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

Case No. 03-03-00606-CV
Regular Panel Decision
Apr 08, 2004

Robert E. Williams, Timothy David Williams, Terry Wayne Tausch, Tommy Joe Robinson, Starley Eugene Shugart, and Charles J. Giammalva v. Texas Board of Orthotics and Prosthetics Donna S. Flippin, Individually and in Her Capacity as Executive Director of the Texas Board of Orthotics and Prosthetics And Texas Department of Health

This case addresses the validity of rules established by the Texas State Board of Orthotics and Prosthetics regarding licensing exemptions under the 1997 Orthotics and Prosthetics Act. Appellants, orthotists practicing before the Act's passage, challenged the Board's denial of their licenses under 'grandfather' and 'unique qualifications' exemptions. The Board's rules required experience in manufacturing orthotic devices, which appellants contended was overly restrictive. The district court's summary judgment favoring the Board was reversed by the Court of Appeals. The appellate court ruled that the Board's definition of 'comprehensive orthotic care,' which included fabrication, contradicted the Act's intent to provide reasonable opportunities for already competent orthotists. Additionally, the 'unique qualifications' rule was deemed invalid for being redundant, as it imposed the same 'comprehensive orthotic care' standard, thus negating the distinct purpose of a second exemption pathway.

Orthotics and Prosthetics ActLicensing ExemptionsGrandfather ClauseUnique QualificationsAdministrative LawStatutory InterpretationAgency AuthorityComprehensive Orthotic CareFabrication RequirementAppellate Review
References
54
Case No. MISSING
Regular Panel Decision

Williams v. Texas State Board of Orthotics & Prosthetics

This case addresses a challenge by several orthotists (appellants) against rules established by the Texas State Board of Orthotics and Prosthetics. The appellants contested the validity of rules defining "comprehensive orthotic care" for a "grandfather" licensing exemption and "unique qualifications" for a second exemption under the new Orthotics and Prosthetics Act. They argued that the Board exceeded its statutory authority by mandating fabrication experience for the "grandfather" provision and by making the "unique qualifications" exemption redundant. The appellate court overturned the district court's summary judgment, ruling that the Board's definitions for "comprehensive orthotic care" and "unique qualifications" were invalid for not aligning with the Act's broader objectives and legislative intent.

OrthoticsProstheticsLicensing ExemptionsGrandfather ClauseAdministrative Rules ValidityStatutory InterpretationDeclaratory JudgmentSummary Judgment AppealTexas Occupational CodeAgency Authority
References
26
Case No. MISSING
Regular Panel Decision

Paisley v. Coin Device Corp.

Plaintiffs Dougal Paisley and Rohan Christie, employees of Coin Device Corporation, were terminated after being arrested for missing money, despite charges being dismissed. They subsequently filed an action against Coin Device Corporation, Biju Thomas, and Brian Gibbons, alleging malicious prosecution, wrongful termination, negligence, and loss of consortium. The Supreme Court initially denied the defendants' motion to dismiss these claims. On appeal, the higher court reversed this decision, ruling that the defendants were not liable for malicious prosecution as they merely provided information to the police, who made the arrest decision. Furthermore, the court found the wrongful termination claims invalid due to the plaintiffs' at-will employment status, and the negligence claims barred by Workers' Compensation Law, leading to the dismissal of all specified claims against the appellants.

malicious prosecutionwrongful terminationnegligenceloss of consortiumpunitive damagesat-will employmentWorkers' Compensation LawCPLR 3211appealemployer liability
References
7
Case No. 2023 NY Slip Op 00908 [213 AD3d 1117]
Regular Panel Decision
Feb 16, 2023

Matter of Petre v. Allied Devices Corp.

Claimant Gheorghe Petre appealed a decision from the Workers' Compensation Board that denied his application for reconsideration and/or full Board review. The underlying Board decision had affirmed a Workers' Compensation Law Judge's ruling, which amended the claimant's work-related injury claim and directed his doctor to seek prior authorization for Gabapentin. The Appellate Division, Third Department, reviewed the Board's denial, limiting its scope to whether the Board had abused its discretion or acted arbitrarily. Finding no new evidence, material change in condition, or improper consideration of issues by the Board, the Appellate Division affirmed the Board's decision. Thus, the claimant's appeal for reconsideration and/or full Board review was ultimately denied.

Workers' CompensationAppellate ReviewBoard DiscretionReconsiderationInjury ClaimMedical ExpensesDrug FormularyGabapentinProcedural Due ProcessAdministrative Law
References
7
Case No. ADJ854108 (OAK 0281808)
Regular
Oct 07, 2008

PATRICIA BECK vs. INTEGRATED DEVICES TECHNOLOGY, SAFETY NATIONAL CASUALTY CORPORATION, MATRIX ABSENCE MANAGEMENT, RANDSTAND, CIGA ON BEHALF OF LEGION INSURANCE IN LIQUIDATION, BROADSPIRE

This case involves an applicant who sustained an industrial injury to her left thumb, hand, and wrist while employed by both a general employer (Randstand) and a special employer (Integrated Devices Technology, IDT). The Workers' Compensation Appeals Board (WCAB) granted reconsideration to correct minor errors in the original Findings and Award, specifically regarding citations to the Insurance Code and the identification of the general employer. The WCAB affirmed the original decision that IDT's insurer, Safety National Casualty Corporation, constitutes "other insurance," thereby relieving CIGA of liability for the claim.

