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

Case No. 03-17-00707-CV
Regular Panel Decision
Nov 21, 2018

What Happened in Felix vs. Weber Metals Reconsideration?

CoreALM, LLC appealed a trial court's judgment that awarded Keen Fusion, Inc. damages for tortious interference with contract and business disparagement. CoreALM contended that the economic loss rule barred the award and that the evidence was legally insufficient to support the jury's findings. The appellate court affirmed the trial court's judgment. It determined that the economic loss rule did not preclude Keen Fusion's recovery on its tort claims because the duty not to interfere with contractual relationships arises from common law, independent of any contractual agreement between the interfering party and the party whose contract was interfered with. The court also found factually sufficient evidence to support the jury's finding that CoreALM tortiously interfered with Keen Fusion’s contract with eCommQuest, which proximately caused Keen Fusion to lose an engagement with Johnson Controls. Given the valid finding on tortious interference, the court did not address the challenge to the business disparagement claim.

Tortious Interference with ContractEconomic Loss RuleBusiness DisparagementContract BreachAppellate ReviewFactual Sufficiency of EvidenceProximate CauseCommon Law DutyIndependent Contractor DisputeSubcontractor Agreement
References
17
Case No. 08-06-00170-CV
Regular Panel Decision
Jun 30, 2008

How Did the WCAB Rule in Hardgrove vs. Intercon Security?

This case concerns an appeal by Fireman’s Fund Insurance Company against a district court's judgment favoring workers' compensation claimant, Weldon Weeks. The core dispute revolved around the legal sufficiency of evidence for Weeks' impairment rating and maximum medical improvement (MMI) date, following an on-the-job spinal injury and subsequent fusion surgery. The district court had adopted a 25 percent impairment rating and April 17, 2002 MMI date, based on Dr. Chapman's report, which considered the spinal fusion surgery in violation of AMA Guides for impairment ratings. The Court of Appeals, affirming that surgery is not a permissible factor under the AMA Guides' Injury Model, found Dr. Chapman's reliance on the spinal fusion legally insufficient. Consequently, the appellate court reversed the district court’s judgment and rendered judgment for Fireman’s Fund, effectively upholding the Division's original decision of a 10 percent impairment rating and January 28, 2002 MMI date.

Impairment RatingMaximum Medical Improvement (MMI)Spinal Fusion SurgeryAMA GuidesLegal SufficiencyAppellate ReviewTrial Court JudgmentDesignated DoctorTexas Labor CodeDiagnosis-Related Estimate (DRE)
References
13
Case No. MISSING
Regular Panel Decision

What Did the WCAB Decide in Cuadra vs. Community Home Care?

Demica Hawkins, a Black former Accounts Payable Coordinator, sued her employer, The Center for Spinal Surgery (CSS), alleging race discrimination, retaliation, and FMLA interference. The lawsuit stemmed from denied pay raises, disciplinary actions, and ultimately her termination while on pregnancy leave, which Hawkins claims was discriminatory and retaliatory. CSS filed a renewed motion for summary judgment, and Hawkins filed a partial motion for summary judgment. The court granted in part and denied in part CSS's motion, dismissing Hawkins' pregnancy discrimination and certain retaliation claims. However, Hawkins' retaliatory discharge and FMLA interference claims related to her 2013 termination will proceed to trial due to genuine disputes of material fact regarding CSS's motivations.

Race DiscriminationRetaliationFMLA InterferenceSummary JudgmentEmployment LawTitle VIIPregnancy Discrimination ActMcDonnell Douglas FrameworkHonest Belief RulePretext
References
64
Case No. MISSING
Regular Panel Decision

How Were Death Benefits Handled in Bocanegra vs. Sun-Gro Commodities?

Plaintiffs United Spinal Association and Disabled in Action brought an action against the Board of Elections in the City of New York (BOE) under Title II of the Americans with Disabilities Act and Section 504 of the Rehabilitation Act, alleging pervasive access barriers at poll sites. The Court previously denied a preliminary injunction. Both parties subsequently moved for summary judgment. The Court found no genuine dispute of material fact regarding the existence of pervasive and recurring accessibility barriers and deemed the BOE's accommodation methods insufficient. Consequently, the Court granted the plaintiffs' motion for summary judgment on liability and denied the defendants' cross-motion. The case is now referred to a Magistrate Judge for the determination of the appropriate remedy.

AccessibilityVoting RightsAmericans with Disabilities ActRehabilitation ActPoll SitesSummary JudgmentDisability DiscriminationBoard of ElectionsMeaningful AccessReasonable Accommodation
References
26
Case No. MISSING
Regular Panel Decision

Can a WCJ Be Disqualified for Appearance of Bias?

This case involves an appeal by Fireman’s Fund Insurance Company against a district court’s judgment in favor of workers’ compensation claimant, Weldon Weeks. Weeks sustained a lower back injury on the job, leading to spinal fusion surgery. The core dispute centers on Weeks’s Maximum Medical Improvement (MMI) date and impairment rating, with the district court adopting Dr. Chapman’s findings of a 25 percent impairment and an MMI date of April 17, 2002. Fireman's Fund argued that Dr. Chapman’s reliance on spinal fusion surgery to determine impairment was legally insufficient under the AMA Guides, fourth edition. The appellate court agreed, reversing the district court's judgment and rendering judgment for Fireman’s Fund, thereby affirming the Division's earlier decision which had adopted Dr. Singleton's 10 percent impairment rating and January 28, 2002 MMI date.

workers' compensationimpairment ratingmaximum medical improvementspinal fusionAMA Guideslegal sufficiencyDRE categorylumbar radiculopathyappellate reviewTexas Labor Code
References
13
Case No. SAL 0107786
Regular
Oct 16, 2007

What Were the Key Rulings in Torrez vs. SuperShuttle?

