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

Case No. 03-14-00726-CV
Regular Panel Decision
Oct 30, 2014

Texas San Marcos Treatment Center, L.P. D/B/A San Marcos Treatment Center v. Veronica Payton

Texas San Marcos Treatment Center appeals the trial court's denial of its motion to dismiss Veronica Payton's health care liability claim. Payton alleged negligence after being assaulted by a patient at the treatment center. The appellant argues that the expert report provided by Dr. William H. Reid is deficient, lacking factual support and specificity concerning the standard of care, its breach, and causation, as required by Chapter 74 of the Texas Civil Practices and Remedies Code. The appellant asserts the trial court abused its discretion by finding the report adequate and requests dismissal of the claims.

Medical MalpracticeExpert ReportMotion to DismissAbuse of DiscretionStandard of CareBreach of DutyCausationHealth Care Liability ClaimPsychiatric FacilityEmployee Assault
References
25
Case No. E2014-00302-COA-R3-CV
Regular Panel Decision
Jan 30, 2015

American Heritage Apartments, Inc. v. The Hamilton County Water and Wastewater Treatment Authority, Hamilton County, Tennessee

The plaintiff, American Heritage Apartments, Inc., challenged a monthly flat charge imposed by the Hamilton County Water and Wastewater Treatment Authority (County WWTA) for sewer lateral repairs. The trial court granted summary judgment to the County WWTA, finding no private right of action under the Utility District Law of 1937 (UDL). On appeal, the Court of Appeals reversed the summary judgment, concluding the UDL was inapplicable as the County WWTA was formed under the Tennessee Water and Wastewater Treatment Authority Act (WWTA Act). The appellate court held that the WWTA Act implicitly provides a private right of action for ultra vires and contract claims. The court also affirmed the trial court's alternative ruling that class action certification for affected customers was appropriate.

Water UtilityWastewater TreatmentFlat Rate ChargeClass Action CertificationSummary Judgment ReversalPrivate Right of ActionUltra Vires ClaimGovernmental ImmunityUtility District LawWater and Wastewater Treatment Authority Act
References
48
Case No. 08-11-00264-CV
Regular Panel Decision
Oct 08, 2014

Maria G. Thompson/Luis Marioni, D.C. v. Jaime Stolar, M.D., Alivio Medical Center, Alivio Treatment Centers, P.A. and Luis Marioni, D.C./Maria G. Thompson

This multi-party appeal originated from a medical and chiropractic malpractice lawsuit filed by Maria G. Thompson against Dr. Jaime Stolar, Dr. Luis Marioni, and Alivio Medical Center and Alivio Treatment Centers, P.A. Thompson alleged negligence resulting in severe knee injuries, including infection and fusions, following injections and treatment. A jury found Dr. Stolar and Dr. Marioni negligent, awarding damages. On appeal, the court reversed the judgment against Dr. Marioni due to insufficient evidence of causation but affirmed the judgment against Dr. Stolar. The court also upheld the denial of Thompson's claims regarding damages and apparent agency against Alivio.

Medical MalpracticeChiropractic MalpracticeKnee InjuryKnee InfectionSpontaneous FusionSurgical FusionNegligenceCausationDamages AssessmentApparent Agency
References
48
Case No. MISSING
Regular Panel Decision
Jan 22, 2004

Mete v. New York State Office of Mental Retardation

This class action alleged age discrimination in employment against the New York State Office of Mental Retardation and Development Disabilities (OMRDD). Plaintiffs, former Chiefs of Developmental Center Treatment Services, claimed disparate treatment and disparate impact arising from a 1989 reduction in force (RIF) that eliminated their positions. All 46 Chiefs, who were over 40, were either demoted or retired, and statistical evidence showed a disproportionate impact on employees over 40. The Supreme Court granted defendants’ motion for summary judgment, dismissing all causes of action. The appellate court affirmed, finding that while plaintiffs established a prima facie case, OMRDD provided a legitimate, nondiscriminatory reason for the RIF (economic conditions and long-standing concerns about the position's utility), which plaintiffs failed to adequately prove was a pretext for discrimination.

Age DiscriminationClass ActionSummary JudgmentDisparate TreatmentDisparate ImpactReduction in ForceEmployment LawPretextPrima Facie CaseStatistical Evidence
References
11
Case No. MISSING
Regular Panel Decision

Claim of Evevsky v. Liberty Mutual Group

This case involves an appeal from a Workers’ Compensation Board decision regarding a claimant's unauthorized medical treatment. The claimant, who sustained neck and shoulder injuries in 1993, had her case reopened in 2001 after the employer's carrier objected to her request for authorized massage therapy. Both the Workers’ Compensation Law Judge and the Board determined that the treatment was not authorized under Workers’ Compensation Law § 13-b, as the massage therapist was not Board-authorized nor supervised by an authorized physician. The appellate court reviewed the Board's decision, affirming that there was no legal basis to overturn the finding. The court also considered and dismissed the claimant's constitutional arguments as being without merit.

