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

Case No. No. M2018-01696-COA-R3-CV; No. 15-4-IV
Regular Panel Decision
Dec 07, 2020

American Board of Craniofacial Pain v. American Board Of Orofacial Pain

This case involves an appeal concerning a failed merger between two professional dental associations, American Board of Craniofacial Pain (ABCP) and American Board of Orofacial Pain (ABOP). ABCP sued ABOP, alleging a breach of an agreement to merge formed through email exchanges and seeking specific performance and damages. The Chancery Court for Davidson County granted summary judgment to ABOP, finding no meeting of the minds and thus no enforceable contract. The Court of Appeals of Tennessee affirmed this decision, concluding that the parties’ objective manifestations showed a lack of mutual assent because an essential term (disposition of intellectual property) was not agreed upon and they intended to reduce the agreement to a formal Memorandum of Understanding, which was never finalized. The court also agreed that specific performance was not an available remedy due to the incompleteness of the purported contract.

Contract DisputeMerger NegotiationsCorporate MergerDental ProfessionMutual AssentSpecific Performance DenialSummary Judgment AffirmationTennessee Court of AppealsContract FormationLack of Agreement
References
26
Case No. MISSING
Regular Panel Decision
Aug 04, 1995

Claim of Diliberto v. Hickory Farms, Inc.

The claimant was injured at work on December 30, 1987, sustaining injuries to his neck, shoulder blade, and left arm, with findings later expanded to include the lower back. The employer and its insurer disputed the causal relationship of the lower back injury. Although a Workers’ Compensation Law Judge found the lower back injury causally related, the Workers’ Compensation Board ultimately disallowed this claim due to a lack of credible medical evidence. The Board's decision was affirmed on appeal, as it was within the Board's authority to resolve conflicting expert medical testimony. Supporting the Board's finding, medical experts indicated no causal link, and the claimant did not report lower back pain until 16 months post-accident.

Causality DisputeMedical Expert TestimonyBoard DiscretionAffirmationLower Back PainDelayed SymptomsInjured WorkerEmployer LiabilityInsurance DisputeAppellate Division
References
3
Case No. 2021 NY Slip Op 01018 [191 AD3d 548]
Regular Panel Decision
Feb 16, 2021

Matter of Tenants United Fighting for the Lower E. Side v. City of New York Dept. of City Planning

The Appellate Division reversed a lower court order that had annulled approvals by the New York City Planning Commission (CPC) for new building constructions. The Supreme Court had initially granted petitions from Tenants United Fighting for the Lower East Side and Lower East Side Organized Neighbors. The appellate court held that the Supreme Court should have deferred to the CPC's reasonable interpretation of the New York City Zoning Resolution (ZR). Specifically, the Appellate Division clarified that ZR § 78-043's requirement for findings as a condition precedent only applies to modifications granted by special permit or authorization, not to other types of modifications to large-scale residential developments. Consequently, the petitions were denied and the proceedings dismissed.

Zoning ResolutionLarge-Scale Residential DevelopmentCity Planning CommissionAdministrative LawAppellate ReviewJudicial DeferenceStatutory InterpretationArticle 78 ProceedingNYC ZoningUrban Planning
References
7
Case No. MISSING
Regular Panel Decision
Apr 12, 2013

Matter of Poverelli v. Nabisco/Kraft Company

Claimant sustained a compensable lower back injury in 1986. Years later, in 2008, she began experiencing bilateral knee pain, which she asserted was a consequential injury arising from her established back injury. Both a Workers’ Compensation Law Judge and the Workers’ Compensation Board found insufficient medical evidence to establish a causal relationship between the back injury and the knee pain. The Board also assessed a penalty against claimant's attorney for pursuing review without reasonable grounds. The Appellate Division affirmed the Board's decision, concluding that the finding of no causal relationship was supported by substantial evidence from medical testimony, including an independent medical examination.

Workers' CompensationConsequential InjuryBilateral Knee PainLower Back InjuryCausal RelationshipMedical EvidenceIndependent Medical ExaminationDegenerative DiseaseAttorney PenaltyWorkers' Compensation Board Appeal
References
7
Case No. MISSING
Regular Panel Decision

Texas Employers Insurance Ass'n v. Campos

Rodrigo Campos, an employee of Freedman Brothers Packing Company, sustained injuries during an altercation with his foreman, Alexis Abarca, on February 17, 1981. He was diagnosed with chest pain and later developed lower back pain, leading to a lumbar laminectomy. After returning to light duty, he experienced recurrent back pain and was eventually refused continued employment without an unconditional medical release, which his doctor, Dr. Jocson, refused to provide due to his medical history. The jury found Campos to be totally and permanently incapacitated since March 4, 1981. The Texas Employers’ Insurance Association appealed the jury's findings and the resulting judgment. The appellate court affirmed the trial court's judgment.

