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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. ADJ7927652
Regular
Oct 25, 2016

Bozenna Kasperowicz vs. Metropolitan State Hospital, State Compensation Insurance Fund

This case involves an industrial injury to the applicant, a psychiatric technician, sustained on June 14, 2011, from a patient strike to the head. The Workers' Compensation Appeals Board (WCAB) granted reconsideration to address disputes over psychiatric impairment and a sleep disorder rating. The WCAB affirmed the original award but reduced the permanent disability rating from 76% to 70% by excluding the sleep dysfunction impairment. The WCAB found Dr. O'Brien's opinion on psychiatric impairment more persuasive than conflicting medical evaluations and determined Dr. Matos's opinion on sleep impairment lacked substantial medical evidence due to staleness.

WCABReconsiderationPsychiatric ImpairmentWhole Person ImpairmentGAF ScoreSleep DisorderSubstantial Medical EvidencePermanent DisabilityQualified Medical EvaluatorInsomnia
References
0
Case No. 2020 NY Slip Op 06424 [188 AD3d 1381]
Regular Panel Decision
Nov 12, 2020

Matter of Hluska v. Central New York Psychiatric Ctr.

Claimant Kevin Hluska, who previously received a 13% schedule loss of use (SLU) award for his left arm due to a 2016 shoulder injury, sustained a new work-related injury to his left elbow in 2017. His physician determined this new injury resulted in a 10% SLU of the left arm. The Workers' Compensation Law Judge and the Workers' Compensation Board ruled that claimant was not entitled to a further SLU award for the elbow injury because the previous SLU award for the same arm exceeded the current impairment. The Appellate Division, Third Department, affirmed this decision, citing Workers' Compensation Law § 15 (3), which limits SLU awards for permanent impairments to specific body parts and allows for multiple awards only if for more than one member or parts of more than one member, but the total award for a member is capped.

Schedule Loss of UseSLU AwardLeft Arm InjuryElbow InjuryShoulder InjuryWorkers' Compensation Board DecisionAppellate Division Third DepartmentPermanent ImpairmentPrior AwardSubsequent Injury
References
4
Case No. 03-00-00766-CV
Regular Panel Decision
Feb 28, 2002

Jacqueline Tomhave v. the Oaks Psychiatric Hospital, Inc.

Jacqueline Tomhave, a therapist, was terminated by The Oaks Psychiatric Hospital after inquiring about an alleged inappropriate relationship between an employee and a juvenile resident. She claimed whistleblower protection under the Texas Health & Safety Code, asserting a causal link between her report and termination. The hospital moved for summary judgment, arguing Tomhave was fired for violating various policies and procedures concerning the juvenile's treatment and discharge. This dissenting opinion contends that Tomhave failed to present sufficient evidence to rebut the hospital's legitimate, non-retaliatory reasons, arguing that temporal proximity and subjective belief alone are insufficient. The dissent concludes that the trial court correctly granted summary judgment in the hospital's favor.

Whistleblower ActRetaliatory DischargeSummary JudgmentEmployment LawMental Health FacilityPolicy ViolationsTherapist TerminationTravis CountyTexas Court of AppealsCausation Element
References
24
Case No. MISSING
Regular Panel Decision

Mott v. Central New York Psychiatric Center

The claimant, a guard at a state-run psychiatric center, suffered a work-related injury and received workers’ compensation benefits. During his disability, he used personal leave time for which he received full wages. The employer sought reimbursement for these advance payments, but the Workers’ Compensation Board denied reimbursement for the personal leave portion. The Appellate Division reversed this decision, differentiating personal leave from sick leave by noting that personal leave could not be accrued or converted, thus not conferring a permanent benefit to the employer or a detriment to the claimant. The court concluded that denying reimbursement would result in the claimant receiving both full wages and compensation for the same period, a disfavored outcome, and therefore, reimbursement should be granted.

ReimbursementAdvance PaymentsPersonal LeaveSick LeaveWorkers' Compensation BenefitsDisabilityEmployer ReimbursementDisproportionate ResultAppellate DivisionNew York
References
9
Case No. MISSING
Regular Panel Decision

Kevin M. v. South Beach Psychiatric Center

Kevin M. was arrested for stalking Grammy-winning singer Robyn Fenty (Rihanna) after sending her hundreds of delusional letters and frequently appearing near her Manhattan apartment. Found unfit to stand trial, he was civilly committed to South Beach Psychiatric Center (SBPC). During a subsequent hearing, medical experts testified to his severe psychotic disorder, continuous delusions, and assessment as a danger to himself and others. The court denied Kevin M.'s application for release, finding existing Mental Hygiene Law inadequate to protect Ms. Fenty. Exercising its general equity jurisdiction, the court issued a permanent injunction and an order of protection, prohibiting Kevin M. from any contact with Ms. Fenty or her properties, and allowing for immediate arrest if violated, addressing perceived gaps in New York law concerning dangerously mentally ill individuals with specific targets.

