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

Case No. 04-08-00183-CV
Regular Panel Decision
Jun 24, 2009

Midwest Employers Casualty Company on Behalf of Terry English v. Charles Harpole, Jim Carroll, Alan Kwast, Albert Lopez and Brock Pittman

This appeal examines a negligence claim brought by Midwest Employers Casualty Company, on behalf of injured football coach Terry English, against several referees, including Charles Harpole. English sustained a severe head injury after Harpole collided with him in a designated restricted area during a high school football game. Midwest, the worker's compensation insurer for English's employer, argued the referees had a duty to enforce safety rules and that Harpole failed to exercise reasonable care. The appellate court affirmed the trial court's summary judgment in favor of the referees, ruling that Harpole owed no duty to foresee English's presence in the restricted area, as English was in violation of game rules, and there was no evidence of a breach of duty by the referees.

AppealSummary JudgmentNegligenceDuty of CareForeseeabilitySports LawFootball RefereePersonal InjuryWorker's CompensationTexas Law
References
34
Case No. 14-13-00731-CV
Regular Panel Decision
Jan 27, 2015

Sabrina Taylor v. the Hartford Insurance of Midwest

This case involves Sabrina Taylor appealing a summary judgment granted in favor of The Hartford Insurance Company of the Midwest by the trial court. The appeal stems from a judicial review of a workers' compensation appeals panel decision. Taylor challenged the trial court's decision to sustain a contest to her affidavit of indigence, its consideration of inadmissible evidence (Dr. Korivi's deposition), and its alleged failure to address her impairment rating. The Fourteenth Court of Appeals affirmed the trial court's judgment, ruling the indigence issue moot as Taylor received relief, finding no indication of improper evidence consideration, and concluding that Taylor's pleadings did not challenge the impairment rating.

Workers' CompensationSummary JudgmentJudicial ReviewAppeals PanelImpairment RatingAffidavit of IndigenceAdmissible EvidenceTexas Labor CodeMaximum Medical ImprovementInjury Coverage
References
6
Case No. 2019-02-0530
Regular Panel Decision
Aug 06, 2020

Morris, Jerry v. MIdwest LP and Innovative Pane

Jerry Morris, an employee of Midwest LP, sought medical and temporary disability benefits for a back injury. He initially reported an injury at home on August 29, 2019, claiming he missed a step and fell, although he frequently complained of back pain at work. Midwest LP did not file a First Report of Injury or provide a physician panel, citing the non-work-related nature of the injury. The Court convened an Expedited Hearing and ultimately denied Morris's request for benefits. The decision was based on the lack of expert medical proof linking his injuries primarily to his employment, with evidence suggesting the injury occurred at home.

Workers' CompensationBack InjuryMedical BenefitsTemporary DisabilityCausationExpedited HearingDenial of BenefitsEmployee ClaimEmployer ResponsibilityMedical Proof
References
2
Case No. MISSING
Regular Panel Decision

Midwest Employers Casualty Co. Ex Rel. English v. Harpole

Midwest Employers Casualty Company, acting as subrogee for permanently disabled high school football coach Terry English, appealed a summary judgment that favored five referees. Coach English suffered a severe brain injury after referee Charles Harpole collided with him in a designated restricted sideline area during a game. Midwest argued the referees were negligent by failing to prevent English's presence in the restricted zone and Harpole by not maintaining a lookout. The appellate court affirmed the trial court's decision, concluding that the referees owed no duty to English in this context, as Harpole was performing his duties in the designated area and could not foresee English's violation of the rules.

NegligenceDuty of CareSummary JudgmentAppellate ReviewFootball InjurySports OfficiatingSubrogationTexas LawForeseeabilityReferee Conduct
References
38
Case No. Cause No. 87-3451
Regular Panel Decision

American Home Assurance Co. v. Cooper

The Relator, American Home Assurance Company, sought mandamus relief from a pretrial discovery order compelling production of an adjuster's investigation file. The underlying case involved workers’ compensation claims filed by Nancy Ann Labbe Walker for her disability and her deceased husband's death benefits. A key dispute centered on the employment status of the Walkers and the responsible compensation carriers: Argonaut Midwest Insurance Company or American Home Assurance Company (Relator). The Relator claimed privilege over the adjuster's file, arguing it was prepared in anticipation of litigation. The appellate court reviewed whether the trial judge abused discretion by ordering discovery and by not conducting an in camera inspection. The court found no abuse of discretion, concluding that the trial court's decision was within its broad discretionary powers and that an in camera inspection was not strictly necessary given the Relator's general claim of privilege. Consequently, the petition for writ of mandamus was denied.

