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

Case No. 03-03-00176-CV
Regular Panel Decision
Dec 04, 2003

Texas Workers' Compensation Insurance Fund/Texas Workers' Compensation Commission and Leonard D. Watts v. Texas Workers' Compensation Commission and Leonard D. Watts/Texas Workers' Compensation Insurance Fund

This case involves a cross-appeal stemming from a workers' compensation claim by Leonard D. Watts, who sought lifetime income benefits for injuries sustained as a truck driver. The Texas Workers' Compensation Commission (appeals panel) initially reversed a hearing officer's decision and awarded Watts benefits, but this decision was later set aside by a Travis County district court. In this appeal, the Texas Workers' Compensation Insurance Fund (Texas Mutual) and the Commission challenged the district court's ruling. The Court of Appeals addressed arguments regarding the appeals panel's statutory authority for factual-sufficiency review and the interpretation of "issue" under the labor code, including legal doctrines of res judicata and collateral estoppel. The court ultimately reversed the judgment of the district court, thereby affirming the decision of the Commission's appeals panel which granted Watts lifetime income benefits.

Workers' CompensationLifetime Income BenefitsAppeals Panel ReviewFactual SufficiencyStatutory AuthorityCross-AppealRes JudicataCollateral EstoppelCausationMaximum Medical Improvement
References
17
Case No. 2022 NY Slip Op 00917 [202 AD3d 1232]
Regular Panel Decision
Feb 10, 2022

Matter of Eastman v. Glens Falls Hosp.

The case involves Stacy Eastman, who was injured at work and awarded workers' compensation benefits, including a 10% schedule loss of use of her right leg. The employer, Glens Falls Hospital, and its carrier applied for reconsideration and/or full Board review, arguing that the Board improperly failed to consider apportionment of the SLU award with a prior injury. The Workers' Compensation Board denied this application. The Appellate Division, Third Department, affirmed the Board's denial, finding that the Board's decision was neither arbitrary and capricious nor an abuse of discretion, as the employer failed to demonstrate newly discovered evidence, a material change in condition, or that the Board improperly failed to consider the issues.

Workers' CompensationSchedule Loss of UseApportionmentReconsiderationFull Board ReviewAppellate ReviewAbuse of DiscretionArbitrary and CapriciousPrior InjuryMedical Evidence
References
5
Case No. 07-02-0169-CV
Regular Panel Decision
Jan 14, 2003

Texas Workers' Compensation Commission v. Texas Workers' Compensation Insurance Fund

The Texas Workers' Compensation Commission (Commission) appealed a summary judgment that relieved the Texas Worker's Compensation Insurance Fund (Insurance Fund) of liability for workers' compensation benefits to Glenn Everett, the real party of interest. The Commission contended that the Texas Workers' Compensation Act abrogates the common law defense of election of remedies and that Everett did not make an election. Everett had previously settled a personal injury suit for $37,500 and later pursued a worker's compensation claim. The Court of Appeals affirmed the trial court's decision, finding that the Act does not abrogate the election of remedies defense and that Everett made an informed choice to elect remedies by settling his claim after consulting with attorneys, thus barring his right to workers' compensation benefits.

Workers' CompensationElection of RemediesSummary JudgmentTexas Appellate CourtStatutory InterpretationCommon Law DefenseIndemnificationSettlement AgreementEmployee StatusInsurance Fund Liability
References
18
Case No. 03-03-00435-CV
Regular Panel Decision
Jul 29, 2004

Texas Workers' Compensation Commission Richard Reynolds, in His Official Capacity as Executive Director of the Texas Workers' Compensation Commission/East Side Surgical Center Clinic for Special Surgery And Surgical and Diagnostic Center, L.P. v. East Side Surgical Center Clinic for Special Surgery/Texas Workers' Compensation Commission Richard Reynolds, in His Official Capacity as Executive Director of the Texas Workers' Compensation Commission

