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

Case No. 03-03-00176-CV
Regular Panel Decision
Dec 04, 2003

Texas Workers' Compensation Insurance Fund/Texas Workers' Compensation Commission and Leonard D. Watts v. Texas Workers' Compensation Commission and Leonard D. Watts/Texas Workers' Compensation Insurance Fund

This case involves a cross-appeal stemming from a workers' compensation claim by Leonard D. Watts, who sought lifetime income benefits for injuries sustained as a truck driver. The Texas Workers' Compensation Commission (appeals panel) initially reversed a hearing officer's decision and awarded Watts benefits, but this decision was later set aside by a Travis County district court. In this appeal, the Texas Workers' Compensation Insurance Fund (Texas Mutual) and the Commission challenged the district court's ruling. The Court of Appeals addressed arguments regarding the appeals panel's statutory authority for factual-sufficiency review and the interpretation of "issue" under the labor code, including legal doctrines of res judicata and collateral estoppel. The court ultimately reversed the judgment of the district court, thereby affirming the decision of the Commission's appeals panel which granted Watts lifetime income benefits.

Workers' CompensationLifetime Income BenefitsAppeals Panel ReviewFactual SufficiencyStatutory AuthorityCross-AppealRes JudicataCollateral EstoppelCausationMaximum Medical Improvement
References
17
Case No. MISSING
Regular Panel Decision

Claim of Rodriguez v. Reicon Group, LLC

Claimant, a dock builder, was injured and sought state workers' compensation benefits. The employer contested the Workers’ Compensation Board's jurisdiction, asserting that the Longshore and Harbor Workers’ Compensation Act (LHWCA) was applicable and a waiver of federal rights under Workers’ Compensation Law § 113 was required. Both the Workers’ Compensation Law Judge and the Board found concurrent jurisdiction between state law and the LHWCA for land-based injuries, rendering a § 113 waiver unnecessary. The appellate court affirmed, clarifying that § 113 applies only where a federal scheme preempts state remedies, which is not the case with LHWCA. The court also highlighted that concurrent jurisdiction prevents double recovery.

Concurrent JurisdictionLongshore and Harbor Workers’ Compensation ActWorkers’ Compensation BoardAdmiralty LawFederal PreemptionWaiver of Federal RightsLand-Based InjuriesDock BuilderDouble RecoveryJones Act
References
12
Case No. 07-02-0169-CV
Regular Panel Decision
Jan 14, 2003

Texas Workers' Compensation Commission v. Texas Workers' Compensation Insurance Fund

The Texas Workers' Compensation Commission (Commission) appealed a summary judgment that relieved the Texas Worker's Compensation Insurance Fund (Insurance Fund) of liability for workers' compensation benefits to Glenn Everett, the real party of interest. The Commission contended that the Texas Workers' Compensation Act abrogates the common law defense of election of remedies and that Everett did not make an election. Everett had previously settled a personal injury suit for $37,500 and later pursued a worker's compensation claim. The Court of Appeals affirmed the trial court's decision, finding that the Act does not abrogate the election of remedies defense and that Everett made an informed choice to elect remedies by settling his claim after consulting with attorneys, thus barring his right to workers' compensation benefits.

Workers' CompensationElection of RemediesSummary JudgmentTexas Appellate CourtStatutory InterpretationCommon Law DefenseIndemnificationSettlement AgreementEmployee StatusInsurance Fund Liability
References
18
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. 03-94-00124-CV
Regular Panel Decision
May 24, 1995

Texas Workers' Compensation Commission, the Subsequent Injury Fund, and Todd Brown in His Official Capacity as Executive Director of the Texas Workers' Compensation Commission v. the City of Bridge City, Texas, and the Texas Municipal League Intergovernmental Risk Pool

The Texas Workers' Compensation Commission and other appellants appealed a trial court's declaratory judgment and permanent injunction that found parts of the Texas Workers' Compensation Act unconstitutional. The trial court's decision was based on alleged violations of the Texas Constitution, particularly regarding the requirement of immediate payment of benefits during an appeal without reimbursement. The appellate court reversed the trial court's judgment, dissolved the injunction, and rendered a declaratory judgment affirming the constitutionality of the statutory scheme. The court reasoned that municipal corporations are not protected by certain constitutional provisions and that the 'suitability' of laws is a political question. It concluded that the payment scheme was rationally related to the state's interest in securing prompt payments to injured workers.

