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

Case No. MISSING
Regular Panel Decision
Jun 01, 2017

Claim of Lala v. Siteworks Contracting Corp.

Claimant Nick Lala sustained work-related injuries in an October 2007 motor vehicle accident and settled a third-party action for $100,000, with a net recovery of $64,541.51. The employer's workers' compensation carrier agreed to the settlement, reserving its right to a credit under Workers' Compensation Law § 29 (4) but also acknowledging its obligation to pay a proportionate share of litigation expenses under Burns v Varriale. A Workers' Compensation Law Judge (WCLJ) ruled that the carrier's credit, as reduced by its share of litigation expenses, was exhausted on August 20, 2013, a decision subsequently upheld by the Workers' Compensation Board. The employer and carrier appealed, contending that the Board miscalculated the credit and erroneously determined the exhaustion date. The Appellate Division affirmed the Board's decision, finding that the WCLJ's method of deducting the carrier's proportionate share of litigation expenses directly from the claimant's net recovery before calculating the credit was consistent with established case law and the statute's purpose.

Workers' Compensation Law § 29 (4)Third-party action settlementCarrier credit exhaustionLitigation expenses apportionmentBurns v Varriale ruleEquitable shareTemporary total disability benefitsMotor vehicle accident injuryAppellate DivisionWorkers' Compensation Board decision
References
6
Case No. 04-10-00704-CV
Regular Panel Decision
Aug 03, 2011

Bairon Israel Morales v. Michelin North America, Inc.

Bairon Israel Morales was injured in a truck accident while working for K&K Repair Service, LLC. Texas Mutual Insurance Company, K&K's workers' compensation carrier, paid Morales benefits. Morales sued Michelin North America, Inc. and Discount Tire Company of Texas, eventually settling with them after nonsuiting his employer and the driver. The appeal concerns the allocation of Texas Mutual's subrogation lien and whether Morales's attorney is entitled to a proportionate share of expenses from Texas Mutual's recovery. The court ruled that Texas Mutual was not actively represented in the third-party action, thus section 417.003(a) of the Texas Labor Code applies, entitling Morales's attorney to a proportionate share of expenses. The judgment was modified to reduce Texas Mutual's payment by this share. The court denied Morales's request for a determination of the employer's percentage of responsibility, stating the issue was moot due to the settlement with all defendants.

Workers' CompensationSubrogation LienAttorney's FeesLitigation ExpensesTexas Labor CodeCivil Practice and Remedies CodeSummary JudgmentAppellate ReviewActive RepresentationSettlement Agreement
References
20
Case No. MISSING
Regular Panel Decision

Wood v. Firestone Tire & Rubber Co.

Anthony N. Wood, severely injured while employed by the Town of Stillwater Highway Department, settled a third-party action against Firestone Tire and Rubber Company for $1.1 million. The workers' compensation carrier, Saratoga County Self-Insured Plan, had a lien of over $63,000 for compensation and medical payments. Wood moved to apportion legal fees and expenses against the carrier's lien, arguing that the carrier's equitable share should consider the present value of estimated future benefits it would no longer have to pay, citing *Matter of Kelly v State Ins. Fund*. The Saratoga County Self-Insured Plan opposed, disputing the calculation of future benefits and arguing for consideration of potential future death benefits. The court, guided by *Kelly*, found the respondent's arguments lacked merit and applied a formula that included the lien amount plus the discounted value of future payments saved by the carrier. The court determined an equitable apportionment of $114,112.67, concluding that the offset exceeded the carrier's lien due to the substantial benefits the carrier received from the extinguishment of future obligations.

ApportionmentLegal FeesThird-Party ActionLien OffsetFuture Benefits CalculationEquitable ApportionmentSettlement ProceedsEconomist Expert WitnessPermanent DisabilityCarrier Liability
References
10
Case No. 126300 R.D.
Regular Panel Decision

Bazner v. American States Insurance Co.