This case involves the Texas Workers’ Compensation Commission's failure to establish fee guidelines for ambulatory surgical centers under the Texas Workers’ Compensation Act. East Side Surgical Center, Clinic for Special Surgery, and intervenor Surgical and Diagnostic Center, L.P. (collectively "East Side") sued the Commission to invalidate certain default rules that applied when specific guidelines were absent. The district court declared one rule (133.304(i)) invalid and enjoined its enforcement, citing unlawful delegation of authority. On appeal, the Court of Appeals reversed the district court's judgment regarding the rule's invalidity and dissolved the injunction, citing a Texas Supreme Court decision finding no unlawful delegation. The court affirmed that East Side was not entitled to its usual and customary fee in the absence of specific guidelines.

Workers' CompensationAdministrative LawDelegation of AuthorityRulemakingAmbulatory Surgical CentersJudicial ReviewInsurance CarrierFee GuidelinesFair and Reasonable RatesStatutory Interpretation
References
38
Case No. 532391
Regular Panel Decision
Nov 18, 2021

Matter of Richman v. New York State Workers' Compensation Bd.

Claimant, Rebecca Richman, appealed three decisions from the Workers' Compensation Board regarding her claim for a work-related right shoulder injury. She alleged a fall at work on January 19, 2018, but did not seek medical treatment for 19 months. A Workers' Compensation Law Judge initially established the claim, but the Board reversed, finding that Richman failed to submit sufficient, credible medical evidence to demonstrate a causally-related injury and denied her claim. The Board subsequently denied her application for reconsideration and/or full Board review. The Appellate Division affirmed the Board's decisions, concluding that the Board's finding of no causally-related injury was supported by substantial evidence and that the Board did not abuse its discretion in denying reconsideration.

Workers' Compensation ClaimCausation (Medical)Shoulder InjuryMedical Evidence SufficiencyBoard ReversalAppellate Division ReviewBurden of ProofCredibility of EvidenceOsteoarthritis DiagnosisDelayed Medical Treatment
References
8
Case No. 2018 NY Slip Op 07811 [166 AD3d 1263]
Regular Panel Decision
Nov 15, 2018

Matter of Murray v. South Glens Falls Sch. Dist.

The case "Matter of Murray v South Glens Falls Sch. Dist." involves an appeal to the Appellate Division, Third Department, concerning a Workers' Compensation Board decision. The core issue was whether claimant Bonnie J. Murray had been classified with a permanent partial disability following work-related injuries sustained in December 2007. WCLJ D. Jeffrey Romeo had issued decisions regarding the degree of disability and awards, with a subsequent amended decision from WCLJ Jonathan Frost finding no such classification had been made. The employer appealed, arguing for classification based on prior decisions or claimant's counsel's alleged concession. The Appellate Division affirmed the Board's decision, concluding that substantial evidence supported the finding that claimant was never classified with a permanent partial disability.

Workers' Compensation BenefitsPermanent Partial DisabilityDisability ClassificationWage-Earning Capacity LossWorkers' Compensation Board AppealAppellate Division Third DepartmentRes Judicata DoctrineLaw of the Case DoctrineJudicial ReviewMaximum Medical Improvement
References
1
Case No. 2023 NY Slip Op 01392 [214 AD3d 1332]
Regular Panel Decision
Mar 17, 2023

Matter of Niagara Falls Captains & Lieutenants Assn. (City of Niagara Falls)

The Niagara Falls Captains and Lieutenants Association, as petitioner, appealed an order from the Supreme Court, Niagara County, which denied their petition to vacate an arbitration award. The arbitration award had previously denied the association's grievances against the City of Niagara Falls. The petitioner contended that the award should be vacated because it failed to meet the standards of finality and definiteness required by CPLR 7511 (b) (1) (iii). The Appellate Division, Fourth Department, affirmed the lower court's order, emphasizing the extremely limited judicial review of arbitration awards. The court found that the award sufficiently defined the parties' rights and obligations regarding the alleged violation of their collective bargaining agreement or past practice concerning the filling of six vacancies by the City. Ultimately, the court concluded that the award was definite and final, resolving the submitted controversy without creating new ambiguities.

Arbitration AwardVacate AwardFinalityDefinitenessCPLR 7511Collective Bargaining AgreementGrievancesJudicial ReviewAppellate DivisionPublic Sector Employment
References
9
Case No. 03-94-00124-CV
Regular Panel Decision
May 24, 1995

Texas Workers' Compensation Commission, the Subsequent Injury Fund, and Todd Brown in His Official Capacity as Executive Director of the Texas Workers' Compensation Commission v. the City of Bridge City, Texas, and the Texas Municipal League Intergovernmental Risk Pool

The Texas Workers' Compensation Commission and other appellants appealed a trial court's declaratory judgment and permanent injunction that found parts of the Texas Workers' Compensation Act unconstitutional. The trial court's decision was based on alleged violations of the Texas Constitution, particularly regarding the requirement of immediate payment of benefits during an appeal without reimbursement. The appellate court reversed the trial court's judgment, dissolved the injunction, and rendered a declaratory judgment affirming the constitutionality of the statutory scheme. The court reasoned that municipal corporations are not protected by certain constitutional provisions and that the 'suitability' of laws is a political question. It concluded that the payment scheme was rationally related to the state's interest in securing prompt payments to injured workers.

Texas Court of AppealsWorkers' Compensation ActConstitutional LawDeclaratory JudgmentPermanent InjunctionDue ProcessMunicipal CorporationsGovernmental ImmunityStatutory InterpretationLegislative Power
References
24
Case No. 532522
Regular Panel Decision
Feb 10, 2022

In the Matter of the Claim of Stacy Eastman

Claimant Stacy Eastman was injured at work and filed a claim for workers' compensation benefits, which was established with a 10% schedule loss of use (SLU) of her right leg. The Workers' Compensation Board affirmed this initial decision. Subsequently, Glens Falls Hospital, the employer, and its workers' compensation carrier applied for reconsideration and/or full Board review, contending that the Board had improperly failed to fully consider the issue of apportionment of the SLU award with a prior injury. The Board denied this application. The Supreme Court, Appellate Division, Third Judicial Department, affirmed the Board's denial, concluding that the denial was neither arbitrary and capricious nor an abuse of discretion, as the employer had not demonstrated newly discovered evidence, a material change in condition, or that the Board improperly failed to consider the issues raised.

Workers' Compensation BenefitsSchedule Loss of UseApportionmentReconsideration DenialAppellate ReviewAbuse of DiscretionArbitrary and CapriciousPrior InjuryMedical EvidenceWorkers' Compensation Board Review
References
5
Case No. MISSING
Regular Panel Decision

Curran v. International Union, Oil, Chemical & Atomic Workers

Plaintiff, an employee of Carborundum Company, suffered a partial hand amputation in a "rubber roll" machine accident on March 8, 1979. He sued his unions, International Union, Oil, Chemical & Atomic Workers, AFL-CIO, and Abrasive Workers, Local 8-12058, Oil, Chemical & Atomic Workers International Union, alleging state law negligence for failing to safeguard him from dangers and a federal claim for breaching their duty of fair representation. The unions moved for summary judgment, arguing federal law preempts the negligence claim and they did not breach their duty of fair representation. The court granted the unions' motion regarding the negligence claim, ruling that a union's duty to its members, arising from a collective bargaining agreement, is governed exclusively by federal law and does not include a duty of care. However, the court denied the motion regarding the breach of fair representation claim, finding sufficient facts and allegations to infer that the unions may have discharged their duty in an arbitrary, perfunctory manner or in bad faith, thus leaving triable issues of fact.

Union LiabilityDuty of Fair RepresentationNegligence ClaimFederal PreemptionCollective Bargaining AgreementSummary Judgment MotionLabor LawWorkplace AccidentSafety and Health CommitteeArbitrary Union Action
References
8
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