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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

McCarver v. Insurance Co. of the State of Pennsylvania

This workers' compensation case before the Tennessee Supreme Court centered on two critical issues: the constitutionality of a state statute granting jurisdiction to the General Sessions Court for Warren County in workers' compensation matters, and the vocational disability award for the claimant. The defendants, Carrier Corporation and The Insurance Company of the State of Pennsylvania, challenged the jurisdiction of the General Sessions Court for Warren County, arguing that Tennessee Code Annotated section 16-15-5004(c) violated article XI, section 8 of the Tennessee Constitution. The Court affirmed the trial court's decision, finding a rational basis for the statute and thus upholding the lower court's jurisdiction. Additionally, the Supreme Court affirmed the trial court's award of 88.2% permanent partial disability to the claimant, Betty Sue McCarver, whose bilateral shoulder injuries from her employment with Carrier Corporation led to a finding of significant vocational disability supported by medical and vocational expert testimony.

Workers' CompensationJurisdictionConstitutional LawTennessee Constitution Article XI Section 8General Sessions CourtWarren CountySubject Matter JurisdictionDisability AwardShoulder InjuryRotator Cuff
References
17
Case No. MISSING
Regular Panel Decision

Matter of Williams v. Preferred Meal Systems

Claimant, a driver, suffered injuries to his right knee and back in 2009 while making a delivery, leading to an established workers' compensation claim. The claim was later amended to include consequential adjustment disorder, and the Workers' Compensation Board ultimately found that claimant had sustained a permanent total disability from May 2012 onward. The employer, workers’ compensation carrier, and policy administrator appealed this decision, arguing that further proof was needed regarding claimant's vocational and functional capacity. The court affirmed the Board's decision, holding that extensive evidence of vocational and functional capacity is not required when medical proof demonstrates a permanent total disability and inability to engage in any gainful employment, as benefits continue for life in such cases. The court found substantial evidence in the opinions of treating and independent medical examination orthopedists to support the finding of permanent total disability.

Workers' CompensationPermanent Total DisabilityWage-Earning CapacityMedical ProofVocational CapacityFunctional CapacityAppellate ReviewNew York LawDisability BenefitsClaimant Rights
References
4
Case No. MISSING
Regular Panel Decision

Donaldson v. Texas Department of Aging & Disability Services

David Donaldson appealed a trial court's summary judgment in favor of the Texas Department of Aging and Disability Services (DADS) on claims of race and disability discrimination, retaliation, and hostile work environment under the TCHRA and Title VII. Donaldson, an African-American employee diagnosed with multiple conditions including prostate cancer and PTSD, alleged DADS failed to accommodate his disabilities and discriminated against him through various adverse actions, culminating in his termination. The appellate court affirmed the summary judgment for DADS on the race discrimination, retaliation, and hostile work environment claims, finding insufficient evidence of discriminatory intent or materially adverse actions in those areas. However, the court reversed and remanded the reasonable accommodation claim, concluding that Donaldson presented a fact issue regarding DADS's failure to provide continued assistance for his disabilities despite initial accommodations. This decision partially reverses the trial court's judgment, necessitating further proceedings on the reasonable accommodation aspect of the disability discrimination claim.

DiscriminationRetaliationHostile Work EnvironmentDisability DiscriminationRace DiscriminationReasonable AccommodationSummary JudgmentTexas Commission on Human Rights ActTitle VIIEmployment Law
References
83
Case No. 2021 NY Slip Op 07401
Regular Panel Decision
Dec 23, 2021

Matter of Carola B.-M. v. New York State Off. of Temporary & Disability Assistance

Petitioners Carola B.-M. and Tiara M. challenged the denial of their supplemental nutrition assistance program (SNAP) benefits by the New York State Office of Temporary and Disability Assistance and the Orleans County Department of Social Services. The benefits were denied because they were deemed ineligible college students. The Appellate Division, Fourth Department, reversed this determination, holding that participation in the Adult Career and Continuing Education Services, Vocational Rehabilitation program (ACCES-VR) qualifies as a Job Training Partnership Act (JTPA) program. This status exempts the students from certain SNAP eligibility requirements. The court found that the original determination was based on an unreasonable interpretation of relevant regulations, annulled the decision, granted the petition, and remitted the case for a calculation of retroactive benefits.

SNAP benefitscollege student eligibilityJob Training Partnership ActACCES-VRvocational rehabilitationCPLR article 78regulatory interpretationpublic assistancefood stampsAppellate Division
References
28
Case No. 08-23-00177-CV
Regular Panel Decision
Aug 30, 2024

Texas Department of Aging and Disability Services v. Claudia Gomez

The Texas Department of Aging and Disability Services (DADS) terminated Claudia Gomez, alleging she physically assaulted a coworker; Gomez contended the termination was discriminatory based on age, gender, and disability. The trial court denied DADS's plea to the jurisdiction regarding Gomez's discrimination claims. On appeal, the court found Gomez failed to present evidence of a similarly situated comparator, thus not establishing a prima facie case for age, gender, or disability discrimination. Furthermore, Gomez did not demonstrate that DADS's stated reason for termination was a pretext for discrimination. Consequently, the appellate court reversed the trial court's decision and dismissed Gomez's claims for lack of jurisdiction.

