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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
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

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. 02-14-00084-CV
Regular Panel Decision
Dec 11, 2014

William D. Layton v. City of Fort Worth, City of Fort Worth Employees' Retirement Fund, and Board of City of Fort Worth Employees' Retirement Fund

Appellant William D. Layton sued the City of Fort Worth and its retirement entities after his disability benefits were terminated. The trial court granted the defendants' plea to the jurisdiction, which Layton appealed. The appellate court affirmed, holding that no statute provided a right to judicial review of the Board’s order terminating disability benefits. Furthermore, Layton had no vested property right in the benefits, and his due course of law claim seeking reinstatement of benefits would improperly control the Board's discretionary decision-making, thus implicating governmental immunity.

Disability BenefitsGovernmental ImmunityPlea to JurisdictionJudicial ReviewVested Property RightsDue Course of LawMunicipal Retirement SystemAdministrative OrderDiscretionary AuthorityTexas Constitution
References
37
Case No. MISSING
Regular Panel Decision
Jun 11, 1990

Waldeck v. New York City Employees' Retirement System

A New York Supreme Court panel reversed a lower court's decision that had granted a deferred retirement allowance to a Department of Sanitation employee, Barbaro. Barbaro, a member of NYCERS since 1969, sought a deferred retirement allowance in July 1989, with an intended retirement date of August 18, 1989. However, he was dismissed on August 17, 1989, for soliciting unlawful payments. The appellate court determined that his dismissal occurred prior to his intended retirement date, thereby rendering him ineligible for the vested retirement allowance under Administrative Code § 13-173.1. The court clarified that the effective date of discharge was when the Commissioner signed the termination letter, irrespective of the date for commencing an appeal.

Retirement AllowancePublic EmployeeDismissalVestingAdministrative LawCivil ServiceNew York CityDepartment of SanitationAppellate ReviewEmployment Law
References
1
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. MISSING
Regular Panel Decision

Claim of Clohesy v. Consolidated Edison Co.

Claimant, a utility company employee, filed three workers’ compensation claims between 1979 and 1997 for back/neck injuries and asbestosis. He resigned in December 1999, which the employer contended was a voluntary withdrawal from the labor market. A Workers’ Compensation Law Judge disagreed, but the Workers’ Compensation Board reversed, finding the retirement voluntary. Claimant appealed this Board decision. The Appellate Division found the Board’s decision was not supported by substantial evidence, noting the claimant had legitimate medical ailments interfering with his duties, and the Board unduly emphasized the lack of explicit medical advice to retire. The court reversed the Board's decision and remitted the matter for further proceedings.

Voluntary withdrawal from labor marketWorkers' Compensation benefitsPermanent partial disabilityAsbestosis diagnosisMotor vehicle accident claimsMedical evidenceSubstantial evidence reviewAppellate reviewRemittalDisability contributing to retirement
References
7
Case No. 03-05-00837-CV
Regular Panel Decision
Dec 23, 2008

Lamb County Electric Cooperative, Inc. v. Public Utility Commission of Texas

Diana Foster, a retired teacher, appealed the dismissal of her lawsuit against the Teacher Retirement System (TRS) and Aetna Life Insurance Company after her intravenous immune globulin infusion therapy (IVIG) claims were denied. The lawsuit, initially filed by Foster and Quality Infusion Services, alleged breach of contract, bad faith, insurance code, and deceptive trade practices violations, alongside a request for a declaratory judgment. The trial court had granted pleas to the jurisdiction and dismissed the case without prejudice, citing sovereign immunity. Foster argued against the immunity's application to her declaratory judgment claim and Aetna, asserting legislative waiver and a right to judicial review under the Administrative Procedures Act. The appellate court affirmed the dismissal, ruling that TRS and its agent Aetna were protected by sovereign immunity, the APA did not grant judicial review in this context, and dismissal was appropriate given the lack of jurisdiction.

Sovereign ImmunityGovernmental ImmunityDeclaratory JudgmentInsurance CoverageAdministrative Procedures ActJudicial ReviewBreach of ContractDue ProcessTexas Court of AppealsHealth Insurance
References
28
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