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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

Main Evaluations, Inc. v. State

The claimant, Main Medical Evaluations, entered into contracts with the New York State Office of Temporary and Disability Assistance (OTDA) to perform consultative medical evaluations. OTDA terminated these contracts, alleging the claimant failed to disclose professional disciplinary proceedings against its chief medical officer, Arvinder Sachdev, and submitted false information during the bidding process. Following the dismissal of its claim in the Court of Claims, the claimant appealed. The appellate court affirmed the lower court's judgment, concluding that OTDA had legitimate grounds for termination due to the claimant's misrepresentations and failure to report substantial contract-related issues concerning Sachdev's integral role. Additionally, the court rejected the claimant's equal protection argument, finding no evidence of selective enforcement based on impermissible considerations.

Contract TerminationProfessional MisconductFalse RepresentationEqual ProtectionGovernment ContractsAppellate ReviewBreach of ContractMedical LicensingAdministrative ProceedingsDue Diligence
References
5
Case No. 13-09-00350-CV
Regular Panel Decision
Jan 21, 2010

Gulf Coast Medical Center, LLC, Tony Todd, Crna, Dan Madsen, M.D. and South Texas Medical Clinics, P.A. v. Jacqueline Temple and Marcus Banks, Individually and as Representatives of the Estate of Markasia Banks, a Minor Child

Appellants, Gulf Coast Medical Center, LLC, Tony Todd, CRNA, Dan Madsen, M.D., and South Texas Medical Clinics, P.A., appealed the trial court's denial of their motions to dismiss. The underlying suit was filed by appellees Jacqueline Temple and Marcus Banks, alleging negligence in the care and treatment of their deceased minor child, Markasia Banks. The core issue on appeal was the appellees' failure to timely serve an expert medical report as required by the Texas Civil Practice and Remedies Code. The Court of Appeals determined that the appellees' claims were 'health care liability claims' and that the expert report was indeed untimely, and that an abatement due to a failure to provide medical authorization did not extend the deadline. The court also affirmed the constitutionality of the expert report requirement. Consequently, the appellate court reversed the trial court's judgment, granted the appellants' motions to dismiss, and remanded the case for the award of attorney's fees and costs to the appellants.

Health Care Liability ClaimExpert Medical ReportMotion to DismissTimeliness of ReportAbatementMedical MalpracticeNegligenceDue ProcessTexas ConstitutionAppellate Review
References
32
Case No. 2016-08-1486
Regular Panel Decision
Nov 30, 2018

Nance, Amy v. JCSD Emergency Medical Group d/b/a Medic One Response

Ms. Nance, an emergency medical technician, injured her left upper extremity while moving a patient. After conservative treatment, she was diagnosed with cubital tunnel syndrome and later recommended for a cervical spine evaluation by Dr. Cole. Medic One denied the requested benefits, claiming misrepresentation and non-work-related activity. The Court found Ms. Nance likely to prevail for medical benefits, ordering Medic One to authorize a cervical spine evaluation and allow her to select a specialist. However, Ms. Nance was not found eligible for temporary disability benefits due to insufficient medical proof of disability.

Workers' CompensationMedical BenefitsTemporary Disability BenefitsCubital Tunnel SyndromeCervical Spine EvaluationMedical MisrepresentationCausal ConnectionExpedited HearingPermanent ImpairmentTreating Physician
References
3
Case No. 13-15-00024-CV
Regular Panel Decision
Jul 06, 2015

Maria Zamarripa, as Temporary Guardian of the Estates of R. F. R. and R. J. R., Minors, and Olga Flores, as Temporary Administrator of the Estate of Yolanda Iris Flores v. Bay Area Health Care Group, Ltd. D/B/A Corpus Christi Medical Center, Hidalgo County EMS, and Hidalgo County Emergency Medical Service Foundation

This case involves an appeal by Maria Zamarripa and Olga Flores (Appellants) against Bay Area Health Care Group, Hidalgo County EMS, and Hidalgo County Emergency Medical Service Foundation (Appellees). The Appellants are challenging the trial court's orders that granted the Appellees' motions to dismiss. The core of the appeal centers on the qualifications of Nurse Spears as an expert witness and the sufficiency of expert reports regarding the standard of care, its breach, and causation in a medical malpractice claim involving Yolanda Iris Flores's injuries and death from placenta accreta and pre-term labor. Appellants argue that Nurse Spears is qualified, the expert reports adequately connect CCMC's alleged breach of care to the injuries, and alternatively, they are entitled to amend the reports. They pray for the reversal of the trial court's dismissal orders and a remand for further proceedings.

Medical MalpracticePlacenta AccretaPre-term LaborMedical NegligenceStandard of CareCausationExpert Witness QualificationsHospital LiabilityEmergency Medical Services (EMS)Wrongful Death
References
16
Case No. MISSING
Regular Panel Decision

Davis v. Medical Evaluation Specialists, Inc.

Justice Wilson dissents from the majority's decision on a motion for rehearing, arguing that the majority improperly considered non-evidence and engaged in speculation. The dissent contends that Lennie Davis's controverting affidavit by Dr. Bergeron, which stated a 17% impairment rating compared to the defendants' 0%, was conclusory and insufficient to establish bad faith by Medical Evaluation Specialists, Inc., Dr. DeFrancesco, and Dr. Dozier. Justice Wilson believes that the affidavit failed to meet the objective 'no reasonable doctor' standard for controverting good faith, and therefore, the trial court's summary judgment in favor of the defendants should have been affirmed based on official immunity.

