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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

Saldana v. Houston General Insurance Co.

Daniel Saldana, Jr., sustained a knee injury in March 1976 while working for Houston Poultry and Egg Company, requiring surgery. After a subsequent fall in October 1976, he reported back pain, which he contended was an extension of his initial injury. He sued Houston General Insurance Company, the worker's compensation carrier, for a general injury. The jury, however, found the injury was specific to his right leg and awarded him $3,775.78 for permanent partial incapacity, with a $40 weekly decrease in earning capacity. The appellate court affirmed the trial court's judgment, rejecting Saldana's eight points of error regarding the judgment's conformity to the verdict, sufficiency of evidence, and admission of evidence.

Worker's CompensationSpecific InjuryGeneral Injury ClaimKnee InjuryBack Injury DisputeJury Verdict AppealMedical Expert TestimonyPermanent Partial DisabilityWage Earning CapacityEvidence Admissibility
References
10
Case No. MISSING
Regular Panel Decision

Gilberto Rincones v. Whm Custom Services, Inc.

Gilberto Rincones appealed a take-nothing judgment after being declared ineligible to work due to a disputed positive drug test. He sued his employer WHM Custom Services, Inc., Exxon Mobil Corporation, and DISA, Inc., alleging discrimination, retaliation, defamation, and negligence. The appellate court reversed summary judgments against WHM on claims of discrimination, retaliation, and compelled self-defamation. It also reversed summary judgments against Exxon and DISA for tortious interference with contract and negligence, remanding these claims for further proceedings. Summary judgments for Exxon on discrimination, retaliation, and defamation, and for DISA on breach of contract and defamation were affirmed, while finding jurisdictional basis for pattern or practice discrimination claims against WHM and Exxon.

Employment DiscriminationRetaliationDefamationCompelled Self-DefamationNegligenceTortious InterferenceDrug Testing PolicySubstance AbuseSummary Judgment AppealDisparate Treatment
References
83
Case No. 2021-06-1167
Regular Panel Decision
May 25, 2023

Carrillo, Miguel Garcia v. Carlos Sanchez Hurtado, a/k/a Carlos Ramirez Rios, Gilberto Cavazos, Kosinski Homes, Kosinski Properties LLC, Hartford Casualty Insurance Company, and Hartford Underwriters Insurance Company

Miguel Garcia Carrillo, an employee of Carlos Sanchez Hurtado, sustained arm and leg injuries from a fall at a construction site. The court determined Gilberto Cavazos to be the statutory employer, making him and his insurer, Hartford Underwriters Insurance Company, responsible for workers' compensation benefits. They are ordered to provide a panel of orthopedists for Mr. Carrillo's medical treatment. However, requests for payment of past medical bills and temporary disability benefits were denied due to a lack of admissible evidence, though Mr. Carrillo may re-submit these claims with proper documentation. Additionally, the case is referred for investigation into potential penalties against Carlos Sanchez Hurtado, Gilberto Cavazos, and Hartford Underwriters Insurance Company for various statutory non-compliances, including failure to provide insurance and medical treatment.

Workers' CompensationConstruction AccidentStatutory EmployerUninsured EmployerMedical BenefitsTemporary DisabilityPenaltiesOrthopedists PanelAdmissible EvidenceEmployer Liability
References
10
Case No. ADJ7701496
Regular
Nov 08, 2012

GILBERTO SALDANA vs. SCOTT CHUONG, FARMERS INSURANCE EXCHANGE

The Workers' Compensation Appeals Board (WCAB) affirmed a prior decision finding that Scott Chuong was not the applicant's employer when he sustained a back injury while painting Chuong's home. The applicant was instead found to be employed by Filiberto Montano, an unlicensed and uninsured contractor who hired the applicant. The WCAB also imposed $250 in sanctions against the applicant's attorney for frivolous filings and violations of WCAB Rules, finding no good cause to excuse these actions.

Workers' Compensation Appeals BoardGilberto SaldanaScott ChuongFarmers Insurance ExchangeADJ7701496Opinion and Decision After ReconsiderationOrder Imposing SanctionsLabor Code section 5813WCAB Rule 10561Filiberto Montano
References
1
Case No. MISSING
Regular Panel Decision

AGUDO-MARTINEZ v. Barnhart

Plaintiff Gilberto Agudo Martinez sought disability insurance benefits and supplemental security income, alleging disability since December 1999. His initial applications were denied by an Administrative Law Judge (ALJ) and subsequently upheld by the Appeals Council. This case involves the plaintiff's challenge to the Commissioner's decision, wherein the Court found that the ALJ failed to properly apply the treating physician rule regarding the conclusions of Dr. Charles Ippolito concerning the plaintiff's physical impairments. Consequently, the Commissioner’s decision denying benefits was reversed, and the matter was remanded for proper consideration of Dr. Ippolito's medical opinions.

