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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

What Happened in Felix vs. Weber Metals Reconsideration?

This Memorandum Opinion addresses a class-action challenge against Tennessee officials regarding the TennCare managed care program's compliance with early and periodic screening, diagnosis and treatment (EPSDT) services for children. The lawsuit, initiated in 1998, operated under a Consent Decree. The State filed a motion to vacate the Decree, arguing substantial compliance. After an evidentiary hearing and review of extensive evidence, the Court found that the State has achieved substantial compliance with the Consent Decree's requirements concerning outreach, screening, diagnosis, treatment, and monitoring of EPSDT services. Consequently, the Court granted the State's motion to vacate the Consent Decree, dissolved all injunctive relief, and dismissed the case, while retaining jurisdiction for fee applications and contempt citations.

TennCareMedicaid ActEPSDT ProgramConsent Decree VacatedSubstantial ComplianceChild HealthcareManaged Care OrganizationsMedical ScreeningDiagnosis and TreatmentOutreach Efforts
References
4
Case No. MISSING
Regular Panel Decision

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

Richard E. Scheele, Jr., a sole proprietor, sought workers' compensation insurance through Abbott Insurance Agency for his work as a satellite dish installer. He applied for coverage with Hartford, requesting an effective date of January 12, 2004, and paid a deposit premium, also submitting a Form 1-4 to the Department of Labor on December 29, 2003, which was stamped as received on December 31, 2003. He sustained a severe hip injury on January 21, 2004, but Hartford denied benefits, arguing he was not covered due to non-compliance with the thirty-day notice requirement and insufficient premium payment. The trial court found Mr. Scheele had substantial compliance with the notice requirement and coverage existed due to the binder and policy terms. The appellate court affirmed the trial court's judgment, holding that substantial compliance with the thirty-day notice requirement was sufficient and that the paid premium, though an estimate, maintained coverage.

Workers' CompensationSole Proprietor CoverageInsurance PolicyNotice RequirementSubstantial ComplianceStatutory InterpretationInsurance BinderPremium PaymentEffective Date of CoverageTennessee Law
References
14
Case No. MISSING
Regular Panel Decision

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

In 1991, while working for a gold jewelry manufacturer, the claimant was robbed at gunpoint. A 2002 Workers' Compensation Law Judge (WCLJ) decision found a work-related injury of posttraumatic stress disorder (PTSD), which was affirmed by the Workers' Compensation Board. Following a 2015 hearing, a WCLJ determined that the claimant continued to suffer from PTSD with a temporary marked partial disability, awarding weekly compensation. The Board upheld this decision, leading to the employer's appeal. The court affirmed the Board's determination, finding substantial evidence from psychologists Ranita Fooks and Elina Spektor supported a further causally-related disability. The court also rejected the employer's contention that an independent medical examination (IME) report was wrongly deemed inadmissible due to noncompliance with Workers’ Compensation Law § 137 (1) (a), clarifying that partial compliance is not substantial compliance.

Workers' CompensationPTSDWork-related injuryCausally-related disabilityTemporary marked partial disabilityIndependent Medical Examination (IME)Admissibility of evidenceSubstantial compliancePsychological testingRobbery
References
7
Case No. MISSING
Regular Panel Decision

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

Rosa Rodriguez appealed a workers' compensation decision concerning her back injury claim against Service Lloyds Insurance Company. She challenged an impairment rating and maximum medical improvement date, which had been affirmed by the Texas Workers' Compensation Commission (TWCC) and its appeals panel due to untimely contestation. At the district court, Rodriguez asserted a 'substantial change of condition' and challenged the standard of review. The trial court ordered her to replead under the 'substantial evidence rule' and drop the 'substantial change of condition' claim. Upon her non-compliance and failure to provide an adequate administrative record, the trial court struck her pleadings and dismissed the case. The appellate court affirmed, ruling that the 'substantial change of condition' statutes were inapplicable to her specific challenges at the TWCC, and that she failed to present the required administrative record for review under the 'substantial evidence rule'.

impairment ratingmaximum medical improvementsubstantial change of conditionjudicial reviewadministrative proceduresubstantial evidence rulepleadingsdismissal of actionappellate courtTexas law
References
1
Case No. 01-08-00487-CV
Regular Panel Decision
Feb 11, 2010

Can a WCJ Be Disqualified for Appearance of Bias?

On cross motions for summary judgment in a suit to collect on a McGregor Act payment bond, the trial court granted summary judgment in favor of appellee, Boring & Tunneling Company of America ("Bortunco"), and denied the motion of appellant, United Fire & Casualty Company ("United Fire"). United Fire appealed, arguing that Bortunco failed to substantially comply with the notice provisions of the McGregor Act due to a missing notary signature and seal on its sworn statement. Bortunco, a subcontractor, contended that its notice substantially complied as the omission was merely a clerical error. The appellate court affirmed the trial court's judgment, emphasizing the remedial nature of the McGregor Act and that substantial compliance is adequate for notice provisions, especially when actual notice was received. The court concluded that Bortunco's document met the essential requirements of the statute and protected all parties from undue liability.

McGregor ActPayment BondSubstantial ComplianceNotice ProvisionsSuretySubcontractorClerical ErrorSummary JudgmentTexas Government CodeAppellate Review
References
14
Case No. MISSING
Regular Panel Decision

What Were the Key Rulings in Torrez vs. SuperShuttle?

