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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
May 14, 2014

Forest Rehabilitation Medicine PC v. Allstate Insurance

Plaintiff Forest Rehabilitation Medicine PC sued defendant Allstate to recover $3,490 for no-fault medical benefits provided to assignor Tracy Fertitta. The core issue was the medical necessity of "Calmare pain therapy" (scrambler therapy), a novel treatment. The court conducted a bench trial, hearing expert testimony from both sides. Dr. Ayman Hadhoud, for the defense, argued the treatment was not medically necessary, not cost-effective, and essentially a form of physical therapy. Dr. Jack D’Angelo, for the plaintiff, countered that the therapy, though new, had FDA approval, was used by the military, and reduced the assignor's pain levels. Applying the Frye standard, the court found the evidence regarding Calmare scrambler therapy reliable and ruled it was medically necessary for Ms. Fertitta's pain management. Consequently, judgment was awarded to the plaintiff, Forest Rehabilitation Medicine PC, for $3,490 plus attorney's fees and interest.

No-Fault InsuranceMedical NecessityCalmare Pain TherapyScrambler TherapyNovel TreatmentFrye StandardExpert TestimonyPain ManagementFDA ApprovalCervical Radiculopathy
References
14
Case No. 2020-02-0173
Regular Panel Decision
Mar 18, 2021

Ramey, Joshua v. Sleep Zone, Inc.

Mr. Ramey requested additional workers' compensation benefits from Sleep Zone, Inc., for injuries sustained from a fall while carrying a mattress. Sleep Zone denied the claim based on surveillance video and the authorized treating physician, Dr. Jody Helms, who determined Mr. Ramey’s complaints were not causally related to the fall. Mr. Ramey’s credibility was questioned, especially his argument that the surveillance video depicted his twin brother. The Court found no medical proof supporting his claim and denied his requests for medical and temporary disability benefits, concluding he was unlikely to prevail on the merits.

CredibilitySurveillance VideoMedical CausationTemporary Disability BenefitsExpedited HearingAuthorized Treating PhysicianMaximum Medical ImprovementInjury ClaimMedical Treatment ComplianceFraud Allegations
References
2
Case No. 2024 NY Slip Op 00599 [224 AD3d 428]
Regular Panel Decision
Feb 06, 2024

Matter of New Millennium Pain & Spine Medicine, P.C. v. Garrison Prop. & Cas. Ins. Co.

This case involves two appeals by New Millennium Pain & Spine Medicine, P.C. against Garrison Property & Casualty Insurance Company and GEICO Casualty Company. New Millennium sought to vacate master arbitration awards that denied its claims for no-fault benefits for medical services. The Supreme Court denied these applications. The Appellate Division, First Department, affirmed the Supreme Court's decisions, stating that an arbitrator's award will not be set aside unless it is irrational. The court also addressed the argument regarding a 20% wage offset in no-fault benefits, finding it unavailing under Insurance Law § 5102 (b). Ultimately, New Millennium was not entitled to attorneys' fees as it was not the prevailing party.

No-fault benefitsarbitration awardvacaturinsurance lawwage offsetappellate reviewmedical servicesno-fault policy exhaustionattorneys' feesCPLR Article 75
References
8
Case No. 2020 NY Slip Op 04896 [186 AD3d 1770]
Regular Panel Decision
Sep 03, 2020

Matter of Wen Liu v. Division of Gen. Internal Medicine, Mount Sinai Sch. of Medicine

Wen Liu, a data programming analyst, filed for workers' compensation benefits in May 2010, claiming a neck injury from a June 5, 2008 fall at work due to dizziness. The employer failed to timely file a notice of controversy, but a Workers' Compensation Law Judge (WCLJ) disallowed the claim, finding no causal connection between the injuries and employment. The Workers' Compensation Board upheld this decision, which the claimant appealed. The Appellate Division affirmed the Board's decision, emphasizing that the employer's procedural failure did not absolve the claimant of proving a causal relationship. Substantial evidence supported the Board's rejection of the claimant's medical proof, as emergency room records contradicted her later descriptions of the incident and indicated pre-existing conditions.

Workers' CompensationCausationMedical EvidenceTimely NoticeBurden of ProofInjuryFallDizzinessNeck InjuryCarpal Tunnel Syndrome
References
7
Case No. 2017 NY Slip Op 06635
Regular Panel Decision
Sep 26, 2017

Hamburg v. New York University School of Medicine

Plaintiff, Carole Hamburg, M.D., sued New York University School of Medicine for age discrimination under the New York City Human Rights Law and for breach of contract after her employment was not renewed. The Supreme Court granted NYU summary judgment on the age discrimination claim but denied it for the breach of contract claim. On appeal, the Appellate Division, First Department, affirmed the dismissal of the age discrimination claim, finding no evidence of discriminatory intent in NYU's restructuring and phase-out of the general radiology section. The court further modified the lower court's decision, granting summary judgment to NYU on the breach of contract claim, ruling that Dr. Hamburg was not contractually entitled to a year's notice of non-renewal as her non-tenure-eligible position automatically terminated unless renewed. Consequently, the entire complaint was dismissed.

Age DiscriminationEmployment ContractFaculty EmploymentUniversity AdministrationDepartment RestructuringSummary JudgmentAppellate ReviewContract InterpretationTenure-EligibleNon-Tenure Track
References
19
Case No. 01-04-00797-CV
Regular Panel Decision
Jul 20, 2006

Marine Transport Corporation v. the Methodist Hospital, the Institute for Preventive Medicine/Methodist Healthcare Systems, the Methodist Hospital/Institute for Preventive Medicine Management, Inc. and Rashid Khan, M.D.

