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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

Hand v. Stevens Transport, Inc. Employee Benefit Plan

Jean and Howard Hand appealed the trial court's grant of summary judgment which dismissed their claims for health care benefits against the Stevens Transport, Inc. Employee Benefit Plan as time-barred. The Hands argued that the Plan's failure to comply with ERISA's notification requirements should invalidate or toll the contractual limitations period. The appellate court found that while the Plan's notice was non-compliant, it still provided reasonable notice of partial denial, and the Hands failed to exercise due diligence. The court concluded that the twenty-seven month contractual limitations period was reasonable and was not tolled by the Plan's ERISA non-compliance or the pursuit of administrative remedies. Therefore, the Hands' claims were barred, and the trial court's judgment was affirmed.

ERISAHealth Insurance BenefitsContractual Limitations PeriodStatute of LimitationsSummary JudgmentDenial of BenefitsEquitable TollingAdministrative RemediesNotice RequirementsEmployee Benefit Plan
References
19
Case No. MISSING
Regular Panel Decision

Davis v. Medical Evaluation Specialists, Inc.

Justice Wilson dissents from the majority's decision on a motion for rehearing, arguing that the majority improperly considered non-evidence and engaged in speculation. The dissent contends that Lennie Davis's controverting affidavit by Dr. Bergeron, which stated a 17% impairment rating compared to the defendants' 0%, was conclusory and insufficient to establish bad faith by Medical Evaluation Specialists, Inc., Dr. DeFrancesco, and Dr. Dozier. Justice Wilson believes that the affidavit failed to meet the objective 'no reasonable doctor' standard for controverting good faith, and therefore, the trial court's summary judgment in favor of the defendants should have been affirmed based on official immunity.

Summary JudgmentOfficial ImmunityGood FaithImpairment RatingMedical AffidavitConclusory StatementsTexas Workers' Compensation ActAppellate ReviewDissenting OpinionPermanent Disability
References
7
Case No. 14-19-00539-CV
Regular Panel Decision
Dec 22, 2020

Hand & Wrist Center of Houston, P.A. v. Lowery Masonry, LLC

Appellant Hand & Wrist Center of Houston, P.A. (HWC) appealed a summary judgment that denied it recovery from Appellee Lowery Masonry, LLC, on a guaranty agreement. Lowery's president had signed a "Letter of Guarantee" to ensure prompt medical treatment for an injured employee, Sandro Tovar, and to pay HWC's usual and customary fees. Lowery later argued an exception applied because it had workers' compensation insurance with Texas Mutual Insurance Company, leading the trial court to grant summary judgment. The appellate court determined that Lowery's interpretation of the exception was unreasonable as it would render the phrase "additional payment" meaningless within the contract. Consequently, the appellate court reversed the trial court's judgment and remanded the cause for further proceedings, concluding that Lowery had not conclusively established its entitlement to summary judgment.

Contract LawGuaranty AgreementSummary JudgmentWorker's Compensation InsuranceMedical BillingAppellate ReviewContract InterpretationTexas LawHarris CountyFourteenth Court of Appeals
References
25
Case No. 01-23-00704-CV
Regular Panel Decision
Dec 23, 2025

Industrial Specialists, LLC v. Blanchard Refining Company LLC and Marathon Petroleum Company LP

This case addresses whether an indemnitee can recover from its indemnitor the portion of a settlement attributable to other defendants under a comparative indemnity scheme, even if the indemnitee was also found negligent. Industrial Specialists, LLC (Appellant) was sued by Blanchard Refining Company LLC and Marathon Petroleum Company LP (Appellees) for breach of a contractual indemnity agreement. A fire at a refinery injured employees, leading to a $104 million settlement by Marathon and other contractors, where Marathon paid $86 million. The jury found Marathon 38% negligent and Industrial 17% negligent, among others. The core issue is the enforceability of the indemnity provision under the express negligence doctrine, specifically concerning comparative indemnity. The Court of Appeals reversed the trial court's judgment, holding that the indemnity provision failed to expressly provide for comparative indemnity, thus rendering it unenforceable as a matter of law.

Contractual IndemnityExpress Negligence DoctrineComparative IndemnityOil and Gas IndustryRefinery FirePersonal Injury ClaimsSettlement AgreementsBreach of ContractTexas LawAppellate Court Decision
References
17
Case No. MISSING
Regular Panel Decision

Hand & Wrist Center of Houston, P.A. v. SGS Control Services, Inc.

Charles Reagan was injured at work and treated by Hand & Wrist Center. SGS North America, his employer, signed a "Letter of Guarantee" promising to pay for treatment if workers' compensation insurance didn't cover it. SGS failed to pay, leading Hand & Wrist to sue for breach of contract. SGS filed a plea to the jurisdiction, arguing Hand & Wrist failed to exhaust administrative remedies under the Workers' Compensation Act. The trial court granted the plea, and Hand & Wrist appealed, contending SGS did not invoke its workers' compensation coverage and that exclusive remedies provisions do not apply to healthcare providers. The appellate court affirmed the trial court's decision, holding that SGS invoked its workers' compensation coverage when it obtained it, and Hand & Wrist was required to exhaust administrative remedies with the Texas Department of Insurance-Workers’ Compensation Division before filing suit, as the Division has exclusive jurisdiction over medical fee disputes.

