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Case Law Database

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

Case No. 2016-06-1429

Regular Panel Decision

Mar 31, 2017

What Happened in Felix vs. Weber Metals Reconsideration?

Mr. Eldon B. Jackson sought payment for past medical expenses through an expedited hearing, claiming a recurrence of costochondritis was caused by his work for Express Services, Inc. The employer argued the injury was not primarily work-related and costochondritis was a pre-existing condition. The Court found Mr. Jackson failed to provide expert medical proof establishing a causal link between his employment and the condition's recurrence, which is required for non-obvious cases. Furthermore, Mr. Jackson also failed to present the actual medical bills for which he sought payment. Consequently, the Court denied his request for reimbursement of medical expenses but allowed for the possibility of presenting additional proof in the future.

Workers' CompensationMedical ExpensesExpedited HearingCostochondritisCausationPre-existing ConditionExpert Medical ProofTennesseeMisdiagnosisAortic Dissection

References

Case No. 2016-03-0449

Regular Panel Decision

Oct 03, 2016

How Did the WCAB Rule in Hardgrove vs. Intercon Security?

Katherine Rodgers, an employee, filed an Expedited Hearing Request seeking temporary disability benefits and reimbursement for unauthorized medical expenses after a work-related right shoulder injury. The employer, NHC Healthcare, and its carrier, Premier Group Insurance, had provided authorized medical panels, but Rodgers sought additional treatment without their authorization due to ongoing pain. The Court found that Rodgers' decision to seek unauthorized care was not reasonable, as she failed to properly notify her employer and did not establish the necessity and reasonableness of the associated charges. Furthermore, the Court concluded that she was not entitled to temporary disability benefits because no authorized medical provider had taken her completely off work, and she did not substantiate her claims regarding work restrictions. Consequently, the Workers' Compensation Judge denied Ms. Rodgers' claims for both unauthorized medical treatment expenses and temporary disability benefits.

Workers' CompensationTemporary Disability BenefitsMedical ExpensesUnauthorized TreatmentExpedited HearingWork InjuryShoulder InjuryCertified Nursing AssistantEmployer ObligationsEmployee Responsibilities

References

Case No. 2-06-016-CV

Regular Panel Decision

Mar 15, 2007

What Did the WCAB Decide in Cuadra vs. Community Home Care?

Shioleno Industries, Inc. appealed a summary judgment granted in favor of Columbia Medical Center of Arlington Subsidiary, L.P. and Columbia North Texas Subsidiary, GP, LLC d/b/a Medical Center of Arlington (the Hospital). The case originated from the Hospital's alleged failure to disclose an employee's positive drug and alcohol test results to Shioleno after an on-the-job injury. Shioleno contended that this omission led to increased workers' compensation premiums and expenses in unemployment benefit disputes. The appellate court affirmed the trial court's judgment, ruling that Shioleno failed to provide a valid authorization for the disclosure of medical information. Consequently, the Hospital had no legal duty to disclose the results and could not be held liable for negligence, breach of contract, or Deceptive Trade Practices Act (DTPA) violations.

Summary JudgmentMedical RecordsDisclosure AuthorizationHealth & Safety CodeNegligenceBreach of ContractDTPADrug TestingAlcohol TestingEmployer Liability

References

Case No. 126300 R.D.

Regular Panel Decision

How Were Death Benefits Handled in Bocanegra vs. Sun-Gro Commodities?

Walter Bazner, an insulator diagnosed with asbestosis, previously received workers' compensation benefits from L.D. Powell & Company and its insurer, American States Insurance Company, for permanent total disability and medical expenses incurred up to the judgment date. When Bazner incurred additional medical expenses post-judgment, American refused payment, arguing the prior judgment was res judicata and required pre-approval for new expenses. Bazner initiated a new suit, and the trial court sided with him. On appeal, the Supreme Court held that Bazner's claim for future medical expenses was not barred, reiterating that such expenses are recoverable under T.C.A. § 50-6-204 and established procedural rules for seeking them via petition in the original action. The court also found Bazner's decision to seek further medical attention from his treating physician reasonable under the circumstances. The case was remanded for further proceedings regarding future medical payments and related issues.

AsbestosisOccupational DiseaseFuture Medical ExpensesPost-Judgment CareRes Judicata DefenseEmployer Medical AuthorizationInsurance LiabilityStatutory BenefitsAppellate ReviewRemand Order

References

Case No. 2015-06-1304

Regular Panel Decision

Jun 03, 2016

Can a WCJ Be Disqualified for Appearance of Bias?