Walter Bazner, an insulator diagnosed with asbestosis, previously received workers' compensation benefits from L.D. Powell & Company and its insurer, American States Insurance Company, for permanent total disability and medical expenses incurred up to the judgment date. When Bazner incurred additional medical expenses post-judgment, American refused payment, arguing the prior judgment was res judicata and required pre-approval for new expenses. Bazner initiated a new suit, and the trial court sided with him. On appeal, the Supreme Court held that Bazner's claim for future medical expenses was not barred, reiterating that such expenses are recoverable under T.C.A. § 50-6-204 and established procedural rules for seeking them via petition in the original action. The court also found Bazner's decision to seek further medical attention from his treating physician reasonable under the circumstances. The case was remanded for further proceedings regarding future medical payments and related issues.

AsbestosisOccupational DiseaseFuture Medical ExpensesPost-Judgment CareRes Judicata DefenseEmployer Medical AuthorizationInsurance LiabilityStatutory BenefitsAppellate ReviewRemand Order
References
6
Case No. No. 06-03609, No. 06-03654
Regular Panel Decision

Padilla v. Wells Fargo Home Mortgage, Inc. (In Re Padilla)

This case addresses how the Bankruptcy Code and Federal Rules of Bankruptcy Procedure affect a mortgage lender's right to collect 'Reimbursable Expenses' in Chapter 13 bankruptcy cases. The Court examined the collection of such expenses both pre- and post-confirmation of a Chapter 13 plan. It held that Bankruptcy Rule 2016(a) governs the collection of these expenses by mortgage lenders in Chapter 13 cases, both pre and post-confirmation. The Court determined that while Section 506(b) limits pre-confirmation expenses for oversecured creditors, it does not apply post-confirmation. Furthermore, the Court found that failure to comply with Rule 2016(a) or the imposition of unauthorized expenses would entitle a debtor to relief, but that such conduct does not violate the automatic stay. The cross-motions for partial summary judgment were denied due to insufficient evidence regarding actual collection of disputed charges.

Bankruptcy LawChapter 13Mortgage ServicingReimbursable ExpensesAttorney FeesBankruptcy ProcedureRule 2016(a)Section 506(b)Plan ConfirmationAutomatic Stay
References
86
Case No. MISSING
Regular Panel Decision

Carminucci v. Pepsico, Inc.

The intervener plaintiff Madrone Excavating Company, Inc., by its subrogee ITT Hartford Accident Indemnity Company appealed an order from the Supreme Court, Westchester County. The original order determined that New York Workers’ Compensation Law applied, denying full reimbursement to ITT Hartford for benefits paid to Mark T. Carminucci and compelling ITT Hartford to pay a pro rata share of litigation expenses. The appellate court reversed, ruling that Connecticut law applies because benefits were paid under Connecticut's Workers’ Compensation Act. Under Connecticut law, ITT Hartford, as subrogee, is entitled to full reimbursement of both past and the present value of future workers’ compensation benefits. The court further held that ITT Hartford is not required to share litigation expenses on a pro rata basis. The case was remitted to the Supreme Court for a hearing to determine the total reimbursement amount.

Workers' CompensationSubrogationReimbursementChoice of LawConnecticut LawNew York LawPersonal InjuryMotor Vehicle AccidentAppellate ReviewLitigation Expenses
References
5
Case No. 07-15-00113-CV
Regular Panel Decision
Nov 18, 2016

Mohammed Fawwaz Shoukfeh, M.D., P.A., D/B/A Texas Cardiac Center v. James G. Grattan and Texas Workforce Commission

Dr. Grattan filed a wage claim against Mohammed Fawwaz Shoukfeh, M.D., P.A., d/b/a Texas Cardiac Center (TCC) under the Texas Payday Act, alleging miscalculation of his pro rata share of overhead expenses. The dispute arose because TCC included Dr. Qaddour's salary in overhead but excluded him from the pro rata division among physicians for expense calculation. After various appeals, the Texas Workforce Commission ultimately awarded Dr. Grattan $125,988.81 in unpaid wages. TCC then sought a trial de novo, where the 99th District Court granted summary judgment in favor of Dr. Grattan and the TWC. The Seventh District Court of Appeals affirmed the trial court's judgment, concluding there was substantial evidence that Dr. Grattan's employment agreement did not permit TCC to deduct more than a pro rata share based on all physicians employed.

