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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

Northern Assurance Co. v. Gutierrez

In a worker's compensation case, the Appellee sustained an incisional hernia and sought total and permanent disability benefits. The Appellant argued that the injury was limited to a hernia under Tex.Rev.Civ. Stat.Ann. art. 8306, sec. 12b, which would limit compensation to twenty-six weeks for a successful surgical repair. The trial court disregarded jury findings that the injury was confined to a hernia and that the operation was successful, instead awarding total and permanent benefits. The appellate court reversed the trial court's judgment, holding that the injury met the statutory criteria for a compensable hernia and the repair was successful. The case was remanded with instructions to enter judgment for the Appellee for twenty-six weeks of compensation as provided by the hernia statute.

Worker's CompensationIncisional HerniaHernia StatuteTexas LawJury FindingsTrial Court ErrorAppellate ReviewRemandDisability BenefitsMedical Examination
References
6
Case No. MISSING
Regular Panel Decision

Cook v. Great West Casualty Co.

This worker's compensation case addresses a claim for benefits stemming from the recurrence of an occupational hernia. The employee, who had a compensable hernia in 1981, experienced a recurrence in 1982 while working, leading to further surgeries and temporary total disability benefits from the insurer. The trial court denied additional compensation for the recurrence, citing T.C.A. § 50-6-212(a)(5) which states a hernia must not exist prior to the accident. The Tennessee Supreme Court reversed, clarifying that this statute applies to pre-existing non-compensable hernias, not to the recurrence or aggravation of a previously compensable one. The Court held that an employee is entitled to further benefits if a compensable hernia recurs or is aggravated in the course of employment, and remanded the case for a new trial to determine causation and additional benefits.

worker's compensationherniarecurrenceoccupational injurystatutory interpretationTennessee Supreme Courtremandtemporary total disabilitypermanent partial disabilitycausation
References
7
Case No. MISSING
Regular Panel Decision

Mannery v. WAL-MART DISTRIBUTION CENTER

This workers' compensation appeal concerns Robert Phillip Mannery's claim for a right inguinal hernia sustained while working for Wal-Mart Distribution Center in 1998. The central issue was whether the hernia existed prior to the accident, which would bar recovery under Tenn.Code Ann. § 50-6-212(a)(5). Despite a 1994 medical note mentioning a small right inguinal hernia, the trial court found that the 1998 hernia was a new injury in a different location, a finding supported by Mannery's testimony. The trial court awarded 21% permanent partial disability, which was affirmed by the Special Workers’ Compensation Appeals Panel and subsequently by the Supreme Court of Tennessee. The Supreme Court emphasized that the statute refers to the current hernia resulting from the accident, not a past, unrelated condition.

Workers' CompensationHernia ClaimPre-existing ConditionCausationMedical TestimonyPermanent Partial DisabilityAppellate ReviewInguinal HerniaStatutory InterpretationCredibility Determination
References
10
Case No. 2018-03-1517
Regular Panel Decision
Jul 30, 2019

Mullis, Sr., Phillip v. Blount County Community Action Agency

Phillip Mullis Sr., an employee of Blount County Community Action Agency (BCCAA), filed a Request for Expedited Hearing seeking benefits for an alleged work-related hernia. Mullis claimed he sustained a hernia in September 2018 while lifting a box of food, experiencing sharp pain and a 'pop'. BCCAA disputed the claim, stating Mullis provided no medical evidence, failed to give timely notice, and time records contradicted his account. Furthermore, BCCAA presented evidence from co-workers and VA records indicating Mullis had a pre-existing right inguinal hernia since 2011. The Court found Mullis failed to definitively prove the hernia criteria, including a work injury resulting in a hernia, immediate appearance, immediate follow-up to an accident, and that it did not exist prior to the accident. Therefore, the Court denied his claim.

HerniaDenied BenefitsExpedited HearingPre-existing ConditionTimely NoticeMedical EvidenceEmployment InjuryVA RecordsEmployee TestimonyEmployer Dispute
References
2
Case No. ADJ10222181 (MF) ADJ10222198
Regular
Jan 30, 2019

SAM ALBOUDOOR vs. AMJES, INC. dba K&B FREIGHT SYSTEMS

This case concerns claims for hernias and spine injuries sustained by a truck driver. The Workers' Compensation Appeals Board granted reconsideration to review the finding that hernias were work-related, noting the medical evaluator's conflicting opinions on causation. The Board determined further medical development is required on the hernia issue due to contradictory expert testimony. Additionally, the issue of reimbursement for self-procured medical treatment was deferred pending the resolution of the hernia claims.

