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

Case No. 03-06-00404-CV
Regular Panel Decision
Mar 06, 2007

Johnnie M. Charles v. Texas Property and Casualty Insurance Guaranty Association, on Behalf of Phico Insurance Company, an Impaired Carrier

This case involves a restricted appeal filed by Johnnie M. Charles from a trial court's order dismissing her cause without prejudice. Charles initially appealed a Texas Workers' Compensation Commission decision regarding her impairment rating. After a venue transfer to Travis County, her case was dismissed for failure to pay filing fees. A nunc pro tunc order was later issued to correct a clerical error in the cause number of the original dismissal order. Charles appealed, citing errors in the dismissal, the lack of a court reporter, and the original hearing. The appellate court affirmed the dismissal, ruling that Charles's challenges to the original dismissal were untimely and that no error occurred in the nunc pro tunc order, which merely corrected a clerical error without altering the original judgment's substance.

restricted appealdismissal without prejudicenunc pro tunc orderclerical errorwant of prosecutionappellate jurisdictiontimeliness of appealTexas Rules of Civil ProcedureTexas Rules of Appellate Procedureworkers' compensation
References
13
Case No. NO. 03-06-00631-CV
Regular Panel Decision
Mar 26, 2009

Samuel Campos v. Texas Property & Casualty Insurance Guaranty Association for Reliance National Indemnity Company, an Impaired Carrier

Samuel Campos, an employee, was injured on the job, leading to disputes over his impairment rating and reimbursement for travel expenses. The Texas Workers’ Compensation Commission affirmed a designated doctor's 6% impairment rating and denied travel expenses, which Campos challenged in court. The case involved the Texas Property & Casualty Insurance Guaranty Association (TPCIGA) because Campos's employer's insurer became impaired. Initially filed in Winkler County, the case was transferred to Travis County, where TPCIGA was granted summary judgment. The Third District Court of Appeals reversed the summary judgment, ruling that the Workers' Compensation Act's specific mandatory venue provision, which places venue in the county of the employee's residence at the time of injury (Winkler County), overrides the Guaranty Act's general venue provision, which would place it in Travis County. The court remanded the case with instructions to transfer it to Winkler County.

Workers' CompensationVenue DisputeMandatory VenueStatutory ConstructionTexas Labor CodeTexas Insurance CodeImpairment RatingTravel Expenses ReimbursementJudicial ReviewAppellate Procedure
References
12
Case No. 03-08-00483-CV
Regular Panel Decision
Mar 19, 2010

Texas Property and Casualty Insurance Guaranty Association for Reliance National Insurance Company, an Impaired Company v. Doris J. Toberny

Doris J. Toberny, an exhibit decorator, injured her back on the job in May 2000, leading to spinal-fusion surgery that also corrected pre-existing scoliosis. Initially, her employer's insurer, Texas Property and Casualty Insurance Guaranty Association for Reliance National Insurance Company ('the Company'), paid for the surgery. However, in December 2001, the Company disputed the claim, asserting the injury was only a lower back strain and not the cause of her scoliosis. After a designated doctor assigned Toberny a 25-percent impairment rating in 2002, the Company paid supplemental income benefits for eight quarters. Three years later, in September 2005, the Company sought to dispute her impairment rating and discontinue benefits, claiming her pre-existing conditions were not compensable. The Division of Workers’ Compensation and the district court found that the Company had waived its right to contest the impairment rating under former rule 130.102(g) due to late dispute filing, and affirmed Toberny's 25-percent impairment rating and entitlement to benefits. The Texas Court of Appeals affirmed the trial court's judgment, upholding the validity of rule 130.102(g) and the finding of waiver, thus confirming Toberny's impairment rating and attorney's fees.

Workers' CompensationImpairment Rating DisputeSupplemental Income BenefitsWaiver DoctrineCompensability of InjuryExtent of InjuryJudicial Review of Agency DecisionTexas Appeals CourtAdministrative Rule ValidityMaximum Medical Improvement
References
12
Case No. 2016-03-0413
Regular Panel Decision
Oct 05, 2017

Dodson, Deborah v. LHC Group

Deborah Dodson, an employee of LHC Group, injured her left ankle and right knee in May 2015. She underwent knee surgery and was placed at maximum medical improvement by Dr. Johnson. She later developed small fiber neuropathy, and despite a referral, faced difficulties obtaining a neurologic impairment evaluation. The Court granted Ms. Dodson's request for a neurologic impairment evaluation, either by Dr. Butler or another neurologist, referring Dr. Butler to the Penalty Program for failure to provide an impairment opinion. However, the Court denied her claim for additional temporary total disability benefits, finding she reached MMI on March 23, 2017, when Dr. Butler ceased active treatment.