This case concerns an injured worker who had cervical spine surgery involving diskectomy, vertebrectomy, decompression, and fusion. The defendant sought reconsideration of an award granting temporary disability benefits beyond the statutory 104-week limit, arguing the surgery was not an amputation. The Appeals Board rescinded the prior award and returned the matter for further proceedings, as the definition of "amputation" in precedent excludes internal body parts like those removed during spinal fusion.

Workers' Compensation Appeals BoardDominican Santa Cruz HospitalOctagon Risk ServicesMolly KirkpatrickIndustrial InjuryCervical Spine SurgeryTemporary Disability IndemnityLabor Code Section 4656(c)AmputationDiskectomy
References
1
Case No. 2016-04-0074
Regular Panel Decision
Sep 26, 2016

Why Was Removal Denied in Rush vs. California Correctional Institution?

Randy White, an employee, filed a Request for Expedited Hearing against Boles Trucking, the employer, seeking medical and temporary disability benefits for a lumbar spine fusion surgery. The alleged work-related injury occurred on February 11, 2015, exacerbating a pre-existing spondylolisthesis. The court evaluated whether the injury primarily arose out of employment and if the aggravation was compensable. Judge Robert Durham found sufficient evidence that Mr. White was likely to prevail, concluding that the February 2015 incident was a specific work-related event that significantly contributed to his current condition and need for surgery. Consequently, the court ordered Boles Trucking to provide the recommended L4-5 spinal fusion and associated medical treatment.

Workers' CompensationSpinal FusionSpondylolisthesisExacerbationPre-existing ConditionCausationMedical BenefitsTemporary DisabilityTruck Driver InjuryLumbar Spine Injury
References
4
Case No. 2021 NY Slip Op 00608 [191 AD3d 1078]
Regular Panel Decision
Feb 04, 2021

What Did the WCAB Clarify in Ontiveros vs. Savers Stores?

Harry Peck, a carpenter, sustained a work-related back injury in 2013 and received workers' compensation benefits. After spinal fusion surgery, he was deemed medically unable to return to work. Following authorization for a spinal cord simulator trial in 2018, the employer's carrier alleged that Peck violated Workers' Compensation Law § 114-a, citing surveillance footage inconsistent with his claimed disability. Although a Workers' Compensation Law Judge initially found no misrepresentation, the Workers' Compensation Board reversed, finding a violation and imposing mandatory and discretionary penalties, including disqualification from future wage replacement benefits. The Appellate Division, Third Department, affirmed the Board's decision, concluding that substantial evidence supported the finding that Peck made willful misrepresentations regarding the extent of his disability to physicians.

Workers' Compensation FraudDisability MisrepresentationSurveillance EvidencePenalty ImpositionWage Replacement DisqualificationSpinal Cord InjuryBack PainClaimant CredibilityAppellate Review of Board DecisionMaterial False Statement
References
10
Case No. 2022-06-0596
Regular Panel Decision
Dec 05, 2022

Why Was Reconsideration Denied in Gomez vs. Dorothy Stevens?

Lynn Freeman, an employee of Kirby Pines Estates, sought an expedited hearing to compel her employer to provide a recommended lumbar fusion surgery by her authorized treating physician, Dr. Glenn Crosby, for a back injury sustained in July 2021. The proposed surgery, a transforaminal lumbar interbody fusion (TLIF), was initially denied through utilization review and upheld on appeal, with medical experts citing Official Disability Guidelines (ODG) and a lack of significant spinal instability. While Dr. Crosby supported the surgery and dismissed the guidelines, the Court found the employer successfully rebutted the presumption of medical necessity using the opinions of Drs. Samuel Murrell and Maria Sumas. Their assessments, which aligned with ODG and noted the resolution of Ms. Freeman's radicular complaints, were deemed more persuasive. Consequently, the Court denied Ms. Freeman’s request for the TLIF procedure, setting a status conference for future proceedings.

Lumbar FusionTLIFHerniated DiscRadiculopathyUtilization ReviewMedical NecessityOfficial Disability GuidelinesWorkers' Compensation ClaimsExpedited HearingSpine Surgery
References
4
Case No. 2017-06-0405
Regular Panel Decision
Dec 06, 2017

Why Was Reconsideration Dismissed in Sabino vs. Johnson Pump Company?

David Valle Castillo, an employee of The Hotel Group Holdings, LLC, filed a request for expedited hearing seeking additional medical and temporary benefits for a compensable injury. Mr. Castillo, a dishwasher, slipped and fell on October 7, 2016, and the claim was accepted. He sought treatment from Dr. Edward Mackey, who recommended spinal fusion surgery due to symptomatic spinal stenosis. The employer denied further medical benefits based on an independent medical examination by Dr. Tarek Elalayli, who concluded the work injury was less than 50% related. The Court found that Dr. Mackey's opinion, affirmed by a causation letter, was presumed correct and that the employer failed to rebut this presumption. The Court granted Mr. Castillo's request for medical benefits, ordering The Hotel Group to authorize continued treatment with Dr. Mackey, including the recommended surgery. However, the request for temporary disability benefits was denied due to incomplete records regarding the duration of disability.

Expedited HearingMedical BenefitsTemporary BenefitsSpinal StenosisSpinal FusionCausation OpinionTreating PhysicianIndependent Medical ExaminationPresumption of CorrectnessBurden of Proof
References
3
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