Workers' Compensation Appeals BoardAMJES INCK&B Freight SystemsSam Alboudoorherniahiatal herniainguinal hernialumbar spinethoracic spinePQME
References
0
Case No. ADJ300802 (AHM 0109743) ADJ2310921 (AHM 0115931)
Regular
Nov 21, 2008

CHRISTOPHER SHIELDS vs. LAIDLAW TRANSIT; BROADSPIRE

The Appeals Board granted reconsideration, amending the original award to establish a permanent and stationary date of January 3, 2005, for applicant's abdominal hernia injuries. The Board deferred the issues of permanent disability and attorneys' fees, returning the case to the trial level for re-rating based on hernia/abdominal injuries rather than spinal injuries. The Board affirmed the finding of an industrial inguinal hernia injury, while also noting that the defendant did not provide evidence of unreasonable refusal of medical treatment for the hernias.

HerniaUmbilical herniaInguinal herniaLow back painPermanent and stationary dateTemporary total disabilityMedical treatmentAttorney's feesReconsiderationWorkers' Compensation Appeals Board
References
0
Case No. MISSING
Regular Panel Decision

Fusco v. Birdville Independent School District

Albert J. Fusco sued his employer, Bird-ville Independent School District, a self-insurer, for worker's compensation benefits after allegedly suffering a compensable hernia. The jury found an injury but failed to find that the hernia appeared suddenly and immediately following the injury, leading to a judgment for the defendant. Fusco appealed, arguing that certain special issues were inferential rebuttal issues and should not have been submitted, and that the hernia statute should not apply since no operation was tendered. The court disagreed, holding that the statutory requirements for hernia claims under Tex.Rev.Civ.Stat.Ann. art. 8306, § 12b must be met. The appellate court affirmed the trial court's judgment.

Workers' CompensationHernia ClaimJury InstructionsStatutory InterpretationTex.Rev.Civ.Stat.Ann. art. 8306 § 12bInferential Rebuttal IssuesSelf-InsurerEmployer LiabilityAppellate ReviewTexas Civil Procedure
References
10
Case No. 2016-01-0212
Regular Panel Decision
Oct 25, 2016

Richards, Edward v. Kiewit Power Constructors Company

Edward Richards, an electrician, suffered a hernia in February 2015 while working for Kiewit Power Constructors Company, which was accepted as compensable. He underwent surgery by Dr. Claudine Siegert. In February 2016, Richards experienced a recurrence of the hernia after lifting a toolbox while working for another employer. Dr. Siegert opined that the recurrent hernia was a direct result of the original work-related hernia. The Court granted Mr. Richards' request for medical benefits, finding he is likely to prevail in proving entitlement to additional medical benefits, based on the direct and natural consequence rule. However, his request for temporary disability benefits was denied due to insufficient medical documentation of his disability post-February 2016.

Workers' CompensationHernia RecurrenceMedical BenefitsTemporary DisabilityCausationDirect and Natural Consequence RuleExpedited HearingEmployer LiabilityInsurance CarrierMedical Opinion
References
6
Case No. 2019-06-1141
Regular Panel Decision
Feb 07, 2020

Angel, Heriberto v. El Molcajete Mexican Restaurant

The Court held an expedited hearing to consider whether Mr. Angel suffered a work-related hernia that would entitle him to workers’ compensation benefits. Mr. Angel alleged he suffered a hernia from lifting beer kegs for El Molcajete Mexican Restaurant, with an alleged injury date of December 23, 2018. However, medical testing conducted soon after the accident, specifically a sonography on January 3, 2019, showed no evidence of a hernia. The Court found it unlikely that Mr. Angel could prove his work incident resulted in a hernia that appeared suddenly and immediately followed the accident, as required by Tenn. Code Ann. § 50-6-212. Consequently, the Court denied his interlocutory claim for medical and temporary disability benefits.

Workers' CompensationHerniaExpedited HearingMedical EvidenceCausationInjury by AccidentBurden of ProofTennessee LawDenial of BenefitsInguinal Hernia
References
0
Case No. 2019-03-0360
Regular Panel Decision
Oct 07, 2019

Gonzales, Elman v. Smoky Mountain Resort Services

Elman Gonzales, an employee, filed a claim alleging that his hernias arose from lifting a heavy dumpster at work in August 2017. Despite reporting pain and undergoing emergency treatment, initial medical assessments by providers at University General Surgeons did not confirm a work-related hernia or attributed his pain to other sources like a rectus muscle strain. Later, Dr. Roy Frank Roberts identified an inguinal hernia but specifically stated he could not causally link it to Mr. Gonzalez’s work activities due to a significant treatment gap and other non-work-related factors. Consequently, the Court found that Mr. Gonzales failed to provide sufficient medical expert opinion to prove his hernias were work-related, leading to the denial of his requested medical benefits at the expedited hearing.

HerniaWork InjuryCausationMedical EvidenceExpedited HearingDenial of BenefitsTennessee Workers' CompensationUmbilical HerniaInguinal HerniaMedical Expert Opinion
References
2
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