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

Case No. AD J8835024 AD J8996815
Regular
Jun 14, 2016

TRACIE KEILLOR vs. COUNTY OF SACRAMENTO

The Workers' Compensation Appeals Board granted reconsideration, rescinded a prior award, and found that the applicant, a deputy sheriff, did not sustain industrial injury from a stroke. While Labor Code section 3212.5 creates a presumption of industrial causation for heart trouble in peace officers, the applicant failed to establish, based on a qualified medical evaluator's opinions, that her stroke was caused by heart trouble or that she suffered from any heart trouble. The expert consistently found no evidence of heart trouble contributing to the stroke and opined that an intracranial thrombosis was the probable cause. Therefore, the presumption under section 3212.5 was not applicable as the applicant did not meet the threshold requirement of showing heart trouble.

Workers' Compensation Appeals BoardDeputy SheriffStrokeHeart PresumptionLabor Code Section 3212.5Occupational CausationMedical ProbabilityPanel Qualified Medical EvaluatorCardiologistIn Situ Thrombosis
References
6
Case No. 03-14-00717-CV
Regular Panel Decision
Dec 04, 2014

Vivek Goswami, M.D. and Austin Heart, PLLC v. Nancy Jo Rodriguez

Nancy Jo Rodriguez filed a health care liability claim against Vivek Goswami, M.D., and Austin Heart, PLLC, alleging negligence related to her continued use of the drug Pradaxa. Rodriguez claims that despite an order from Dr. David Kessler to discontinue Pradaxa, Dr. Goswami failed to follow this order, and nurses/staff at Austin Heart authorized refills. This, she alleges, led to her hospitalization. Appellants objected to the expert report by Dr. Jeffrey A. Breall, arguing it was conclusory, lacked factual support, and failed to adequately define the standard of care, breach, and causation for each appellant. The trial court denied Appellants' motion to dismiss, finding Dr. Breall's report adequate. Appellants are appealing this denial, contending the trial court abused its discretion as the report did not constitute a good-faith effort to comply with Chapter 74 requirements, effectively negating its purpose by concealing facts and offering vague conclusions.

Medical MalpracticeExpert Report AdequacyTexas Civil Practice and Remedies CodeAbuse of DiscretionStandard of CareBreach of DutyCausationConclusory Expert OpinionsMotion to DismissPradaxa Medication
References
24
Case No. 03-02-00196-CV
Regular Panel Decision
Aug 29, 2003

Heart Hospital IV, L.P. and Texas Workforce Commission v. Charles A. King

Charles A. King, an employee of Heart Hospital IV, L.P., was denied unemployment benefits by the Texas Workforce Commission (TWC) after failing a drug test. King sought judicial review, initially filing in Travis County and later refiling in Bastrop County, 125 days after the TWC's final decision. Heart Hospital and TWC challenged the refiling, arguing King missed the 14-day statutory deadline for judicial review. The district court denied TWC's plea to the jurisdiction. The Court of Appeals reversed, holding that the 14-day deadline in the labor code is a jurisdictional prerequisite, making the sixty-day tolling provision of section 16.064 and equitable tolling inapplicable. Consequently, the district court lacked jurisdiction, and the cause was dismissed.

Unemployment BenefitsJurisdictional PrerequisiteStatutory DeadlinesJudicial ReviewTexas Labor CodePlea to JurisdictionTolling ProvisionsEquitable TollingCourt of AppealsAdministrative Law
References
16
Case No. ADJ12288761
Regular
Dec 29, 2020

MICHAEL GOMEZ vs. CALIFORNIA INSTITUTION FOR WOMEN, STATE COMPENSATION INSURANCE FUND, STATE CONTRACT SERVICES

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration, upholding a finding of 62% permanent disability for a correctional officer with cumulative trauma. The core issue was whether Left Ventricular Hypertrophy (LVH), found by a QME, constituted "heart trouble" under Labor Code section 3212.2, triggering a presumption of industrial injury. The Board affirmed the WCJ's decision, relying on prior case law and expert medical opinions that LVH, even if minor, qualifies as "heart trouble" for purposes of the presumption. Defendant's arguments that LVH was not "heart trouble" and that medical opinions were contradicted were rejected as insufficient to rebut the presumption.

Workers' Compensation Appeals BoardCalifornia Institution for Womencorrectional officercumulative traumainternal organshypertensionGERDheart trouble presumptionLabor Code section 3212.2Left Ventricular Hypertrophy
References
13
Case No. ADJ9430358
Regular
May 20, 2015

GARY HALL vs. COUNTY OF LAKE, Permissibly Self-Insured, administered by INTERCARE HOLDINGS INSURANCE SERVICES, INC.

The Workers' Compensation Appeals Board granted reconsideration, finding the applicant's claim for cumulative heart injury was not barred by the statute of limitations, res judicata, or collateral estoppel. The Board determined that previous medical opinions concluding the applicant had no heart trouble did not address the current claim of manifestation of heart trouble within the statutory presumption period for deputy sheriffs. Therefore, the case was returned to the trial level for further proceedings and a decision on the merits.