Boring & Tunneling Company of America (Bortunco), a subcontractor, was not paid by Golf Services Group (contractor) for work performed on public water line projects. Bortunco, seeking payment under a bond secured by United Fire & Casualty Company (surety) as per the McGregor Act, sent a notice of claim. The initial notice lacked a notary's signature and seal on the sworn statement of account, though the statement was properly sworn to by Bortunco's agent. United Fire, after receiving the notice, argued that this defect constituted a failure to comply with the McGregor Act's notice provisions and moved for summary judgment. Bortunco contended it had substantially complied with the Act, or that United Fire had waived its right to assert notice defects, supporting its claim with affidavits confirming the notary's omission was a clerical error. The trial court granted summary judgment in favor of Bortunco, awarding it $142,542.75. On appeal, the court affirmed, holding that the McGregor Act, being remedial, requires only substantial compliance for notice provisions other than deadlines. The court found Bortunco's notice substantially complied as it provided actual notice, contained all essential information, and the defect was a mere clerical error that did not frustrate the statute's purpose.

McGregor ActPayment BondSubstantial ComplianceNotice ProvisionsSworn StatementClerical ErrorSummary JudgmentSuretySubcontractorPublic Works Project
References
16
Case No. MISSING
Regular Panel Decision

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

East-West Realty Corporation, owner of 37 acres in the Town of Colonie, sought to have its property, along with an additional 6 acres, annexed by the City of Watervliet to facilitate a senior citizen assisted-living development. The Town of Colonie denied the petition, citing non-compliance with the State Environmental Quality Review Act (SEQRA) and lack of overall public interest. The City of Watervliet, however, approved the petition and initiated a court proceeding to determine if the annexation was in the public interest, with East-West intervening as a petitioner. The Town of Colonie moved to dismiss the petition, arguing that Watervliet failed to comply with SEQRA prior to approving the annexation. The court found that annexation constitutes an 'action' subject to SEQRA review, even for parcels less than 100 acres, and that such review must occur at the earliest opportunity. Concluding that no SEQRA compliance occurred before the joint hearing, the court granted the Town of Colonie's motion and dismissed the petition.

annexationSEQRAenvironmental reviewzoning restrictionspublic interestmunicipal lawType I actionunlisted actionCPLR 404General Municipal Law
References
14
Case No. MISSING
Regular Panel Decision

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

This case involves a 1974 consent decree limiting public access to arrest records of individuals not convicted of charges, entered into by John Doe (plaintiff class representative), Metropolitan Government of Nashville and Davidson County, and the State of Tennessee. The plaintiff filed a motion to assure compliance, alleging the defendants violated the decree by disseminating arrest records, including posting "johns" on the internet. Defendants Tennessee Bureau of Investigation (TBI) and Metro, along with intervenors The Tennessean and NewsChannel 5, moved to dissolve the decree. The court found that the constitutional right underpinning the 1974 decree, related to reputation and due process, has eroded due to subsequent Supreme Court decisions like Paul v. Davis. Additionally, Tennessee statutory laws (T.C.A. § 10-7-503 and § 38-6-120) now mandate public access to arrest records. Consequently, the court denied the plaintiff's motion for compliance, granted the defendants' and intervenors' motions to dissolve the 1974 consent decree, and dismissed the case, noting that the 1973 consent decree, which addresses employment-related record use, remains in effect.

Consent DecreeRule 60(b) MotionDue Process ClauseFourteenth AmendmentRight of PrivacyArrest RecordsPublic Records ActConstitutional LawJudicial ReviewModification of Injunction
References
57
Case No. ADJ3885172 (SAC 0357351)
Regular
Nov 14, 2016

Why Was Reconsideration Denied in Gomez vs. Dorothy Stevens?

The Workers' Compensation Appeals Board denied Linda O'Brien's petition for reconsideration. O'Brien sought to challenge a prior finding that her former attorney, William J. Carlisle, had "substantially complied" with an order to deliver her workers' compensation file. The Board adopted the administrative law judge's report, which found sufficient evidence, including letters from Carlisle, to support substantial compliance despite O'Brien's claims of non-receipt. The Board also rejected O'Brien's supplemental response.

Workers' Compensation Appeals BoardPetition for ReconsiderationWorkers' compensation administrative law judgeSpecific injurySubstantial complianceSanctionsDeclaration of Readiness to ProceedMinutes of HearingFinding of FactPetitioners Contentions
References
0
Case No. MISSING
Regular Panel Decision

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

This case concerns an appeal filed by William Thomas Clark against Martha Hill Jamison, challenging the denial of his motion to decrease child support payments. Clark argued that his financial circumstances had substantially changed and that the existing support was not in compliance with guidelines. The trial court denied the modification, finding that the children's needs had not decreased and Clark's financial resources remained substantial. The appellate court affirmed the trial court's decision, concluding that there was no abuse of discretion in maintaining the child support order.

Child Support ModificationParental ObligationFinancial CircumstancesBest Interest of the ChildAppellate ReviewAbuse of DiscretionTexas Family LawChild Support GuidelinesMaterial Change in CircumstancesAgreed Order
References
21
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