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

Case No. NO. 03-06-00631-CV
Regular Panel Decision
Mar 26, 2009

Samuel Campos v. Texas Property & Casualty Insurance Guaranty Association for Reliance National Indemnity Company, an Impaired Carrier

Samuel Campos, an employee, was injured on the job, leading to disputes over his impairment rating and reimbursement for travel expenses. The Texas Workers’ Compensation Commission affirmed a designated doctor's 6% impairment rating and denied travel expenses, which Campos challenged in court. The case involved the Texas Property & Casualty Insurance Guaranty Association (TPCIGA) because Campos's employer's insurer became impaired. Initially filed in Winkler County, the case was transferred to Travis County, where TPCIGA was granted summary judgment. The Third District Court of Appeals reversed the summary judgment, ruling that the Workers' Compensation Act's specific mandatory venue provision, which places venue in the county of the employee's residence at the time of injury (Winkler County), overrides the Guaranty Act's general venue provision, which would place it in Travis County. The court remanded the case with instructions to transfer it to Winkler County.

Workers' CompensationVenue DisputeMandatory VenueStatutory ConstructionTexas Labor CodeTexas Insurance CodeImpairment RatingTravel Expenses ReimbursementJudicial ReviewAppellate Procedure
References
12
Case No. MISSING
Regular Panel Decision

the Claim of Brigandi v. Town & Country Linoleum & Carpet

This case involves an appeal by an employer and its compensation carrier against decisions made by the Workers’ Compensation Board. The decedent, a carpet layer, died from cardiac arrest during work, with an autopsy revealing underlying coronary atherosclerotic disease. His widow was awarded death benefits. The employer’s carrier sought reimbursement from the Special Disability Fund under Workers’ Compensation Law § 15 (8), asserting a preexisting permanent physical impairment. However, the Board determined that there was no evidence that the decedent’s heart condition hindered his job potential before his death, thus releasing the Special Disability Fund from liability and holding the compensation carrier responsible. The employer's subsequent application for reconsideration was denied by the Board, leading to these appeals. The appellate court affirmed the Board's decisions, concluding that the Board rationally found no proof that the decedent's heart disease impaired his job potential, a necessary condition for reimbursement under WCL § 15 (8) (d).

Special Disability FundPreexisting Permanent ImpairmentCardiac ArrestCoronary Atherosclerotic DiseaseDeath Benefits ClaimEmployer ReimbursementCarrier LiabilityBoard Decision ReviewAppellate AffirmationMedical Evidence Interpretation
References
2
Case No. MISSING
Regular Panel Decision

Claim of Rosa v. Britt Fast Freight, Inc.

A truck driver's husband suffered a fatal heart attack during employment. His employer and its workers' compensation carrier sought reimbursement from the Special Disability Fund, arguing that a preexisting heart condition contributed to his death. The Workers' Compensation Board discharged the Fund, finding no evidence that the preexisting condition hindered the decedent's employment potential. The employer and carrier appealed this decision. The Appellate Division affirmed the Board's decision, holding that Workers' Compensation Law § 15 (8) requires more than just the preexisting impairment contributing to death; it must also be shown that the impairment hindered job potential.

Workers' CompensationSpecial Disability FundPreexisting ConditionHeart DiseaseFatal AccidentEmployment HindranceReimbursementAppellate ReviewBoard DecisionStatutory Interpretation
References
2
Case No. MISSING
Regular Panel Decision
Oct 08, 1986

Claim of Fischer v. Princess Ribbon Corp.

The Special Disability Fund appealed a Workers’ Compensation Board decision, which found the employer and its insurance carrier eligible for reimbursement under Workers’ Compensation Law § 15 (8) for death benefits paid to the claimant’s widow and minor child. The Fund argued that the employer lacked knowledge of the claimant's preexisting permanent physical impairment, a requirement for reimbursement, and also contested the necessity for an 'informed decision' by the employer. The court found substantial evidence supporting the Board’s conclusion that the employer's secretary/treasurer had knowledge and a good-faith belief in the impairment’s permanency. Additionally, the Fund contended that the Board failed to address the contribution of the preexisting impairment to the claimant's death and that the record lacked supporting evidence for such a finding. The court affirmed the Board's decision, stating that the Board had addressed the contribution issue and that substantial evidence in the record supported its conclusion.

Workers' CompensationSpecial Disability FundReimbursementPreexisting Permanent Physical ImpairmentEmployer KnowledgeWorkers' Compensation Law § 15 (8)Death BenefitsAppellate ReviewSubstantial EvidenceRetroactive Effect of Amendment
References
4
Case No. 03-06-00404-CV
Regular Panel Decision
Mar 06, 2007

Johnnie M. Charles v. Texas Property and Casualty Insurance Guaranty Association, on Behalf of Phico Insurance Company, an Impaired Carrier

This case involves a restricted appeal filed by Johnnie M. Charles from a trial court's order dismissing her cause without prejudice. Charles initially appealed a Texas Workers' Compensation Commission decision regarding her impairment rating. After a venue transfer to Travis County, her case was dismissed for failure to pay filing fees. A nunc pro tunc order was later issued to correct a clerical error in the cause number of the original dismissal order. Charles appealed, citing errors in the dismissal, the lack of a court reporter, and the original hearing. The appellate court affirmed the dismissal, ruling that Charles's challenges to the original dismissal were untimely and that no error occurred in the nunc pro tunc order, which merely corrected a clerical error without altering the original judgment's substance.

restricted appealdismissal without prejudicenunc pro tunc orderclerical errorwant of prosecutionappellate jurisdictiontimeliness of appealTexas Rules of Civil ProcedureTexas Rules of Appellate Procedureworkers' compensation
References
13
Case No. MISSING
Regular Panel Decision
Jan 14, 2012

Claim of Murphy v. Riverside Gas & Oil

Claimant, an oil truck driver, sought workers' compensation benefits for right shoulder and rotator cuff pain sustained over years of work, with a date of injury in 1998 and disability in 2004. The employer and its carrier sought reimbursement from the Special Disability Fund under Workers' Compensation Law § 15 (8) due to a preexisting shoulder impairment. The Workers’ Compensation Board initially granted the employer's application, but the Special Disability Fund appealed this decision. The appellate court reversed the Board's decision, finding insufficient evidence to prove that the claimant's subsequent work-related injury was a separable condition and not merely a progression of the preexisting impairment. The case was remitted to the Workers’ Compensation Board for further development of the record.

