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Case Law Database

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

Case No. MISSING
Regular Panel Decision

Pig Newton, Inc. v. Boards of Directors of the Motion Picture Industry Pension Plan

Plaintiff Pig Newton, Inc. commenced an action against the Boards of Directors of the Motion Picture Industry Pension Plan, Health Plan, and Individual Account Plan, seeking a declaration that certain provisions of the Plans’ Trust Agreements were invalid and unenforceable. The Defendants counterclaimed for delinquent contributions under ERISA. The core dispute revolved around "Controlling Employee Provisions" in the Trust Agreements, which obligated employers to contribute for Controlling Employees for a specified number of hours and weeks regardless of actual hours worked. Pig Newton argued these provisions were invalid, not properly incorporated, or conflicted with collective bargaining agreements (CBAs). The Court, applying federal common law and an arbitrary and capricious standard of review for the Directors' interpretation, found the provisions valid, properly incorporated, and not in conflict with the CBAs, concluding that Szekely (Pig Newton's sole owner) qualified as a Controlling Employee. Consequently, the Court denied Plaintiff's motion for summary judgment and granted Defendants' cross-motion for summary judgment, dismissing Plaintiff's complaint and awarding Defendants the sought-after contributions, interest, auditors’ fees, and liquidated damages.

ERISAMultiemployer PlanPension PlanHealth PlanDeclaratory JudgmentSummary JudgmentTrust AgreementsCollective Bargaining AgreementsControlling Employee ProvisionsDelinquent Contributions
References
44
Case No. 13-17-00346-CV
Regular Panel Decision
May 09, 2019

Audrey Nickerson v. Julio Pineda and Unique Employment, LLC, Unique Employment Services, Unique Employment I, LTD, D/B/A Unique Employment Services

Audrey Nickerson, an employee of the City of Corpus Christi, sued Julio Pineda, a temporary worker, and Unique Employment Services for negligence after Pineda, operating a City-owned backhoe, caused an injury. Appellees filed a plea to the jurisdiction, which the trial court granted. The appellate court affirmed the dismissal of claims against Pineda, determining he qualified as a government employee under the Texas Tort Claims Act and was therefore immune from suit. However, the court reversed the dismissal of claims against Unique Employment Services, concluding that the borrowed-employee doctrine, on which Unique relied, is an affirmative defense to liability and not a jurisdictional matter properly addressed in a plea to the jurisdiction. The case against Unique was remanded for further proceedings.

Plea to the JurisdictionGovernmental ImmunityTexas Tort Claims ActElection of RemediesBorrowed Employee DoctrineNegligenceTemporary StaffingVicarious LiabilityAppellate ReviewSubject Matter Jurisdiction
References
35
Case No. 15-24-00114-CV
Regular Panel Decision
Oct 04, 2024

Cecile Erwin Young, in Her Official Capacity as the Executive Commissioner of the Texas Health and Human Services Commission; Molina Healthcare of Texas, Inc.; And Aetna Better Health of Texas, Inc. v. Cook Children's Health Plan, Texas Children's Health Plan, Superior Health Plan, Inc., and Wellpoint Insurance Company

This case involves an appeal concerning a temporary injunction and the denial of a plea to the jurisdiction issued by the 353rd Judicial District of Travis County. The appellants, including Cecile Erwin Young (Executive Commissioner of HHSC), Molina Healthcare of Texas, Inc., and Aetna Better Health of Texas, Inc., are challenging the lower court's decision. The appellees (Cook Children's Health Plan, Texas Children's Health Plan, Superior Health Plan, Inc., and Wellpoint Insurance Company) had sought to enjoin the Texas Health and Human Services Commission (HHSC) from proceeding with STAR & CHIP and STAR Kids managed care procurements. The core legal arguments revolve around whether HHSC's procurement processes violated Texas law, thereby rendering the intended contract awards unlawful ultra vires acts, and whether the appellees' claims are barred by sovereign immunity or failure to exhaust administrative remedies. The appellants contend that the district court abused its discretion by granting the injunction and denying the plea.

