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

Case No. 07-10-0367-CR; 07-10-0368-CR
Regular Panel Decision
Oct 20, 2010

Carlos Vigil v. State

This appellate decision concerns two criminal appeals from Carlos Vigil. The appellate court noted that neither the clerk's record nor the reporter's records were filed, and appellant's counsel sought to withdraw, citing non-employment and appellant's affidavit of indigence. The court abated the appeals and remanded the causes to the trial court to determine if Vigil wished to prosecute the appeals, his indigence, and his entitlement to a free appellate record and appointed counsel. Additionally, the decision addresses issues related to Lee Lewis Construction, Inc. (LLC) and KK Glass in a separate but consolidated aspect of the case, concerning a death case (Jimmy Harrison). The court found legally and factually sufficient evidence for gross negligence against LLC but deemed the $500,000 compensatory damages for pain and mental anguish factually insufficient, suggesting a remittitur to $50,000. The summary judgment granted to KK Glass, denying LLC's claims for contribution and indemnity, was affirmed.

Criminal AppealIndecency with a ChildAppellate ProcedureAbatement and RemandIndigence DeterminationRight to CounselWorkers' Compensation ExclusivityGross NegligenceExemplary DamagesCompensatory Damages
References
35
Case No. MISSING
Regular Panel Decision

Powell v. Vigilant Insurance Co.

J. Frank Powell, a partner in Ponderosa Motor Inn, filed a workers' compensation claim after an injury, receiving an award. Vigilant Insurance Company, the insurer, appealed to the District Court, seeking to set aside the award. Powell counterclaimed for total and permanent disability. The insurance company moved for summary judgment, arguing Powell, as a partner, was not covered by the policy due to the absence of a specific endorsement as required by Art. 8309, sec. 1a. The trial court granted summary judgment for the insurer, which was affirmed on appeal. Powell contended the insurer was estopped from denying coverage based on the agent's representation and inclusion of his salary in financial statements for premium calculation, but the appellate court found no evidence of a special contract for partner coverage.

Workers' CompensationPartnership LawInsurance CoverageSummary JudgmentEstoppelPolicy EndorsementInsurance Agent AuthorityEmployee StatusTexas LawAppellate Review
References
6
Case No. MISSING
Regular Panel Decision

Vigilant Insurance Co. v. Travelers Property Casualty Co. of America

The case concerns a coverage lawsuit for equitable subrogation between Vigilant Insurance Co. (Plaintiff) and Travelers Property Casualty Company of America (Defendant). Vigilant sought to recover $650,000 it contributed to a $5.3 million settlement in an underlying personal injury case, arguing Travelers improperly refused to acknowledge priority of coverage. Travelers countered that Vigilant's payment was voluntary and the settlement unreasonable. The Court granted Vigilant's motion in part, finding its payment was not voluntary and was an obligation for which Vigilant was not primarily liable. However, the Court denied summary judgment on the reasonableness of the settlement, citing a genuine dispute of material fact and scheduling a trial for this issue.

Equitable SubrogationInsurance CoverageVoluntary Payment DoctrineSummary JudgmentPersonal Injury SettlementNew York Labor LawIndemnificationExcess InsurancePrimary InsuranceDeclaratory Judgment
References
51
Case No. MISSING
Regular Panel Decision
Jul 22, 2005

National Football League v. Vigilant Insurance

This appeal addresses whether a former college football player's antitrust lawsuit against the NFL, regarding its draft eligibility rule, falls under the employment practices exclusion of an insurance policy issued by Vigilant. The court determined that the exclusion was open to a reasonable interpretation that would make it inapplicable to the antitrust claim. As a result, the trial court's dismissal of the complaint was reversed. The court emphasized that the exclusion, primarily focused on employment law claims and workplace torts, did not clearly and unambiguously extend to the NFL's liability when not acting as an employer in an antitrust context. Consequently, any ambiguity in the policy's scope was resolved in favor of the insured, the NFL.