Workers' CompensationSpecial Disability FundReimbursementPreexisting ConditionRotator Cuff InjuryShoulder PainMedical Expert TestimonyPermanent ImpairmentWork-Related InjuryAppellate Review
References
4
Case No. MISSING
Regular Panel Decision

Claim of Regeiro v. Harbor Distributing Corp.

Decedent, an employee of Harbor Distributing Corporation, sustained back and leg injuries in May 1985, leading to permanent disability and workers' compensation benefits. Subsequently, he was diagnosed with metastatic adenocarcinoma, which rapidly progressed and resulted in his death. His widow's claim for death benefits was granted, establishing a causal link between the death and the accident. The employer then sought reimbursement from the Special Funds Conservation Committee (Fund) under Workers' Compensation Law § 15 (8) (e). However, both the Workers' Compensation Law Judge and the Board discharged the Fund, finding no evidence of a preexisting permanent physical impairment, a decision the employer appealed. The appellate court reversed, holding that the Fund could not relitigate the existence of a preexisting permanent impairment, and remitted the case for further proceedings.

Workers' CompensationPermanent DisabilityDeath BenefitsCausationPreexisting ConditionSpecial FundsReimbursementAppellate ReviewCancerMetastatic Adenocarcinoma
References
5
Case No. MISSING
Regular Panel Decision

Claim of Torres v. Kaufman's Bakery

A claimant, a machine operator and supervisor, developed bilateral carpal tunnel syndrome and flexor tenosynovitis, and separately, a back injury. His claim for workers’ compensation benefits for the carpal tunnel syndrome was established, and he was classified with a permanent partial disability. The employer and its workers’ compensation carrier sought reimbursement from the Special Disability Fund, arguing the 2004 back injury constituted a preexisting permanent impairment hindering job potential. The Workers’ Compensation Board granted the application for reimbursement, leading the Fund to appeal this decision. The appellate court found substantial evidence to support the Board's determination that the claimant's back injury was indeed a preexisting permanent physical impairment which was likely to hinder employment, thus upholding the Board's decision.

Workers' CompensationSpecial Disability FundReimbursement ClaimPermanent Partial DisabilityPreexisting Permanent ImpairmentCarpal Tunnel SyndromeBack InjuryHindrance to EmploymentMaterially and Substantially Greater DisabilityAppellate Review
References
7
Case No. 03-08-00483-CV
Regular Panel Decision
Mar 19, 2010

Texas Property and Casualty Insurance Guaranty Association for Reliance National Insurance Company, an Impaired Company v. Doris J. Toberny

Doris J. Toberny, an exhibit decorator, injured her back on the job in May 2000, leading to spinal-fusion surgery that also corrected pre-existing scoliosis. Initially, her employer's insurer, Texas Property and Casualty Insurance Guaranty Association for Reliance National Insurance Company ('the Company'), paid for the surgery. However, in December 2001, the Company disputed the claim, asserting the injury was only a lower back strain and not the cause of her scoliosis. After a designated doctor assigned Toberny a 25-percent impairment rating in 2002, the Company paid supplemental income benefits for eight quarters. Three years later, in September 2005, the Company sought to dispute her impairment rating and discontinue benefits, claiming her pre-existing conditions were not compensable. The Division of Workers’ Compensation and the district court found that the Company had waived its right to contest the impairment rating under former rule 130.102(g) due to late dispute filing, and affirmed Toberny's 25-percent impairment rating and entitlement to benefits. The Texas Court of Appeals affirmed the trial court's judgment, upholding the validity of rule 130.102(g) and the finding of waiver, thus confirming Toberny's impairment rating and attorney's fees.

Workers' CompensationImpairment Rating DisputeSupplemental Income BenefitsWaiver DoctrineCompensability of InjuryExtent of InjuryJudicial Review of Agency DecisionTexas Appeals CourtAdministrative Rule ValidityMaximum Medical Improvement
References
12
Case No. 2016-03-0413
Regular Panel Decision
Oct 05, 2017

Dodson, Deborah v. LHC Group

Deborah Dodson, an employee of LHC Group, injured her left ankle and right knee in May 2015. She underwent knee surgery and was placed at maximum medical improvement by Dr. Johnson. She later developed small fiber neuropathy, and despite a referral, faced difficulties obtaining a neurologic impairment evaluation. The Court granted Ms. Dodson's request for a neurologic impairment evaluation, either by Dr. Butler or another neurologist, referring Dr. Butler to the Penalty Program for failure to provide an impairment opinion. However, the Court denied her claim for additional temporary total disability benefits, finding she reached MMI on March 23, 2017, when Dr. Butler ceased active treatment.

Workers' CompensationNeurologic Impairment EvaluationTemporary Total Disability BenefitsMaximum Medical ImprovementSmall Fiber NeuropathyPain ManagementExpedited HearingMedical TreatmentImpairment RatingPenalty Program
References
3
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