Workers' CompensationAdministrative RemediesSubject Matter JurisdictionPlea to the JurisdictionBreach of ContractHealthcare Provider ReimbursementExclusive RemediesTexas Labor CodeMedical Fee DisputeAppellate Review
References
17
Case No. 01-12-00216-CV
Regular Panel Decision
Feb 04, 2014

Hand & Wrist Center of Houston, P.A. and SCA Houston Hospital for Specialized Surgery L.P. v. Maintenance Supply Headquarters, LP

Appellants Hand & Wrist Center, P.A. and SCA Houston Hospital for Specialized Surgery, L.P. appealed the trial court's summary judgment in favor of Maintenance Supply Headquarters, L.P., concerning a breach of contract claim. The dispute arose from a "Letter of Guarantee" signed by Maintenance Supply for medical services provided to an injured employee, Daniel Contreras, whose workers' compensation claim was denied. Maintenance Supply argued estoppel and the applicability of the Labor Code's exclusive remedies provision. The Court of Appeals found the estoppel defense inapplicable and, crucially, ruled that Labor Code section 408.001(a)'s exclusive remedies provision applies only to employees and their beneficiaries, not to health care providers. Consequently, the appellate court reversed the summary judgment and remanded the case for further proceedings.

Breach of contractSummary judgmentWorkers' compensationExclusive remedyHealth care providersStatutory interpretationTexas Labor CodeEstoppelLetter of GuaranteeAppellate review
References
10
Case No. 2022-01-0565
Regular Panel Decision
Mar 14, 2023

Cintron, Adelino v. Wheeler Technologies, LLC

Adelino Cintron, an employee, sought a court order for his employer, Wheeler Technologies, LLC, to authorize an evaluation with hand specialist Dr. Peter Lund or provide a panel of hand specialists for his carpal tunnel syndrome, which he alleged was related to a November 2020 work injury. Wheeler denied the entitlement, asserting the condition was not work-related. The Court found Mr. Cintron likely to prevail, ordering Wheeler to authorize the evaluation with Dr. Lund. This decision was based on the employer's failure to timely respond to a direct referral from Dr. David Lowry. The case was also referred to the Compliance Program for consideration of penalty assessment against Wheeler for delaying medical treatment.

Workers' CompensationCarpal Tunnel SyndromeExpedited HearingMedical ReferralCausationTimely AuthorizationPanel PhysicianEmployer Non-compliancePenalty AssessmentTennessee Court of Workers' Compensation Claims
References
2
Case No. MISSING
Regular Panel Decision

United Way of San Antonio, Inc. v. Helping Hands Lifeline Foundation, Inc.

This is a dissenting opinion by Justice Antonio G. Cantu regarding a majority's decision on a motion for rehearing. The primary case involved claims of slander, libel, and business disparagement brought by Helping Hands Lifeline Foundation and Ruth Mahl against United Way of San Antonio and Bexar County, Inc. and Dick Brown. The dissent argues that the majority improperly reversed and remanded on the business disparagement issue, believing that Helping Hands failed to preserve this complaint for appellate review due to a lack of specific and timely objections to expert testimony at trial. Justice Cantu details the trial court's proceedings regarding the expert witness, Dean Barbara Aldave, who testified that the statements in question were not defamatory. The dissent contends that the trial court did not abuse its discretion in admitting Aldave's testimony and that Helping Hands waived its objections, suggesting the judgment should have been reformed and otherwise affirmed.

DefamationSlanderLibelBusiness DisparagementExpert TestimonyAdmissibility of EvidencePreservation of ErrorMotion for RehearingDissenting OpinionTrial Procedure
References
36
Case No. 2016-03-0885
Regular Panel Decision
Feb 07, 2017

Adams, Roy v. Beverly Park Place Health and Rehabilitation

Roy Adams, a Maintenance Assistant, sustained chemical burns to his hands while cleaning machinery with hazardous chemicals. He received treatment from Dr. King at Nova Medical Center, who diagnosed irritant dermatitis and cleared him for full duty. Despite Dr. King's assessment, Mr. Adams continued to experience pain, cramping, and difficulty grasping objects, prompting him to request a specialist referral and temporary disability benefits. Beverly Park Place Health and Rehabilitation argued that Dr. King had consulted with specialists and found no need for further referrals, and his medical opinion is presumed correct. The Court ultimately denied Mr. Adams' requests for both a specialist referral and temporary disability benefits, citing insufficient medical evidence to rebut Dr. King's opinion.

Chemical BurnIrritant DermatitisTemporary Disability BenefitsSpecialist ReferralMedical OpinionPhysician's PresumptionWorkers' CompensationExpedited HearingKnox CountyHand Injury
References
5
Case No. 2015-03-0285
Regular Panel Decision
Feb 02, 2016

Long, Joann v. Southeast Eye Specialists

This Expedited Hearing Order addresses Joann Long's request for medical and temporary disability benefits after a workplace fall. Ms. Long, employed by SouthEast Eye Specialists, sustained a severe hamstring injury. She initially received treatment from Dr. Hovis, the authorized treating physician, who did not recommend surgery. Ms. Long sought a second opinion and, dissatisfied with Dr. Hovis's care, pursued unauthorized surgery with Dr. Damon Petty. SouthEast Eye Specialists subsequently suspended her benefits, citing her non-compliance with the authorized physician. The Court found insufficient evidence to determine if Dr. Hovis's treatment was inappropriate, and thus, Ms. Long failed to justify seeking unauthorized medical care. Consequently, the Court denied her requests for reimbursement of medical expenses incurred with Dr. Petty and for temporary total disability benefits. Dr. Hovis is to remain the authorized treating physician, or SES must provide a new panel.

Workers' Compensation LawExpedited HearingMedical BenefitsTemporary Total DisabilityUnauthorized Medical TreatmentAuthorized Treating PhysicianPanel of PhysiciansBurden of ProofConflicting Medical OpinionsHamstring Injury
References
5
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