MandamusDiscovery DisputeLitigation PrivilegeWorkers' CompensationInsurance ClaimEmployer LiabilityBad Faith LitigationTrial Court DiscretionAppellate ReviewIn Camera Inspection
References
11
Case No. ADJ9338499
Regular
Jun 03, 2015

JOVANNI MONTELONGO vs. PHIL BRUNO ENTERPRISES, INC., dba EXCLUSIVE FRESH, INC., PROCENTURY INSURANCE COMPANY

This case involves a dispute over the proper Medical Provider Network (MPN) for an injured worker. The defendant argued that the applicant's chosen physicians were not part of the correct MPN, Midwest Rising. The Appeals Board granted reconsideration, reversing the original findings. They found that the defendant provided sufficient notice of the correct MPN and that the applicant's chosen physicians were not within it. The Board determined that the applicant was not misled and the defendant did not neglect to provide reasonable medical treatment.

Workers' Compensation Appeals BoardMedical Provider NetworkMPN disputeRising InterplanMidwest RisingProcentury Insurance CompanyIllinois Midwest Insurance AgencyAdministrative Directorprimary treating physicianindustrial injury
References
3
Case No. ADJ7518237; ADJ7518238
Regular
Nov 28, 2011

MARCELA ACOSTA vs. FLOYD'S 99 BARBERSHOP, STAR INSURANCE COMPANY, Administered by ILLINOIS MIDWEST INSURANCE COMPANY, TOWER SELECT INSURANCE COMPANY, Administered by ILLINOIS MIDWEST INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) granted removal in this case and issued a notice of intent to sanction attorney Daniel V. Anaya $500.00 for unspecified reasons. No objection was filed by Anaya, and the $500.00 sanction was subsequently paid. The WCAB confirms the sanction and acknowledges the payment has been transmitted to the General Fund.

RemovalSanctionsWorkers' Compensation Appeals BoardDaniel V. AnayaFloyd's 99 BarbershopStar Insurance CompanyTower Select Insurance CompanyIllinois Midwest Insurance CompanyGeneral FundBradford & Barthel
References
0
Case No. ADJ7432904
Regular
Sep 24, 2012

NEDA MOTAVAKEL vs. FANTASTIC SAM'S, TOWER SELECT INSURANCE CO., ILLINOIS MIDWEST INSURANCE AGENCY, LLP, STAR INSURANCE CO., ILLINOIS MIDWEST INSURANCE AGENCY, LLP, ENDURANCE WORKERS' COMPENSATION, SOUTHERN INSURANCE CO., FIRSTCOMP OMAHA

This case involves an appeal by Star and Tower Insurance Companies regarding a workers' compensation award. The primary issue is the applicant's average weekly earnings, specifically the inclusion of tip income, which was not adequately substantiated by documentary evidence. The Appeals Board found the initial decision lacked substantial evidence regarding earnings and rescinded the award. The matter is remanded for further proceedings to properly develop the evidentiary record on earnings and insurance coverage dates before a new decision is issued.

Workers' Compensation Appeals BoardNeda MotavakelFantastic Sam'sTower Select Insurance CompanyStar Insurance CompanyIllinois Midwest Insurance AgencyLLEndurance Workers' CompensationSouthern Insurance CompanyFirstComp Omaha
References
6
Case No. MISSING
Regular Panel Decision

Claim of Coyle v. Midwest Steel

The claimant, an ironworker, suffered a work-related left knee injury in 1998, leading to multiple surgeries and consequential injuries to his back and right hip. After his light-duty job was eliminated, he retired in August 2009 due to medical restrictions, declining a full-duty position. The employer's workers’ compensation carrier argued voluntary removal from the labor market. A Workers’ Compensation Law Judge initially found involuntary retirement, but the Workers’ Compensation Board later denied further benefits, citing the claimant's failure to maintain attachment to the labor market. This court reverses the Board's decision, affirming that an involuntary retirement due to disability creates an inference of continued reduced earning capacity, and the employer failed to provide direct and positive proof that another factor was the sole cause of the reduced earning capacity, rather than relying solely on the claimant's failure to seek work post-retirement.

Involuntary RetirementLabor Market AttachmentReduced Earning CapacityCausally Related DisabilityEmployer Burden of ProofMedical RestrictionsAppellate ReviewSubstantial EvidenceReversed DecisionWorkers' Compensation Board Ruling
References
0
Case No. ADJ8675032
Regular
Jun 12, 2015

BERTHA AGUIRRE vs. LUCASEY MANUFACTURING, THE HARTFORD COMPANY OF THE MIDWEST

The Workers' Compensation Appeals Board granted reconsideration and rescinded an administrative law judge's award due to insufficient medical evidence regarding causation and apportionment. Both the primary treating physician and the agreed medical evaluator's reports were deemed lacking substantial medical evidence. The case is returned to the trial level for further development of the record and a new decision. This is necessary to properly determine industrial injury to the cervical spine and right upper extremity and apportionment in light of prior injuries.

WCABPetition for ReconsiderationFindings of FactAwardCumulative InjuryPermanent DisabilityApportionmentSubstantial Medical EvidenceAgreed Medical EvaluatorPrimary Treating Physician
References
19
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