DiscriminationAge DiscriminationGender DiscriminationDisability DiscriminationEmployment LawTerminationPretextPrima Facie CaseSovereign ImmunityTexas Labor Code
References
30
Case No. MISSING
Regular Panel Decision

Smith v. Bayer Corp. Long Term Disability Plan

Plaintiff Terry Smith, a former Diabetes Sales Specialist for Bayer Corporation, filed an action under ERISA to recover long-term disability benefits, claiming wrongful denial due to psychiatric impairments including depression, panic disorder, and bi-polar disorder. The Plan administrator, Bayer, upheld the denial based on reviews by non-examining physicians. However, Smith's treating psychiatrists, Dr. LeBuffe and Dr. McCool, consistently found him disabled. The court found the Plan's reliance on non-examining doctors, who 'cherry-picked' medical records and distorted findings, to be arbitrary and capricious. Consequently, the court granted Smith's motion for benefits, denying Bayer's, and also awarded partial disability benefits, ruling that Smith's failure to seek rehabilitation approval was excused by the prior wrongful denial.

ERISALong-term disabilityDisability benefits denialPsychiatric impairmentDepressionPanic disorderBi-polar disorderAttention Deficit Disorder (ADD)Treating physician ruleArbitrary and capricious standard
References
26
Case No. ADJ11184599, ADJ11184523
Regular
Feb 24, 2020

Gregory White vs. Sky 2 Collision Corporation, Illinois Midwest Insurance Company, Inc., National Casualty Company

The Workers' Compensation Appeals Board denied Gregory White's petition for reconsideration of a $47\%$ permanent disability award. White argued he was permanently totally disabled due to vocational limitations, but the Board found substantial evidence supported his ability to benefit from vocational rehabilitation. The Board affirmed the Administrative Law Judge's finding that White was not permanently totally disabled and that his vocational expert's report was less persuasive than the defense vocational expert's. Issues regarding vocational costs were deferred pending a separate petition.

Cumulative traumaSpecific injuryLow back injuryLumbar spineBacterial infectionStreptoccocusLaminectomyPermanent disabilityVocational rehabilitationQualified injured worker
References
4
Case No. ADJ8287242, ADJ9662736, ADJ9662737, ADJ9662738, ADJ9662740, ADJ9662743, ADJ9662744, ADJ9662745, ADJ9662746, ADJ9662747, ADJ9662748
Regular
Jul 29, 2019

TOBIAS ZUCCO vs. CALIFORNIA DEPARTMENT OF STATE HOSPITALS, STATE COMPENSATION INSURANCE FUND

This case involves multiple workers' compensation claims by applicant Tobias Zucco against the California Department of State Hospitals. The initial decision found a $77\%$ permanent disability based on scheduled impairments, rejecting vocational experts' opinions of total disability. Applicant sought reconsideration, arguing for unapportioned permanent total disability. The Appeals Board granted reconsideration, rescinded the prior decision, and remanded the case to find $80\%$ permanent disability, incorporating a $20\%$ non-industrial apportionment to the vocational experts' findings of total disability. The Board found the vocational experts' conclusions supported overall permanent total disability, overriding the trial judge's credibility assessment.

Workers' Compensation Appeals BoardPsychiatric TechnicianCumulative InjuryPermanent DisabilityVocational RehabilitationPermanent Total DisabilityAgreed Medical EvaluatorApportionmentCredibilityJoint Findings of Fact
References
0
Case No. MISSING
Regular Panel Decision

Smith v. New York State & Local Retirement Systems

Petitioner, a taxpayer services representative, sustained a back injury in March 1981 while lifting forms, leading to a decline in attendance and eventual termination in November 1989. She applied for accidental and ordinary disability retirement benefits, both of which were denied by the Comptroller. The accidental disability claim was denied because the incident was not deemed an 'accident' under Retirement and Security Law § 63. The ordinary disability claim was denied as untimely, having been filed approximately six months after her termination, exceeding the 90-day limit stipulated by Retirement and Social Security Law § 62. The Supreme Court dismissed the challenge to the ordinary disability denial due to untimeliness and transferred the accidental disability challenge to this Court. This Court confirmed the Comptroller's determination on both counts, rejecting the petitioner's estoppel argument regarding the untimely ordinary disability application and finding substantial evidence to support the finding that the injury did not constitute an 'accident' within the meaning of the relevant law, as it resulted from ordinary employment duties without an unexpected event.

Disability Retirement BenefitsAccidental DisabilityOrdinary DisabilityUntimely ApplicationEstoppel Against GovernmentWork-Related InjuryBack InjuryDefinition of AccidentOrdinary Employment DutiesSubstantial Evidence Review
References
16
Case No. ADJ8903652
Regular
Nov 30, 2017

Deric Hobson vs. BECHTEL GROUP, INC.

The Workers' Compensation Appeals Board granted reconsideration, amending the original award to find applicant permanently totally disabled (100% permanent disability). This decision overturned the trial judge's finding of 88% permanent disability, accepting the applicant's argument that his admitted Valley Fever injury rendered him unemployable. The Board found persuasive the vocational expert's opinion that the applicant's chronic pain, fatigue, and concentration issues made him unemployable and not amenable to vocational rehabilitation, despite the defense's vocational expert's opposing view. The case was returned for a new award reflecting 100% permanent disability.

Valley FeverCoccidiomycosiscumulative traumapermanent total disabilityvocational expertAMA GuidesWhole Person Impairmentsemi-sedentary workactivities of daily livingvocational rehabilitation
References
2
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