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

Case No. Civ. A. No. 3:93-CV-0171-G.
Regular Panel Decision
Aug 31, 1993

Mills v. INJURY BENEFITS PLAN OF SCHEPPS-FOREMOST

Walter Mills was injured during his employment and sought benefits under his employer's Injury Benefits Plan. He subsequently filed a civil action alleging wrongful termination in retaliation for filing a workers' compensation claim under Texas law. Defendants removed the case to federal court, asserting ERISA preemption. The court granted the defendants' motion to dismiss Mills' claims against the Injury Benefits Plan, finding them preempted by ERISA. However, the court denied the dismissal of Mills' state law claims against Schepps-Foremost, Inc., d/b/a Oak Farms Dairies. Ultimately, the court remanded the remaining state law claims against Schepps-Foremost, Inc. to the County Court at Law Number 5 of Dallas County, Texas, due to a lack of federal subject matter jurisdiction.

ERISA preemptionWorkers' CompensationRetaliatory dischargeTexas lawFederal jurisdictionMotion to dismissRemandEmployee benefitsCivil procedureDallas County
References
18
Case No. 10-93-224-CV
Regular Panel Decision
May 18, 1994

Subsequent Injury Fund of the State of Texas (Formerly the Second Injury Fund) v. Larry Milligan

The Subsequent Injury Fund appeals a judgment awarding Larry Milligan lifetime benefits for injuries sustained at work. Milligan suffered two ankle injuries in 1987 and a third in 1989, leading to the total loss of use of both feet. He sued the Fund for lifetime benefits after settling with the workers' compensation carrier. The jury found permanent, total loss of use of both feet. The Fund challenged its statutory liability for lifetime benefits and the court's refusal to submit a jury question on total and permanent incapacity. The appellate court affirmed, finding the first issue unpreserved and the second resolved by a statutory conclusive presumption of total and permanent incapacity for the loss of both feet.

Workers' Compensation LawSubsequent Injury FundLifetime BenefitsTotal Permanent IncapacityAnkle InjuriesStatutory InterpretationAppellate ReviewJury InstructionsConclusive PresumptionOccupational Injuries
References
6
Case No. 2021 NY Slip Op 04070
Regular Panel Decision
Jun 24, 2021

Matter of Cisnero v. Independent Livery Driver Benefit Fund

Claimant Jeffrey Cisnero, an independent livery driver, sustained injuries when he was shot during a dispatch. He filed a claim for workers' compensation benefits, which was initially disallowed by a WCLJ but later reversed by the Workers' Compensation Board, finding coverage through the Independent Livery Driver Benefit Fund (ILDBF). The carrier appealed, arguing misinterpretation of the relevant statutes, particularly Executive Law § 160-ddd (1). The Appellate Division, Third Department, affirmed the Board's decision, determining that Cisnero's injuries arose out of and in the course of providing covered services as an independent livery driver dispatched by an ILDBF member. The court found that the vehicle's attenuated affiliation with the New York Black Car Operators' Injury Compensation Fund, Inc. did not alter ILDBF's liability.

Workers' CompensationLivery DriverIndependent ContractorBenefit FundAccidental InjuryCourse of EmploymentStatutory InterpretationExecutive LawWorkers' Compensation LawAppellate Review
References
3
Case No. MISSING
Regular Panel Decision

State Ex Rel. Second Injury Fund v. Mireles

Felix T. Míreles, who lost vision in one eye in childhood, suffered a second workplace injury resulting in total blindness. After receiving 100 weeks of benefits for the second injury from his employer's insurer, he sought lifetime benefits from the Second Injury Fund. The State of Texas, as trustee of the Fund, appealed a trial court judgment ordering lifetime benefits, arguing Míreles was only entitled to 301 additional weeks based on the 401-week maximum under the Workers’ Compensation Act. The appellate court examined statutory provisions, emphasizing liberal construction in favor of the employee and the legislative intent behind the Second Injury Fund to fully compensate employees with successive injuries. The court concluded that article 8306, section 12c-l, provides for lifetime benefits from the Second Injury Fund in such cases, affirming the trial court's judgment.

Workers' CompensationSecond Injury FundLifetime BenefitsStatutory InterpretationTotal Permanent IncapacitySuccessive InjuriesHandicapped EmploymentTexas LawAppellate ReviewVisual Impairment
References
6
Case No. ADJ6445214, ADJ7300126, ADJ4142400 (SRO 0141131), ADJ1321514 (SRO 0141130)
Regular
Aug 03, 2016

BONNIE MCLAUGHLIN vs. SUBSEQUENT INJURIES BENEFITS TRUST FUND, ALBERTSON'S/SAVE MART

This case involves Bonnie McLaughlin's claim for Subsequent Injuries Benefits Trust Fund (SIBTF) benefits stemming from multiple industrial injuries to her neck, back, extremities, and psyche. The Workers' Compensation Appeals Board (WCAB) overturned a prior decision denying these benefits. The WCAB found that McLaughlin met the criteria for SIBTF eligibility under Labor Code section 4751, as her cumulative injury through May 3, 2007, resulted in additional permanent disability that, when combined with prior injuries, caused a disability greater than that from the subsequent injury alone. Therefore, SIBTF benefits are awarded.

Subsequent Injuries Benefits Trust FundSIBTFpermanent disabilitycumulative traumaspecific injuryapportionmentvocational expertAgreed Medical EvaluatorQualified Medical Evaluatorcompensable injury
References
4
Case No. ADJ2651648 (MON 0342704)
Regular
Jul 18, 2017

TERESA SANCHEZ vs. HAWTHORNE UNIFIED SCHOOL DISTRICT, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Subsequent Injuries Benefits Trust Fund (SIBTF) sought reconsideration of an award granting applicant benefits for a 2006 industrial injury, arguing the prior disability rating was insufficient. The applicant had two industrial injuries: a 1997-2002 cumulative trauma and the 2006 specific injury, both causing fibromyalgia. The WCJ found the combined disability from both injuries exceeded the threshold for SIBTF benefits, based on her primary treating physician's rating. The Appeals Board affirmed the WCJ's decision, adopting the judge's report which found the applicant met the criteria for SIBTF benefits, and denied the SIBTF's petition.

Subsequent Injuries Benefits Trust FundSIBTFcumulative traumacompensable consequencefibromyalgiapermanent and stationaryAgreed Medical ExaminerAMA Guides1997 rating scheduleprimary treating physician
References
0
Case No. ADJ488924 (SDO 0329999), ADJ226519 (SDO 0302236), ADJ2353553 (SDO 0250184), ADJ4021935 (SDO 0269434)
Regular
Dec 10, 2020

Craig Stevens vs. Subsequent Injuries Benefits Trust Fund

The Workers' Compensation Appeals Board (WCAB) rescinded a previous order denying benefits from the Subsequent Injuries Benefits Trust Fund (SIBTF). Applicant Craig Stevens sought SIBTF benefits for a claimed subsequent cumulative trauma injury to his neck ending April 2, 2009, with a compensable consequence injury to his right shoulder and low back. The WCAB found the medical evidence regarding the causation, date of injury, and permanent disability ratings for the alleged subsequent injuries, as well as prior injuries, to be insufficient and inconsistent. The case was returned to the trial level for further development of the record, including obtaining new medical opinions to clarify the various injuries and establish SIBTF eligibility thresholds.

Subsequent Injuries Benefits Trust FundSIBTF eligibilitycumulative trauma injurycompensable consequence injurypermanent disabilityapportionmentmedical evidencecausationfurther development of the recordLabor Code section 4751
References
9
Case No. ADJ3388364 (VNO 0526713) ADJ2633182 (VNO 0342427)
Regular
Oct 24, 2014

RICHARD FROMKNECHT vs. SUBSEQUENT INJURIES BENEFITS TRUST FUND

The applicant sought reconsideration of a decision denying him benefits from the Subsequent Injuries Benefits Trust Fund (SIBTF). The applicant claimed a pre-existing disability from a 1996 spinal injury caused further permanent disability with a subsequent 1998 spinal injury. However, both injuries became permanent and stationary concurrently, meaning there was no distinct pre-existing ratable disability at the time of the second injury. Therefore, the applicant did not meet the criteria for SIBTF benefits under Labor Code section 4751, and his petition for reconsideration was denied.

Subsequent Injuries Benefits Trust FundLabor Code section 4751Petition for ReconsiderationFindings and OrderStipulations with Requests for AwardsAgreed Medical Evaluatorapportionmentpermanent and stationarypreexisting disabilityindustrial injury
References
0
Case No. ADJ5621413
Regular
Sep 15, 2016

LORI RENFRO vs. SUMMIT COUNSELING AND EDUCATION, STATE COMPENSATION INSURANCE FUND, SUBSEQUENT INJURIES BENEFIT TRUST FUND

This case involves applicant Lori Renfro's claim for Subsequent Injuries Benefit Trust Fund (SIBTF) benefits following a work injury. The WCJ initially awarded benefits, finding the industrial injury's standalone disability exceeded the 35% threshold. The SIBTF appealed, arguing the injury's standalone disability was below 35% and the prior disability should be measured at the time of the subsequent injury. The Appeals Board rescinded the award, finding the WCJ erred by not properly applying the 35% threshold for the subsequent injury alone. The matter is remanded to determine the applicability of Labor Code section 4751(a) and to re-evaluate the 70% combined disability threshold, measuring prior disability as it existed before the subsequent injury.

Subsequent Injuries Benefit Trust FundSIBTFpermanent disability thresholdapportionmentLabor Code section 4751combined disabilityprior disabilitysubsequent injuryvocational expertQME
References
4
Case No. ADJ3135090 (SAC 0355157) ADJ6834808
Regular
Sep 12, 2019

GUY LEE vs. UOP/MCGEORGE SCHOOL OF LAW, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Workers' Compensation Appeals Board affirmed the WCJ's decision denying benefits from the Subsequent Injuries Benefits Trust Fund (SIBTF). Applicant's prior stipulation dismissing claims for sleep disturbance, sexual dysfunction, and psychiatric injury bound him from pursuing these for SIBTF benefits. Even without those dismissals, applicant's permanent disability rating for the subsequent injury, after adjustments, did not meet the 35% threshold required for SIBTF eligibility. The WCJ's finding that the industrial injury was not the predominant cause of the claimed psychiatric injury also contributed to the denial.

Subsequent Injuries Benefits Trust FundLabor Code section 4751permanent partial disabilitystipulated dismissalpredominant causepsychiatric injurybilateral carpal tunneldiminished future earning capacityWCJWorkers' Compensation Appeals Board
References
4
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