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

Case No. 2015-01-0281
Regular Panel Decision
Mar 19, 2018

Tucker, David E. v. Star Transportation

David Tucker, an employee of Star Transportation, sought to change his treating physician for a shoulder injury sustained on July 1, 2015. He expressed a loss of confidence in Dr. Mejia due to perceived ineffectual treatment, improper impairment assessment methodology, and the physician's refusal to complete a Physician Certification Form. The Court, citing precedents like Scott v. Integrity Staffing Solutions and Baker v. Electrolux, found no legal basis to compel the employer to provide a new panel of physicians. The Court ruled that Mr. Tucker's subjective dissatisfaction and the alleged inadequacies of Dr. Mejia did not warrant a change in treating physician.

Workers' CompensationShoulder InjuryTreating PhysicianMedical TreatmentImpairment RatingAMA GuidesTennessee LawRight to Control Medical TreatmentPhysician Certification FormMMI (Maximum Medical Improvement)
References
3
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. MISSING
Regular Panel Decision

Billy Overstreet v. TRW Commercial Steering Division

This concurring opinion by Judge William C. Koch, Jr. addresses the legal basis for prohibiting ex parte communications between an employer's counsel and an employee's treating physician in a Workers' Compensation Act claim. While the Court's main conclusion relies on an implied-in-law contract theory, Judge Koch advocates for a fiduciary duty stemming from the physician-patient relationship. He clarifies that physicians have a duty of non-disclosure, subject to statutory exceptions for workers' compensation reports, but these exceptions do not permit ex parte communications. The opinion asserts that employees retain their medical privacy unless explicitly altered by law.

Physician-patient privilegeConfidentialityEx parte communicationWorkers' CompensationFiduciary dutyImplied contractMedical records disclosureHIPAALegal ethicsPatient rights
References
34
Case No. 23-0697
Regular Panel Decision
Jun 28, 2024

State of Texas Office of the Attorney General of the State of Texas Texas Medical Board Texas Health and Human Services Commission And Ken Paxton, in His Official Capacity as Attorney General of the State of Texas v. Lazaro Loe, Individually and as Next Friend of Luna Loe, a Minor Mary Moe and Matthew Moe, Individually and as Next Friends of Maeve Moe, a Minor Nora Noe, Individually and as Next Friend of Nathan Noe, a Minor Sarah Soe and Steven Soe, Individually and as Next Friends of Samantha Soe, a Minor Gina Goe, Individually and as Next Friend of Grayson Goe, a Minor Pflag, Inc. Richard Ogden Roberts III, M.D. David L. Paul, M.D. Patrick W. O'malley, M.D. And American Association of Physicians for Human

The Supreme Court of Texas reversed and vacated a temporary injunction against Senate Bill 14, which prohibits certain medical treatments for minors related to gender transition. Parents of children with gender dysphoria, along with physicians and LGBTQ+ advocacy groups, had challenged the law as unconstitutional, alleging infringements on parental rights, occupational freedom for physicians, and discrimination based on sex and transgender status. The Court concluded that the plaintiffs failed to establish a probable right to relief, asserting that parental rights are not absolute and the Legislature has constitutional authority to regulate medicine, especially regarding novel treatments for new conditions. The Court also found no unconstitutional discrimination, stating the law treats males and females equally in its prohibitions and that "transgender status" is not a protected class under the Texas Constitution.

Parental RightsMedical RegulationGender DysphoriaConstitutional LawDue Course of LawEqual ProtectionTransgender RightsMinors' Medical TreatmentLegislative AuthorityTexas Supreme Court
References
62
Case No. ADJ4378069 (AHM 0085676) ADJ2997222 (AHM 0085721)
Regular
Jun 09, 2010

LARRY LAZAR vs. HOME DEPOT, Permissibly Self-Insured

The Workers' Compensation Appeals Board denied the applicant's petition for removal and dismissed his petition for disqualification of the judge. The applicant argued that his treating physician's reports constituted substantial evidence and questioned the need for a court-appointed regular physician. The Board found that the judge correctly followed procedures for supplementing the medical record and that the existing reports lacked substantial evidence. Therefore, the Board upheld the judge's appointment of a regular physician.

Workers Compensation Appeals BoardPetition for RemovalPetition for DisqualificationRegular PhysicianLabor Code Section 5701Findings and OrderIndustrial InjuryPermanent DisabilitySubstantial EvidenceTreating Physician
References
1
Case No. ADJ9749961
Regular
Oct 11, 2017

ROMEL MAAIA vs. REDNECK TRAILER SUPPLY, INC., NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURG, PA.

