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

Case No. ADJ1529826 (LBO 0387552)
Regular
2015-00-00

MARY COSS vs. CENTURY 21, NATIONAL LIABILITY & FIRE INSURANCE COMPANY

The Appeals Board dismissed the lien claimant's petition for reconsideration as untimely, finding it was filed over a year after the deadline. Despite the lien claimant's claims of not receiving notice, the Board found evidence of prior knowledge, including refiling the lien claim and a pattern of alleging lack of notice. The Board also initiated proceedings to assess attorney's fees, costs, and/or sanctions against the lien claimant for filing a frivolous and untimely petition. This decision highlights the importance of adhering to procedural deadlines and substantiating claims with evidence in workers' compensation proceedings.

References
6
Case No. MISSING
Regular Panel Decision

Angulo v. City of New York

In a personal injury action, the defendant City of New York appealed an order from the Supreme Court, Queens County. The original order denied the City's motion to dismiss the complaint for failure to timely serve a notice of claim and granted the plaintiff's cross-motion to deem his notice of claim timely served nunc pro tunc. The plaintiff, injured in May 2005, served his notice of claim in August 2005, which the City rejected as untimely. The Appellate Division reversed the lower court's order, granting the City's motion to dismiss the complaint and denying the plaintiff's cross-motion. The court held that timely service of a notice of claim is a condition precedent to suing the City and that the plaintiff failed to make a timely application for leave to serve a late notice of claim. Furthermore, the court ruled that the plaintiff could not rely on the workers' compensation carrier's notice of claim.

Personal InjuryNotice of ClaimTimelinessCondition PrecedentCPLR 3211(a)(7)General Municipal Law § 50-eDismissal of ComplaintLate Notice of ClaimNunc Pro TuncWorkers' Compensation Carrier
References
7
Case No. ADJ7405264
Regular
Oct 18, 2011

IVORY PHILLIPS vs. IRWIN INDUSTRIES, INC./ZURICH NORTH AMERICA

The Appeals Board dismissed Defendant Irwin Industries' untimely petition for removal. The Board then initiated removal on its own motion, intending to impose sanctions on adjuster Richard Bailey for failing to appear at a hearing despite explicit notice that the hearing would proceed. The Board found Bailey's non-appearance may constitute a bad faith tactic intended to cause unnecessary delay, noting this refusal undermined the arbitration process.

Petition for RemovalUntimelyArbitratorJurisdictionSanctionsLabor Code § 5813Independent Medical ExaminerMedical Provider NetworkCompensabilityADR Agreement
References
1
Case No. ADJ5814563
Regular
Nov 19, 2012

MARIA VILLEGAS vs. BURKE WILLIAMS, INC., TRAVELERS SACRAMENTO

The Appeals Board dismissed the lien claimant's Petition for Reconsideration as untimely, unverified, and unserved. The Board also initiated removal and a notice of intention to impose a $250 sanction against the lien claimant and its representative for frivolous conduct, including filing a petition with willful misrepresentations of the record. The lien claimant failed to appear at a lien conference, leading to a Notice of Intention to Dismiss, which formed the basis of the dismissed petition. The Board found the lien claimant's assertion of lack of notice contradicted the record, which showed service of the conference notice.

Notice of Intention to Dismiss LienPetition for ReconsiderationLien claimantRemovalSanctionsLabor Code § 5813Due processVerificationServiceUntimely
References
9
Case No. MISSING
Regular Panel Decision

Benavidez v. TRAVELERS INDEMNITY COMPANY OF CONNECTICUT

This case addresses two key issues concerning judicial review of a Texas Workers' Compensation Commission Appeals Panel decision. The first issue is when a party seeking judicial review is required to file a copy of its petition with the Commission under Texas Labor Code section 410.253. The second issue is whether untimely notice to the Commission under this section deprives the trial court of jurisdiction over the judicial review action. The court of appeals had previously held that the filing was required within forty days of the Appeals Panel decision and was mandatory and jurisdictional. However, the Supreme Court, referencing Albertson’s, Inc. v. Sinclair, clarifies that the petition must be filed with the Commission on the same day it is filed in the trial court, and while timely filing is mandatory, it is not jurisdictional. Consequently, the court of appeals' judgment was reversed, and the case was remanded to the trial court for further proceedings.