Michael Moss, a porterman for Wood Personnel Services, sustained a back injury on November 2, 2015, while lifting a tote. He sought medical treatment, but his claim was later denied by Wood Personnel, citing a lack of medical evidence for a work injury. Mr. Moss filed an Expedited Hearing Request seeking additional medical benefits, including a panel of orthopedic specialists, and reimbursement for past medical expenses and temporary disability benefits. The Court found Mr. Moss's testimony regarding his work-related injury credible and determined he is likely to prevail on the merits. Consequently, the Court granted his request for a panel of orthopedic specialists but denied his requests for reimbursement of past medical expenses and temporary disability benefits due to insufficient proof.

Back injuryOrthopedic specialistMedical benefitsExpedited hearingMedical causationBurden of proofTemporary disabilityReimbursementPanel of physiciansWorkers' compensation judge

References

Case No. 03-17-00352-CV

Regular Panel Decision

Aug 22, 2018

What Were the Key Rulings in Torrez vs. SuperShuttle?

This case involves cross-appeals stemming from a dispute over the appropriate reimbursement for medical services provided by Vista Medical Center Hospital and its affiliates to injured employees covered by the State Office of Risk Management (SORM) under Texas workers’ compensation statutes. The district court had affirmed 23 administrative orders that required SORM to make additional payments to Vista, a decision which SORM challenged on appeal citing insufficient evidence. Vista, in turn, cross-appealed the district court's denial of prejudgment interest. The appellate court found substantial evidence supported the administrative law judges' conclusion that SORM's original reimbursement model was unfair and unreasonable, and that Vista's proposed methodology was valid. Consequently, the court affirmed the district court's judgment but modified it to include the prejudgment interest that Vista was statutorily entitled to.

Workers' CompensationMedical ReimbursementAdministrative LawAppellate ReviewSubstantial EvidencePrejudgment InterestTexas LawHealthcare ProvidersInsurance DisputesFee Guidelines

References

Case No. MISSING

Regular Panel Decision

Why Was Removal Denied in Rush vs. California Correctional Institution?

A volunteer fireman suffered an acute lumbosacral strain requiring frequent hospital and doctor visits. He sought reimbursement for 290 miles of travel expenses. The Workers' Compensation Board approved reimbursement at 20 cents per mile, leading to this appeal. The court examined whether travel expenses for medical treatment are reimbursable under the Volunteer Firemen’s Benefit Law and Workers’ Compensation Law. It concluded that access to medical treatment implies the financial means to obtain it, upholding the humanitarian goals of the legislation.

Volunteer FiremanLumbosacral StrainMileage ReimbursementTravel ExpensesMedical TreatmentWorkers' Compensation LawVolunteer Firemen's Benefit LawStatutory InterpretationRemedial LawLiberal Construction

References

Case No. MISSING

Regular Panel Decision

What Did the WCAB Clarify in Ontiveros vs. Savers Stores?

The plaintiff appealed the denial of their motion for reimbursement of expenses and attorney's fees under T.R.C.P. 37.03. This motion stemmed from the defendant's objections to requests for admissions concerning medical causation, which necessitated the plaintiff taking depositions of two doctors for trial proof. The trial court initially denied worker's compensation benefits for one alleged accident and awarded medical expenses for another, but denied the motion for expenses and fees. On appeal, the court affirmed the trial court's denial of the motion for expenses, noting that the plaintiff failed to provide a complete record for review and that expert medical opinion is not discoverable under T.R.C.P. 36. Furthermore, the appellate court granted the defendant's request for damages, deeming the plaintiff's appeal frivolous under T.C.A. § 27-1-122.

Discovery SanctionsRule 37.03Rule 36Appellate ProcedureWorker's Compensation BenefitsMedical Expert TestimonyEvidentiary StandardsAbuse of Discretion StandardFrivolous AppealsCost Reimbursement

References

Case No. 2016-03-1427

Regular Panel Decision

Jun 21, 2017

Why Was Reconsideration Denied in Gomez vs. Dorothy Stevens?

Applicant Darlene Fredia Eaves filed motions for contempt and payment of medical expenses against Ametek, Inc. and Trumbell Insurance Company, seeking a decision on the record. The central issues were whether Ametek was in contempt for failing to authorize treatment ordered by Dr. Harold Cates and if Ms. Eaves was entitled to reimbursement for past medical expenses. The Court denied Ms. Eaves' Motion for Contempt, finding Ametek complied with utilization review procedures. However, the Court granted her Petition for Payment of Medical Expenses, concluding she demonstrated likelihood to prevail on reimbursement for past medical expenses incurred due to the work-related injury. Ametek is ordered to repay Ms. Eaves' private health insurer and reimburse her for out-of-pocket expenses.

