CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

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

Case No. MISSING
Regular Panel Decision

Surgicare Surgical v. National Interstate Insurance

This case addresses whether an insurer complies with New York's 11 NYCRR 68.6 regulation by reimbursing for out-of-state medical services according to the host state's (New Jersey's) no-fault fee schedule. Plaintiff Surgicare Surgical, assignee of an injured party, sought full payment for surgery performed in New Jersey, but defendant National Interstate Insurance Company paid a reduced amount based on New Jersey's fee schedule. The court affirmed the defendant's method, ruling that when medical services are rendered in another jurisdiction with its own fee schedule, the 'permissible' charge under that schedule constitutes the 'prevailing fee' under New York's regulation. The decision emphasized alignment with legislative intent to contain no-fault insurance costs and reduce judicial burden, dismissing the plaintiff's complaint and denying its cross-motion.

No-Fault BenefitsInsurance LawFee Schedule DisputeOut-of-State Medical ServicesNew York RegulationsNew Jersey Fee ScheduleStatutory InterpretationAutomobile AccidentReimbursement DisputeSummary Judgment
References
17
Case No. 14-07-00083-CV
Regular Panel Decision
Nov 25, 2008

Jimmy J. Kelly v. American Interstate Insurance Co., Hammerman & Gainer, Inc., and Sheryl Butman

Jimmy J. Kelly appeals separate trial court orders transferring venue and sustaining pleas to the jurisdiction and granting a motion to dismiss for lack of jurisdiction. Kelly argued that he was not given proper notice of the venue hearing and that he was not required to exhaust further administrative remedies due to binding Benefit Dispute Agreements (BDAs). The court found that Kelly had sufficient actual notice of the venue hearing. Regarding jurisdiction, the court determined that the BDAs, while affirming a compensable injury, did not create an express entitlement to specific medical benefits like spinal fusion, thereby requiring Kelly to exhaust administrative remedies with the Texas Workers' Compensation Commission (TWCC) before suing. The court affirmed the trial court's judgment, concluding it lacked subject-matter jurisdiction.

Venue TransferSubject-Matter JurisdictionAdministrative Remedies ExhaustionWorkers' Compensation ActBenefit Dispute AgreementMedical Benefits DenialSpinal FusionNotice RequirementAppellate ReviewAbuse of Discretion
References
17
Case No. MISSING
Regular Panel Decision

Interstate Mechanical Contractors, Inc. v. McIntosh

Billy McIntosh sustained a severe hand injury while operating a power roller machine at Interstate Mechanical Contractors, Inc. He subsequently tested positive for marijuana, triggering a statutory presumption under Tennessee's Drug-Free Workplace Act that his drug use proximately caused the injury. The trial court, however, found that McIntosh successfully rebutted this presumption, concluding that the injury was proximately caused by an inexperienced coworker engaging the machine, not McIntosh's impaired reaction time. Interstate Mechanical Contractors, Inc. appealed this decision, arguing the trial court erred in its application of the statutory presumption and causation. The appellate court affirmed the trial court's judgment, upholding the finding that McIntosh had successfully rebutted the presumption.

References
10
Case No. MISSING
Regular Panel Decision

Committee of Unsecured Creditors of Interstate Cigar Co. v. Interstate Distribution, Inc. (In Re Interstate Cigar Co.)

This Memorandum Decision addresses the Plaintiff's Motion for Summary Judgment regarding damages in an adversary proceeding. The Committee of Unsecured Creditors of Interstate Cigar Co., Inc. sued Interstate Distribution, Inc. and Congress Financial Corporation, alleging violations of Article 6 of the Uniform Commercial Code (Bulk Sales Law). A New York State Appellate Court had already determined Congress's liability for violating the Bulk Sales Law. The Bankruptcy Court, presided over by Judge Dorothy Eisenberg, was tasked with determining the appropriate damages. The court granted summary judgment in favor of the Plaintiff, concluding that Congress is liable for the value of the inventory and equipment transferred, fixing damages at $14,976,662.00. The decision also awarded prejudgment interest to compensate the Plaintiff for Congress's wrongful retention of asset value, with the specific interest rate to be determined in a subsequent hearing.

Bankruptcy LawBulk Sales LawUniform Commercial Code Article 6Summary JudgmentDamages CalculationPrejudgment InterestFraudulent ConveyanceAsset TransferCreditor ProtectionTrustee Powers
References
40
Case No. MISSING
Regular Panel Decision

Matter of Campbell v. Interstate Materials Corporation

The claimant, an operating manager for Interstate Materials Corporation, suffered injuries to his neck, back, and knees in August 2006 and a second lower back injury in April 2008. A Workers' Compensation Law Judge initially classified the claimant with a permanent total disability and struck the independent medical examiner's report. The Workers' Compensation Board reversed this, finding the IME report improperly precluded due to the examiner's hospitalization and reclassified the claimant with a permanent partial disability, equally apportioned between the two accidents. The Appellate Division affirmed the Board's decision, finding no abuse of discretion in considering the IME report and that substantial evidence supported both the permanent partial disability classification and the equal apportionment of the disability.