Workers' Compensation Appeals BoardDeputy SheriffCumulative TraumaStatute of LimitationsCollateral EstoppelRes JudicataMedical-Legal EvaluationsHeart InjuryLabor Code Section 3212.5Agreed Medical Examiner
References
4
Case No. ADJ7494670
Regular
Jun 01, 2012

JOSEPH CURRAN, Deceased, JERI CURRAN, Spouse vs. CITY OF SACRAMENTO

The Workers' Compensation Appeals Board denied reconsideration of a decision finding that the deceased firefighter, Joseph Curran, suffered a heart injury arising out of and in the course of employment. The Board affirmed that the Labor Code Section 3212 heart trouble presumption applied. The defendant failed to rebut this presumption by demonstrating that a contemporaneous non-work-related event was the *sole* cause of the heart trouble. Dr. Bellinger's testimony, while stating the presumption was necessary, did not affirmatively prove exclusive non-industrial causation.

Labor Code 3212heart trouble presumptionindustrial causationrebutted presumptionanti-attribution clausesole causenonwork-related eventcumulative injuryfirefighterdeath benefits
References
5
Case No. ADJ8254799
Regular
Apr 21, 2014

TERRY MILLER vs. WASCO STATE PRISON, STATE COMPENSATION INSURANCE FUND

The Workers' Compensation Appeals Board (WCAB) granted reconsideration to find that correctional officer Terry Miller sustained an industrial heart injury, not just hypertension, based on Labor Code section 3212.2's presumption for heart trouble in correctional officers. The WCAB overturned the judge's decision to apportion the injury, ruling that Labor Code section 4663(e) prohibits apportionment for injuries covered by the heart trouble presumption. Consequently, Miller was awarded an unapportioned 60% permanent disability rating, an increase from the original 51%.

Labor Code section 3212.2heart trouble presumptioncorrectional officerleft ventricular hypertrophycumulative traumaindustrial hypertensionunapportioned awardpermanent disabilityWasco State PrisonState Compensation Insurance Fund
References
4
Case No. MISSING
Regular Panel Decision

Bullock v. American Heart Ass'n

Carole Bullock was discharged from her employment with the American Heart Association (AHA) and entered into a separation agreement. AHA mistakenly overpaid Bullock, who then refused to return the funds, alleging unlawful employment practices and demanding more money. AHA sued to recover the overpayments. The trial court granted summary judgment in favor of AHA on most issues and awarded attorney's fees. Bullock appealed, contending the trial court erred in granting summary judgment, enforcing a jury waiver, and quashing subpoenas. The appellate court affirmed the trial court's judgment, concluding that Bullock's arguments were without merit.

Breach of Separation AgreementSummary JudgmentJury Waiver EnforcementApex DepositionEmployment DisputeOverpayment RecoveryAttorney's FeesAppellate ProcedureWaiver of ClaimsAge Discrimination Claims
References
27
Case No. ADJ2618279
Regular
Feb 11, 2011

Jon Vinson vs. CITY OF GLENDALE

This case involves Jon Vinson, a former firefighter for the City of Glendale, seeking reconsideration of a previous Workers' Compensation Appeals Board (WCAB) decision. The WCAB previously reversed an administrative law judge's finding, ruling that Vinson did not sustain an industrial cumulative trauma injury to his pulmonary system or heart. This decision was based on a lack of substantial medical evidence proving heart trouble within the 60-month window required for the Labor Code Section 3212 heart trouble presumption. Vinson argues the prior decision relied on an incorrect legal theory, thus denying him due process. The WCAB denied Vinson's petition, re-affirming their conclusion that he failed to meet his burden of proof for an industrial injury.

WCABVinsonCity of GlendaleReconsideration DeniedLabor Code 3212Heart Trouble PresumptionPulmonary System InjuryCumulative TraumaFirefighter InjuryMedical Evidence
References
0
Case No. ADJ10343521
Regular
Jan 03, 2019

JESUS LOPEZ vs. CITY OF COMPTON

This case involves a firefighter's claim for workers' compensation benefits for heart trouble. The applicant, Jesus Lopez, was found to have sustained 54% permanent disability due to an industrial injury to his heart on December 17, 2015. The Workers' Compensation Appeals Board (WCAB) affirmed the administrative law judge's decision, relying on Labor Code section 3212, which presumes heart trouble in firefighters arises out of employment. The defendant, City of Compton, argued that the presumption was rebutted by evidence of non-industrial events and that the Qualified Medical Evaluator's opinion was not substantial medical evidence. However, the WCAB found that the defendant failed to provide substantial medical evidence to rebut the presumption, particularly in light of the anti-attribution clause in Labor Code section 3212.

Labor Code section 3212presumption of industrial causationheart troublefirefighter paramedicQualified Medical EvaluatorQMEsubstantial medical evidencedue processrebut the presumptionanti-attribution clause
References
7
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