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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
Apr 27, 2012

China Auto Care, LLC v. China Auto Care (Caymans)

Plaintiffs China Auto Care, LLC and China Auto Care Holdings, LLC brought an action against China Auto Care (Caymans), Digisec Corporation, and the estate of Chander Oberoi, alleging various causes of action stemming from the 2011 sale of Digisec's assets. Defendants sought to dismiss the complaint and compel arbitration, citing an arbitration clause in the parties' "Business Relationship and Shareholder Agreement." The court analyzed the scope of the arbitration clause under the Federal Arbitration Act. Finding the clause to be broad, the court concluded that the plaintiffs' claims were within its scope, as they "touch matters" governed by the Shareholder Agreement. Consequently, the court granted the defendants' motion, staying the litigation and compelling arbitration.

ArbitrationShareholder AgreementCorporate DisputeMotion to CompelFederal Arbitration ActSecond Circuit PrecedentFraudulent InducementCorporate GovernanceCayman Islands LawStay of Proceedings
References
25
Case No. MISSING
Regular Panel Decision
Mar 03, 2008

Texas Mutual Insurance Co. v. Sara Care Child Care Center, Inc.

Texas Mutual Insurance Company appealed two summary judgment orders and a final judgment in favor of its insured, Sara Care Child Care Center, Inc., and employee Martha Martinez. The core issue was whether Sara Care's workers' compensation policy was extended due to Texas Mutual's alleged failure to comply with statutory cancellation notice requirements, thus covering Ms. Martinez's injury. The Workers' Compensation Commission Appeals Panel and the trial court affirmed coverage. The appellate court affirmed the trial court's judgment regarding judicial review of the Appeals Panel decision, Sara Care's common law claims (breach of contract, promissory estoppel), and the attorney's fee award. However, the court reversed and remanded the trial court's judgment on Sara Care's statutory claims (Texas Insurance Code and Texas Deceptive Trade Practices Act) and the 'knowingly' finding, stating a fact issue remained on whether coverage liability was 'reasonably clear' for these claims.

Workers' Compensation InsurancePolicy NonrenewalStatutory Notice RequirementsSummary Judgment ReviewAppellate Court DecisionBreach of ContractTexas Insurance Code ViolationsDTPA ViolationsAttorney's FeesJudicial Review
References
30
Case No. 08-08-00192-CV
Regular Panel Decision
Sep 15, 2010

Texas Mutual Insurance Company v. Sara Care Child Care Inc. and Martha Martinez

This case involves an appeal by Texas Mutual Insurance Company (TMI) against Sara Care Child Care Center, Inc. and Martha Martinez, challenging summary judgment orders and a final judgment. The core dispute revolves around workers' compensation insurance coverage for an employee's work-related injury, which TMI denied based on policy expiration. The appeals panel and trial court found TMI liable due to its failure to comply with Texas Labor Code Section 406.008 notice requirements for policy cancellation or nonrenewal, extending Sara Care's coverage. The appellate court affirmed the trial court's decision regarding TMI's judicial review petition and its liability for common law claims and attorney's fees. However, the court reversed and remanded the judgment concerning Sara Care's statutory claims under the Texas Insurance Code and the Deceptive Trade Practices Act, as a fact issue remained regarding whether TMI's coverage liability was "reasonably clear," impacting the "knowingly" finding for additional damages.

Workers' Compensation InsurancePolicy NonrenewalSummary Judgment AppealTexas Labor CodeTexas Insurance CodeDeceptive Trade Practices Act (DTPA)Breach of ContractPromissory EstoppelAttorney's FeesJudicial Review
References
30
Case No. 01-14-00767-CV
Regular Panel Decision

Shirley Lenoir, Individually and as Personal Representative of the Estate of Shana Lenoir and Christopher McKnight , Individually and as Next Friend of Nayla McKnight v. U.T. Physicians