Permanent Partial DisabilityPermanent Total DisabilityWorkers' Compensation BoardApportionment of DisabilityMedical EvidenceIndependent Medical Examination (IME)Cross-Examination RightsAbuse of DiscretionSubstantial EvidenceConflicting Medical Opinions
References
12
Case No. MISSING
Regular Panel Decision

Pollack v. Hobbs

Sanford Pollack, previously convicted of arson and other crimes, filed a pro se petition under 28 U.S.C. § 2241, seeking to vacate his arson conviction. He argued that the federal court lacked jurisdiction due to an insufficient interstate commerce nexus for the property involved. The government opposed the motion on both procedural and substantive grounds. The court ultimately denied the petition, finding it procedurally barred because Pollack failed to raise the jurisdictional challenge on direct appeal or in a timely § 2255 motion. Additionally, the court found the jurisdictional claim to be without merit, citing Pollack's own guilty plea allocution where he admitted the property's use in interstate commerce.

Habeas Corpus PetitionArson ConvictionFederal JurisdictionInterstate Commerce NexusProcedural BarPlea Agreement WaiverCollateral Attack28 U.S.C. 224128 U.S.C. 2255Timeliness
References
18
Case No. MISSING
Regular Panel Decision
Nov 10, 2005

American Interstate Insurance Co. v. Hinson

William E. Hinson, an employee, filed a workers' compensation claim after falling from a steel structure, which was initially denied due to an intoxication allegation. A jury found Hinson was not intoxicated, leading American Interstate, the insurer, to appeal the verdict. The appellate court reviewed the legal and factual sufficiency of the evidence, including Hinson's testimony and an expert's opinion based on a post-accident urinalysis showing marijuana metabolites. The court concluded that the jury could reasonably disregard the expert testimony and the delayed urinalysis results, given Hinson's consistent testimony of normal faculties and work performance. Consequently, the trial court's judgment in favor of Hinson was affirmed.

Workers' CompensationIntoxication DefenseMarijuana UseExpert Witness TestimonyUrinalysis ResultsSufficiency of EvidenceAppellate Court DecisionEmployee InjuryWorkplace SafetyMedical Toxicology
References
27
Case No. MISSING
Regular Panel Decision

Brauch v. Interstate Brands Corp.

A former employee of Interstate Brands Corp. sued Interstate, his union (IAM), and its representative for $50,000 in lost pension benefits after his benefits were terminated under a new IAM pension plan. The termination occurred because Interstate ceased contributions less than four years after joining the plan. The plaintiff alleged misrepresentation by the union and its representative, and failure to inform by Interstate regarding the plan's termination provision and their intent to cease contributions. The court, however, found no legal duty for the employer to inform the employee about collective bargaining agreement terms. Consequently, the appellate court unanimously reversed the lower court's denial of Interstate's motion for summary judgment, granted the motion, and dismissed the complaint against Interstate.

Pension Benefits TerminationEmployer LiabilityUnion LiabilityCollective Bargaining Agreement InterpretationDuty to InformSummary Judgment AppealWrongful Termination of BenefitsEmployee RightsLabor DisputeAppellate Reversal
References
0
Case No. MISSING
Regular Panel Decision

Bass v. Waller County Sub-Regional Planning Commission

The Waller County Sub-Regional Planning Commission challenged the court's jurisdiction over an appeal filed by James Bass, Executive Director of the Texas Department of Transportation. The appeal concerned interlocutory orders from a district court, which included granting partial summary judgment to the Planning Commission and deferring a ruling on a plea to the jurisdiction by the Executive Director. The Executive Director argued for jurisdiction under Section 51.014(a)(8) of the Civil Practice and Remedies Code, asserting an implicit denial of his jurisdictional challenges. However, the appellate court concluded it lacked jurisdiction because the district court's explicit deferral of the jurisdictional ruling contradicted any implied denial, or alternatively, effectively vacated any such implied ruling. Consequently, the Planning Commission's motion was granted, and the appeal was dismissed.

interlocutory appealsubject-matter jurisdictiongovernmental immunityplea to the jurisdictionpartial summary judgmentTexas Civil Practice and Remedies CodeLocal Government Codemandamus reliefinjunctive reliefultra vires claims
References
26
Case No. MISSING
Regular Panel Decision

Huse v. Fidelity Interstate Life Insurance Co.

Lydia M. Huse, the beneficiary of an accidental death policy from Fidelity Interstate Life Insurance Company, sued for benefits after the insured, T. L. Gaines, died in an automobile accident while on duty. Benefits were denied due to a worker's compensation exclusion in the policy. The case was presented as an agreed case to the trial court, which ruled in favor of the insurance company. Huse appealed, arguing the exclusion was invalid as she did not receive worker's compensation benefits, though Gaines' minor daughter did. The appellate court affirmed the trial court's judgment, holding the exclusion was valid and enforceable.

Accidental Death BenefitsInsurance Policy ExclusionWorker's CompensationNamed BeneficiaryAgreed CaseContract LawTexas LawUninsured Motorist CoveragePolicy InterpretationInsurance Contract
References
11
Showing 1-10 of 4,478 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational