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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

Perfect Dental, PLLC v. Allstate Insurance

In this consolidated action, plaintiffs Perfect Dental Care, P.C., Zodiac Dental, PLLC, and Smooth Dental PLLC (Dental PCs) sought unpaid insurance claims from Allstate Insurance Company and State Farm Mutual Automobile Insurance Company (Insurers). The Insurers countersued alleging insurance fraud and unjust enrichment, and initiated a third-party action against various individuals and entities. The Insurers moved for partial summary judgment, seeking a declaratory judgment that Dental PCs could not recover for services provided by dentists and physical therapists, and for summary judgment on their fraud and unjust enrichment counterclaims. The court denied summary judgment concerning dentists' services, finding a triable issue of fact regarding their employment status. However, it granted summary judgment for the Insurers regarding physical therapy services, as Dental PCs conceded these services were provided by non-employees. Consequently, the court also denied summary judgment on the fraud and unjust enrichment claims, as their resolution depended on the unresolved employment status of the dentists.

Insurance ClaimsHealthcare ServicesContract LawSummary JudgmentProfessional CorporationsIndependent ContractorsEmployment LawFraud AllegationsUnjust EnrichmentDeclaratory Judgment
References
17
Case No. 03-14-00726-CV
Regular Panel Decision
Oct 30, 2014

Texas San Marcos Treatment Center, L.P. D/B/A San Marcos Treatment Center v. Veronica Payton

Texas San Marcos Treatment Center appeals the trial court's denial of its motion to dismiss Veronica Payton's health care liability claim. Payton alleged negligence after being assaulted by a patient at the treatment center. The appellant argues that the expert report provided by Dr. William H. Reid is deficient, lacking factual support and specificity concerning the standard of care, its breach, and causation, as required by Chapter 74 of the Texas Civil Practices and Remedies Code. The appellant asserts the trial court abused its discretion by finding the report adequate and requests dismissal of the claims.

Medical MalpracticeExpert ReportMotion to DismissAbuse of DiscretionStandard of CareBreach of DutyCausationHealth Care Liability ClaimPsychiatric FacilityEmployee Assault
References
25
Case No. 14-14-00318-CV
Regular Panel Decision
May 14, 2015

Lance Thai Tran, DDS, PA D/B/A Broadway Family Dental Care v. Maria Chavez

Maria Chavez, a dental assistant, sued her employer, Lance Thai Tran, DDS, PA d/b/a Broadway Family Dental Care, for negligence after she slipped on a wet floor in the dental office. The employer moved to dismiss the suit, arguing it was a health care liability claim (HCLC) under the Texas Medical Liability Act (TMLA) and required an expert report, which Chavez failed to provide. The trial court denied the motion. On appeal, the Fourteenth Court of Appeals, guided by Ross v. St. Luke’s Episcopal Hospital, affirmed the trial court's decision, finding no substantive nexus between the alleged safety standards violation (floor maintenance in employee work areas) and the provision of health care, thus concluding Chavez's claim was not an HCLC.

Premises LiabilityNegligenceHealth Care Liability Claim (HCLC)Texas Medical Liability Act (TMLA)Expert Report RequirementMotion to DismissAppellate ReviewDental OfficeEmployee InjuryStatutory Construction
References
4
Case No. 01-03-00924-CV
Regular Panel Decision
Oct 06, 2005

Mary Williams, D.D.S. and Russell Williams, D.D.S. v. L.M.S.C., Inc., D/B/A the Dental Solution

Mary Williams, D.D.S. and Russell Williams, D.D.S. appealed a judgment in favor of L.M.S.C., Inc., d/b/a The Dental Solution (TDS), stemming from a breach of contract dispute. TDS, a dental placement service, sued the Williams for an unpaid permanent placement fee after Diana Flanagan, whom TDS had previously placed temporarily as a dental hygienist, was hired by the Williams as a full-time dentist. The appellants challenged the jury's findings, arguing the contract did not cover dentists, lacked new consideration for modifications, and missed essential terms. The First District of Texas Court of Appeals affirmed the trial court's judgment, concluding that the placement agreement, as modified by subsequent fee schedules, applied to the placement of dentists and that sufficient evidence supported the jury's finding that the Williamses breached the contract by failing to pay the permanent placement fee. The court also upheld the award of attorney’s fees.

Breach of ContractPlacement AgreementDental IndustryPermanent Placement FeeContract ModificationConsiderationMeeting of the MindsLegal Sufficiency of EvidenceAttorney's FeesPrejudgment Interest
References
35
Case No. MISSING
Regular Panel Decision

First District Dental Society v. Sencer

The petitioners, dental societies in New York City, initiated an Article 78 proceeding to challenge a directive from the New York City Department of Health. The directive, dated August 14, 1981, mandated that all radiation installation licensees, including dental offices, make complete copies of Article 175 of the New York City Health Code available for staff examination. Petitioners argued this requirement was arbitrary and capricious due to its impracticality, financial burden, and the existence of an alternative provision allowing a descriptive notice. Respondents defended the directive as a rational measure to protect public health and ensure worker instruction regarding radiation safety, aligning with state and federal regulations. The court, applying the standard for administrative review, found a rational basis for the Department's interpretation and upheld the directive, denying the petitioners' request for nullification, though a 60-day stay on enforcement was granted.