This is a health care liability appeal where Shirley Lenoir and Christopher McKnight, individually and as representatives of the Estate of Shana Lenoir and Nayla McKnight, challenge the trial court's decision to grant U.T. Physicians' plea to the jurisdiction and motion to dismiss. The appellants allege that U.T. Physicians' negligence in treating Shana Lenoir’s twin pregnancy, specifically the administration of a medically unnecessary and contraindicated progesterone injection by Nurse Matthews, proximately caused her death. U.T. Physicians claimed sovereign immunity as a governmental unit. Appellants argue that U.T. Physicians is a private non-profit corporation and an independent contractor, not entitled to sovereign immunity, and that a waiver of immunity under the Texas Tort Claims Act was sufficiently pled due to the use of tangible physical property.

Sovereign ImmunityGovernmental UnitIndependent ContractorTexas Tort Claims ActHealth Care LiabilityMedical MalpracticeNegligenceProgesterone InjectionTwin PregnancyWrongful Death
References
16
Case No. 04-06-00417-CV
Regular Panel Decision
Jun 25, 2008

Sylvia Casas, Ind. Substantively Consolidated Bankruptcy Estates of Fountain View, Inc. as Successor to Summit Care Corporation, Summit Care Texas, L.P. D/B/A Comanche Trail Nursing Center and Summit Care Management Texas and Robert Gundling, Ind. v. Rosamarie Paradez, as the Administrator and Heir at Law of the Estate of Tranquilino Mendoza

This case involves a medical malpractice survival action initiated by Rosamarie Paradez, daughter of the deceased Tranquilino Mendoza, against Sylvia Casas, Robert Gundling, and the consolidated bankruptcy estates of Fountain View, Inc. (successor to Summit Care Corp. and Summit Care Texas, L.P., operators of Comanche Trail Nursing Center). Mendoza, an 81-year-old nursing home resident, suffered severe injuries after being beaten by a violent roommate, allegedly due to the appellants' negligence. The appellants challenged various aspects of the trial court's judgment, including the denial of new trial motions, sufficiency of damages, excessive awards, and the application of damages caps. The appellate court affirmed the trial court's judgment, upholding the damages awarded for pain, mental anguish, and physical impairment, and finding no error in the application of the damages cap or the finding of negligence against Gundling.

Medical MalpracticeNursing Home NegligencePersonal InjurySurvival ActionAppellate ReviewJury ArgumentDamages CapFactual SufficiencyMental AnguishPhysical Impairment
References
35
Case No. 14-07-00925-CV
Regular Panel Decision
Feb 24, 2009

Latoya Basey v. Davita Inc., D/B/A Total Renal Care, Nelda Boatwright and Fresenius Medical Care Holding Inc., D/B/A Fresenius Medical Care North America D/B/A Northwest Houston Dialysis, and Biomedical Applications of Texas, Inc.

Latoya Basey appealed a take-nothing summary judgment in a disability discrimination and tort case against her former employer, DaVita, Inc., and potential employer, Fresenius Medical Care Holding, Inc. Basey claimed DaVita fired her after a work-related back injury and that Fresenius refused to hire her due to her injury and prior discrimination charge. The trial court granted summary judgment without specifying grounds. The appellate court affirmed, finding Basey failed to provide evidence of disability for her discrimination and failure-to-accommodate claims, and lacked evidence of causation for her retaliation claims.

Disability DiscriminationRetaliationSummary JudgmentWorkers' CompensationEmployment LawCausal LinkTexas Court of AppealsADAFailure to AccommodateEmployment Termination
References
11
Case No. 2022-08-0687
Regular Panel Decision
Nov 18, 2025

McCool, Martha v. Professional Care Services

Martha McCool, a psychiatric nurse practitioner for Professional Care Services, was injured in 2019 after being attacked by a patient, leading to multiple surgeries and PTSD. A 2023 settlement agreement allowed for future medical expenses. In 2024, her authorized treating physician, Dr. Dan Shell, recommended reconstructive surgery. The employer authorized the surgery but denied McCool's request for a second surgical opinion. The trial court initially ordered the employer to authorize the second opinion and awarded attorney's fees, but later denied the fees. The Tennessee Workers' Compensation Appeals Board affirmed the order compelling the employer to authorize and pay for a second opinion, interpreting the relevant statute to mean an employee is entitled to a second opinion when surgery is recommended, regardless of whether the treating physician ordered it. The Board also reversed the denial of attorney's fees, modifying the trial court's judgment to award McCool's attorney $10,150.00.

