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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

Mercury Life and Health Company v. De Leon

Mercury Life and Health Company filed an inter-pleader action to determine the proper recipient of $500 under an insurance policy issued to Gregorio Flores De Leon. De Leon, St. Francis Hospital, and Dr. Thomas G. Otto, as defendants, counter-sued, asserting the policy covered occupational injuries up to $5,000. A jury found De Leon's injury occurred in the course of his employment, leading to a judgment against Mercury Life for the hospital and medical expenses. Mercury Life appealed, contending De Leon was a borrowed employee at the time of injury, thus not covered under his original employment contract. The appellate court affirmed the trial court's judgment, finding sufficient evidence to support the jury's determination that De Leon was indeed in the course of his employment with Douglas and Young.

Insurance DisputeOccupational InjuryBorrowed Employee DoctrineMigratory Farm WorkersInterpleader ActionEmployer-Employee RelationshipJury VerdictAppellate ReviewTexas LawWorkman's Compensation Principles
References
8
Case No. 13-08-00351-CV
Regular Panel Decision
Aug 31, 2009

Mitch Burkhart and Christine Burkhart v. Sedgwick Claim Management Services, Inc. and Concentra Integrated Services, and rgv/nueces Rehabilitation D/B/A Innovative Physical and Occupational Therapy

Mitch Burkhart sustained a foot and ankle injury while training for his employer, Verizon Communications. Verizon's workers' compensation claims were administered by Sedgwick Claim Management Services, Inc., who, along with Concentra Integrated Services, arranged a Functional Capacity Evaluation (FCE) for Burkhart with RGV/Nueces Rehabilitation d/b/a Innovative Physical and Occupational Therapy. The Burkharts alleged that the FCE aggravated Mitch's injury, causing permanent damage. They sued Sedgwick, Concentra, and Innovative, claiming negligence, civil conspiracy, assault, fraud, and breach of the duty of good faith and fair dealing. The trial court dismissed the case against Innovative for an inadequate expert report and granted summary judgment to Sedgwick and Concentra, citing the exclusive remedy provision of the Texas Workers' Compensation Act. The appellate court affirmed the trial court's judgment, concluding that Mitch's aggravation injury was an 'extension injury' covered by the exclusive remedy provision of the TWCA.

Workers' CompensationFunctional Capacity EvaluationExclusive RemedyAggravation InjurySummary JudgmentMedical Expert ReportHealth Care LiabilityCivil ConspiracyBreach of Duty of Good Faith and Fair DealingTexas Court of Appeals
References
23
Case No. 10-93-224-CV
Regular Panel Decision
May 18, 1994

Subsequent Injury Fund of the State of Texas (Formerly the Second Injury Fund) v. Larry Milligan

The Subsequent Injury Fund appeals a judgment awarding Larry Milligan lifetime benefits for injuries sustained at work. Milligan suffered two ankle injuries in 1987 and a third in 1989, leading to the total loss of use of both feet. He sued the Fund for lifetime benefits after settling with the workers' compensation carrier. The jury found permanent, total loss of use of both feet. The Fund challenged its statutory liability for lifetime benefits and the court's refusal to submit a jury question on total and permanent incapacity. The appellate court affirmed, finding the first issue unpreserved and the second resolved by a statutory conclusive presumption of total and permanent incapacity for the loss of both feet.

Workers' Compensation LawSubsequent Injury FundLifetime BenefitsTotal Permanent IncapacityAnkle InjuriesStatutory InterpretationAppellate ReviewJury InstructionsConclusive PresumptionOccupational Injuries
References
6
Case No. No. 08-07-00346-CV
Regular Panel Decision
Feb 24, 2010

W.C. LaRock, D.C., P.C. D/B/A Auto & Work Injury Clinic and Maria Del Carmen Gallardo/Rosemary Smith v. Rosemary Smith/W.C. LaRock, D.C., P.C. D/B/A Auto & Work Injury Clinic and Maria Del Carmen Gallardo

Rosemary Smith, an El Paso Police Officer, sued W.C. LaRock, D.C., P.C., d/b/a Auto & Work Injury Clinic, and its employee Maria Gallardo, alleging negligence after a physical therapy session aggravated a prior back injury. The City of El Paso, Smith's worker's compensation subrogee, joined as a plaintiff. The jury found Gallardo negligent, awarding Smith $488,000, which the trial court reduced to $339,983.58. Both parties appealed. The Court of Appeals found the expert testimony on causation insufficient to establish that Gallardo's therapy proximately caused Smith's reherniation, as the expert only stated it was "possible." The court reversed the trial court's judgment.

Medical MalpracticeNegligenceCausationExpert TestimonyPhysical TherapyHerniated DiscSpinal SurgeryProximate CauseLegal SufficiencyAppeal
References
33
Case No. MISSING
Regular Panel Decision

Johnson v. Second Injury Fund

Walter Johnson, who had previously lost vision in his right eye, suffered an injury at work resulting in the loss of vision in his left eye, leaving him totally and permanently disabled. He received benefits from Texas Employer’s Insurance Association and the Second Injury Fund. Johnson and his wife then sued Texas Industries, Inc. for negligence. Both TEIA and the Second Injury Fund intervened, seeking subrogation rights. The trial court denied the Second Injury Fund's claim to subrogation, but the court of appeals reversed. The Texas Supreme Court reviewed whether the Second Injury Fund is subrogated to Walter Johnson's rights in his personal injury suit. The Court concluded that subrogation is a legislative creation and the statute funding the Second Injury Fund explicitly enumerates funding methods without including subrogation. Therefore, the Supreme Court reversed the court of appeals' judgment and affirmed the trial court's decision, denying subrogation for the Second Injury Fund.