Appellate CourtTemporary InjunctionPlea to the JurisdictionSovereign ImmunityUltra Vires ClaimsProcurement DisputeManaged Care ContractsMedicaidCHIPTexas Health and Human Services Commission
References
95
Case No. MISSING
Regular Panel Decision

Equal Employment Opportunity Commission v. Firestone Tire & Rubber Co.

The Equal Employment Opportunity Commission (EEOC) brought a lawsuit against Firestone Tire & Rubber Company and its unions, alleging age discrimination under the Age Discrimination in Employment Act of 1967 (ADEA). The EEOC contended that Firestone unlawfully failed to provide severance awards to employees eligible for pensions when its Memphis plant closed in 1983. The court ruled that the EEOC's claim was time-barred due to exceeding the two-year statute of limitations, and found no willful violation by Firestone. Furthermore, the court concluded that Firestone's P&I Plan, viewed comprehensively, did not adversely affect older employees, who received greater overall benefits. The court also upheld Firestone's defense that its plan was a bona fide employee benefit plan. Consequently, the defendants' motion for summary judgment was granted.

Age DiscriminationSeverance PayPension PlanADEAStatute of LimitationsSummary JudgmentEmployee BenefitsPlant ClosureCollective BargainingWillful Violation
References
17
Case No. Civ. A. No. 3:93-CV-0171-G.
Regular Panel Decision
Aug 31, 1993

Mills v. INJURY BENEFITS PLAN OF SCHEPPS-FOREMOST

Walter Mills was injured during his employment and sought benefits under his employer's Injury Benefits Plan. He subsequently filed a civil action alleging wrongful termination in retaliation for filing a workers' compensation claim under Texas law. Defendants removed the case to federal court, asserting ERISA preemption. The court granted the defendants' motion to dismiss Mills' claims against the Injury Benefits Plan, finding them preempted by ERISA. However, the court denied the dismissal of Mills' state law claims against Schepps-Foremost, Inc., d/b/a Oak Farms Dairies. Ultimately, the court remanded the remaining state law claims against Schepps-Foremost, Inc. to the County Court at Law Number 5 of Dallas County, Texas, due to a lack of federal subject matter jurisdiction.

ERISA preemptionWorkers' CompensationRetaliatory dischargeTexas lawFederal jurisdictionMotion to dismissRemandEmployee benefitsCivil procedureDallas County
References
18
Case No. 2018 NY Slip Op 05049 [163 AD3d 577]
Regular Panel Decision
Jul 05, 2018

Matter of Peterson v. Planning Bd. of the City of Poughkeepsie

This case concerns an appeal by Jeanette Peterson, representing the Historic Southside Neighborhood Association, challenging a lower court's decision that upheld a negative declaration issued by the Planning Board of the City of Poughkeepsie. The negative declaration was related to Thomas LaPerch's application for site plan approval to construct multi-family housing near a historic district. The Association argued that the Planning Board's determination violated the State Environmental Quality Review Act (SEQRA) by failing to adequately assess environmental impacts. The Appellate Division reversed the judgment, finding the Planning Board's issuance of a negative declaration arbitrary and capricious due to its conclusory findings regarding historic impact and its unsubstantiated claims about vegetation removal. The court remitted the matter to the Planning Board, ordering the preparation of an Environmental Impact Statement.

Environmental ReviewSEQRAPlanning BoardNegative DeclarationEnvironmental Impact StatementHistoric PreservationJudicial ReviewArbitrary and CapriciousSite Plan ApprovalDutchess County
References
14
Case No. MISSING
Regular Panel Decision

In re Robert Plan Corp.