Second OpinionSurgical RecommendationAttorney's FeesMedical ExpensesWorkers' Compensation LawStatutory InterpretationCompensable InjuryEmployer ObligationsEmployee RightsAppellate Review
References
15
Case No. ADJ7422993
Regular
Apr 06, 2015

SHIRLEY LESCALLETT vs. WAL-MART, ACE AMERICAN INSURANCE, YORK RISK SERVICES

In this workers' compensation case, the applicant sought to select a pain management specialist as her primary treating physician. The employer's Medical Provider Network (MPN) did not have any pain management specialists within the 15-mile/30-minute access standard for primary physicians, though it did have specialists within a 30-mile/60-minute radius. The Appeals Board affirmed the WCJ's decision, holding that if an applicant chooses a specialist for their primary care, the MPN must provide at least three physicians of that specialty within a 15-mile/30-minute radius. Since the defendant's MPN failed to meet this standard for pain management specialists, the applicant was permitted to choose one outside the MPN. A dissenting opinion argued that the 30-mile/60-minute standard for specialists should apply, allowing the applicant to select a physician within that broader radius from the MPN.

MPNMedical Provider NetworkPrimary Treating PhysicianSpecialistAccess StandardsAdministrative Director's RulePain Management PhysicianGeographic RadiusLabor CodeWorkers' Compensation Appeals Board
References
3
Case No. 2019 NY Slip Op 05756 [175 AD3d 134]
Regular Panel Decision
Jul 23, 2019

Matter of People Care Inc. v. City of New York Human Resources Admin.

The New York Appellate Division, First Department, affirmed the Supreme Court's decision, which annulled the Human Resources Administration's (HRA) demand to recoup approximately $7 million in Health Care Reform Act (HCRA) funds from People Care Incorporated. The core issue was whether HRA possessed the authority to audit and recover these HCRA funds, established as a distinct Medicaid reimbursement program for worker recruitment and retention, from personal care service providers. The Court found that neither Public Health Law § 2807-v (1) (bb) nor the Memorandum of Understanding between the Department of Health (DOH) and HRA delegated such auditing and recoupment powers to HRA. It rejected HRA's arguments that HCRA funds were merely a subset of general Medicaid funds subject to its existing contractual audit authority, or that DOH's actions constituted ratification of HRA's authority. Consequently, the Court upheld the injunction preventing HRA from recouping the disputed HCRA funds from People Care.

Administrative LawMedicaid ReimbursementAuditing AuthorityStatutory ConstructionInter-agency AgreementsHealthcare Reform ActPersonal Care ServicesGovernment ContractsCPLR Article 78Delegation of Power
References
8
Case No. 2018-06-0451
Regular Panel Decision
Dec 16, 2019

Adiole v. Logan Senior Care, LLC

The employee, Vera Adiole, alleged a work-related low back injury and aggravation of a pre-existing hip condition from an accident at Logan Senior Care, LLC. After receiving authorized treatment, she sought additional medical care. The employer filed a motion for summary judgment, supported by opinions from three physicians, while the employee submitted a sworn declaration from a physician's assistant to establish causation. The trial court granted the employer's motion, concluding that the employee's evidence was insufficient. The Appeals Board affirmed the trial court's decision, ruling that a physician's assistant is not qualified to offer expert opinion on medical causation and that the submitted opinions did not meet the statutory causation standards, thereby certifying the order as final.

Appellate ReviewSummary Judgment RulingMedical Expert OpinionPhysician Assistant QualificationsCausation in Workers' CompLumbar Back PainHip Arthritis AggravationPre-existing Medical ConditionBurden of ProofTennessee Legal Precedent
References
3
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