidelines and that a new public notice and comment period was not required.

Workers' Compensation LawMedical ReimbursementFee GuidelinesAdministrative Procedure ActAgency RulemakingDelegation DoctrineArbitrary and CapriciousJudicial ReviewTexas LawHealth Policy
References
43
Case No. 03-03-00435-CV
Regular Panel Decision
Jul 29, 2004

Texas Workers' Compensation Commission Richard Reynolds, in His Official Capacity as Executive Director of the Texas Workers' Compensation Commission/East Side Surgical Center Clinic for Special Surgery And Surgical and Diagnostic Center, L.P. v. East Side Surgical Center Clinic for Special Surgery/Texas Workers' Compensation Commission Richard Reynolds, in His Official Capacity as Executive Director of the Texas Workers' Compensation Commission

This case involves the Texas Workers’ Compensation Commission's failure to establish fee guidelines for ambulatory surgical centers under the Texas Workers’ Compensation Act. East Side Surgical Center, Clinic for Special Surgery, and intervenor Surgical and Diagnostic Center, L.P. (collectively "East Side") sued the Commission to invalidate certain default rules that applied when specific guidelines were absent. The district court declared one rule (133.304(i)) invalid and enjoined its enforcement, citing unlawful delegation of authority. On appeal, the Court of Appeals reversed the district court's judgment regarding the rule's invalidity and dissolved the injunction, citing a Texas Supreme Court decision finding no unlawful delegation. The court affirmed that East Side was not entitled to its usual and customary fee in the absence of specific guidelines.

Workers' CompensationAdministrative LawDelegation of AuthorityRulemakingAmbulatory Surgical CentersJudicial ReviewInsurance CarrierFee GuidelinesFair and Reasonable RatesStatutory Interpretation
References
38
Case No. MISSING
Regular Panel Decision

Yeshiva University v. New England Educational Institute, Inc.

In a Lanham Act action, defendants, who prevailed after a jury trial against plaintiff Yeshiva, sought approximately $50,000 in attorney's fees. The application presented a novel question: whether a prevailing defendant is entitled to fees when the plaintiff's liability claims were asserted in good faith but the damage claims were grossly exaggerated. The court first affirmed the applicability of the Lanham Act's attorney fee provision, § 35(a), to actions involving unregistered marks, citing precedent. Despite acknowledging the plaintiff's highly exaggerated damage claims, the court determined that the case, which was close on the merits regarding the initial copying allegations, did not meet the 'exceptional cases' standard required for awarding attorney's fees to a prevailing defendant. Consequently, the defendants' application for attorney's fees was denied.

Lanham ActAttorney's FeesPrevailing DefendantExceptional CasesUnregistered MarkDamage ClaimsExaggerated DamagesGood Faith LitigationJury VerdictNon-profit Dispute
References
7
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