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Case Law Database

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

Case No. 2016-08-0977
Regular Panel Decision
Mar 09, 2018

Smith, Stephanie v. TJ Maxx

Stephanie Smith, an employee of TJ Maxx, sought additional medical and temporary disability benefits for a foot injury sustained in July 2016. She suffered a puncture wound, but subsequent diagnoses by authorized physician Dr. John Lochemes, including a ganglion cyst and plantar fasciitis, were deemed unrelated to the work injury. TJ Maxx argued it had paid all entitled benefits and that Dr. Lochemes' causation opinion was presumed correct. The Court denied Ms. Smith's request, finding she failed to establish that the compensable injury contributed more than 50% to her medical care needs or a causal connection for additional temporary disability benefits, effectively upholding Dr. Lochemes' findings.

Workers' CompensationExpedited HearingFoot InjuryPuncture WoundMedical Benefits DeniedTemporary Disability DeniedCausation DisputeMedical OpinionOrthopedic SurgeonPlantar Fasciitis
References
2
Case No. MISSING
Regular Panel Decision
Feb 02, 1996

Doe v. United States

Plaintiffs Jane and John Doe filed an action under the Federal Tort Claims Act (FTCA) against the United States, seeking damages for injuries Jane Doe sustained after being pricked by an HIV-infected patient's needle during a phlebotomy rotation at the Buffalo Veterans’ Administration Medical Center (VAMC). The plaintiffs allege gross negligence, breach of contract, and wrongful disclosure of confidential information, claiming emotional distress and loss of consortium. The government moved to dismiss, asserting that the Federal Employees’ Compensation Act (FECA) provides the exclusive remedy, as a FECA claim for Ms. Doe's puncture wound had been accepted. The court denied the government's motion to dismiss but ordered a stay of proceedings, ruling that a substantial question exists regarding FECA's applicability and Ms. Doe's employee status, which must be definitively determined by the Secretary of Labor before the court can proceed with the FTCA claims.

Federal Tort Claims ActFederal Employees' Compensation ActSubject Matter JurisdictionSovereign ImmunityExclusive RemedyJudicial ReviewEmployee Status DisputeEmotional Distress ClaimLoss of ConsortiumMedical Negligence
References
8
Case No. MISSING
Regular Panel Decision

Castro v. New York Life Insurance

Zoila Castro, a cleaning worker, sustained a hypodermic needle puncture wound to her right thumb while working at New York Life Insurance Co.'s offices on June 22, 1989. She subsequently developed a 'generalized anxiety disorder' and 'AIDS phobia' due to the incident, leading her and her husband, Osvaldo Castro, to file a personal injury action alleging negligence by New York Life for improper disposal of hazardous medical waste. New York Life moved to dismiss the complaint and for summary judgment, arguing that fear of AIDS without reasonable certainty is not compensable and that there was no medical evidence to support the claim. The court denied both of New York Life's motions, finding that Castro's claim for mental anguish and 'AIDS Phobia' was directly tied to the incident. It concluded that a reasonable person exposed to a discarded hypodermic needle could develop such a fear, thus guaranteeing the genuineness of her claim and necessitating a trial.

Personal InjuryNegligenceHypodermic Needle InjuryAIDS PhobiaEmotional DistressSummary Judgment MotionMotion to DismissHazardous Waste DisposalCausation of InjuryGeneralized Anxiety Disorder
References
9
Case No. 02-09-00296-CR
Regular Panel Decision
Jan 26, 2012

Robert Cruz Lozano v. State

Robert Cruz Lozano appealed his murder conviction for the shooting death of his wife, Virginia Lozano, who died from a gunshot wound at their Denton residence. Lozano claimed the death was an accidental self-inflicted wound or suicide while he was at a tanning salon. However, investigators found numerous inconsistencies with his account, including lividity in the victim's body indicating she had been dead longer than Lozano claimed, and evidence suggesting the crime scene was staged with misplaced items and an excessively oiled gun. Furthermore, his affair and the existence of multiple life insurance policies on his wife provided a strong motive. The medical examiner's official finding on the manner of death remained "undetermined," acknowledging possibilities for homicide, suicide, or accident. The Court of Appeals affirmed the conviction, concluding that the cumulative force of evidence, including Lozano's inconsistent statements and implausible explanations, was legally sufficient for a rational jury to find him guilty beyond a reasonable doubt.

Murder ConvictionAppellate ReviewCircumstantial EvidenceStaged Crime SceneLividity AnalysisForensic EvidenceGlock PistolDomestic DisputeAlibi DefenseWitness Credibility
References
58
Case No. MISSING
Regular Panel Decision

Claim of Stepcic v. ADC Construction

The case involves an appeal from a Workers' Compensation Board decision denying death benefits to a claimant. The decedent, a laborer, was fatally wounded when a shotgun he removed from a dumpster from an unrelated work site discharged. The Workers' Compensation Board reversed a prior ruling that found the injury work-related, determining the death did not occur in the course of employment. The appellate court affirmed the Board's decision, concluding that the record contained substantial evidence to support the finding that the decedent's actions in handling the discarded firearm were unreasonable and completely unrelated to his employment.