Insurance Coverage LitigationEmployment Practices ExclusionAntitrust Law ChallengeNFL Draft RulesPolicy AmbiguityContract InterpretationDeclaratory ReliefWrongful Deprivation of Career OpportunityStatutory ConstructionEjusdem Generis Principle
References
8
Case No. MISSING
Regular Panel Decision

Marquez v. Providence Memorial Hospital

Ophelia Marquez appealed the dismissal of her medical malpractice suit against Providence Memorial Hospital, Tenet Healthcare Corporation, and Dr. Jacob Vigil. The trial court had dismissed the case for Marquez's failure to comply with the expert report requirements of the Texas Medical Liability and Insurance Improvement Act (MLIIA). Marquez contended the trial court abused its discretion in denying her motion for a grace period and challenged the constitutionality of the MLIIA's sanctions and the award of attorney's fees. The appellate court affirmed the dismissal, finding no abuse of discretion as Marquez did not sufficiently prove her non-compliance was accidental or mistaken, and upheld the constitutionality of the MLIIA and the attorney's fee awards.

Medical MalpracticeExpert ReportMedical Liability and Insurance Improvement ActMLIIADismissalGrace PeriodDue ProcessConstitutional ChallengeAttorney FeesStandard of Review
References
30
Case No. ADJ11201607 (MF); ADJ11201608
Significant
Jun 10, 2024

Sammy Vigil vs. County of Kern

The Appeals Board holds that the Combined Values Chart (CVC) in the Permanent Disability Ratings Schedule (PDRS) may be rebutted by adding impairments when an applicant demonstrates through substantial evidence that there is no overlap in the impact on Activities of Daily Living (ADLs), or that any overlap creates a synergistic effect that amplifies the disability.

Workers' Compensation Appeals BoardEn Banc DecisionReconsiderationPermanent Disability Ratings ScheduleCombined Values ChartRebuttalActivities of Daily LivingSynergistic EffectApportionmentHikida
References
18
Case No. ADJ11201607, ADJ11201608
Regular
Jun 10, 2024

SAMMY VIGIL vs. COUNTY OF KERN

The Appeals Board held that the Combined Values Chart (CVC) may be rebutted and impairments added where an applicant establishes the impact of each impairment on the activities of daily living (ADLs) and shows either that there is no overlap between the effects on ADLs or that the overlap increases or amplifies the impact on the overlapping ADLs.

WCABEn BancReconsiderationFindings of FactAwards and OrdersPermanent Partial DisabilityHip Replacement SurgeryApportionmentCombined Values ChartPermanent Disability Ratings Schedule
References
19
Case No. MISSING
Regular Panel Decision

Lozano v. Vigilant Insurance Co.

This is an appeal from a take-nothing judgment in a worker’s compensation case. The appellant claimed the trial court erred in overruling his motion for a new trial because the jury answers regarding partial incapacity and earning capacity were in irreconcilable conflict. The jury found permanent partial incapacity with an average weekly earning capacity during incapacity equal to the alleged pre-injury wage. The appellate court found no statement of facts or stipulation regarding pre-injury earning capacity in the record. Citing precedent, the court affirmed that a worker’s compensation claimant can be partially disabled without a reduction in earning capacity, thereby finding no irreconcilable conflict in the jury’s answers. The judgment of the trial court was affirmed.

Worker's CompensationPartial IncapacityEarning CapacityJury VerdictIrreconcilable ConflictMotion for New TrialAppellate ReviewAffirmationSufficiency of EvidenceJudgment
References
3
Case No. ADJ3639705
Regular
Oct 01, 2009

THEMAS VIGIL vs. SAN DIEGO UNIFIED SCHOOL DISTRICT

The WCAB rescinds the WCJ's decision and returns the matter for further proceedings to develop the record on apportionment and for a new decision by the WCJ.

ApportionmentLabor Code Section 4664Labor Code Section 4663Permanent DisabilityPrior Industrial InjuriesConclusive PresumptionOverlapMedical EvidenceAgreed Medical EvaluatorCumulative Trauma
References
10
Case No. ADJ971954 (OAK 0113623)
Regular
Dec 19, 2014

LEO VIGIL vs. MILAN'S SMOKED MEATS, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board granted reconsideration and affirmed the finding that the defendant's utilization review (UR) denials were untimely served, rendering them invalid. As a result, the Board found the requested medications, Norco and Pennsaid, to be reasonably necessary based on substantial medical evidence from the applicant's physician. However, the Board limited Norco refills to five, acknowledging that ongoing opioid use requires periodic review, unlike the nurse case manager services in a prior case. The case was returned to the trial level for further proceedings.

Utilization ReviewRequest for AuthorizationNorcoPennsaidTimelinessServiceInvalid URMedical NecessityDubon IDubon II
References
6
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