Workers' CompensationPermanent IncapacityCourse of EmploymentProducing CauseMedical TestimonyJury VerdictAppealInjuryBack InjuryLumbar Laminectomy
References
11
Case No. MISSING
Regular Panel Decision

STATE OFFICE OF RISK MANAGEMENT v. Allen

Jerome D. Allen, a juvenile correction officer, was injured in March 2004 during employment. The State Office of Risk Management (SORM), administrator of workers' compensation, accepted head and shoulder injuries but disputed a lower back injury. A contested case hearing and subsequent appeals panel both found Allen's compensable injury extended to his lower back. SORM sought judicial review, and a jury also found in Allen's favor. SORM appealed, arguing the trial court erred in admitting hearsay evidence (a hearing officer's decision and order) and that the verdict was factually insufficient. The appellate court found any error in admitting the decision and order harmless, as the evidence was cumulative and also presented through SORM's own expert witness. The court also found the evidence factually sufficient to support the jury's verdict, noting Allen's testimony about new back pain symptoms post-injury and the compensability of aggravating a pre-existing condition. The trial court's judgment was affirmed.

Workers' CompensationAppellate ReviewHearsay EvidenceFactual SufficiencyJury VerdictCompensable InjuryLower Back InjuryPre-existing ConditionMedical RecordsChiropractor Testimony
References
6
Case No. MISSING
Regular Panel Decision

Queens Blvd. Medical, P.C. v. Travelers Indemnity Co.

The plaintiff, Queens Blvd. Medical, P.C., sought $950 in first-party no-fault benefits for biofeedback medical services provided to its assignor for lower back and chronic pain syndrome. The central issue at trial was the medical necessity of these services under Insurance Law § 5102 (a) (1). The plaintiff established a prima facie case with expert testimony from a board-certified neurologist affirming the medical appropriateness of biofeedback. The defendant insurance company failed to present admissible evidence to disprove medical necessity, as its expert was deemed incompetent to testify on biofeedback for back pain. Consequently, the court granted the plaintiff's motion for a directed verdict, awarding judgment for $950 along with statutory costs, interest, and attorney's fees.

No-fault benefitsMedical necessityBiofeedback treatmentExpert testimonyDirected verdictInsurance lawChronic pain syndromeBack injuryCPT codesBurden of proof
References
9
Case No. 13-09-00610-CV
Regular Panel Decision
Mar 10, 2011

Humberto A. Rangel v. Nueces County

Humberto A. Rangel appealed the trial court's summary judgment in favor of Nueces County and the denial of his cross-motion regarding a workers' compensation dispute. Rangel sustained a lower back injury in 2003 while working as a mechanic's assistant for Nueces County, a self-insured entity. After experiencing subsequent back pain incidents in 2004 and 2006, the DWC ruled the 2006 incident was a new injury, not an exacerbation of the 2003 injury. The appellate court reviewed conflicting medical opinions from Dr. Chodosh and Dr. Puentes, finding a genuine issue of material fact on the causality of Rangel's 2006 pain. Consequently, the court affirmed the denial of Rangel's summary judgment, reversed Nueces County's summary judgment, and remanded the case for further proceedings.

Workers' CompensationSummary JudgmentBack InjuryLumbar SpineMedical CausationAgreed Statement of FactsExacerbationHerniated DiscJudicial ReviewAppellate Procedure
References
24
Case No. MISSING
Regular Panel Decision

Claim of Bruno v. Kelly Temp Service

In 1997, the claimant suffered a noncompensable lower back injury, but continued to work 40-60 hours per week for 18 months without missing work despite intermittent pain and medical treatment. In February 2000, she sustained a work-related lower back injury while working for Eastman Kodak Company. The Workers’ Compensation Board found that her award should be apportioned 75% to the 1997 injury and 25% to the 2000 injury, based on the preexisting condition being symptomatic and actively treated. The appellate court reversed this decision, clarifying that apportionment applies only when the prior condition constitutes a 'disability in a compensation sense,' not merely a symptomatic condition. Since the claimant was fully employed and able to perform her duties effectively, her prior condition was not disabling, and the Board's finding lacked substantial evidence.

Workers' CompensationApportionmentPreexisting ConditionDisabilitySubstantial EvidenceReversalRemittalBack InjuryWork-Related InjurySymptomatic Condition
References
5
Case No. 533203
Regular Panel Decision
Oct 06, 2022

Matter of Cotterell v. Trinity Health Corp.

Claimant, Meggan Cotterell, sustained a lower back injury in 2015 while working for Trinity Health Corporation. Later, a right hip injury was found to be causally-related to the original work injury. The employer and carrier argued the hip injury claim was untimely under Workers' Compensation Law § 28, which mandates claims be filed within two years of the accident. The Workers' Compensation Board affirmed the claim amendment, crediting the treating orthopedist's testimony that initial hip pain was confused with low back symptoms and the hip labral tear was diagnosed later. The Appellate Division affirmed the Board's decision, finding that medical reports indicating hip pain filed within two years, coupled with the delayed diagnosis, provided substantial evidence to support the Board's determination that the amendment was not time-barred.

Workers' CompensationHip InjuryLabral TearTimelinessWorkers' Compensation Law § 28CausationMedical EvidenceOrthopedist TestimonyAppellate ReviewBoard Decision
References
7
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