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

Case No. 02-23-00220-CV
Regular Panel Decision
Apr 17, 2025

Bianco Brain and Spine, PLLC and Nikhil Kanti Patel, M.D. v. Larry Jones and Shelley Jones

This case concerns a medical malpractice claim brought by Larry and Shelley Jones against Bianco Brain and Spine, PLLC and Dr. Nikhil Kanti Patel. Mr. Jones suffered a cauda equina injury during spine surgery performed by Dr. Patel. The jury found Dr. Patel negligent, and his negligence proximately caused Mr. Jones's injury. On appeal, Dr. Patel challenged the legal and factual sufficiency of the evidence. The Court affirmed the judgment against Dr. Patel, finding sufficient evidence to support the jury's finding that Dr. Patel's intraoperative surgical technique (removing existing hardware before stabilizing the L3-L4 junction) breached the standard of care and caused the injury. Bianco Brain and Spine, PLLC was sued under a theory of respondeat superior. The Court reversed the judgment imposing liability on Bianco, holding that the Joneses waived their independent ground of recovery for respondeat superior by failing to submit a jury question on this claim, and the evidence of Dr. Patel's employment status was not conclusive.

Medical MalpracticeMedical NegligenceSpine SurgeryCauda Equina InjuryRespondeat SuperiorVicarious LiabilityLegal SufficiencyFactual SufficiencyExpert TestimonyProximate Cause
References
87
Case No. MISSING
Regular Panel Decision

Transportation Insurance Co. v. George E. Failing Co.

Transportation Insurance Company (Transportation) appealed a summary judgment in a declaratory judgment action. George E. Failing Company (Failing) sought a declaration that it was an omnibus insured under a motor vehicle liability policy issued by Transportation to Southwestern Laboratories, Inc. An employee of Southwestern was injured by a truck manufactured by Failing and subsequently sued Failing, alleging defects. Failing contended it was covered under the policy's omnibus clause due to the alleged negligence of Southwestern's employees. The court reversed the summary judgment, ruling that Failing's potential liability arose from its own negligence, not that of Southwestern's insured parties, and therefore Failing was not an omnibus insured.

Insurance CoverageOmnibus InsuredMotor Vehicle LiabilitySummary Judgment AppealNegligenceProducts LiabilityDeclaratory JudgmentTexas Law
References
1
Case No. 14-07-00887-CV
Regular Panel Decision
Jun 02, 2009

Tanya E. Dowell v. Theken Spine, L.L.C

Tanya E. Dowell appealed the trial court's grant of summary judgment in favor of Theken Spine, LLC, arguing lack of proper notice for the summary judgment motion and hearing. Dowell's motion for summary judgment was granted after her certified mail for the notice was returned "unclaimed." The appellate court affirmed the trial court's judgment, finding that Dowell failed to provide verified proof at the time of the summary judgment ruling to rebut the presumption of actual notice. The court also upheld the denial of Dowell's motion for new trial, stating that a complete record of the hearing on the motion was not presented by the appellant, thus precluding a finding of abuse of discretion by the trial court.

Summary JudgmentNoticeDue ProcessCertified MailUnclaimed MailPresumption of ReceiptMotion for New TrialAbuse of DiscretionAppellate ProcedureTexas Rules of Civil Procedure
References
21
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. LAO 0811779, LAO 0811780
Regular
Mar 06, 2008

ELENA BLANKEVOORT vs. HUNTINGTON MEMORIAL HOSPITAL, S&B SURGERY CENTER

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded a trial judge's order disallowing a lien claim from S&B Surgery Center. The WCAB found that while S&B Surgery Center did have a required "surgical clinic" license, it failed to prove compliance with fictitious business name filing requirements. However, the WCAB returned the case to the trial level for further proceedings, allowing S&B Surgery Center an opportunity to correct this procedural defect to recover on its lien.

Fictitious business nameLien claimantSurgical clinic licenseBusiness and Professions Code section 17910Medical BoardDepartment of Health ServicesBurden of proofReconsiderationWorkers' Compensation Appeals BoardOutpatient setting
References
12
Case No. MISSING
Regular Panel Decision

Aaron S. Holmes, Dallas Spine Care P A v. Zurich American Insurance Company

This workers' compensation case involves an appeal of a summary judgment granted in favor of Zurich American Insurance Company and Gallagher Bassett Services, Inc. Appellants, including injured worker Aaron S. Holmes and medical providers, sought payment for Holmes's spinal surgery, which Zurich denied claiming it exceeded the scope of the compensable injury. The Division of Workers' Compensation (DWC) had determined Holmes's compensable injury included a disc protrusion, and an Independent Review Organization (IRO) found the surgery medically necessary. However, the appellate court affirmed the trial court's judgment, ruling that appellants failed to exhaust administrative remedies by not obtaining a DWC determination on whether the surgery solely repaired the compensable injury or what portion was related.