Marine Transport Corporation (Marine) appealed the dismissal of its claims against The Methodist Hospital and Dr. Rashid Khan. Marine's employee, Richard Guillory, a seaman, was certified fit for duty by the appellees despite medical issues and later died from an infection. Marine sought damages under the maritime doctrine of maintenance and cure, alleging negligence in the fitness-for-duty certification. The appellate court affirmed that while federal maritime law applied to Marine's claim, the underlying health care liability claims were governed by state law's former article 4590i, requiring expert reports. However, the trial court abused its discretion by denying Marine's motion for a 30-day extension to file these reports, as the attorney's failure was due to accident or mistake, not conscious indifference. Therefore, the judgment of dismissal was reversed, and the case was remanded for further proceedings.

Maritime LawMaintenance and CureHealth Care LiabilityMedical NegligenceExpert Report RequirementTexas Civil Practice and Remedies CodeAbuse of DiscretionAccident or MistakeSeaman InjuryFitness for Duty Certification
References
41
Case No. MISSING
Regular Panel Decision

Davis v. Medical Evaluation Specialists, Inc.

Justice Wilson dissents from the majority's decision on a motion for rehearing, arguing that the majority improperly considered non-evidence and engaged in speculation. The dissent contends that Lennie Davis's controverting affidavit by Dr. Bergeron, which stated a 17% impairment rating compared to the defendants' 0%, was conclusory and insufficient to establish bad faith by Medical Evaluation Specialists, Inc., Dr. DeFrancesco, and Dr. Dozier. Justice Wilson believes that the affidavit failed to meet the objective 'no reasonable doctor' standard for controverting good faith, and therefore, the trial court's summary judgment in favor of the defendants should have been affirmed based on official immunity.

Summary JudgmentOfficial ImmunityGood FaithImpairment RatingMedical AffidavitConclusory StatementsTexas Workers' Compensation ActAppellate ReviewDissenting OpinionPermanent Disability
References
7
Case No. MISSING
Regular Panel Decision

Icahn School of Medicine at Mount Sinai v. Neurocrine Biosciences, Inc.

The plaintiff, Icahn School of Medicine at Mount Sinai, moved to strike several affirmative defenses and dismiss corresponding counterclaims brought by the defendant, Neurocrine Biosciences, Inc. The core dispute involves a patent license agreement and an alleged unlicensed sublicense by Neurocrine to AbbVie. The court granted Mt. Sinai's motion, striking Neurocrine's affirmative defenses for patent invalidity, non-infringement, and patent misuse. The decision emphasized that Neurocrine was estopped from challenging patent validity due to prior benefits from the license and clarified that Mt. Sinai's damages claim was for breach of contract, not future royalties. Consequently, Neurocrine's related declaratory judgment counterclaims were also dismissed.

Patent invalidityNon-infringementPatent misuseBreach of contractLicense agreementSublicenseDeclaratory judgmentMotion to strikeAffirmative defensesEstoppel
References
23
Case No. 14-19-00488-CV
Regular Panel Decision
Dec 31, 2020

Gensetix, Inc. v. Baylor College of Medicine, Diakonos Research, Ltd., and William K. Decker

Appellant Gensetix, Inc. appealed the trial court's dismissal of its claims against Baylor College of Medicine, Diakonos Research, Ltd., and William K. Decker under the Texas Citizens Participation Act (TCPA). The appellate court determined that the TCPA applied to Gensetix's claims, which involved communications related to medical research on cancer treatment, thus constituting a matter of public concern. However, Gensetix failed to provide clear and specific evidence of damages for its claims of breach of contract, promissory estoppel, tortious interference, and civil conspiracy, offering only conclusory allegations. Consequently, the trial court's dismissal of Gensetix's claims was affirmed, and the court also upheld the constitutionality of the TCPA's mandatory fee-shifting provisions.

Texas Citizens Participation ActTCPAAnti-SLAPPFree SpeechRight of AssociationIntellectual PropertyPatent RightsBreach of ContractTortious InterferenceCivil Conspiracy
References
53
Case No. 01-23-00704-CV
Regular Panel Decision
Dec 23, 2025

Industrial Specialists, LLC v. Blanchard Refining Company LLC and Marathon Petroleum Company LP

This case addresses whether an indemnitee can recover from its indemnitor the portion of a settlement attributable to other defendants under a comparative indemnity scheme, even if the indemnitee was also found negligent. Industrial Specialists, LLC (Appellant) was sued by Blanchard Refining Company LLC and Marathon Petroleum Company LP (Appellees) for breach of a contractual indemnity agreement. A fire at a refinery injured employees, leading to a $104 million settlement by Marathon and other contractors, where Marathon paid $86 million. The jury found Marathon 38% negligent and Industrial 17% negligent, among others. The core issue is the enforceability of the indemnity provision under the express negligence doctrine, specifically concerning comparative indemnity. The Court of Appeals reversed the trial court's judgment, holding that the indemnity provision failed to expressly provide for comparative indemnity, thus rendering it unenforceable as a matter of law.

Contractual IndemnityExpress Negligence DoctrineComparative IndemnityOil and Gas IndustryRefinery FirePersonal Injury ClaimsSettlement AgreementsBreach of ContractTexas LawAppellate Court Decision
References
17
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