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

Case No. 03-05-00837-CV
Regular Panel Decision
Dec 23, 2008

Diana Foster v. Texas Retirement System, Trustee for Texas Public Retired School Employees Group Insurance Program Aetna Life Insurance Company And Aetna Health Management, LLC

Diana Foster, a retired teacher, sued the Teacher Retirement System of Texas (TRS) and its insurance administrators, Aetna, after her claim for intravenous immune globulin infusion therapy (IVIG) was denied. She asserted claims for breach of contract, breach of the duty of good faith and fair dealing, violations of the insurance code, and deceptive trade practices, along with a request for declaratory judgment. The trial court granted appellees' pleas to the jurisdiction, dismissing the lawsuit without prejudice, citing sovereign immunity. Foster appealed, arguing her declaratory judgment claim was not barred, legislative immunity was waived, the administrative procedures act provided for judicial review, and Aetna was not protected by sovereign immunity. The appellate court affirmed the trial court's dismissal, finding that sovereign immunity applied to TRS and, by extension, to Aetna as its agent, and that Foster's claims did not fall under any exceptions for judicial review or waiver of immunity.

Sovereign ImmunityGovernment AgencyInsurance DisputeDeclaratory JudgmentAdministrative Procedures ActAgency AdjudicationJudicial ReviewBreach of ContractDuty of Good Faith and Fair DealingDeceptive Trade Practices Act
References
26
Case No. MISSING
Regular Panel Decision
Aug 30, 2001

Claim of Amicola v. New York Telephone Co.

Claimant, an employee of New York Telephone, sustained a low back injury in December 1992 and underwent disc repair surgery. After returning to light duty, he experienced increased back pain, and despite his physician's direction to stop working, he applied for an early retirement incentive program in May 1994, which was granted the following month. The Workers’ Compensation Board subsequently reversed a WCLJ decision, ruling that the claimant voluntarily withdrew from the labor market due to his early retirement. The Court affirmed the Board's determination, finding substantial evidence to support that the claimant elected to retire, influenced by a significant financial incentive, despite his injury. The decision emphasized that the availability of workers' compensation benefits would not cease with retirement, further supporting the voluntary nature of his withdrawal.

Workers' CompensationVoluntary WithdrawalLabor MarketEarly RetirementDisabilityBack InjuryAppealBoard DecisionSubstantial EvidenceFinancial Incentive
References
5
Case No. MISSING
Regular Panel Decision

Grant v. Grant

This case addresses whether a husband can avoid a spousal support order by voluntarily retiring. The respondent, a 62-year-old bricklayer and construction worker, sought to terminate a $15 weekly support order for his 59-year-old wife after electing early retirement and receiving social security. The court found that eligibility for retirement does not negate the responsibility to support, emphasizing earning power over actual earnings. Citing precedents, the court asserted that a husband's obligation continues if he possesses sufficient means or earning capacity. The decision concluded that the respondent's early retirement appeared motivated by a desire to avoid support, especially since he could earn up to $1,800 annually under Social Security Law. The support order was continued, with an additional $3 weekly payment ordered to cover arrears.

AlimonySpousal SupportVoluntary RetirementEarning CapacitySocial Security BenefitsArrearsFamily CourtDomestic RelationsSupport Order ModificationAbility to Earn
References
6
Case No. 03-03-00199-CV
Regular Panel Decision
Jan 08, 2004

Valentine Cantu, Maria Padilla, Carolyn Chatham, Suzanne Hoog-Watson and George Denton v. Texas Workforce Commission and Employees Retirement System of Texas

This case, heard by the Texas Court of Appeals, Third District, involves an appeal from a summary judgment in a suit alleging age discrimination under the Texas Commission on Human Rights Act. Appellants, former employees of the Texas Workforce Commission, claimed they were terminated due to age and that the Employees Retirement System of Texas misinterpreted a government code section regarding early retirement benefits. The Court of Appeals affirmed the district court's summary judgment, concluding that the appellants failed to establish a prima facie case of age discrimination and that the Retirement System's interpretation of former government code section 814.1041(b) was correct. The court also found no abuse of discretion in denying attorney's fees or excluding evidence.

Age discriminationSummary judgmentTexas Commission on Human Rights ActRetirement benefitsGovernment code interpretationStatutory constructionLegislative intentDisparate impactPretext methodPrima facie case
References
28
Case No. MISSING
Regular Panel Decision

Martinez v. Schlumberger Ltd.

This case involves an action removed from state court, where plaintiffs William Martinez, Frank Ditta, and Lafayette Kirksey sued Schlumberger Limited and Schlumberger Technology Corporation. Plaintiffs' state-law claims of fraud, fraudulent inducement, negligence, and gross negligence, stemming from alleged misrepresentations about future early retirement benefits, were preempted by the Employee Retirement Income Security Act of 1974 (ERISA). Plaintiffs contended that Schlumberger falsely denied considering enhanced early retirement packages, leading them to retire before a new Voluntary Early Retirement Plan (VERP) was announced. The court construed the action as a breach of fiduciary duty claim under ERISA and adopted a version of the 'serious consideration' test to determine when an employer's duty to disclose plan changes arises. Finding that the VERP was not under 'serious consideration' until after the plaintiffs' retirement, the court granted summary judgment in favor of the defendants on all claims, including the breach of fiduciary duty and an unresolved claim for interest on profit sharing plans.