StalkingMental IllnessInvoluntary CommitmentOrder of ProtectionPermanent InjunctionPsychotic DisorderPublic SafetyCriminal Procedure LawMental Hygiene LawEquity Jurisdiction
References
23
Case No. MISSING
Regular Panel Decision

Claim of Regenbogen v. New York State Willard Psychiatric Center

The case involves an appeal regarding a workers' compensation claim for mental injury filed by a former employee of Willard Psychiatric Center, who later worked for the Workers’ Compensation Board. The claim, initially found compensable, faced jurisdictional challenges after a March 1997 amendment to Workers’ Compensation Law § 20 (2) (a) mandated neutral arbitration for Board employees' claims pending on or after its effective date. The court found that the Workers’ Compensation Board lacked jurisdiction to issue its June 1997 amended decision because the claim was still 'pending' after the amendment's effective date. Consequently, the court reversed the Board's decisions and remitted the entire matter for arbitration, emphasizing that the legislative intent was to remove any appearance of partiality in such claims.

Workers' Compensation BoardJurisdictional DisputeRetroactive Application of LawStatutory AmendmentArbitration MandateMental Stress ClaimAppellate ProcedurePending ClaimsBoard Employee ClaimsAdministrative Law
References
5
Case No. MISSING
Regular Panel Decision

Claim of Keser v. New York State Elmira Psychiatric Center

This case addresses whether late payment penalty provisions of Workers’ Compensation Law § 25 (3) (f) apply to reimbursements made by an employer’s compensation carrier for wages paid during an employee's disability, and if so, whether they apply when reimbursement is in a form other than monetary payment to the employee. The Court affirmed the Appellate Division's decision, answering both questions in the affirmative. A 20% penalty was upheld against the State Insurance Fund for late reimbursement to the New York State Elmira Psychiatric Center, the employer of claimant Peter Keser. The ruling emphasizes that for penalty purposes, no distinction should be made between awards payable directly to claimants and those payable to an employer as reimbursement, and the mechanics of payment (e.g., accounting credit) do not alter the need for timely compliance with award terms, promoting prompt payment of workers' compensation benefits.

Workers' CompensationLate Payment PenaltyEmployer ReimbursementDisability BenefitsStatutory InterpretationSection 25(3)(f)Compensation DefinitionCarrier LiabilityPrompt PaymentAccrued Leave
References
6
Case No. 2020 NY Slip Op 04221 [185 AD3d 1342]
Regular Panel Decision
Jul 23, 2020

Matter of Kleban v. Central NY Psychiatric Ctr.

Claimant Derek Kleban sustained a right shoulder injury in 2013, for which he received a 28.75% schedule loss of use (SLU) award for his right arm. In 2017, he suffered a work-related injury to his right elbow, with his physician finding a 20% SLU of the right elbow. The Workers' Compensation Law Judge and subsequently the Workers' Compensation Board ruled that claimant was not entitled to a further SLU award for the elbow injury because the prior SLU award for the right arm exceeded the current 20% SLU. The Appellate Division, Third Department, affirmed this decision, citing Workers' Compensation Law § 15 (3) and prior precedents, which limit SLU awards based on the injured body member and degree of impairment, and allow multiple awards only for loss of use of more than one member or parts thereof, but not when a subsequent injury to a part of a previously awarded larger member results in a lower SLU.

Schedule Loss of Use (SLU)Workers' Compensation BenefitsRight Shoulder InjuryRight Elbow InjuryImpairment RatingPrior AwardSubsequent InjuryAppellate DecisionAffirmationWorkers' Compensation Board
References
4
Case No. 2020 NY Slip Op 05264
Regular Panel Decision
Oct 01, 2020

Matter of Rickard v. Central New York Psychiatric Ctr.

Claimant James Rickard suffered a work-related injury to his left knee while restraining a patient. An orthopedist determined he sustained a 17.5% schedule loss of use (SLU) of his left leg, specifically 7.5% for loss of extension and 10% for chondromalacia. The workers' compensation carrier sought credit for a prior 10% SLU award to the same left leg stemming from a 2015 hip injury. Both the Workers' Compensation Law Judge and the Workers' Compensation Board affirmed this credit, resulting in a 7.5% SLU award for the current injury. The Appellate Division, Third Department, affirmed the Board's decision, holding that prior SLU awards for the same body member should be credited against subsequent awards, as all impairments to separate parts of a member are encompassed by the overall SLU award for that member.

Workers' CompensationSchedule Loss of UseLeft Leg InjuryPrior Injury CreditMaximum Medical ImprovementChondromalaciaKnee InjuryHip InjuryAppellate Division DecisionCredit Application
References
4
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