Disability BenefitsSocial SecurityTreating Physician RuleMedical ImpairmentMental ImpairmentAtrial FibrillationDiabetes MellitusAnxiety DisorderALJ ErrorRemand
References
14
Case No. MISSING
Regular Panel Decision

Dallas National Insurance Co. v. Morales

Dallas National Insurance Company appealed a judgment and orders entered in favor of Gilberto Morales. Dallas National challenged the legal and factual sufficiency of evidence supporting Morales's entitlement to Lifetime Income Benefits (LIBS) and Supplemental Income Benefits (SIBS), as well as the award of attorney's fees. Morales, a construction worker, sustained a work-related injury in 2003, leading to multiple surgeries and a 27 percent impairment rating. The jury determined Morales was entitled to LIBS and SIBS. The appellate court reviewed all issues, ultimately affirming the jury's findings on LIBS and SIBS, and upholding the award of attorney's fees.

Workers' CompensationLifetime Income Benefits (LIBS)Supplemental Income Benefits (SIBS)Attorney's FeesLegal SufficiencyFactual SufficiencyRadiculopathySpinal InjuryPermanent DisabilityAppellate Review
References
21
Case No. MISSING
Regular Panel Decision

Arrellano v. Texas Employment Commission

Mr. Gilberto U. Arrellano appealed the denial of unemployment benefits by the Texas Employment Commission (TEC), which had found he voluntarily left his work with Holguin Bros. without good cause. Arrellano challenged the district court's grant of summary judgment, arguing an incorrect standard of review was used and genuine issues of material fact existed. The appellate court affirmed the district court's decision, holding that the proper standard of review for TEC decisions is the "substantial evidence/trial de novo" standard, which involves a legal question of whether the agency's ruling is supported by substantial evidence. The court further clarified that summary judgment is appropriate in such cases since the fact-finding is concluded at the administrative level. The court found that despite conflicting evidence presented to the Commission, there was sufficient substantial evidence to support the TEC's finding that Arrellano voluntarily separated from his employment.

Unemployment Benefits AppealVoluntary QuittingSubstantial Evidence StandardTrial De Novo ReviewSummary Judgment ProprietyAdministrative Agency DecisionsAppellate Court AffirmationTexas LawEmployment Commission RulingJudicial Review of Agency Action
References
14
Case No. ADJ2425893 (LAO 0847633) ADJ1073862 (LAO 0827989)
Regular
Sep 07, 2014

GILBERTO BANUELOS vs. NUPLA CORPORATION, STATE COMPENSATION INSURANCE FUND

This case involves a workers' compensation claim for extensive injuries to applicant Gilberto Banuelos, including permanent total disability due to chronic pain syndrome. The Workers' Compensation Appeals Board granted reconsideration primarily on the issue of home health care services. The Board affirmed the original award but deferred the determination of home health care services for further proceedings. This deferral is due to insufficient development of the record regarding the necessity, start date, and rate of reimbursement for these services, particularly in light of recent legislative changes.

Workers Compensation Appeals BoardReconsiderationFindings and AwardAgreed Medical EvaluatorsPermanent DisabilityChronic Pain SyndromeHome Health Care ServicesLabor Code SectionsNeri HernandezPrescription Requirement
References
2
Case No. 08-11-00197-CV
Regular Panel Decision
Dec 27, 2012

Dallas National Insurance Company v. Gilbert Morales

Dallas National Insurance Company appealed a judgment and two orders in favor of Gilberto Morales regarding Lifetime Income Benefits (LIBS), Supplemental Income Benefits (SIBS), and attorney's fees. Morales sustained a work-related injury in 2003, leading to chronic pain and conditions affecting his legs and ability to work. The jury found Morales entitled to LIBS based on a total and permanent loss of use of his feet, and to SIBS for a specific quarter, also awarding attorney's fees. Dallas National challenged the sufficiency of evidence and the attorney's fees award. The Court of Appeals affirmed the trial court's judgment, concluding there was sufficient evidence for LIBS and SIBS and that the award of attorney's fees was supported.

Workers' CompensationLifetime Income Benefits (LIBS)Supplemental Income Benefits (SIBS)RadiculopathySpinal InjuryFoot InjuryAttorney's FeesAppellate ReviewLegal SufficiencyFactual Sufficiency
References
24
Case No. ADJ12910087
Regular
Dec 28, 2020

ESTHER LEMUS SALDANA vs. TAO TAI HOMES CORPORATION, INSURANCE COMPANY OF THE WEST

This case concerns a dispute over the correct Qualified Medical Evaluator (QME) panel for applicant Esther Lemus Saldana. The defendant sought reconsideration of an order finding the applicant's chiropractic QME panel valid and the defendant's orthopedic panel invalid. The Workers' Compensation Appeals Board denied the petition, upholding the administrative law judge's decision. The Board found the applicant properly requested a new panel after retaining counsel, and despite a service error on the chiropractic panel, the defendant had opportunity to contest the specialty. Therefore, the applicant's chiropractic QME panel remains the correct one for the medical-legal evaluation.

QME PanelChiropractic QMEOrthopedic QMEPetition for ReconsiderationFindings of Fact and OrdersMedical-Legal EvaluationQualified Medical EvaluatorAdministrative Director RuleRomero v. Costco WholesaleLabor Code Section 4062.1
References
9
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