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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

Claim of Kessler v. Fairmont Theater, Inc.

Claimant, employed for two days in 1986 as a projectionist, sought workers' compensation benefits for psychiatric injury and eye injury. He alleged harassment from his employer and supervisor caused a nervous breakdown, and projector light injured his eyes. The Workers’ Compensation Law Judge dismissed the psychiatric injury claim but found prima facie evidence for vision impairment, remitting that part for further development. The Workers’ Compensation Board subsequently ruled against the psychiatric trauma claim, a decision supported by employer and supervisor testimony denying harassment and claimant's psychiatrist confirming prior psychiatric issues. The appellate court affirmed the Board's decision, concluding that it was based on substantial evidence and that issues of credibility are within the Board's purview.

Psychiatric InjuryNervous BreakdownEye InjuryEmployment TerminationIntoxicationHarassmentCredibilitySubstantial EvidenceWorkers' Compensation BenefitsAppellate Review
References
2
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. ADJ1279352
Regular
Nov 18, 2010

WARREN BARNA vs. PACIFIC TUBE, ST. PAUL TRAVELERS, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Subsequent Injuries Benefits Trust Fund (SIBTF) sought reconsideration of an award finding them liable for an applicant's psychiatric injury. The applicant had previously settled orthopedic claims and a cumulative trauma claim. The Appeals Board granted reconsideration to amend the original decision, adding specific findings required by Labor Code section 4751 regarding the applicant's pre-existing psychiatric disability and the compensable industrial psychiatric injury. The Board affirmed the original finding of liability against the SIBTF, while clarifying the applicant's eligibility for SIBTF benefits and addressing the issue of potential offsets.

Subsequent Injuries Benefits Trust Fundpsychiatric disabilitypre-existing disabilityindustrial injurypermanent partial disabilityLabor Code section 4751Workers' Compensation Appeals Boardreconsiderationcumulative traumaspecific injury
References
0
Case No. ADJ3135090 (SAC 0355157) ADJ6834808
Regular
Sep 12, 2019

GUY LEE vs. UOP/MCGEORGE SCHOOL OF LAW, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Workers' Compensation Appeals Board affirmed the WCJ's decision denying benefits from the Subsequent Injuries Benefits Trust Fund (SIBTF). Applicant's prior stipulation dismissing claims for sleep disturbance, sexual dysfunction, and psychiatric injury bound him from pursuing these for SIBTF benefits. Even without those dismissals, applicant's permanent disability rating for the subsequent injury, after adjustments, did not meet the 35% threshold required for SIBTF eligibility. The WCJ's finding that the industrial injury was not the predominant cause of the claimed psychiatric injury also contributed to the denial.

Subsequent Injuries Benefits Trust FundLabor Code section 4751permanent partial disabilitystipulated dismissalpredominant causepsychiatric injurybilateral carpal tunneldiminished future earning capacityWCJWorkers' Compensation Appeals Board
References
4
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. 2018-01-0404 / 25193-2018
Regular Panel Decision
Jan 28, 2019

Engstrom, Katerina v. Chattanooga Billiards Club

Katerina Engstrom sought medical benefits for bilateral knee and psychological injuries following a work-related fall in April 2018. The employer, Chattanooga Billiards Club, contested the claim, arguing the injuries were not primarily work-related. The Court determined that Engstrom would likely prevail on her claim for bilateral knee injuries, finding that the fall aggravated pre-existing conditions based on Dr. Tew's medical opinion and post-injury MRI findings. However, the Court denied her claim for psychiatric care, concluding it did not primarily arise from the compensable physical injury, citing extensive pre-existing psychiatric treatment for a military sexual assault and other non-work-related factors influencing her mental health.

Bilateral Knee InjuriesPsychological InjuryPre-existing ConditionAggravation of InjuryExpedited HearingMedical Benefits ClaimCausation DisputeSlip and Fall AccidentMajor DepressionGeneralized Anxiety Disorder
References
1
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
Jun 02, 1997

Claim of Crawford v. New York City Health & Hospital Corp.

This case concerns an appeal from a Workers’ Compensation Board decision regarding a claimant who sustained a finger injury from a hypodermic needle in 1987. After an initial workers' compensation award, the case was reopened in 1993 when the claimant asserted a claim for a consequential posttraumatic neurosis or 'AIDS reaction phobia'. The employer argued that the two-year Statute of Limitations under Workers’ Compensation Law § 28 barred the psychiatric claim. However, the Board rejected this argument and affirmed the Workers’ Compensation Law Judge's decision to address the psychiatric condition. The Appellate Division affirmed the Board's decision, ruling that Section 28 does not bar amendment of a timely claim to include consequential injuries if a relationship exists between the subsequent claim and the initial injury.

Psychiatric Injury ClaimStatute of Limitations Workers' CompConsequential Psychological InjuriesHypodermic Needle InjuryAIDS Reaction PhobiaWorkers' Compensation Board AppealSection 28 BarAmendment of Timely ClaimCausally Related Disability
References
3
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. ADJ9674255
Regular
Jul 10, 2017

YAN LIU vs. HAWAIIAN GARDENS CASINO, INSURANCE COMPANY OF THE WEST

This case concerns an applicant who alleges both orthopedic and psychiatric injuries from her employment as a casino dealer. While the Board affirmed the finding of orthopedic injury, it deferred the issue of psychiatric injury. The Board clarified that Labor Code § 4660.1(c) does not bar psychiatric claims arising directly from employment events, but it requires a medical apportionment of causation between direct psychiatric injury and injury as a consequence of physical injury. The matter was returned to the trial level for further development of the record regarding the psychiatric injury and its apportionment.

AOE/COELabor Code Section 4660.1(c)psychiatric injurycompensable consequenceviolent actsubstantial medical evidencetreating physicianQMEcontinuous traumaharassment
References
10
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