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Case Law Database

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

Case No. MISSING
Regular Panel Decision

Menin v. Tully

The petitioner, an estate planner and life insurance agent, sought to review a State Tax Commission determination sustaining a deficiency assessment for unincorporated business taxes for various years between 1964 and 1974. The respondent concluded that the petitioner was an independent contractor rather than an employee. Petitioner worked under an agent’s career contract for New England Life Insurance Company and its general agent, but also sold insurance for other principals and operated with considerable independence, including maintaining his own office and incurring substantial business expenses. The court affirmed the determination, finding substantial evidence to support the conclusion that the petitioner was an independent contractor and therefore subject to the unincorporated business tax.

unincorporated business taxindependent contractorinsurance agentState Tax Commissiontax assessmentCPLR Article 78employer controlbusiness expensestax deficiencyappellate review
References
8
Case No. MISSING
Regular Panel Decision

Marshall v. Roth Brothers Smelting Corp.

A claimant sustained a work-related injury in July 1995 and received a schedule loss of use award, partly from a third-party settlement and a deficiency award from the employer's carrier. The case was closed until January 2006 when the claimant sought payment for prescription medication, leading to the case's reopening. The Workers' Compensation Board transferred liability to the Special Fund for Reopened Cases under Workers' Compensation Law § 25-a, as statutory time periods had elapsed and the third-party settlement did not influence their expiration. The Special Fund appealed, arguing that liability for deficiency compensation awards does not shift. The court affirmed the Board's ruling, clarifying that the exception for 'awards for deficiency compensation' in § 25-a (8) only applies when the calculation or payment was delayed due to third-party litigation or settlement, which did not occur in this case.

Workers' Compensation LawSpecial Fund for Reopened CasesLiability TransferDeficiency CompensationThird-Party SettlementStatutory Time PeriodsCase ReopeningAppellate DecisionWorkers' Compensation BoardJudicial Review
References
12
Case No. 05-11-00912-CV
Regular Panel Decision
Aug 13, 2013

Compass Bank v. Manchester Platinum Management, Inc.

This case is an appeal from a summary judgment in a deficiency action. Compass Bank, the appellant, challenged the trial court's decision to deny its motion for summary judgment and grant the appellees' motion, which applied a fair market value offset against the deficiency owed. Compass Bank argued that Manchester Platinum Management, Inc., Todd Allan deVeilleneuve, and Allan R. deVeilleneuve had contractually waived their right to such an offset. The appellate court agreed, concluding that the waiver language in both the deed of trust and the guaranty agreements was sufficient to waive the appellees' rights under Texas Property Code section 51.003. Consequently, the court reversed the trial court's judgment, rendered judgment in favor of Compass Bank for the principal deficiency, and remanded the case for further proceedings regarding attorney's fees and interest calculation.

Summary Judgment AppealDeficiency ActionContractual WaiverFair Market Value OffsetGuaranty AgreementsDeed of TrustTexas Property CodeNonjudicial ForeclosurePromissory NoteAppellate Procedure
References
11
Case No. MISSING
Regular Panel Decision

Baylor University Medical Center v. Biggs

This case involves an interlocutory appeal of a medical malpractice claim where Baylor University Medical Center, Edmund Sanchez, M.D., and Srinath Chinnakotla, M.D. (appellants) challenged the trial court’s denial of their motions to dismiss. The family of Cheri Jean Wells Biggs, who died after a rabies-infected kidney transplant, sued the appellants for failing to obtain informed consent regarding the high-risk donor's medical and social history. The appellants argued that the family’s expert reports were deficient under Texas Civil Practice and Remedies Code § 74.351(r)(6) for not providing a fair summary of opinions on the standard of care, breach, and causation for each defendant. The appellate court agreed, finding the expert reports deficient for both Baylor and the doctors. Consequently, the court reversed the trial court's order and remanded the case for the trial court to determine whether the family should be granted an extension to cure the deficiencies in their expert reports.

Medical MalpracticeInformed ConsentKidney TransplantExpert Witness SufficiencyTexas Civil Practice and Remedies CodeStandard of CareCausationAppellate ReviewMotion for RehearingInterlocutory Appeal
References
27
Case No. MISSING
Regular Panel Decision
Apr 21, 2005

Claim of Kusy v. South Orangetown Central School District

Claimant was injured in a work-related automobile accident in 1985, receiving workers’ compensation benefits and settling a personal injury action, with the State Insurance Fund (SIF) applying a $3,000 credit. After the case was reopened in 2003 for medical expenses, SIF attempted to shift liability to the Special Fund for Reopened Cases, citing Workers’ Compensation Law § 25-a. The Special Fund disputed this, contending the claim was for deficiency compensation, an exception under Workers’ Compensation Law § 25-a (8). Both the Workers’ Compensation Law Judge and the Board affirmed this, reasoning that SIF had already applied its credit against awards not in lieu of first-party benefits, meaning subsequent awards, including medical expenses, constituted deficiency compensation. The court affirmed the Board’s decision, holding that liability does not shift to the Special Fund when deficiency compensation is awarded, particularly since SIF’s payments for lost time beyond three years were not ‘basic economic loss,’ allowing SIF to properly exercise its credit.