Workers' CompensationScope of EmploymentPersonal ActAccidental DeathShotgun IncidentOff-Duty ConductUnrelated ActivityDecedentBoard DecisionAppellate Review
References
6
Case No. MISSING
Regular Panel Decision

Claim of Kotlarich v. Incorporated Village of Greenwood Lake

Claimant, a part-time police officer, was injured by an accidental gunshot wound from a co-worker's gun during horseplay at the police station. The Workers’ Compensation Board denied benefits, concluding that the claimant initiated the horseplay by reaching for his own gun. The court affirmed this decision, reasoning that workers' compensation coverage for injuries resulting from horseplay is limited and does not apply when the injury is precipitated by the claimant's isolated act of foolery, particularly when such conduct violates departmental regulations against the unnecessary display of weapons. The court found that the injury did not arise out of and in the course of his employment.

Workers' CompensationHorseplay InjuryPolice OfficerScope of EmploymentEmployee MisconductAccidental ShootingAffirmation of Board DecisionNew York LawInitiation of HorseplayUnnecessary Weapon Display
References
5
Case No. MISSING
Regular Panel Decision
Jul 30, 1929

Texas Employers' Ins. Ass'n v. Mitchell

This case concerns an employee, Mrs. Mitchell, who sustained an injury from an infected vaccination wound. Her employer mandated the vaccination during a smallpox epidemic, not as a public health measure, but to prevent business disruption. The court ruled that the infection constituted an accidental injury and that the employer-mandated vaccination, despite occurring off-hours and off-premises, was incidental to her employment, making the injury compensable under the Workmen's Compensation Law. The judgment was modified to award Mrs. Mitchell a lump sum of $2,680.04 with interest, affirming the compensability of her injury and overruling the appellant's arguments.

Vaccination InjuryMandatory VaccinationEmployment ScopeAccidental InfectionCompensabilityEmployer DirectiveBusiness InterestTexas Civil AppealsWage ComputationLump Sum Award
References
18
Case No. ADJ12315169
Regular
Sep 10, 2019

Gregory Williams vs. Redwood Electric Group, Travelers Property Casualty Company of America

The Appeals Board affirmed an Arbitrator's finding that an electrician's injuries, potentially from electrocution, arose out of employment. Despite the unwitnessed nature of the injury and lack of direct evidence on the precise cause, the Board applied the *Clemmens* doctrine, creating a presumption that the injury occurred in the course of employment when the employee is placed at the location by the employer. Circumstantial evidence, including entry and exit wounds and the active construction site environment, supported the industrial nature of the injury. The defendant's arguments regarding the neutral risk doctrine, burden of proof, and denial of due process were found unpersuasive or waived.

Workers' Compensation Appeals BoardRedwood Electric GroupTravelers Property Casualty Company of AmericaJourneyman Electricianupper and lower extremitiesbody systemskinkidneysheartbrain
References
2
Case No. ADJ10265190
Regular
Jun 12, 2017

HANAN MEGALLA vs. COUNTY OF SAN BERNARDINO

This case involves a worker who sustained severe injuries from gunshot wounds and sought additional physical therapy. The defendant employer argued that the request was untimely and beyond the post-surgical treatment period, and that the applicant failed to establish medical necessity. The Workers' Compensation Appeals Board denied the employer's petition for reconsideration, upholding the finding that the employer failed to timely and effectively serve the Utilization Review denial. The Board found the additional physical therapy was reasonable and necessary, and that the request fell within the permissible 24-visit limitation after the post-surgical period concluded.

Workers' Compensation Appeals BoardUtilization ReviewService of DeterminationReconsiderationMedical TreatmentFindings and AwardWCJApplicantDefendantSan Bernardino County
References
3
Case No. MISSING
Regular Panel Decision

Cortijo v. Ilfin Corp.

A decedent, employed as a building superintendent, was found dead from a 12-gauge shotgun wound on his employer's premises during working hours. The Workers' Compensation Board determined that the unexplained death, occurring on the employer's property and during working hours, raised a presumption of compensability under section 21 of the Workers' Compensation Law. This presumption led to the conclusion that the death arose out of and in the course of employment, justifying an award of death benefits to the claimant. The Board found that police testimony regarding the decedent's prior illegal activities was insufficient to rebut this statutory presumption. The appellate court affirmed the Board's decisions, finding them supported by substantial evidence.

Workers' CompensationDeath BenefitsPresumption of CompensabilityUnexplained DeathEmployment InjuryOn-Premises DeathStatutory PresumptionRebuttal of PresumptionSubstantial EvidenceAppellate Review
References
0
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