ERISAFiduciary DutySummary JudgmentEarly Retirement PlanMisrepresentationEmployee BenefitsSerious Consideration TestPreemptionFraudNegligence
References
27
Case No. MISSING
Regular Panel Decision
May 06, 2002

Claim of De Simone v. Consolidated Edison Co. of New York, Inc.

A claimant, after a 33-year career with the employer involving asbestos exposure, was diagnosed with a severe, permanent asbestos-related pulmonary and pleural disease by July 2000. He retired in May 2001 at age 55, informing his employer that his disability prevented him from continuing work. The employer challenged his eligibility for post-retirement benefits, asserting a voluntary withdrawal from the labor market. However, a Workers’ Compensation Law Judge and subsequently the Workers’ Compensation Board found a causal link between his disability and retirement, awarding him benefits. The appellate court affirmed the Board's decision, concluding that substantial evidence supported the finding that the claimant's retirement was not a voluntary withdrawal from the labor market.

Asbestos ExposureOccupational DiseasePulmonary AsbestosPleural DiseaseRetirement BenefitsVoluntary WithdrawalLabor MarketSubstantial EvidenceCausationDisability
References
4
Case No. MISSING
Regular Panel Decision

Bell v. Xerox Corp.

Fifteen plaintiffs sued Xerox Corporation and its associated benefit plans under ERISA, alleging that Xerox promised them unchanging lifetime medical and dental benefits during an early retirement program in 1987. They claimed Xerox breached this promise by introducing a reservation-of-rights clause in 2008 and by improperly changing the calculation of the 6% out-of-pocket maximum for medical expenses. Defendants moved to dismiss, citing lack of standing, untimeliness, and arguing the early retirement program was not an ERISA plan. The court denied dismissal on standing, statute of limitations, and the ERISA plan status, allowing most of plaintiffs' claims to proceed. However, it dismissed Xerox Corporation as a defendant for certain claims, along with the state law promissory estoppel claim and the claim for statutory damages under ERISA § 1132(c).

ERISAEmployee BenefitsRetirement PlansMedical BenefitsDental BenefitsPromissory EstoppelStatute of LimitationsStandingReservation of Rights ClausePlan Administrator Discretion
References
47
Case No. MISSING
Regular Panel Decision

Claim of Lombardi v. Brooklyn Union Gas Co.

A claimant, an inspector for Brooklyn Union Gas Company, was injured in a slip and fall in 1994 but returned to normal duties after a period of light duty. He subsequently retired under an early retirement incentive program. The Workers’ Compensation Board reversed a prior decision, determining that the claimant had voluntarily withdrawn from the labor market and thus denied his claim for workers’ compensation benefits. The Appellate Division affirmed the Board’s determination, concluding that it was supported by substantial evidence. The court also rejected the claimant’s argument that the Board improperly considered his pension benefits in its analysis of voluntary withdrawal, stating that pension election is a relevant factor in such determinations.

Voluntary WithdrawalLabor MarketWorkers' Compensation BenefitsEarly RetirementDisability ClaimSubstantial EvidenceMedical TestimonyPension ConsiderationsAppellate ReviewWorkers’ Compensation Law § 30
References
9
Case No. MISSING
Regular Panel Decision

Loucks v. Board of Education of Middle County School District No. 11

Margaret R. Loucks, a former librarian for the Middle County School District No. 11, filed a lawsuit alleging age discrimination under the Age Discrimination in Employment Act (ADEA). She claimed that the school district's early retirement incentive plan discriminated against her because employees who retired at age 55 received 100% health insurance benefits, while she, having retired at 58, received only 50%. Loucks contended that the plan, which based eligibility on age 55, arbitrarily discriminated. The U.S. District Court, presided over by Judge Joseph F. Bianco, examined cross-motions for summary judgment. The Court found the retirement incentive plan to be permissible under the ADEA's safe harbor provision, referencing Auerbach v. Board of Education, which upheld similar early retirement plans. The Court concluded that the plan was voluntary, offered for a reasonable period, and did not arbitrarily discriminate on the basis of age by providing the same benefits to all eligible participants at 55. Consequently, the defendant's motion for summary judgment was granted, the plaintiff's motion was denied, and the complaint was dismissed.

Age DiscriminationEarly Retirement IncentiveADEASummary JudgmentCollective Bargaining AgreementSafe Harbor ProvisionHealth Insurance BenefitsEmployment LawFederal CourtDiscrimination Law
References
33
Case No. MISSING
Regular Panel Decision

Olszowy v. Norton Co.

Plaintiff Henry Olszowy, a former employee of Norton Company, retired in 1983 with a special early retirement option. His pension benefits were subsequently reduced due to a workers' compensation award from a 1973 back injury, as Norton applied an offset provision. Olszowy sued Norton, the Retirement Program, and its trustee, claiming there was no agreement for such an offset. A jury found in favor of Olszowy, leading to a judgment against the Retirement Program and its trustee. The defendants appealed, arguing the jury's verdict was unsupported by evidence, as the agreement between Norton and the union clearly provided for the offset. The appellate court reversed the judgment, finding the jury's verdict was based on plaintiff's unsupported interpretation and not on sufficient evidence.

Pension offsetWorkers' compensation benefitsEarly retirement programCollective bargaining agreementContract interpretationJury verdict reversalSufficiency of evidenceWeight of evidenceAppellate reviewEmployee benefits
References
3
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