Texas Court of AppealsWorkers' Compensation ActConstitutional LawDeclaratory JudgmentPermanent InjunctionDue ProcessMunicipal CorporationsGovernmental ImmunityStatutory InterpretationLegislative Power
References
24
Case No. MISSING
Regular Panel Decision

Curran v. International Union, Oil, Chemical & Atomic Workers

Plaintiff, an employee of Carborundum Company, suffered a partial hand amputation in a "rubber roll" machine accident on March 8, 1979. He sued his unions, International Union, Oil, Chemical & Atomic Workers, AFL-CIO, and Abrasive Workers, Local 8-12058, Oil, Chemical & Atomic Workers International Union, alleging state law negligence for failing to safeguard him from dangers and a federal claim for breaching their duty of fair representation. The unions moved for summary judgment, arguing federal law preempts the negligence claim and they did not breach their duty of fair representation. The court granted the unions' motion regarding the negligence claim, ruling that a union's duty to its members, arising from a collective bargaining agreement, is governed exclusively by federal law and does not include a duty of care. However, the court denied the motion regarding the breach of fair representation claim, finding sufficient facts and allegations to infer that the unions may have discharged their duty in an arbitrary, perfunctory manner or in bad faith, thus leaving triable issues of fact.

Union LiabilityDuty of Fair RepresentationNegligence ClaimFederal PreemptionCollective Bargaining AgreementSummary Judgment MotionLabor LawWorkplace AccidentSafety and Health CommitteeArbitrary Union Action
References
8
Case No. 03-11-00009-CV
Regular Panel Decision
May 26, 2011

Rod Bordelon, Commissioner of the Texas Department of Insurance, Division of Workers' Compensation And the Texas Department of Insurance, Division of Workers' Compensation v. Brian Fanette

The appellants, Rod Bordelon, Commissioner of the Texas Department of Insurance, Division of Workers' Compensation, and the Texas Department of Insurance, Division of Workers' Compensation, filed a motion requesting the dismissal of their appeal. The Texas Court of Appeals, Third District, at Austin, granted this motion and consequently dismissed the appeal. This decision was made in the case against Appellee Brian Fanette.

Texas Court of AppealsWorkers' Compensation DivisionAppeal DismissalAppellant MotionJudicial DistrictTravis CountyMemorandum OpinionAdministrative AgencyState GovernmentAppellate Procedure
References
0
Case No. MISSING
Regular Panel Decision

Pasqualini v. Sheet Metal Workers' National Pension Fund

This case involves principals of Zodiac Industries, Inc. (Carl, Ann, Frank Pasqualini, and Sarah Lido) who sued the Sheet Metal Workers’ National Pension Fund, the International, and Local 38 over pension service credits. The plaintiffs sought fifteen years of past service credit, which they claimed was promised to them to induce Zodiac to sign a collective bargaining agreement (CBA). The Fund denied these credits, citing plan rules. The Court, however, found that 'extraordinary circumstances' warranted applying the principle of estoppel against the Fund. The court ruled in favor of the four owner-members, declaring them entitled to fifteen years of past service credit and ordering the Fund to reconsider their pension applications. Claims brought by other employees and against the Sheet Metal Workers’ International Association and Local 38 were dismissed.

ERISAPension BenefitsPast Service CreditEstoppelCollective Bargaining AgreementUnion OrganizingContract EnforcementEmployee Benefit PlanFiduciary DutyDistrict Court
References
12
Case No. 2018 NY Slip Op 08227
Regular Panel Decision
Nov 29, 2018

Matter of Kelly v. New York State Workers' Compensation Bd.

In 2006, claimant Grace Kelly established a workers' compensation claim for an occupational disease. The State Insurance Fund (SIF) repeatedly sought to transfer liability to the Special Fund for Reopened Cases, which was denied by Workers' Compensation Law Judges. The Workers' Compensation Board affirmed these denials and assessed $500 penalties against both SIF and its counsel, Walsh and Hacker, for filing an application for review without reasonable grounds. Walsh and Hacker appealed the penalty imposed against them to the Appellate Division, Third Department. The Appellate Division found insufficient evidence to support the Board's finding that Walsh and Hacker's application lacked reasonable grounds, and therefore reversed the penalty against them, modifying and affirming the Board's decision.

PenaltiesAppellate ReviewSpecial Fund for Reopened CasesWorkers' Compensation Law § 25-aWorkers' Compensation Law § 114-aAttorney SanctionsAdministrative LawBoard DecisionJudiciary Law § 431
References
4
Case No. 3-91-565-CV AND 3-91-566-CV
Regular Panel Decision
Mar 09, 1994

Methodist Hospitals of Dallas v. Texas Workers' Compensation Commission

Appellants, a coalition of hospitals, challenged fee guidelines established by the Texas Workers' Compensation Commission for services rendered to injured workers. They sought declaratory and injunctive relief against Rule 42.110 and Rule 134.400, arguing invalid promulgation, and also pursued damages for underpayment from workers' compensation insurance carriers. The trial court dismissed their claims as moot. The appellate court affirmed the dismissal, ruling that the challenges to the expired rules were indeed moot. Furthermore, the court held that it lacked jurisdiction over the monetary claims against the carriers because the appellants had not exhausted their administrative remedies before the Commission.

Fee GuidelinesMedical Services ReimbursementAdministrative LawMootness DoctrineJurisdictionExhaustion of Administrative RemediesAppellate ReviewInsurance CarriersStatutory InterpretationRule Validity
References
36
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