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

Case No. MISSING
Regular Panel Decision

Elmont Open MRI & Diagnostic Radiology, P.C. v. New York Central Mutual Fire Insurance

Plaintiff Elmont Open MRI & Diagnostic Radiology, PC. sued defendant New York Central Mutual Fire Insurance Company (NYCMFIC) for overdue first-party no-fault benefits following a brain MRI performed on Abdelghani Kinane. NYCMFIC moved for summary judgment, asserting the action was premature because Elmont allegedly failed to respond to verification requests, thereby tolling NYCMFIC's time to pay or deny the claim. Elmont countered with an affidavit from its billing supervisor, Brijkumar Yamraj, and a certificate of mailing, proving the requested MRI films and information were sent to NYCMFIC on November 12, 2008. The court found Elmont's proof of mailing sufficient to establish a response, thus denying NYCMFIC's motion and subsequently granting summary judgment to Elmont upon searching the record.

No-fault insuranceVerification requestsSummary judgmentProof of mailingMedical benefitsInsurance claims processTolling of time limitMotor vehicle accidentRadiology fee scheduleBusiness records
References
24
Case No. No. 08-19-00272-CV
Regular Panel Decision
Nov 10, 2021

Max Grossman/City of El Paso v. City of El Paso/Max Grossman

This case involves an appeal from the 384th District Court of El Paso County, Texas, regarding a dispute over the City of El Paso's plan to build a multipurpose arena. Appellant Max Grossman challenged the project, particularly the demolition of buildings in the Duranguito neighborhood for the arena's footprint, citing violations of the Texas Antiquities Code. The litigation's progression included multiple lawsuits concerning bond validity, sovereign immunity of the City, and the legality of permits issued by the Texas Historical Commission (THC). The primary legal issues revolve around the waiver of governmental immunity for the City under the Antiquities Code and whether the trial court abused its discretion in denying a temporary injunction against the project. Grossman contended the City's archeological survey design was inadequate to protect potential Mescalero Apache "Peace Camp" artifacts. The dissent argues against the majority's implicit finding of immunity waiver and supports the trial court's denial of the temporary injunction, emphasizing that the Antiquities Code does not unambiguously waive governmental immunity and and that the THC has broad discretion in approving archeological survey plans.

Governmental ImmunitySovereign ImmunityTexas Antiquities CodeArcheological SurveyTemporary InjunctionUltra Vires ClaimBond ReferendumEl Paso Arena ProjectHistorical PreservationJudicial Discretion
References
49
Case No. ADJ3701295 (AHM 0146448)
Regular
Oct 07, 2013

PAULA GUEVARA vs. NORTHGATE GONZALEZ MARKET, ZENITH ESIS

The Workers' Compensation Appeals Board granted reconsideration for lien claimant Max MRI. While affirming the denial of Max MRI's lien claim for lack of evidence, the Board vacated the sanctions imposed. The Board found that Max MRI was denied due process regarding the sanctions, as the issue was not properly noticed or heard. The case is returned to the trial level for further proceedings and a decision on costs and sanctions.

Workers' Compensation Appeals BoardPetition for ReconsiderationLien claimantMax MRIFrivolous lienSanctionsDue processMedical Provider NetworkCompromise and ReleaseFindings and Order
References
3
Case No. 2021 NY Slip Op 21232
Regular Panel Decision
Aug 26, 2021

Phillips v. Max Finkelstein, Inc.

Plaintiff Jesse Phillips, a manual employee of Max Finkelstein, Inc., was paid biweekly, violating Labor Law § 191 (1) (a) (i) which mandates weekly payment for manual workers. Phillips sued over late payments and improper wage statements. The Suffolk County Court initially granted summary judgment dismissing both causes of action. The Appellate Term, Second Department, reversed, citing the precedent in Vega v CM & Assoc. Constr. Mgt., LLC that a private right of action exists under Labor Law § 198 (1-a) for violations of wage frequency requirements. Thus, the court reinstated Phillips' first cause of action concerning late payments but upheld the dismissal of the second cause of action regarding wage statements, as Phillips did receive statements with every payment. The final order modified the lower court's decision, denying the dismissal of the first cause of action.

wage payment frequencymanual employeeLabor Law violationsliquidated damagesprivate right of actionsummary judgmentstare decisisAppellate Division precedentwage statementsemployment law
References
8
Case No. 10-92-225-CV
Regular Panel Decision
Dec 15, 1993

Transportation Insurance Company v. Max F. Hathcock

Transportation Insurance Company appealed a worker's compensation judgment awarding Max F. Hathcock total and permanent incapacity due to a foot injury that extended to his back. Hathcock, a truck driver, sustained the foot injury in a forklift accident. The jury found in his favor, concluding the injury extended to his back and caused permanent total incapacity. Transportation Insurance Company challenged the sufficiency of evidence, the exclusion of evidence regarding Hathcock's pre-existing conditions, and the refusal to submit an injurious-practice defense. The appellate court affirmed the judgment, finding sufficient legal and factual evidence to support the jury's findings on injury extension and total incapacity. The court also upheld the trial court's decisions on evidentiary matters and the injurious-practice defense, noting that the excluded evidence did not establish sole cause for incapacity and that there was no proof of willful refusal by Hathcock to lose weight.