Radiation SafetyHealth CodeAdministrative LawJudicial ReviewDental PracticesRegulatory CompliancePublic HealthArticle 78 ProceedingsAgency InterpretationDirective Challenge
References
8
Case No. E2014-00302-COA-R3-CV
Regular Panel Decision
Jan 30, 2015

American Heritage Apartments, Inc. v. The Hamilton County Water and Wastewater Treatment Authority, Hamilton County, Tennessee

The plaintiff, American Heritage Apartments, Inc., challenged a monthly flat charge imposed by the Hamilton County Water and Wastewater Treatment Authority (County WWTA) for sewer lateral repairs. The trial court granted summary judgment to the County WWTA, finding no private right of action under the Utility District Law of 1937 (UDL). On appeal, the Court of Appeals reversed the summary judgment, concluding the UDL was inapplicable as the County WWTA was formed under the Tennessee Water and Wastewater Treatment Authority Act (WWTA Act). The appellate court held that the WWTA Act implicitly provides a private right of action for ultra vires and contract claims. The court also affirmed the trial court's alternative ruling that class action certification for affected customers was appropriate.

Water UtilityWastewater TreatmentFlat Rate ChargeClass Action CertificationSummary Judgment ReversalPrivate Right of ActionUltra Vires ClaimGovernmental ImmunityUtility District LawWater and Wastewater Treatment Authority Act
References
48
Case No. 08-11-00264-CV
Regular Panel Decision
Oct 08, 2014

Maria G. Thompson/Luis Marioni, D.C. v. Jaime Stolar, M.D., Alivio Medical Center, Alivio Treatment Centers, P.A. and Luis Marioni, D.C./Maria G. Thompson

This multi-party appeal originated from a medical and chiropractic malpractice lawsuit filed by Maria G. Thompson against Dr. Jaime Stolar, Dr. Luis Marioni, and Alivio Medical Center and Alivio Treatment Centers, P.A. Thompson alleged negligence resulting in severe knee injuries, including infection and fusions, following injections and treatment. A jury found Dr. Stolar and Dr. Marioni negligent, awarding damages. On appeal, the court reversed the judgment against Dr. Marioni due to insufficient evidence of causation but affirmed the judgment against Dr. Stolar. The court also upheld the denial of Thompson's claims regarding damages and apparent agency against Alivio.

Medical MalpracticeChiropractic MalpracticeKnee InjuryKnee InfectionSpontaneous FusionSurgical FusionNegligenceCausationDamages AssessmentApparent Agency
References
48
Case No. 2019-01-0569
Regular Panel Decision
Apr 08, 2020

Stewart, Jeffrey v. Day and Zimmerman

Jeffrey Stewart, an employee, filed a Request for Expedited Hearing seeking ongoing treatment and reimbursement for past treatment of two capped teeth, claiming they broke during a fall at Day and Zimmerman (DZ) in November 2018. Day and Zimmerman contested the claim, citing a lack of timely notice and insufficient proof of a causal relationship between the dental injury and the work accident. The Court found that while DZ had actual notice of the overall injury, Mr. Stewart failed to provide medical or dental testimony causally linking his dental injury to the fall. Consequently, the Court denied Mr. Stewart's dental claim, ruling that such an injury is not an obvious one exempt from the requirement of medical proof of causation.

Workers' CompensationExpedited HearingMedical BenefitsDental InjuryCausationNotice RequirementTennessee LawInjury ClaimEmployer LiabilityInsurance Carrier
References
2
Case No. ADJ1184992
Regular
Feb 10, 2015

KATHLEEN MURPHY vs. PETSMART, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION For FREMONT INSURANCE COMPANY, In Liquidation

The Workers' Compensation Appeals Board (WCAB) rescinded a penalty against Petsmart, Inc. for allegedly unreasonably delaying dental treatment. The Board found that Petsmart had no obligation to pay for the dental surgery in advance, as dictated by Labor Code section 4603.2, which requires payment within 45 days after services are provided. While the treating oral surgeon requested prepayment due to high costs, the WCAB determined that the defendant's utilization review approval for the treatment did not constitute an agreement to advance payment. Therefore, the WCAB concluded there was no unreasonable delay or refusal of treatment, negating the basis for a Labor Code section 5814 penalty.

Workers' Compensation Appeals BoardPetition for ReconsiderationLabor Code section 5814unreasonable delaydental careoral surgeryutilization reviewpre-authorizationpayment in advancefee schedule
References
2
Case No. 2020 NY Slip Op 01355
Regular Panel Decision
Feb 26, 2020

Naula v. Utokilen, LLC

The plaintiff, Victor Naula, commenced an action for personal injuries against Utokilen, LLC, and others. The Workers' Compensation Board (WCB) found Naula's employer, Specialized Dental Construction, Inc., uninsured and Adapt Construction, LLC, to be the general contractor, awarding Naula workers' compensation benefits. Utokilen and Nancy Marin-Rojas D.D.S., P.C., initiated a third-party action against Specialized Dental for common-law indemnification and contribution. Specialized Dental moved for summary judgment, asserting exclusivity under Workers' Compensation Law § 11, but Utokilen and Marin-Rojas cross-moved, arguing Specialized Dental could not invoke § 11 due to its uninsured status. The Supreme Court granted the cross-motion and denied Specialized Dental's motion. The Appellate Division dismissed Adapt Construction, LLC's appeal as it was not an aggrieved party and affirmed the Supreme Court's order against Specialized Dental Construction, Inc.

Personal InjuriesWorkers' Compensation LawSummary JudgmentThird-Party ClaimsIndemnificationContributionGrave InjuryUninsured EmployerAppellate PracticeCollateral Estoppel
References
7
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