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Case Law Database

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

Case No. 2022-04-0172
Regular Panel Decision
Mar 05, 2024

Fowler, Alayna v. CRACKER BARREL OLD COUNTRY STORE, INC.

Alayna Fowler, an employee, sought workers' compensation benefits for injuries to her left foot and ankle sustained while working at Cracker Barrel Old Country Store, Inc. The Court held a hearing on Cracker Barrel's Motion for Summary Judgment regarding Ms. Fowler’s claims for additional temporary disability benefits, additional permanent partial disability benefits, and treatment for tarsal tunnel syndrome. The Court granted summary judgment to Cracker Barrel on these additional claims, finding Ms. Fowler did not provide sufficient expert medical opinion to prove causation beyond the 1% impairment assigned to her work-related ankle sprain. However, the Court ordered Cracker Barrel to pay permanent partial disability benefits based on a 1% impairment, totaling $2,439.05, and increased benefits of $3,951.25 due to lack of return to work and age. Dr. Marc Tressler was designated as the authorized physician for her work-related ankle and foot injury.

Workers' CompensationSummary JudgmentPermanent Partial DisabilityAnkle InjuryTarsal Tunnel SyndromeMedical Impairment RatingCausationExpert Medical OpinionSelf-Insured EmployerTennessee Law
References
4
Case No. 2015-05-0415
Regular Panel Decision
Feb 11, 2016

Leas, Anthony v. Opus Inspection, Inc.

Anthony Leas filed a Request for Expedited Hearing seeking medical and temporary disability benefits after allegedly spraining his left ankle and foot while stepping out of his car. His authorized treating physician, Dr. Joseph Wieck, diagnosed a foot sprain but opined that the injury was not primarily caused by the employment incident. The Court noted that Dr. Wieck's causation opinion is presumed correct under Tennessee Code Annotated section 50-6-102(14)(E). Mr. Leas failed to present expert medical evidence to rebut this presumption. Consequently, the Court denied Mr. Leas's requests for medical and temporary disability benefits, concluding he was not likely to prevail at a hearing on the merits.

Workers' CompensationExpedited HearingMedical BenefitsTemporary DisabilityCausationAnkle SprainFoot SprainMedical EvidenceExpert OpinionBurden of Proof
References
3
Case No. MISSING
Regular Panel Decision

Hazelton v. Brown

In an appeal from the Supreme Court of St. Lawrence County, plaintiff Bernard M. Hazelton, a postal worker, was injured in a July 1995 automobile accident caused by defendant Jeffrey R. Brown failing to yield. Hazelton, along with his wife derivatively, sued for damages, claiming a "serious injury" to his right ankle, which had a history of prior sprains but was asymptomatic before the accident. The Supreme Court denied defendants' motion for partial summary judgment on the "serious injury" issue and granted plaintiffs' cross-motion on liability. The Appellate Division affirmed both decisions, ruling that plaintiffs presented sufficient objective medical evidence from their orthopedic surgeon, Bedros Bakirtzian, to raise a factual question regarding a permanent consequential limitation of the ankle due to a substantial exacerbation of the prior injury. The court also upheld the liability finding against Brown, citing his undisputed failure to obey traffic laws at the intersection.

Automobile AccidentSerious InjuryInsurance LawSummary JudgmentLiabilityRight-of-WayPre-existing InjuryChronic Ankle SprainPermanent DisabilityAppellate Review
References
3
Case No. ADJ417505 (STK 173008)
Regular
Oct 07, 2008

MARSHA CRISWELL vs. COUNTY OF STANISLAUS

The Workers' Compensation Appeals Board granted reconsideration and rescinded the prior award of left ankle surgery for applicant Marsha Criswell. The Board found no substantial medical evidence connecting Criswell's current ankle condition to her 2000 industrial injury, noting the ankle injury resolved and a new injury occurred in 2005. Therefore, the applicant failed to meet her burden of proof for industrial causation of the current ankle problem.

Workers' Compensation Appeals BoardReconsiderationMedical CausationIndustrial InjuryLeft Ankle SurgeryAgreed Medical ExaminerTreating PhysicianPreponderance of the EvidenceReasonable Medical ProbabilityLay Testimony
References
8
Case No. 2018-06-0130
Regular Panel Decision
Nov 20, 2018

Lagel. Imad v. Elwood Staffing Services, LLC

Imad Lagel, a temporary employee, experienced right foot pain in July 2016. After initial treatment, Dr. Harold V. Nevels diagnosed an ankle sprain and discharged him to full duty. However, Mr. Lagel's pain reemerged, and during a follow-up, Dr. Nevels concluded that his current symptoms were unrelated to the work injury, attributing them to osteoarthritic changes. Elwood Staffing's motion for summary judgment, which Mr. Lagel failed to respond to, was granted by the Court. The Court found Mr. Lagel could not establish a causal relationship between his workplace injury and his ongoing need for medical treatment.