Workers' Compensation LawPermanent Total DisabilityCausation of InjuryMedical Expert TestimonyAppellate ReviewEvidence AdmissibilityPre-existing Medical ConditionsInjurious Practice DefenseJury InstructionsTexas Courts of Appeals
References
25
Case No. 13-13-00552-CV
Regular Panel Decision
Feb 12, 2015

Nolana Open MRI Center, Inc. v. Guillermo R. Pechero M.D.Ruben D. Pechero M.D. Maplestar Orthopedics, P. A.

Nolana Open MRI Center, Inc. appealed a judgment rendered against it following a bench trial. The appellees, Guillermo R. Pechero, M.D., Ruben D. Pechero, M.D., and Maplestar Orthopedics, P.A., filed a motion to show authority, contending Nolana's counsel lacked the authority to bring the appeal. The underlying dispute involved the sale of Nolana's assets, patient referrals, lease agreements, and counterclaims for fraudulent inducement, conversion, and breach of contract. A key issue was a 50-50 ownership split in Nolana between Jose Castro and Agustin Garcia, where Castro had settled with defendants and granted them limited power of attorney to oppose litigation, while Garcia sought to authorize the appeal. The Court of Appeals, reviewing the trial court's findings, concluded that Nolana's counsel lacked standing due to the unresolved ownership conflict regarding the authority to initiate the appeal.

Appellate ProcedureJurisdictionMotion to Show AuthorityCorporate AuthorityShareholder DisputeLimited Power of AttorneyBreach of ContractTheft Liability ActFraudulent InducementTortious Interference
References
30
Case No. ADJ441097 (MON 0347404)
Regular
Sep 07, 2017

ROBERT ESQUERRA vs. EAGLE IRON CONSTRUCTION, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted Max MRI Imaging's petition for reconsideration, rescinding the prior finding of no liability for the lien. The original decision was based on an issue (RFA form) not properly identified for trial by the parties. The case is returned to the trial level to address the central dispute: whether services provided outside the defendant's Medical Provider Network (MPN) at a non-designated physician's request are compensable despite defendant's objections. The Administrative Law Judge must issue new findings on this specific issue and Max MRI's other contentions.

Workers' Compensation Appeals BoardLien claimantPetition for ReconsiderationMedical Provider NetworkPrimary treating physicianWritten objectionsRequest for authorizationFindings and AwardDecision After ReconsiderationAdministrative law judge
References
0
Case No. 07-08-0359-CV
Regular Panel Decision
Jul 28, 2010

THI of Texas at Lubbock I, LLC, D/B/A Southwest Regional Specialty Hospital Pharmasource Healthcare, Inc. And Omnicare, Inc., D/B/A Pharmasource Healthcare, Inc. v. Mario Perea, Individually and as Representative of the Estate of Jacob Perea, Max Perea, Tony Perea, and George Perea

Appellant THI of Texas at Lubbock I, LLC, d/b/a Southwest Regional Specialty Hospital, appeals a jury verdict in a medical malpractice action, seeking wrongful death and survival damages, in favor of Appellees Mario Perea, Max Perea, Tony Perea, and George Perea, and the estate of their deceased father, Jacob Perea. Jacob Perea died after nurses at Southwest Hospital administered two doses of Ativan despite his documented allergy and prior adverse reactions to the drug. The jury found THI and Pharmasource proximately caused the injury and awarded significant damages, including exemplary damages, against THI. This court reverses the trial court's judgment and remands the case for recalculation of damages in accordance with statutory caps.

Medical malpracticeWrongful deathSurvival damagesNegligent credentialingNegligent hiringAtivanDrug allergyRespiratory depressionGross negligenceExemplary damages
References
85
Case No. MISSING
Regular Panel Decision

Claim of Liebla v. Gro Max, LLC

Claimant, a truck driver, sustained a compensable back injury in 1993 in Connecticut, leading to surgeries and a lump-sum settlement. In 2007, while working for Gro Max, LLC, he suffered another work-related back injury. The employer sought to equally apportion liability between the 1993 and 2007 injuries, a determination upheld by a Workers’ Compensation Law Judge and the Workers’ Compensation Board. Claimant appealed this decision, arguing that apportionment was unsupported by substantial evidence and inapplicable as he worked without restriction prior to the 2007 injury. The court affirmed the Board's determination, finding that substantial medical evidence, including opinions from independent medical examiners, supported the equal apportionment of the disability between the two injuries, considering the pre-existing spinal condition.

ApportionmentPrior InjurySubsequent InjuryBack InjuryLump-sum settlementMedical EvidenceSpinal StenosisDegenerative Disc DiseaseAggravation of ConditionSubstantial Evidence
References
7
Case No. MISSING
Regular Panel Decision

Innoviant Pharmacy, Inc. v. Morganstern

Innoviant Pharmacy, Inc. sued its former sales executive, Max Morganstern, for unfair competition and breach of a non-compete agreement after he joined a competitor, Summit Pharmacy, Inc., and solicited Innoviant's customer referral sources. Innoviant sought a preliminary injunction to prevent Morganstern from contacting 114 key New York referral sources. The court found Innoviant unlikely to succeed on its breach of contract claim because the employment agreement was deemed unenforceable due to a later signed document. However, the court found Innoviant likely to succeed on its unfair competition claim, as Morganstern misappropriated a list of potential referral sources and business cards. Consequently, the court granted the preliminary injunction, restraining Morganstern from contacting the specified referral sources until February 24, 2006, conditioned on Innoviant posting a $100,000 security bond.

Preliminary InjunctionUnfair CompetitionBreach of ContractNon-compete ClauseTrade SecretsCustomer ListsConfidential InformationEmployment AgreementSales ExecutiveReferral Sources
References
50
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