Workers' CompensationMedical TreatmentMassage TherapyAuthorizationBoard DecisionAppellate ReviewStatutory InterpretationPhysician SupervisionConstitutionalityPermanent Partial Disability
References
3
Case No. MISSING
Regular Panel Decision
Sep 13, 1979

Claim of Carley v. Triborough Bridge & Tunnel Authority

The Workers’ Compensation Board filed a decision on September 13, 1979, finding that the claimant's disability after January 21, 1977, was causally related to an industrial accident on January 1, 1977. The Board also determined that the claimant's subsequent treatment at the Veterans Administration Hospital was necessary and authorized. This determination was based on Dr. Russo's testimony. The court reviewed the appeal and found substantial evidence in the record to support the Board's decision. Consequently, the decision was affirmed, with costs awarded to the Workers’ Compensation Board.

Industrial AccidentCausally Related DisabilityMedical Treatment AuthorizationWorkers' Compensation AppealBoard DecisionVeterans Administration HospitalMedical TestimonySubstantial EvidenceAffirmed Decision
References
0
Case No. ADJ2593762 (SAC 0363364)
Regular
Jul 13, 2012

RICHARD HODGE vs. DEPENDABLE HIGHWAY EXPRESS, ZURICH NORTH AMERICA INSURANCE

The Workers' Compensation Appeals Board denied reconsideration, upholding the WCJ's decision to provide psychiatric treatment. Even if the need for psychiatric treatment stems from a potentially non-compensable psychiatric injury, the employer remains liable if the treatment is reasonably required to cure or relieve the effects of a compensable industrial injury. In this case, the applicant's psychiatric treatment was deemed necessary to address cognitive impairment caused by a compensable traumatic brain injury. Therefore, the employer is liable for this treatment under established case law, regardless of the nuances of the six-month employment rule.

Labor Code section 3208.3(d)sudden and extraordinary exceptionsix-month employment rulemedical treatmentLabor Code section 4600reasonably requiredcure or relievenon-compensable injurypsychiatric treatmenttraumatic brain injury
References
6
Case No. 2023-06-4955
Regular Panel Decision
Jun 18, 2024

Kean, Carma v. NAVION BKE BELLEVUE, LLC

Navion BKE Bellevue, LLC, filed a motion for partial summary judgment, contending there was no genuine issue of material fact regarding permanent impairment from Ms. Kean’s work-related injury. After a hearing, the Court granted the motion, finding no permanent impairment. However, because the parties agreed the claim was compensable, the Court ordered Navion to provide continuing reasonable and necessary medical treatment. The Court dismissed Ms. Kean's claim for permanent disability benefits with prejudice but affirmed her entitlement to future medical benefits, the need for which must be determined at the time they are requested.

Summary JudgmentPermanent ImpairmentMedical Treatment BenefitsWorkers' Compensation Appeals BoardAdmissibility of EvidenceC-32 FormsMedical Records AdmissibilityWaiver of ObjectionCompensabilityTemporary Disability Benefits
References
6
Case No. ADJ2500591 (MON 0340362) ADJ1965867 (LBO 0302615)
Regular
May 13, 2011

Kenneth Tarvin vs. ROADWAY EXPRESS, Administered by GALLAGHER BASSET SERVICES

This case involves a lien claimant, Dr. Kenneth Webb, seeking reconsideration of a decision that limited his reimbursement for applicant Kenneth Tarvin's medical treatment. Dr. Webb argued for reimbursement for more than the allowed 24 visits, citing two separate injuries and post-surgical treatment exemptions. However, the Appeals Board denied his petition, finding insufficient substantial medical evidence to rebut the established treatment guidelines or support treatment for the cumulative trauma claim. The Board affirmed the original finding of entitlement to payment for 22 treatments at the reasonable value of services rate.

Workers' Compensation Appeals BoardPetition for ReconsiderationLien ClaimantFindings of Fact and OrderReasonable Value of Services (RVS)Labor Code 4604.5(d)(1)24 visit capIndustrial InjuryCumulative TraumaCompromise and Release (C&R)
References
8
Case No. ADJ7781676
Regular
Nov 01, 2017

TERESA HERNANDEZ vs. T K & J, INC., dba LAS PALMAS RESTAURANT, PREFERRED EMPLOYERS INSURANCE COMPANY

This case involves a lien claim by Comprehensive Outpatient Surgery Center for medical treatment provided to applicant Teresa Hernandez. The applicant sustained a complex injury in 2010, and the employer provided some treatment through Dr. Lane, an MPN physician, including surgeries. The lien claimant contended that proper MPN notice was not provided and that the applicant was therefore entitled to seek treatment outside the MPN. However, the Appeals Board denied reconsideration, finding that the lien claimant failed to demonstrate that any lack of notice resulted in a denial of reasonable medical treatment, a burden of proof established by statute. Therefore, the employer was not liable for the applicant's self-procured treatment with non-MPN providers.

MPNLien ClaimantPetition for ReconsiderationFindings and OrderMedical Provider NetworkReasonably Necessary Medical TreatmentSelf-ProcureBurden of ProofLabor CodeSB 863
References
4
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