Workers' CompensationSummary JudgmentCausationMedical ProofOsteoarthritisAnkle SprainPro Se LitigantTennessee LawPreexisting ConditionExpert Medical Evidence
References
4
Case No. MISSING
Regular Panel Decision
Nov 15, 1999

Leo v. Mt. St. Michael Academy

The case involves an appeal from an order of the Supreme Court, Bronx County, concerning a slip and fall incident. Antonio Leo, a 16-year-old, alleged sustaining an ankle sprain on a worn, wet stairway on October 23, 1995. The defendant moved for summary judgment, presenting meteorological data indicating clear weather on the day of the incident, contradicting the plaintiff's claim of rain causing the wet condition. Witness testimony also refuted the presence of water. The appellate court modified the lower court's decision, granting the defendant's motion for summary judgment and dismissing the complaint, finding no evidence that the defendant had actual or constructive notice of any dangerous condition.

Summary JudgmentNegligencePremises LiabilitySlip and FallHazardous ConditionActual NoticeConstructive NoticeDocumentary EvidenceMeteorological ReportsDeposition Testimony
References
16
Case No. 2018-07-0450
Regular Panel Decision
Nov 28, 2018

Jackson, Brian v. Praxis Industries, Inc.

Mr. Jackson, an employee of Praxis Industries, Inc., suffered a left ankle sprain which allegedly led to right knee pain. His authorized physician, Dr. Randall Frazier, recommended knee surgery due to worsening symptoms and MRI findings of degenerative change and meniscal fraying. Praxis denied the surgery based on utilization reviews by Dr. Gregory Goldsmith and the Bureau's Medical Director, Dr. Robert Snyder, who cited ODG criteria and concerns about pre-existing arthritis. The Court found that Dr. Frazier's opinion as the authorized treating physician was entitled to a presumption of correctness and that the review physicians' opinions were insufficient to rebut it, partly due to incomplete information and failure to offer alternatives. Therefore, the Court ordered Praxis to authorize the recommended surgery.

Workers' CompensationExpedited HearingKnee InjurySurgery AuthorizationPre-existing ConditionUtilization ReviewAuthorized Treating PhysicianMedical NecessityMeniscal TearChondroplasty
References
3
Case No. MISSING
Regular Panel Decision

MacIas v. Schwedler

Manuel Macias suffered work-related injuries, including an ankle sprain and aggravated spinal arthritis. His workers' compensation claim was allegedly mishandled by his insurer, claim administrators, and medical investigators, who reportedly denied proper treatment and provided false medical conclusions. This led to Macias's suicide, prompting his wife, Sara Macias, to file a wrongful death lawsuit. She accused the defendants of violating the Texas Insurance Code, committing fraud, engaging in unfair settlement practices, and inflicting emotional distress. The trial court dismissed the case for lack of subject-matter jurisdiction, citing the failure to exhaust administrative remedies with the Texas Workers' Compensation Commission. The appellate court affirmed the dismissal, agreeing that a court cannot adjudicate such claims without a prior determination by the Commission on the compensability of the injuries.

Wrongful DeathWorkers' Compensation ClaimSubject Matter JurisdictionExhaustion of Administrative RemediesInsurance Bad FaithFraudulent MisrepresentationEmotional DistressClaims DenialMedical OpinionAppellate Affirmation
References
3
Case No. 2020-08-0880, 2020-08-0881, State File No. 50917-2016, 27300-2018
Regular Panel Decision
Aug 16, 2021

HULL EAGER, STEPHANIE v. LOWE’S HOME CENTERS, INC.

Stephanie Hull Eager sought medical benefits for a shoulder injury and an ankle injury from Lowe's Home Centers, Inc. For the shoulder, she requested a panel of physiatrists after her initial referral doctor became unavailable, which Lowe's declined to provide. For the ankle, she requested surgery, which Lowe's also denied, citing an alleged intervening event. The Court found Lowe's failed to justify its refusal for the shoulder physiatrist panel and determined the "pop" in the ankle was not an intervening cause. Consequently, the Court ordered Lowe's to provide both the panel of physiatrists and the ankle surgery, and referred Lowe's to the Compliance Program for consideration of penalties due to untimely provision of benefits.

Workers' Compensation ClaimsMedical BenefitsExpedited HearingShoulder InjuryAnkle InjuryPhysiatrist ReferralAnkle SurgeryMaximum Medical Improvement (MMI)Utilization ReviewCausation
References
4
Case No. 2024-60-0156
Regular Panel Decision
Dec 20, 2024

Yoder, Chris v. Crum and Forster Holdings Corp.

The Court held an expedited hearing on Chris Yoder’s request for additional medical benefits for a right ankle injury. Mr. Yoder claimed he injured his ankle while undergoing physical therapy for a work-related right-knee injury. The employer, Crum and Forster, disputed the injury's occurrence and its relation to work. The Court found Mr. Yoder's testimony credible, concluding the ankle injury occurred during physical therapy and was a direct consequence of his initial compensable knee injury. Consequently, the Court granted Mr. Yoder's request, ordering Crum and Forster to authorize evaluation and treatment of his right ankle by Dr. Downs.

Ankle InjuryKnee InjuryPhysical Therapy InjuryMedical BenefitsExpedited HearingWork-Related InjuryCausationCompensabilityTreating PhysicianMedical Evaluation
References
5
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