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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

Clear Water Psychological Services PC v. American Transit Insurance Co.

Plaintiff Clear Water Psychological Services PC sought no-fault benefits from defendant American Transit Insurance Company. The plaintiff moved for summary judgment, while the defendant cross-moved for a 90-day stay, arguing that the assignor, Oshane Crooks, was acting as an employee at the time of the November 10, 2014 automobile accident, falling under Workers’ Compensation Board jurisdiction. A key issue was the admissibility of an uncertified police accident report (MV-104AN) which suggested the assignor was driving a taxi. The court ruled the uncertified report inadmissible under CPLR 4518 (c) for authentication reasons, despite the officer's personal observations. However, acknowledging the unresolved factual question of the assignor’s employment status and the Workers’ Compensation Board's primary jurisdiction, the court granted the defendant’s motion, staying the action for 90 days for a Workers’ Compensation Law applicability determination.

No-fault benefitsSummary judgmentStay of actionWorkers' CompensationPolice accident reportAdmissibility of evidenceCPLR 4518Vehicle and Traffic LawPrimary jurisdictionEmployment status
References
12
Case No. 2015-455 K C
Regular Panel Decision
Dec 19, 2017

Metro Psychological Servs., P.C. v. Travelers Prop. & Cas. Ins. Co.

This case involves Metro Psychological Services, P.C., as an assignee, seeking first-party no-fault benefits from Travelers Property & Casualty Insurance Company. The defendant moved for summary judgment, arguing the assignor's injuries occurred during employment, which would make workers' compensation benefits applicable. The Civil Court denied the defendant's motion and granted the plaintiff's cross-motion for summary judgment. The Appellate Term reversed this order, concluding there was an unresolved issue as to whether the plaintiff's assignor was acting in the course of employment at the time of the accident. Consequently, the matter was remitted to the Civil Court to be held in abeyance, pending a determination by the Workers' Compensation Board regarding the parties' rights under the Workers' Compensation Law, underscoring the Board's primary jurisdiction in such matters.

No-Fault BenefitsWorkers' Compensation LawPrimary JurisdictionAbeyanceSummary JudgmentAppellate ReviewInsurance DisputeMedical ProviderAssigneeCourse of Employment
References
9
Case No. 2021 NY Slip Op 04626 [197 AD3d 518]
Regular Panel Decision
Aug 04, 2021

D. S. v. Positive Behavior Support Consulting & Psychological Resources, P.C.

This case involves an appeal by the Port Jefferson School District from an order denying its motion to dismiss a personal injury complaint. The infant plaintiff, a special education student, was allegedly injured by a therapist, Vito Silecchia, during a behavioral therapy session. The plaintiffs sued the School District, among others, alleging Silecchia was an employee or agent. The District contended Silecchia was an independent contractor retained through Positive Behavior Support Consulting and Psychological Resources, P.C. The Appellate Division affirmed the Supreme Court's denial of the dismissal motion, stating that the complaint adequately stated a cause of action and that documentary evidence did not conclusively establish an independent contractor relationship, given provisions in the agreement suggesting the District maintained some control over the services.

Personal InjuryRespondeat SuperiorIndependent ContractorMotion to DismissAppellate ReviewVicarious LiabilitySchool District LiabilitySpecial EducationTherapist NegligenceCPLR 3211 (a) (1)
References
25
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. OAK 216926 OAK 207971
Regular
Jun 27, 2008

JAMES SHERRY vs. CONNELLEY'S FINE FURNITURE, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board denied reconsideration of a finding of 100% permanent disability for applicant James Sherry. Although the Board found the presumption of total disability under Labor Code section 4662(d) inapplicable, they affirmed the 100% permanent disability award based on vocational evidence and medical opinions regarding the applicant's severe psychological impairments and constant headaches. The Board also determined that the defendant failed to establish apportionment to a prior disability award, as the current psychological impairments were solely attributed to the industrial injuries.

Workers' Compensation Appeals BoardConnelley's Fine FurnitureState Compensation Insurance FundOAK 216926OAK 207971Opinion and Order Denying Reconsiderationindustrial injurieskneesnecklow back
References
2
Case No. MISSING
Regular Panel Decision

In re Michael M.

The Commissioner of Social Services initiated a proceeding against Leonard M. and Mrs. M. (the mother) alleging sexual abuse of their sons, Michael and Dennis, neglect due to domestic violence, and educational neglect. The court dismissed the sexual abuse allegations against the father, finding insufficient evidence of sexual intent and noting potential influence from the mother's psychological issues. However, the court sustained findings of neglect against the father for exposing the children to consistent domestic violence, causing emotional and psychological impairment. Neglect was also sustained against the mother due to her mental impairment, which hindered her ability to care for the children's best interests, and against both parents for educational neglect resulting from the children's excessive school absences.

References
3
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. 10-06-00338-CV
Regular Panel Decision
May 21, 2008

State Office of Risk Management v. Carolyn Larkins

This workers' compensation case involved Carolyn Larkins, an employee who sustained psychological injuries after an on-the-job assault. The trial court reversed an administrative decision, finding Larkins's psychological conditions compensable and assigning a 70% impairment rating. The State Office of Risk Management appealed, arguing a lack of legally sufficient evidence, specifically that expert testimony was required to link her psychological disorders to the injury. The appellate court agreed, stating that medical records alone were insufficient to establish causation within reasonable medical probability for complex psychological conditions like depression, anxiety, and post-traumatic stress disorder. Consequently, the appellate court reversed the trial court's judgment and remanded the case for a new trial.

Workers' CompensationExpert TestimonyCausationPsychological InjuryLegal SufficiencyMedical RecordsAppellate ReviewRemandTexas LawMental Health
References
21
Case No. 2016-01-0139
Regular Panel Decision
Mar 03, 2023

Brown, Binnie v, Whole Foods Markets, Inc.

Bonnie Brown, an employee of Whole Foods, sought psychiatric evaluation for impairment and ongoing treatment for a mental injury allegedly stemming from a 2015 spinal injury. Whole Foods opposed, arguing a lack of authorized referral and unproven work-relatedness of the mental injury. The Court acknowledged the problem of obtaining mental impairment assessments when only non-physician providers (psychologists) have been authorized, citing Tennessee law that limits impairment ratings to physicians. Consequently, the Court found no mechanism to compel Whole Foods to provide a psychiatrist panel solely for impairment assessment. However, based on Ms. Brown's credible testimony and corroborating medical records, the Court ruled that she would likely prevail in establishing her need for ongoing psychological care. The Court ordered Whole Foods to authorize Ms. Brown to return to Dr. Henriksen or provide a panel of psychologists/psychiatrists for assessment of her need for ongoing care and/or referral.

Mental injuryWorkers' CompensationPsychological evaluationChronic painDepressionAnxietyCausationImpairment ratingPsychiatric referralAuthorized treatment
References
4
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