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

Case No. 03-98-00169-CV
Regular Panel Decision
Jun 17, 1999

Texas Workers' Compensation Commission and Subsequent Injury Fund v. Texas Municipal League Intergovernmental Risk Pool

The Texas Municipal League Intergovernmental Risk Pool (Risk Pool) challenged the constitutionality of specific provisions within the Texas Workers' Compensation Act and related Texas Workers' Compensation Commission (TWCC) rules. These provisions mandated contributions to the Subsequent Injury Fund, which the Risk Pool argued violated constitutional restrictions on political subdivisions lending credit or granting public money, and imposing state ad valorem property taxes. The trial court initially sided with the Risk Pool, declaring the requirements unconstitutional as applied to its members. On appeal, the Court of Appeals addressed the Risk Pool's standing and the core constitutional arguments. The appellate court characterized the mandatory contributions as analogous to a custodial escheat statute, where the state assumes custody of unclaimed death benefits rather than gaining absolute ownership. Consequently, the court reversed the trial court's judgment, concluding that the Risk Pool failed to meet its burden for an "as applied" constitutional challenge, notably by not asserting a limitations defense.

Workers' Compensation ActSubsequent Injury FundDeclaratory JudgmentConstitutional ChallengeAs-Applied ChallengeAssociational StandingAcceptance of Benefits DoctrineEscheat LawCustodial EscheatUnclaimed Death Benefits
References
18
Case No. MISSING
Regular Panel Decision

Runner v. New York Stock Exchange, Inc.

Plaintiff sustained severe hand injuries while moving an 800-pound wire reel down stairs using an improvised pulley system on defendant's premises. The District Court granted judgment for the plaintiff, finding Labor Law § 240 (1) applicable due to a gravity-related risk. The Second Circuit Court of Appeals certified two questions to the New York Court of Appeals regarding the statute's applicability to elevation-related injuries and direct causation by gravity, particularly when neither the worker nor an object directly falls. The Court of Appeals determined that the key inquiry is whether the injury resulted from inadequate protection against a risk arising from a significant elevation differential. It concluded that the plaintiff's injuries were a direct consequence of the force of gravity on the inadequately secured reel, making Labor Law § 240 (1) applicable. The first certified question was answered affirmatively, and the second was deemed unnecessary.

Labor LawScaffolding LawElevation DifferentialGravity RiskConstruction AccidentWorker InjuryMakeshift DeviceCertified QuestionsNew York Court of AppealsStatutory Interpretation
References
6
Case No. 12-19-00144-CV
Regular Panel Decision
Jun 28, 2019

in Re: Old Republic Risk Management, Old Republic Insurance Company, Thornton, Biechlin, Reynolds & Guerra, L.C., Timothy K. Singley and Dana M. Gannon

Relators challenged the respondent's denial of their plea to the jurisdiction and motion to dismiss. The Court conditionally granted the petition, directing the respondent to vacate an earlier order and issue a new order, granting the plea for specific claims and abating the trial court proceeding pending the Division of Workers’ Compensation’s resolution of subrogation and benefit inflation issues. The respondent complied with this order, rendering the mandamus proceeding moot. Consequently, the relators' petition for writ of mandamus is dismissed as moot.

MandamusPlea to JurisdictionMotion to DismissMootnessWorkers' CompensationSubrogation ClaimFraudulent LienInsurance Code ViolationsFraudConspiracy
References
2
Case No. MISSING
Regular Panel Decision

American Risk Funding Insurance Co. Ex Rel. Continental Casualty Co. v. Lambert

This case involves an appeal from a summary judgment concerning a workers' compensation carrier's waiver of subrogation rights. Larry Lambert, Rogers Patino, and Andres Garcia (appellees), employees of U.S. Contractors, Inc., were injured in a chemical plant explosion and settled with third-party defendants (Memc Pasadena, Inc., J.E. Merit Contractors, Inc., and Albemarle Corporation) for $1.8 million. American Risk Funding Insurance Company (appellant), the workers' compensation carrier for U.S. Contractors, Inc., intervened to seek reimbursement for benefits paid, but Lambert denied the claim due to a prior contract waiving subrogation rights. The trial court granted Lambert's motion for summary judgment, which American Risk Funding appealed. The appellate court addressed five issues raised by the appellant, primarily concerning the validity and scope of the subrogation waiver, including arguments about public policy, lack of consideration, intent to benefit appellees, waiver of future benefits, and common law conversion. The court systematically overruled all of appellant's issues, concluding that the waiver of subrogation does not violate public policy, does not require separate consideration, was intended to apply as contracted, waives rights to future credits, and extinguishes common law claims related to subrogation. Consequently, the judgment of the trial court affirming the summary judgment in favor of Lambert was affirmed.

Workers' CompensationSubrogation WaiverSummary Judgment AppealPublic PolicyContract LawTexas LawInsurance Carrier RightsEmployee RightsThird-Party LiabilityReimbursement
References
15
Case No. 07-12-00232-CV
Regular Panel Decision
Jan 08, 2013

Wendell H. Taylor v. Lubbock Regional MHMR & JI Texas Risk Management and Texas Department of Insurance Division of Workers' Compensation

Wendell H. Taylor, an employee of Lubbock Regional MHMR, sustained a compensable injury in 2009. His subsequent claim for chronic pain and related conditions was denied by the Workers' Compensation Division's appeals panel. Taylor filed suit in district court seeking judicial review and alleging intentional torts, bad faith, and other claims against MHMR, JI Specialty Services, Texas Council Risk Management Fund, and the Division. The trial court dismissed most of Taylor's claims against all defendants based on a lack of jurisdiction and governmental immunity. On appeal, the court affirmed the dismissals for MHMR, the Risk Management Fund, and the Division, citing failure to exhaust administrative remedies and sovereign/governmental immunity for tort claims. However, the court reversed the dismissal against JI Specialty Services, Inc., concluding it had not established its claim to governmental immunity. The case was remanded for further proceedings regarding JI Specialty Services.