SubrogationSecond Injury FundWorkers' CompensationStatutory InterpretationExpressio Unius Est Exclusio AlteriusTotal DisabilityPersonal InjuryTexas Supreme CourtFunding MechanismsLegislative Intent
References
9
Case No. MISSING
Regular Panel Decision

Second Injury Fund v. Martinez

Vera Martinez, an injured worker, sought compensation after a workplace injury combined with a pre-existing condition resulted in total permanent incapacity. The Industrial Accident Board initially awarded her limited compensation. Martinez appealed this decision, filing suit against her compensation carrier and, over seven months later, against the Second Injury Fund. The appellate court addressed whether the statutory 20-day period for filing suit after appealing an Industrial Accident Board decision applies to claims against the Second Injury Fund. The court held that this jurisdictional prerequisite applies, and because Martinez failed to timely file suit against the Second Injury Fund, the trial court lacked jurisdiction over the Fund. Consequently, the judgment against the Second Injury Fund was reversed.

Workers' CompensationSecond Injury FundTexas LawJurisdictionTimelinessStatutory InterpretationAppellate ProcedureIndustrial Accident BoardPermanent IncapacityPolio
References
10
Case No. MISSING
Regular Panel Decision

Second Injury Fund v. American Motorists Insurance Co.

This case addresses whether a 1971 amendment to Texas workers' compensation law (Article 8306, Sections 12c and 12c-l) permits an insurance carrier to be reimbursed from the Second Injury Fund when an employee's total and permanent incapacity results from a combination of general, rather than specific, injuries. The trial court had granted a $16,000 judgment for the carrier, American Motorist Insurance Company, but the Second Injury Fund appealed. Citing the precedent set in Second Injury Fund v. Keaton, the appellate court clarified that the 1971 amendment did not expand the fund's liability beyond specific injuries. The court emphasized that legislative intent to alter this established rule was not evident in the amendment. Consequently, the appellate court reversed the trial court's judgment, ruling against reimbursement for general injuries.

Second Injury FundWorkers' CompensationGeneral InjuriesSpecific InjuriesReimbursementStatutory InterpretationArticle 8306Vernon’s Ann.Civ.St.Appellate ReviewLegislative Intent
References
6
Case No. M2004-01683-WC-R3-CV
Regular Panel Decision
Sep 22, 2005

Larry Hopper v. Oshkosh B'Gosh And State of Tennessee, Department of Labor, Division of Workers' Compensation, Second Injury Fund

Larry Hopper, employed by OshKosh B’Gosh, sustained a back injury in 1996 and settled the workers' compensation claim for 20% vocational disability in 1997. After losing his job, he sought to reopen the settlement, filing a motion for reconsideration against the Second Injury Fund only. The trial court granted this, increasing his vocational disability by 30% and assigning liability to the Second Injury Fund. On appeal, the Special Workers’ Compensation Appeals Panel reversed the trial court's decision, finding that the Second Injury Fund's liability is limited to subsequent compensable injuries, not the initial injury for which reconsideration was sought. Therefore, Mr. Hopper’s claim against the Second Injury Fund for a first injury reconsideration was deemed to lack standing and was dismissed.

Workers' CompensationSecond Injury FundVocational DisabilityReconsideration of SettlementStatute of LimitationsSubject Matter JurisdictionAppellate ReviewStatutory ConstructionPre-existing InjuryEmployer Liability
References
11
Case No. MISSING
Regular Panel Decision

State Ex Rel. Second Injury Fund v. Mireles

Felix T. Míreles, who lost vision in one eye in childhood, suffered a second workplace injury resulting in total blindness. After receiving 100 weeks of benefits for the second injury from his employer's insurer, he sought lifetime benefits from the Second Injury Fund. The State of Texas, as trustee of the Fund, appealed a trial court judgment ordering lifetime benefits, arguing Míreles was only entitled to 301 additional weeks based on the 401-week maximum under the Workers’ Compensation Act. The appellate court examined statutory provisions, emphasizing liberal construction in favor of the employee and the legislative intent behind the Second Injury Fund to fully compensate employees with successive injuries. The court concluded that article 8306, section 12c-l, provides for lifetime benefits from the Second Injury Fund in such cases, affirming the trial court's judgment.

Workers' CompensationSecond Injury FundLifetime BenefitsStatutory InterpretationTotal Permanent IncapacitySuccessive InjuriesHandicapped EmploymentTexas LawAppellate ReviewVisual Impairment
References
6
Case No. MISSING
Regular Panel Decision

Injury Fund St. Tx. v. Conrad

This case involves Adelina Conrad, who was born without a right hand or wrist and later sustained a work-related injury to her left arm, resulting in total and permanent disability. She sought lifetime workers' compensation benefits from The Second Injury Fund of Texas, which was established to encourage the employment of handicapped workers by limiting employer liability for second injuries. The Fund appealed a jury verdict in Conrad's favor, contending that a congenital defect cannot be considered a 'previous loss' under the statute because one cannot lose what one never had. The court affirmed the trial court's judgment, interpreting 'loss or loss of use' to include congenital defects, thus allowing Conrad to receive benefits from the Fund. This decision aligns with the legislative intent to aid handicapped workers and provides a broader application of the Second Injury Fund provisions.

Workers' CompensationSecond Injury FundCongenital DefectPermanent Total DisabilityStatutory InterpretationTexas LawAppellate ReviewOccupational InjuryEmployer LiabilityLegislative Intent
References
31
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