Wage claimTexas Payday ActEmployment agreementOverhead expensesPro rata shareSummary judgmentAppellate reviewSubstantial evidenceContract interpretationPhysician compensation
References
23
Case No. MISSING
Regular Panel Decision

Brooks v. United Uniform Co.

The plaintiff appealed the denial of their motion for reimbursement of expenses and attorney's fees under T.R.C.P. 37.03. This motion stemmed from the defendant's objections to requests for admissions concerning medical causation, which necessitated the plaintiff taking depositions of two doctors for trial proof. The trial court initially denied worker's compensation benefits for one alleged accident and awarded medical expenses for another, but denied the motion for expenses and fees. On appeal, the court affirmed the trial court's denial of the motion for expenses, noting that the plaintiff failed to provide a complete record for review and that expert medical opinion is not discoverable under T.R.C.P. 36. Furthermore, the appellate court granted the defendant's request for damages, deeming the plaintiff's appeal frivolous under T.C.A. § 27-1-122.

Discovery SanctionsRule 37.03Rule 36Appellate ProcedureWorker's Compensation BenefitsMedical Expert TestimonyEvidentiary StandardsAbuse of Discretion StandardFrivolous AppealsCost Reimbursement
References
3
Case No. MISSING
Regular Panel Decision

In re Relativity Fashion, LLC

This Memorandum Opinion addresses a motion for attorneys' fees and expenses filed by Relativity Media, LLC (and its affiliates RML Distribution Domestic, LLC, Armored Car Productions, LLC, and DR Productions, LLC, collectively 'Relativity') and Mr. Ryan Kavanaugh against Netflix, Inc. The dispute arose from Netflix's refusal to execute 'Date Extension Amendments' related to a License Agreement, prompting Relativity to seek relief under Section 1142 of the Bankruptcy Code. The Court previously ruled that Netflix was barred by res judicata and judicial estoppel from asserting its claimed contractual rights to distribute films before theatrical release. In this opinion, the Court determined that Relativity was the 'prevailing party' under California Civil Code Section 1717 and the License Agreement's fee provision. Consequently, Relativity is entitled to reimbursement for its own reasonable attorneys' fees and litigation expenses. However, the Court denied Mr. Kavanaugh's request for reimbursement of his counsel's fees and expenses, concluding that he was not a party to the License Agreement and did not meet the exceptions for non-signatories to recover fees. The Court awarded Relativity $818,547.48, comprising $795,732.50 in attorneys’ fees and $22,814.98 in litigation expenses, against Netflix.

Attorneys FeesLitigation ExpensesContract LawCalifornia Civil Code Section 1717Bankruptcy Code Section 1142Prevailing PartyLodestar MethodHourly RatesJudicial EstoppelRes Judicata
References
85
Case No. MISSING
Regular Panel Decision

In Re American Plumbing & Mechanical, Inc.

Gerald Riggs and Rick Jepson, former senior executives of AMPAM Riggs, an operating subsidiary of American Plumbing & Mechanical, Inc. (a Chapter 11 debtor), applied for payment of administrative expenses claims, specifically year-end bonuses based on exceeding EBITDA targets. They argued entitlement under a pre-petition incentive plan and that the payments constituted ordinary course business expenses, which a prior court order allegedly authorized. The Plan Agent and the Official Creditors' Committee objected, contending that Riggs and Jepson were ineligible as they had resigned in April 2004 before bonus payments, and that AMPAM Riggs had not actually met its 2003 EBITDA target once certain late-reported insurance claims were properly factored in. The court found that after adjusting the 2003 EBITDA for these claims, the target was not met, meaning no 15% bonus was owed. Additionally, the court ruled that even if the bonuses were earned, they did not qualify as administrative expenses under Bankruptcy Code section 503(b)(1)(A) because they were not attributable to services rendered post-petition and did not confer a discernible benefit to the estate, especially since the applicants had voluntarily resigned. The application for payment of administrative expense claims was therefore denied.

BankruptcyAdministrative ClaimIncentive Bonus PlanEBITDA AdjustmentPost-Petition ServicesChapter 11 ReorganizationFiduciary DutyCreditors' CommitteeVoluntary ResignationBenefit to Estate
References
27
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