In this workers' compensation case, the Appeals Board granted reconsideration to address the applicant's entitlement to treat outside the defendant's Medical Provider Network (MPN). The defendant contested that the applicant's chosen physician, Dr. Shaw, qualified as a "regular physician" under Labor Code section 4600(d). Specifically, the defendant argued the applicant failed to prove the predesignation notice was submitted to the employer before the injury, and that Dr. Shaw was indeed the applicant's regular physician who retained his records. The Board found the record insufficient to definitively rule on these issues and remanded the case to the WCJ for further development of the evidence.

Predesignation of Personal PhysicianMedical Provider NetworkRegular PhysicianLabor Code section 4600Workers' Compensation Appeals BoardFindings of FactOpinion and Decision After ReconsiderationDevelop the RecordDue ProcessNimish Shah M.D.
References
1
Case No. 533089
Regular Panel Decision
Oct 07, 2021

Matter of Barden v. General Physicians PC

Claimant, a patient services representative, sought to amend her workers' compensation claim to include left shoulder aggravation after a work-related injury to her right shoulder. The Workers' Compensation Board disallowed this request, finding that claimant failed to provide sufficient credible medical evidence to establish a causal relationship between her employment and the left shoulder condition. The Appellate Division, Third Department, affirmed the Board's decision. The court noted that the claimant's treating physician opined the left shoulder pathology was largely preexisting and unrelated to the work injury, and other medical opinions either lacked sufficient weight or were based on inaccurate information, providing no basis to disturb the Board's finding.

Workers' CompensationShoulder InjuryCausationMedical EvidencePreexisting ConditionAppellate ReviewBoard DecisionClaim AmendmentPatient Services Representative
References
10
Case No. ADJ9145724
Regular
Jun 01, 2015

ARZAGA, JOSE vs. CROWN AUTOMOTIVE, INC., AMTRUST NORTH AMERICA

This case involves an applicant seeking to select a pain management specialist outside his employer's Medical Provider Network (MPN). The applicant argued the MPN failed to provide a qualifying specialist within the required 15-mile/30-minute access standard for a primary treating physician. The Board denied the employer's petition for reconsideration, affirming the applicant's right to choose an out-of-network physician and reimbursement for investigative costs. The majority reasoned that the MPN must meet the closer access standard for a primary treating physician, even if that physician is a specialist. A dissenting opinion argued that a specialist, when chosen as a primary treating physician, should fall under the 30-mile/60-minute access standard for specialists.

Medical Provider NetworkMPNprimary treating physicianpain management specialistaccess standardAdministrative Director's Rule 9767.5investigative costsLabor Code section 5703Lescallett v. Wal-MartMartinez v. New French Bakery
References
2
Case No. 2019-01-0399
Regular Panel Decision
Feb 23, 2021

Tate, Meshia v. Daryl Doney d/b/a Middle Tennessee Respiratory

The employee, Meshia Tate, suffered a work-related wrist injury and later a knee injury, treated by authorized physician Dr. Martin Fiala, who performed surgeries and eventually placed her at maximum medical improvement. Dissatisfied, Tate sought an unauthorized second opinion from Dr. Jeffrey Peterson, who recommended further treatment and believed a subsequent meniscal tear was work-related. The trial court sided with Tate, accepting Dr. Peterson's causation opinion and replacing Dr. Fiala as the authorized treating physician, citing Dr. Fiala's perceived failure to treat ongoing symptoms and the employer's initial failure to provide a panel of physicians. On appeal, the Workers' Compensation Appeals Board reversed the trial court's decision, concluding that the evidence did not support the causation finding for the new meniscal tear or the replacement of the authorized physician, especially given Dr. Fiala's willingness to continue treatment. The Board emphasized the lack of sufficient expert medical testimony for causation and the need to follow proper procedures for changing authorized physicians.

Workers' CompensationMedical TreatmentCausationMeniscal TearWrist InjuryKnee InjuryTreating PhysicianMaximum Medical ImprovementDegenerative ConditionExpedited Hearing
References
6
Case No. 2021-06-1132
Regular Panel Decision
Apr 28, 2022

Eddie, Uncle v. Goodwill Industries of Middle Tennessee

At an expedited hearing on April 19, 2022, Mr. Eddie sought further medical care and temporary disability benefits for an accepted back injury, including the appointment of Dr. Narendra Singh as his authorized treating physician. The Court denied his requests because he already has an authorized treating physician, Dr. Malcolm Steele, willing to treat him, and Goodwill was accommodating his restrictions when he quit. The Court found Dr. Singh's opinion ambiguous and not sufficiently different from the authorized physicians' opinions to warrant a change. Mr. Eddie's request for temporary disability benefits was also denied as no physician took him completely off work for his work injury and Goodwill was accommodating his restrictions.

Workers' CompensationExpedited HearingMedical Care Request DeniedTemporary Disability Benefits DeniedAuthorized Treating PhysicianPreexisting ConditionLumbar InjuryBack PainAggravation of InjuryForklift Accident
References
3
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