Workers' CompensationMedical ExpensesContemptUtilization ReviewKnee InjuryAuthorized Treating PhysicianDenial of BenefitsReimbursementExpedited HearingMedical Necessity

References

Case No. 11-03-00346-CV

Regular Panel Decision

Mar 03, 2005

Why Was Reconsideration Dismissed in Sabino vs. Johnson Pump Company?

Ray Warren, M.D. and Texas Medical Images, Inc. (Warren) appealed the trial court's order granting summary judgment to KPH-Consolidation, Inc. d/b/a Columbia Kingwood Medical Center (Kingwood). The dispute arose from Warren's failure to pay rent on two lease agreements, leading Kingwood to sue for breach of contract. The trial court granted Kingwood's motion for summary judgment and ruled against Warren on his counterclaim regarding a breach of an Expense Sharing Agreement and breach of warranty. The Eleventh Court of Appeals affirmed the trial court's judgment, finding Kingwood had proven its breach-of-contract claim and that Warren's counterclaim failed as a matter of law, partly due to an 'as is' clause in the Equipment Lease. The appellate court also upheld the denial of Warren's motion for a new trial, finding no abuse of discretion.

summary judgmentbreach of contractlease agreementequipment leasecounterclaimbreach of warranty"as is" clauseappellate reviewabuse of discretionTexas law

References

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Updated Daily

Case Law Database

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

Case No. 2016-06-1429

Regular Panel Decision

Mar 31, 2017

What Happened in Felix vs. Weber Metals Reconsideration?

Workers' CompensationMedical ExpensesExpedited HearingCostochondritisCausationPre-existing ConditionExpert Medical ProofTennesseeMisdiagnosisAortic Dissection

References

Case No. 2016-03-0449

Regular Panel Decision

Oct 03, 2016

How Did the WCAB Rule in Hardgrove vs. Intercon Security?

References

Case No. 2-06-016-CV

Regular Panel Decision

Mar 15, 2007

What Did the WCAB Decide in Cuadra vs. Community Home Care?

Summary JudgmentMedical RecordsDisclosure AuthorizationHealth & Safety CodeNegligenceBreach of ContractDTPADrug TestingAlcohol TestingEmployer Liability

References

Case No. 126300 R.D.

Regular Panel Decision

How Were Death Benefits Handled in Bocanegra vs. Sun-Gro Commodities?

AsbestosisOccupational DiseaseFuture Medical ExpensesPost-Judgment CareRes Judicata DefenseEmployer Medical AuthorizationInsurance LiabilityStatutory BenefitsAppellate ReviewRemand Order

References

Case No. 2015-06-1304

Regular Panel Decision

Jun 03, 2016

Can a WCJ Be Disqualified for Appearance of Bias?

Back injuryOrthopedic specialistMedical benefitsExpedited hearingMedical causationBurden of proofTemporary disabilityReimbursementPanel of physiciansWorkers' compensation judge

References

Case No. 03-17-00352-CV

Regular Panel Decision

Aug 22, 2018

What Were the Key Rulings in Torrez vs. SuperShuttle?

Workers' CompensationMedical ReimbursementAdministrative LawAppellate ReviewSubstantial EvidencePrejudgment InterestTexas LawHealthcare ProvidersInsurance DisputesFee Guidelines

References

Case No. MISSING

Regular Panel Decision

Why Was Removal Denied in Rush vs. California Correctional Institution?

References

Case No. MISSING

Regular Panel Decision

What Did the WCAB Clarify in Ontiveros vs. Savers Stores?

Discovery SanctionsRule 37.03Rule 36Appellate ProcedureWorker's Compensation BenefitsMedical Expert TestimonyEvidentiary StandardsAbuse of Discretion StandardFrivolous AppealsCost Reimbursement

References

Case No. 2016-03-1427

Regular Panel Decision

Jun 21, 2017

Why Was Reconsideration Denied in Gomez vs. Dorothy Stevens?

Workers' CompensationMedical ExpensesContemptUtilization ReviewKnee InjuryAuthorized Treating PhysicianDenial of BenefitsReimbursementExpedited HearingMedical Necessity

References

Case No. 11-03-00346-CV

Regular Panel Decision

Mar 03, 2005

Why Was Reconsideration Dismissed in Sabino vs. Johnson Pump Company?

summary judgmentbreach of contractlease agreementequipment leasecounterclaimbreach of warranty"as is" clauseappellate reviewabuse of discretionTexas law

References

Showing 1-10 of 13,302 results

Ready to streamline your practice?

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