Workers' CompensationSpecial Fund for Reopened CasesDeficiency CompensationThird-Party SettlementState Insurance FundWorkers' Compensation Law § 25-aInsurance Law § 5102Basic Economic LossCredit OffsetMedical Expenses
References
8
Case No. ADJ16511542
Regular
Apr 25, 2023

ZALANA GRAHAM-BRYANT vs. WKS FROSTY CORPORATION, ADMINISTERED BY SEDGWICK CMS

The Workers' Compensation Appeals Board granted applicant Zalana Graham-Bryant's Petition for Removal. The Board rescinded the WCJ's Order Compelling Applicant's Deposition due to procedural deficiencies. These deficiencies included the WCJ's failure to articulate the basis for the order and the defendant's insufficient efforts to meet and confer before seeking compulsion. The case was returned to the WCJ for further proceedings.

Petition for RemovalOrder Compelling DepositionWCAB Rule 10390Meet and ConferMootnessIrreparable HarmSubstantial PrejudiceWCJ OpinionLabor Code Section 5313Rescinded Order
References
4
Case No. ADJ4676707 (RIV 0032408)
Regular
Mar 07, 2014

PAULA SHARPE vs. MANOR CARE, INC., ROYAL INSURANCE

In this workers' compensation case, the Appeals Board affirmed the original award of 15% permanent disability for an admitted neck injury. The applicant's petition for reconsideration, arguing for total disability based on vocational expert testimony and claiming inadequate compensation, was denied. The Board found the petition lacked merit, failed to cite evidence, and was deficient for not addressing contrary medical opinions. Additionally, the applicant's attorney received a strong admonishment for filing a deficient petition but was not sanctioned due to his timely apology and acceptance of responsibility.

Workers' Compensation Appeals BoardReconsiderationPermanent DisabilityApportionmentVocational ExpertAgreed Medical ExaminerSanctionWCJPetition for ReconsiderationCNA
References
0
Case No. ADJ8949526, ADJ8672351
Regular
Nov 05, 2018

ALFREDO ARGUETA vs. LA BREA DINING, ZENITH INSURANCE COMPANY

The Workers' Compensation Appeals Board denied reconsideration, upholding the administrative law judge's finding that the defendant was not liable for further payment on the lien claimant's invoices. The lien claimant argued the defendant's Explanation of Review (EOR) was deficient and thus they were not obligated to pursue a second bill review. The Board found this argument inconsistent with Labor Code section 4622, which requires timely objection to denied amounts, and adopted the WCJ's report. A dissenting opinion argued that a deficient EOR negates the requirement for a second bill review.

WCABLien claimantPetition for ReconsiderationExplanation of Review (EOR)Labor Code Section 4603.3Labor Code Section 4622Second Bill ReviewWCAB Rule 10451.1Perez v. Colorama Wholesale NurseryMedical-legal billing disputes
References
1
Case No. ADJ3496977 (AHM 0123782)
Regular
Aug 23, 2010

CARL DIXON vs. PHILLIPS BUICK, PONTIAC & MAZDA, CLARENDON NATIONAL INSURANCE COMPANY, Administered By AMERICAN ALL RISK LOSS ADMINISTRATORS, SECURITY INSURANCE COMPANY, Administered By LWP CLAIMS SOLUTIONS

The Workers' Compensation Appeals Board (WCAB) denied the defendant's petition for reconsideration, reaffirming that Labor Code § 4610 utilization review is mandatory for challenging medical treatment requests, even when an Agreed Medical Evaluator (AME) is involved. The WCAB also imposed $900 in sanctions on the Law Offices of Robin Jacobs for filing a deficient and unserved petition for reconsideration, and for failing to disclose a non-attorney's involvement. The applicant's attorney's response failed to adequately address these grounds, leading to the imposition of sanctions. The case is returned to the WCJ to correct prior decision deficiencies.

Workers' Compensation Appeals BoardPetition for ReconsiderationSanctionsUtilization ReviewAgreed Medical EvaluatorLabor Code § 4610Labor Code § 4062SandhagenWCAB RulesNon-attorney
References
1
Case No. 10-12-00261-CV
Regular Panel Decision
Aug 30, 2012

Ricky Thomas Lovell v. Amerisure Insurance Company

Ricky Thomas Lovell, the appellant, filed a notice of appeal which the Tenth Court of Appeals found deficient and appeared untimely. Despite being warned by the court, Lovell failed to adequately address the deficiencies, specifically not demonstrating that he served his notice of appeal on all parties to the trial court proceeding as required by Texas Rule of Appellate Procedure 25.1. The appeal originated from a trial court's final judgment granting Amerisure Insurance Company's motion for summary judgment on July 24, 2012. Due to the appellant's continued non-compliance with appellate rules, the appeal was dismissed without further notification.

Appeal DismissalProcedural DeficiencyUntimely AppealNotice of AppealSummary JudgmentAppellate RulesNon-ComplianceService of ProcessTexas Appellate CourtWorkers' Compensation Case
References
7
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