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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

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. ADJ6824732
Regular
Sep 06, 2012

SHEILA CORREIA, KENNETH BURNETT (Deceased) vs. VERIZON COMMUNICATIONS, AMERICAN HOME ASSURANCE COMPANY, CHARTIS, SEDGWICK CLAIMS MANAGEMENT SERVICES

This case concerns a deceased worker, Kenneth Burnett, diagnosed with mesothelioma due to asbestos exposure. The sole issue was determining the date of last injurious exposure to establish liability. The Workers' Compensation Appeals Board denied reconsideration of the judge's decision. The judge found the applicant's medical expert's opinion on a five to ten-year latency period to be more persuasive than the defendant's expert's twenty-year period. This led to a finding that the decedent's last injurious asbestos exposure occurred between 1996 and 2001, during his employment with Verizon.

MesotheliomaLatency PeriodAsbestos ExposureDate of Last Injurious ExposureLC §5500.5LC §5412Verizon CommunicationsSedgwick Claims Management ServicesDr. LurosDr. Raybin
References
0
Case No. ADJ2678977 (VNO 0516619) ADJ2789939 (VNO 0516618)
Regular
Jul 26, 2017

THOMAS BELLISSIMO vs. CAST & CREW ENTERTAINMENT SERVICES, INC., ZURICH NORTH AMERICA, ENTERTAINMENT PARTNERS, AIG

This case involves two insurers, Zurich and AIG, disputing liability for a worker's cumulative trauma injury. The Arbitrator initially set the liability period as July 4, 2004, to July 3, 2005, and apportioned fault based on days worked. Both insurers sought reconsideration, with AIG challenging the date of injury and allocation method, and Zurich arguing for apportionment based on exposure arduousness. The Board affirmed the Arbitrator's pro rata allocation based on days worked, but amended the liability period to June 28, 2004, to June 28, 2005, based on the last date of injurious exposure.

Labor Code section 5500.5cumulative trauma injuryliability periodapportionmentpro ratadate of injuryLabor Code section 5412disabilityinjurious exposuresuccessive employers
References
4
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. ADJ3477365 (LBO 0284280)
Regular
Mar 22, 2010

JAMES MASON vs. GARDEN GROVE UNIFIED SCHOOL DISTRICT

The Workers' Compensation Appeals Board granted reconsideration of a prior award finding an air conditioning mechanic industrially injured by asbestos exposure and determined the last date of exposure and cumulative injury period. The Board rescinded the award, returning the case to the trial level to determine the applicant's date of injury under Labor Code Section 5412, which is crucial for assessing the statute of limitations and employer liability. The WCJ must also re-evaluate the asbestos exposure evidence and potentially the applicable Permanent Disability Rating Schedule based on the corrected date of injury.

Occupational diseaseAsbestos exposureCumulative injuryStatute of limitationsDate of injuryLabor Code Section 5500.5Labor Code Section 5412Petition for ReconsiderationQualified Medical Evaluator (QME)Permanent disability
References
9
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. W2004-00283-WC-R3-CV
Regular Panel Decision
Dec 16, 2004

Denny Lee Rhodes v. Capital City Insurance Company and James Farmer, Director, Department of Labor, Second Injury Fund

The central issue in this case was whether permanent total disability benefits should begin from the date of maximum medical improvement (MMI) or the last day the employee was able to work due to the injury. The trial court determined that benefits should be paid from the last day of work, prompting the employee to appeal, contending he was totally disabled from his MMI date. He argued that he should collect benefits for the period between MMI and when he ultimately stopped working, as he only worked in a limited capacity. The Supreme Court affirmed the trial court's decision, noting that the employee continued to earn income during the disputed period. The court found no evidence presented that he was unemployable in the general workforce, thus concluding he did not meet the statutory definition of permanent total disability until he ceased working entirely.

Workers' CompensationPermanent Total DisabilityMaximum Medical ImprovementEmployabilityStatutory InterpretationHeart AttackLogging IndustrySecond Injury FundAppellate ReviewDe Novo Review
References
9
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

Claim of Carlson-Fanelli v. St. Luke's Memorial Hospital Center

Claimant, with a history of multiple chemical sensitivity, developed illness due to workplace exposure to various chemicals and fumes while working as a dietetic technician in a hospital. Her symptoms worsened significantly over time, particularly after increasing exposure in the hospital's kitchen, eventually leading her to cease employment in June 1997. Initially, the Workers’ Compensation Board found an occupational disease but later issued an amended decision recognizing it as an accidental injury, which the employer and carrier appealed. The Appellate Division affirmed the Board's amended decision, concluding there was substantial evidence that the claimant's preexisting condition was aggravated by her workplace environment. Medical testimony supported the finding that her exposure resulted in a totally disabling and permanent compensable injury.

Workers' CompensationAccidental InjuryOccupational DiseaseChemical SensitivityMultiple Chemical SensitivityPreexisting ConditionAggravation of ConditionWorkplace ExposureMedical TestimonyDisability
References
7
Case No. ADJ2146690 (VNO 0489062)
Regular
Dec 02, 2011

SHING LING CHI vs. LA TRADE-TECHNICAL COLLEGE

The Workers' Compensation Appeals Board denied the Defendant's Petition for Reconsideration, upholding the Supplemental Findings and Award. The Defendant's petition was found to misstate and present facts not in evidence, violating procedural rules. Medical evidence from AMEs Dr. Levine and Dr. Stalberg supported an industrial injury for the period of February 1999 through January 22, 2004, despite the Defendant's arguments. The Board affirmed that the applicant sustained a new period of temporary disability in 2004 due to this subsequent period of injurious exposure.

Workers' Compensation Appeals BoardReconsideration DeniedContinuous Trauma InjuryOrthopedic InjuryFibromyalgiaPsychiatric InjurySupplemental Findings and AwardPetition for ReconsiderationAdministrative Law JudgeMedical Expert Opinion
References
1
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