Interlocutory AppealPlea to the JurisdictionSovereign ImmunityGovernmental ImmunityTort ClaimsAdministrative Remedies ExhaustionSelf-insured EntityThird-Party Administrator LiabilityWorkers' Compensation BenefitsTexas Appeals Court
References
28
Case No. MISSING
Regular Panel Decision

Smith v. New York State Electric & Gas Corp.

This dissenting opinion concerns the application of Labor Law § 240 (1) in a case where the plaintiff, Ronald C. Smith, was injured while a crane was being used as a winch to drag equipment horizontally. The dissent argues against the majority's interpretation that the statute applies if a safety device is usually related to elevation risk, regardless of its actual use at the time of the accident. It contends that the statute's applicability depends on the activity performed and that the injury was not due to an elevation-related risk, emphasizing that the 'effects of gravity' phrase in the statute is context-specific to elevation-related accidents, not general gravitational forces.

Labor Law § 240 (1)Workplace InjuryCrane AccidentStatutory InterpretationDissenting OpinionElevation RiskSummary JudgmentAppellate ReviewGravity EffectsWinch Operation
References
2
Case No. MISSING
Regular Panel Decision

Casillas v. State Office of Risk Management

Manny Casillas, an employee, sought lifetime income benefits for job-related injuries, claiming total loss of use of both hands, a claim denied by the Texas Workers’ Compensation Commission. He subsequently filed for judicial review, prompting the State Office of Risk Management (SORM) to move for a no-evidence summary judgment. Casillas opposed this with an EMG/NCV report and affidavits from himself and his treating chiropractor, Dr. Manuel Moreno. The appellate court first affirmed its jurisdiction, addressing SORM's challenge regarding compliance with statutory judgment filing requirements. Ultimately, the court concluded that Dr. Moreno's affidavit, based on his long-term treatment and expertise, provided sufficient evidence to create a genuine issue of material fact regarding Casillas's condition. Consequently, the appellate court reversed the summary judgment and remanded the case for further proceedings.

Workers' Compensation ActLifetime Income BenefitsNo-Evidence Summary JudgmentCarpal Tunnel SyndromeMedical Evidence AdmissibilityJurisdictionAppellate ReviewTotal Permanent Loss of UseChiropractic OpinionExpert Witness Qualification
References
14
Case No. 2023 NY Slip Op 01096 [214 AD3d 666]
Regular Panel Decision
Mar 01, 2023

Ortega v. Fourtrax Contr. Corp.

The plaintiff, Jose Santiago Orellana Ortega, sought damages for personal injuries sustained in October 2017 while working at a construction site. He was injured when a dolly transporting sheetrock tipped over and fell onto him. Ortega commenced an action against Fourtrax Contracting Corp. and 375 N. Broadway Associates, L.P., alleging a violation of Labor Law § 240 (1). The Supreme Court, Nassau County, granted the defendants' motion for summary judgment to dismiss the Labor Law § 240 (1) claim and denied the plaintiff's similar motion. The Appellate Division, Second Department, affirmed the Supreme Court's order, concluding that the plaintiff's injuries did not result from an elevation-related or gravity-related risk covered by Labor Law § 240 (1), as the statute applies to specific hazards and not all perils tangentially related to gravity's effects.

Personal InjuryConstruction AccidentLabor Law § 240(1)Summary JudgmentElevation-Related RiskGravity-Related RiskFalling ObjectAppellate ReviewNassau CountySubcontractor Liability
References
9
Case No. 07-05-0268-CV
Regular Panel Decision
Apr 11, 2006

State Office of Risk Management v. Rachel Herrera and Texas Municipal League Intergovernmental Risk Pool

The State Office of Risk Management (SORM) appealed the dismissal of its attempt to judicially review a Texas Worker’s Compensation Commission appeals panel ruling. The trial court had dismissed SORM's petition for lack of jurisdiction, asserting it was not timely filed within 30 days. SORM argued that the dispute concerned compensability, which allowed for a 40-day filing period under the Labor Code. The Court of Appeals determined that the core issue of identifying the responsible employer for death benefits, thereby defining the course and scope of employment, constituted a matter of compensability. Consequently, SORM had 40 days to file. The appellate court reversed the trial court’s order of dismissal and remanded the case for further proceedings.

Worker's CompensationJudicial ReviewJurisdictionTimelinessCompensabilityCourse and Scope of EmploymentDeath BenefitsTexas Labor CodeGovernment CodeAppeals Court
References
3
Case No. 08-06-00077-CV
Regular Panel Decision
May 31, 2007

State Office of Risk Management v. Hector Escalante

The State Office of Risk Management (SORM) appealed a trial court's grant of a no-evidence summary judgment in favor of Hector Escalante. Escalante had suffered two work-related injuries and subsequently sought Supplemental Income Benefits (SIBS), which SORM disputed. Following administrative hearings, the Appeals Panel found Escalante qualified for SIBS for the disputed periods. SORM's appeal to the trial court was unsuccessful, leading to this current appeal. The Court of Appeals affirmed the trial court's judgment, concluding that SORM failed to present sufficient evidence to create a genuine issue of material fact against Escalante's qualification for SIBS.

Supplemental Income BenefitsSummary JudgmentImpairment RatingVocational RehabilitationCausationDisability BenefitsAppellate ReviewNo-Evidence MotionTexas Labor CodeAdministrative Appeals
References
5
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