Workers' CompensationAdministrative RemediesExhaustion DoctrineSummary JudgmentMedical NecessityCompensable InjurySpinal SurgeryInsurance DenialJudicial ReviewTexas Law
References
12
Case No. 2024-50-2711
Regular Panel Decision
Feb 20, 2026

Lusk v. Portopiccolo Group LLC, dba The Portopiccolo Group

This interlocutory appeal concerns an employer's denial of medical treatment for an employee's work-related injuries. Employee Cheryl Lusk, injured by a resident at Portopiccolo Group, LLC, was recommended for cervical spine surgery by her authorized treating physician, Dr. John Burleson. The employer denied the surgery based on a utilization review report, which was upheld by the Bureau's Medical Director. The trial court, however, ordered the employer to provide the surgery, relying on the presumption of medical necessity for treatment recommended by an authorized physician. The Appeals Board affirmed the trial court's decision, concluding that the employer failed to rebut this presumption, and remanded the case for further proceedings.

Workers' CompensationMedical Treatment DenialUtilization ReviewSurgical AuthorizationPresumption of Medical NecessityEmployer AppealCervical Spine InjuryACDF SurgeryAuthorized Treating PhysicianBurden of Proof
References
8
Case No. MISSING
Regular Panel Decision

Prentice v. Levy

Plaintiff sustained a work-related cervical spine injury in 1998 and underwent surgery by defendant Dr. Walter J. Levy in 1999. After the first surgery failed and a second surgery in 2002 to remove loosened hardware, plaintiff settled a medical malpractice action against Levy for $400,000. The self-insured employer, Tops, Inc., and its administrator, MAC Risk Management, as "the carrier," asserted a workers' compensation lien against the settlement. The Supreme Court provisionally set the lien at $22,442.91 and appointed a referee to determine the final lien and offset amounts, with the carrier bearing the costs. The appellate court affirmed the order, ruling that the interim lien was "without prejudice" and the referee's hearing scope was sufficient to conduct a comprehensive evidentiary hearing, thus causing no prejudice to the carrier.

Workers' Compensation LienMedical MalpracticeSettlement LienInterim LienWorkers' Compensation LawAppellate ReviewReferee AppointmentLien EstablishmentOffset PaymentsEvidentiary Hearing
References
2
Case No. 526688
Regular Panel Decision
Dec 27, 2018

Matter of Bufearon v. City of Rochester Bur. of Empl. Relations

Claimant Kamren Bufearon sustained work-related injuries in a motor vehicle collision on March 4, 2016, for which his workers' compensation claim was established for injuries to his left shoulder, left hip, and lower back. Subsequently, he sought to amend his claim to include a causally-related cervical spine injury, which was initially approved by a Workers' Compensation Law Judge. However, the Workers' Compensation Board reversed this decision, finding that the claimant failed to sufficiently demonstrate a causal relationship between his cervical spine condition and the March 4, 2016 incident. The Appellate Division affirmed the Board's decision, noting that the medical testimony from two physicians contained conflicting findings and equivocal narratives regarding causation. The court concluded that the Board was entitled to reject the physicians' opinions as speculative, particularly since neither physician had reviewed the claimant's prior medical records for a pre-existing cervical spine fusion surgery.

Cervical spine injuryCausal relationshipMedical evidenceSubstantial evidence reviewAppellate DivisionWorkers' Compensation BoardPre-existing conditionCredibility of physiciansBurden of proofMotor vehicle accident
References
13
Case No. 08-06-00071-CV
Regular Panel Decision
Aug 30, 2007

Vincent Maes and Cynthia Maes and the Insurance Company of the State of Pennsylvania v. El Paso Orthopaedic Surgery Group

Vincent and Cynthia Maes and The Insurance Company of the State of Pennsylvania appealed the dismissal of a health care liability suit against El Paso Orthopaedic Surgery Group (EPOSG). The Maeses alleged negligence and vicarious liability against EPOSG after Vincent Maes suffered severe complications following back surgery by Dr. Paul Cho, an EPOSG neurosurgeon. The trial court dismissed all claims against EPOSG, finding the expert reports insufficient to address EPOSG's breach of the standard of care, even for vicarious liability claims. On appeal, the Court reviewed whether an expert report was necessary for vicarious liability claims and if the severance of claims against EPOSG was proper. The appellate court ultimately affirmed the trial court's judgment, upholding the dismissal of all claims against EPOSG and the severance.

Health Care LiabilityMedical MalpracticeExpert Report SufficiencyVicarious LiabilityRespondeat SuperiorDismissal with PrejudiceSeverance of ClaimsSpinal Surgery ComplicationsNeuroscienceOrthopedic Surgery Group Liability
References
17
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