Kenneth Kirschenbaum, the Chapter 7 Trustee for The Robert Plan Corporation and The Robert Plan of New York Corporation, sought court approval for fee awards for himself and his professionals for administering an ERISA plan. The U.S. Department of Labor (DOL) objected, asserting the court lacked jurisdiction to award fees from Plan assets and had specific objections to the reasonableness of the fees. The court affirmed its core jurisdiction over the Trustee's actions as Plan administrator and his professionals' compensation, regardless of whether payments came from Plan or estate assets, citing previous rulings. The court analyzed whether Bankruptcy Code §§ 326 and 330 conflicted with ERISA statutes concerning fiduciary compensation, concluding no substantive conflict existed and the Bankruptcy Code's specific compensation scheme governed. Ultimately, the court largely overruled DOL's objections and granted the fee applications for the Trustee, K & K, Witz, and Whitfield, deeming the requested amounts reasonable and compliant with the Bankruptcy Code. The awards are payable from the Plan's Pguy Account, with any shortfall covered by the Debtors' estate.

Bankruptcy LawERISAChapter 7 TrusteeFee ApplicationPlan AdministrationJurisdictionReasonable CompensationStatutory ConstructionDepartment of LaborFiduciary Duties
References
50
Case No. 07-09-00163-CV
Regular Panel Decision
Mar 12, 2010

Potter County, Texas as Plan Administrator for the Health Benefits Plan for the Employees of Potter County, Texas v. Ronda Tuckness and Michael Tuckness

Potter County, acting as the plan administrator for its employee health benefits plan, appealed an order that denied its plea to the jurisdiction. The underlying lawsuit was filed by Ronda and Michael Tuckness, seeking health care benefits after the County denied Michael Tuckness's claim for back surgery costs due to an occupational injury exclusion. The County contended it was immune from suit. The appellate court found that the County's governmental immunity had not been waived by the requests for declaratory relief, the terms of the health plan contract, or the County's conduct. Consequently, the court reversed the trial court's order and dismissed the Tucknesses' case for lack of subject-matter jurisdiction.

Governmental ImmunityImmunity WaiverDeclaratory JudgmentContract LawHealth BenefitsPlan AdministratorOccupational Sickness/InjuryJurisdictionPlea to JurisdictionInterlocutory Appeal
References
20
Case No. MISSING
Regular Panel Decision

Equal Employment Opportunity Commission v. Rappaport, Hertz, Cherson & Rosenthal, P.C.

The Equal Employment Opportunity Commission (EEOC) and Melissa Castillo brought claims of sex discrimination, retaliation, and constructive discharge against Rappaport, Hertz, Cherson & Rosenthal, P.C., William Rappaport, and Herbie Gonzalez under Title VII. Castillo sought to intervene in the EEOC's action and assert additional state and city claims, while the defendant moved to compel arbitration of Castillo's claims based on an employment arbitration agreement. The court granted Castillo's motion to intervene and permitted her state and local claims to proceed under supplemental jurisdiction. The court also granted the defendant's motion to compel arbitration for all of Castillo's claims, determining that the arbitration agreement was an employer-promulgated plan and the associated costs would not be prohibitively expensive. The EEOC's action was not stayed, as it was not a party to the arbitration agreement, but Castillo's individual proceedings were stayed pending arbitration.

Sexual HarassmentRetaliationConstructive DischargeTitle VIIArbitration AgreementInterventionEmployment DiscriminationFederal Arbitration ActSupplemental JurisdictionEEOC Enforcement Action
References
51
Case No. MISSING
Regular Panel Decision

Murphy v. Wal-Mart Associates' Group Health Plan

Hazel and Charlie Murphy sued Wal-Mart Associates’ Group Health Plan and Prudential Health Care Plan after the Plan denied coverage for Mr. Murphy's high-dose chemotherapy and autologous bone marrow transplant for Non-Hodgkin’s Lymphoma. The Murphys alleged the Wal-Mart Plan acted arbitrarily and capriciously in denying benefits and their subsequent appeal, and brought state law claims against Prudential. The court found that Wal-Mart Plan's decision was based on medical expert opinions and was not arbitrary and capricious. Furthermore, it determined that ERISA preempted all state law claims against Prudential. Consequently, the court granted summary judgment for both defendants, dismissing the plaintiffs' claims.

ERISAEmployee BenefitsHealth InsuranceSummary JudgmentArbitrary and Capricious StandardMedical NecessityHigh-Dose ChemotherapyAutologous Bone Marrow TransplantNon-Hodgkin’s LymphomaPlan Administrator Discretion
References
28
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