Workers' CompensationJudicial ReviewAppeals Panel DecisionTimely FilingJurisdictionMandatory RequirementTexas Labor CodeCourt of Appeals ReversalRemandCivil Procedure
References
3
Case No. MISSING
Regular Panel Decision

Claim of Miller v. North Shore University Hospital

Claimant, a registered nurse, allegedly exacerbated an abdominal injury in September 1994 while at work, but did not file a workers' compensation claim until May 1996, after undergoing surgery. The workers' compensation carrier subsequently controverted the claim, citing untimely notice. Both a Workers' Compensation Law Judge and the Workers' Compensation Board determined that the claimant failed to provide timely notice to the employer as mandated by Workers’ Compensation Law § 18. On appeal, the court affirmed the Board's decision, concluding that the emergency room report was insufficient to constitute proper notice. Furthermore, the claimant did not meet his burden of proving that the employer was not prejudiced by the delay in notice, as the delay prevented an investigation prior to his surgery.

Timely NoticeEmployer KnowledgePrejudiceAbdominal InjuryRegistered NurseAccident ReportEmergency RoomSurgeryAppellate ReviewWorkers' Compensation Law § 18
References
5
Case No. MISSING
Regular Panel Decision

Claim of Wilkinson v. Bendix Friction Corp.

Claimant filed a workers' compensation claim after being diagnosed with a lung condition, which a Workers' Compensation Law Judge (WCLJ) determined in August 2003 was an occupational disease causally related to 1969 asbestos exposure while working for the employer, though not currently disabling. The claimant sought review. The Workers' Compensation Board, in January 2004, found the employer's rebuttals to be untimely. Subsequently, the employer and its third-party administrator filed an application for Board review in February 2004, which the Board denied as untimely in October 2004. The employer appealed this denial. The appellate court affirmed the Board's decision, finding no abuse of discretion in denying the application as untimely, given that the employer had received proper notice of the WCLJ decision.

Workers' CompensationUntimely ApplicationBoard ReviewOccupational DiseaseAsbestos ExposureCausal RelationDisability ClaimAppellate Decision
References
4
Case No. MISSING
Regular Panel Decision

McDonald-Besheme v. Verizon Wireless, Inc.

Claimant, an operations specialist, was injured in a fall in March 2003 and subsequently filed a claim for workers’ compensation benefits. The employer failed to file a notice of controversy within the 25-day statutory period after receiving the notice of indexing on August 1, 2003. A Workers’ Compensation Law Judge found the employer's notice untimely, precluding the employer from contesting the employer-employee relationship or that the injury arose out of employment. The Workers’ Compensation Board upheld this determination, as the employer did not demonstrate good cause for the delay. The employer appealed, but the court affirmed the Board’s decision.

Late Notice of ControversyEmployer LiabilityTimeliness of FilingAppeal DecisionAdministrative ReviewStatutory ComplianceDiscretionary PowersAbsence of Good CausePreclusion of DefenseWorkplace Injury Claim
References
4
Case No. MISSING
Regular Panel Decision

Hernandez v. Texas Department of Insurance

Hernandez, an insurance agent, had her license revoked by the Commissioner of Insurance. Her timely motion for rehearing was overruled by operation of law on January 16, 1995, after the Commissioner failed to act within 45 days. Hernandez filed for judicial review on March 3, 1995, after receiving a late notification. The trial court dismissed her petition as untimely. On appeal, Hernandez argued the agency had a duty to notify her of the motion being overruled by operation of law. The appellate court affirmed the trial court's dismissal, holding the Administrative Procedure Act does not require such notice, thus rendering Hernandez's petition for judicial review untimely.

Administrative LawJudicial ReviewTimelinessMotion for RehearingOperation of LawNotice RequirementAppellate ProcedureJurisdictionStatutory InterpretationInsurance Agent
References
10
Case No. ADJ4440540
Regular
Mar 05, 2014

MODESTO VARGAS vs. SPEARS MANUFACTURING CO., ZURICH INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the lien claimants' Petition for Reconsideration, affirming the dismissal of their liens for failing to appear at a noticed lien conference and for subsequently failing to object to the dismissal notices. The Board also imposed $2,500 in sanctions against the lien claimants' representatives, Qualified Billing and Collections, LLC, and Diego S. Plasencia, for filing a skeletal petition without merit and for their untimely and unsubstantiated objection. This decision reiterates the importance of timely appearance and proper procedural compliance in workers' compensation proceedings.

WCABPetition for ReconsiderationOrders Dismissing LiensPetition for ReconsiderationNotice of Intention to Impose SanctionsSanctionsQualified Billing and CollectionsLLCDiego S. PlasenciaLien claimants
References
5
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