Workers' Compensation Appeals BoardIntegrated Devices TechnologySafety National Casualty CorporationMatrix Absence ManagementRandstandCIGALegion InsuranceBroadspirespecial employergeneral employer
References
2
Case No. MISSING
Regular Panel Decision

Kennedy v. Pine Hill Coffee Service, Inc.

Gerald Kennedy, an employee of Sahlem’s Roofing, sustained injuries after falling from a roof while working on a building owned by defendant James DeMarco and occupied by Pine Hill Coffee Services, Inc. Plaintiffs moved for partial summary judgment, arguing a violation of Labor Law § 240 (1) due to the defendants' failure to provide adequate safety equipment. Defendants contended that a co-employee acting as a 'spotter' constituted a safety device and that Kennedy was a recalcitrant worker for continuing to work when the 'spotter' left. The court rejected the argument that a human 'spotter' is a safety device under Labor Law § 240 (1), emphasizing the requirement for physical safety devices. Finding that the absence of proper safety devices was the proximate cause of Kennedy’s injuries, the court granted the plaintiffs' motion for partial summary judgment.

Labor Lawabsolute liabilityconstruction accidentfall from heightsafety devicesrecalcitrant workerproximate causeNew York Lawsummary judgmentowner liability
References
7
Case No. MISSING
Regular Panel Decision

Gallagher v. New York Post

Hugh Gallagher, an ironworker, sustained injuries after falling through an uncovered opening at a work site owned by NYP Holdings, Inc., while cutting metal decking. He and his wife sued NYP, alleging violations of Labor Law §§ 200, 240 (1), and 241 (6), specifically failure to provide safety devices. NYP contended that safety devices were available and that Gallagher's premature return to work after a prior injury was the sole proximate cause of his fall. The Supreme Court and Appellate Division initially denied summary judgment for plaintiffs, citing factual disputes regarding device availability and Gallagher's conduct. However, the Court of Appeals reversed, finding plaintiffs made a prima facie showing of a Labor Law § 240 (1) violation, and NYP failed to demonstrate that Gallagher knew of available safety devices and unreasonably chose not to use them, or that his prior injury was the sole proximate cause. The Court of Appeals granted plaintiffs' motion for partial summary judgment on liability.

Ironworker injuryConstruction accidentFall from heightLabor Law § 240 (1)Scaffolding LawSafety devicesProximate causeSummary judgmentAppellate reviewPersonal injury
References
5
Case No. SFO 0490700
Regular
Mar 26, 2008

Mercedes Abarca vs. RITZ CARLTON HALF MOON BAY

The Board granted reconsideration, amending the original award to limit the payment for the interferential muscle stimulator (IMS) device and supplies. Initially, the Administrative Law Judge found the device necessary for the entire period claimed, but upon reviewing Dr. Wolfer's note, the Board limited coverage to November 19, 2005, to January 30, 2006. This amendment reflects that the IMS device was deemed necessary for the industrial injury only during this specific timeframe.

Workers' Compensation Appeals BoardSupplemental Findings & Awardinterferential muscle stimulator (IMS device)lien claimantRS Medicalself-procured medical expenseutilization reviewsubstantial evidencePetition for ReconsiderationWCJ report and recommendation
References
0
Case No. ADJ7099047
Regular
Dec 13, 2010

NORMA GILLEY vs. CITY OF OCEANSIDE

The Workers' Compensation Appeals Board granted reconsideration of a prior decision that disallowed lien claimant Access Mediquip's claim for $17,685 in medical devices. The original ruling found that the defendant's payment to another provider for the surgery included the cost of these devices. The Board rescinded this decision and returned the case for further development of the record. The primary issue is whether the defendant's payment to the surgical facility satisfied their obligation to pay for the implanted devices, and to what extent.

Workers' Compensation Appeals BoardNorma GilleyCity of OceansideAccess MediquipLLCLien claimantMedical devicesStryker devicesMedial compartmental arthroplastyFindings and Order
References
4
Case No. ADJ5827846
Regular
May 29, 2013

TSHEA PARTNER vs. SOUTHERN CALIFORNIA EDISON

This Workers' Compensation Appeals Board case denied reconsideration of a lien claim by Pinnacle Lien Services on behalf of Access Mediquip. The applicant received spinal stimulator implants, and the lien claimant sought payment for implantable devices. The Appeals Board adopted the judge's report, which found that the charges for the implantable devices were included in the payments made to the surgery center. The court determined that the lien claimant failed to provide sufficient evidence to prove the defendant's liability for these separately itemized devices.

Petition for ReconsiderationWorkers' Compensation Appeals BoardSouthern California EdisonPinnacle Lien ServicesAccess MediquipSpinal stimulatorImplantable devicesCPT codesAmbulatory Surgery CenterDe Anza Ambulatory Surgery Center
References
1
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