Summary JudgmentOfficial ImmunityGood FaithImpairment RatingMedical AffidavitConclusory StatementsTexas Workers' Compensation ActAppellate ReviewDissenting OpinionPermanent Disability
References
7
Case No. ADJ1700793 (SAC 0307437) ADJ3714832 (SAC 0307399)
Regular
Jun 13, 2011

JUANITA BRADLEY (Deceased) vs. COUNTY OF PLACER

This case involves a dispute over liability for a medical-legal report cost. The defendant seeks reconsideration of a prior award holding them responsible for Dr. Adelberg's $4,237.50 report. The defendant argues the judge ignored a prior order for an Agreed Medical Evaluation (AME) and that the applicant's attorney improperly proceeded with Dr. Adelberg's exam. The Board granted reconsideration, preliminarily finding it may be inequitable to place the full cost on the defendant, and intends to split the expense between the defendant and applicant's attorney. A dissenting opinion argues the defendant's own correspondence shows an ongoing dispute regarding the AME, supporting the original award of liability.

Workers' Compensation Appeals BoardReconsiderationMedical-Legal ReportAgreed Medical EvaluationQualified Medical EvaluatorJoint Findings and AwardLabor Code Section 4062(a)Stipulation and OrderEquitable PowersLien Claimant
References
1
Case No. 15-25-00167-CV
Regular Panel Decision
Nov 26, 2025

Shannon Medical Center v. Michael Sickels and James Christopher Cole

Radiologists Michael Sickels and James Christopher Cole sued Shannon Medical Center, alleging the hospital failed to properly monitor, report, and restrict their exposure to radiation while they treated patients, leading to injuries including cancer and amputations. Shannon Medical Center, a licensed health care provider, moved to dismiss these claims under Section 74.351 of the Texas Civil Practice & Remedies Code, arguing that they constituted health care liability claims requiring a statutory expert report. Sickels and Cole denied their claims were health care liability claims, asserting they arose from violations of the Texas Radiation Control Act and Texas Administrative Code, that they were employees of Shannon Medical Center, and that they had satisfied the expert report requirement by providing voluminous medical records. The trial court denied Shannon Medical Center's motion to dismiss, prompting this appeal. Shannon Medical Center argues that the claims satisfy all elements of a health care liability claim, highlighting the substantial nexus to health care, the involvement of medical equipment, and the need for expert testimony. They also contend that Sickels and Cole are not employees of the hospital, but rather independent contractors employed by Shannon Clinic, and that the medical records provided do not meet Chapter 74's expert report requirements for standard of care, breach, and causation, nor was a curriculum vitae served. Shannon Medical Center seeks reversal of the trial court's denial, dismissal of the case with prejudice, and an award of statutory remedies.

Health Care Liability ClaimMedical MalpracticeExpert ReportRadiation ExposureHospital NegligenceTexas Civil Practice and Remedies Code Chapter 74Motion to DismissEmployment StatusIndependent ContractorRadiology
References
36
Case No. MISSING
Regular Panel Decision

Colindres v. Carpenito

Plaintiff Rochelle Colindres sought a protective order to deny defendants' demand for a medical report from her former treating psychologist, Diane Henry, or alternatively, relief from compliance with Uniform Rules for Trial Courts § 202.17(b)(1). Colindres argued that the defendants waived their right to the report as the independent medical examination (IME) already occurred, and that obtaining the report would be an undue hardship since Henry ceased treatment due to Colindres' attendance issues. Defendants Mario Carpenito, Jr., City of White Plains, and White Plains Parking Department opposed, asserting that the report was necessary to clarify alleged injuries, prepare for cross-examination, and facilitate settlement, highlighting Colindres' complex medical history predating the incident. The court denied both branches of Colindres' motion, finding that the rule applies broadly to personal injury actions, defendants did not waive their entitlement, and Colindres failed to prove it was impossible to obtain the report. The court ordered Colindres to exchange a compliant medical report from Diane Henry by March 27, 2017.

protective ordermedical report disclosurediscovery disputepsychological treatmentindependent medical examinationCPLR 310322 NYCRR 202.17waiver of discoveryundue hardshippersonal injury damages
References
12
Case No. ADJ9011624
Regular
Dec 13, 2019

ELISHA HARDEN vs. COUNTY OF SACRAMENTO

This case concerns whether specific medical reports obtained for a disability retirement claim are admissible in a workers' compensation proceeding. The Appeals Board rescinded the prior ruling, holding these reports are relevant and may be provided to the orthopedic Agreed Medical Evaluator (AME) and psychiatric Qualified Medical Evaluator (QME). The Board found the reports relevant to the medical issues, even though they were not obtained through the standard workers' compensation medical-legal evaluation process. Consequently, the applicant's objection to providing these reports to the evaluators was overruled.

RemovalReconsiderationAgreed Medical Evaluator (AME)Qualified Medical Evaluator (QME)Medical-legal evaluatorsMedical recordsLabor CodeFindings and Orders (F&O)Disability retirementPermanent impairment
References
9
Case No. ADJ519728
Regular
Aug 08, 2011

LOWELL BAPTISTE vs. METROPOLITAN TRANSIT AUTHORITY

The Workers' Compensation Appeals Board granted reconsideration of a prior award finding industrial injury and temporary total disability dating back to 2000. The Board found that the medical opinion relied upon by the workers' compensation judge was not substantial evidence due to staleness, lack of complete records, and insufficient specialization. To ensure a fair resolution, the Board ordered new evaluations by independent orthopedic and psychiatric physicians, who will report on all outstanding medical issues.

Workers' Compensation Appeals BoardReconsiderationCompelling Medical EvaluationsTemporary Total DisabilityIndustrial InjuryOrthopedicsPsychiatrySubstantial EvidenceMedical OpinionWCJ
References
2
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