Workers' CompensationNeurologic Impairment EvaluationTemporary Total Disability BenefitsMaximum Medical ImprovementSmall Fiber NeuropathyPain ManagementExpedited HearingMedical TreatmentImpairment RatingPenalty Program
References
3
Case No. MISSING
Regular Panel Decision
Sep 01, 1992

Seelig v. Sielaff

The Supreme Court, New York County, initially issued a judgment enjoining respondents from releasing the social security numbers of correction officers without their consent and ordered the implementation of privacy safeguards. This judgment was subsequently reversed on appeal, vacated, and the proceeding was converted to one for a declaratory judgment. The appellate court declared that the release of correction officers' social security numbers by the respondents, in response to a Public Officers Law § 87 request, constituted an unwarranted invasion of privacy under Public Officers Law § 89 (2), citing federal precedents. The injunctive relief previously granted was also deemed improper as the Personal Privacy Protection Law (Public Officers Law § 92 [1]) exempts local government units and the judiciary from its provisions.

Freedom of Information LawPrivacy InvasionSocial Security NumbersCorrection OfficersPublic Officers LawDeclaratory JudgmentAppellate ReviewGovernment RecordsConfidentialityCPLR Article 78
References
9
Case No. ADJ1904323 (GRO 0034275) ADJ3208896 (GRO 0034276) ADJ649343 (GRO 0034277)
Regular
Nov 01, 2010

SARAH SHIPP vs. GOTTSCHALKS, SPECIALTY RISK SERVICES

The Appeals Board granted reconsideration, rescinding the prior award due to the Workers' Compensation Judge's (WCJ) improper reliance on an Agreed Medical Evaluator's (AME) hernia analogy to rate upper extremity impairment. This analogy violated *Almaraz II* by not adhering to the AMA Guides and potentially incorporating pre-2005 rating schedules. The rater also used an incorrect impairment number and occupational adjustment. The case is remanded for further proceedings and a new decision by the WCJ, ensuring the rating is not based on the flawed hernia analogy.

Workers' Compensation Appeals BoardSarah ShippGottschalksSpecialty Risk ServicesJoint Findings and Awardindustrial injuryright shoulderleft shoulderright elbowthumb
References
4
Case No. MISSING
Regular Panel Decision

Sanchez v. Berryhill

Plaintiff Ruben Sanchez sought judicial review of the Acting Commissioner of Social Security's final decision denying his application for disability insurance benefits. The plaintiff alleged disability since December 2012 due to multiple impairments including hypertension, diabetes, and COPD. His application was denied initially and on reconsideration, and an ALJ upheld the denial. The district court affirmed the Commissioner's decision, finding that the ALJ's determination was supported by substantial evidence and any legal error was harmless, particularly regarding the number of jobs existing in the national economy and the evaluation of the plaintiff's intellectual impairment.

Social Security ActDisability BenefitsALJ DecisionResidual Functional CapacityVocational ExpertUnskilled WorkIntellectual ImpairmentSubstantial EvidenceHarmless ErrorJudgment on Pleadings
References
17
Case No. MISSING
Regular Panel Decision

the Claim of Brigandi v. Town & Country Linoleum & Carpet

This case involves an appeal by an employer and its compensation carrier against decisions made by the Workers’ Compensation Board. The decedent, a carpet layer, died from cardiac arrest during work, with an autopsy revealing underlying coronary atherosclerotic disease. His widow was awarded death benefits. The employer’s carrier sought reimbursement from the Special Disability Fund under Workers’ Compensation Law § 15 (8), asserting a preexisting permanent physical impairment. However, the Board determined that there was no evidence that the decedent’s heart condition hindered his job potential before his death, thus releasing the Special Disability Fund from liability and holding the compensation carrier responsible. The employer's subsequent application for reconsideration was denied by the Board, leading to these appeals. The appellate court affirmed the Board's decisions, concluding that the Board rationally found no proof that the decedent's heart disease impaired his job potential, a necessary condition for reimbursement under WCL § 15 (8) (d).

Special Disability FundPreexisting Permanent ImpairmentCardiac ArrestCoronary Atherosclerotic DiseaseDeath Benefits ClaimEmployer ReimbursementCarrier LiabilityBoard Decision ReviewAppellate AffirmationMedical Evidence Interpretation
References
2
Case No. MISSING
Regular Panel Decision

Sattanino v. Sanitary District Number 6

In 2003, the claimant, a sanitation worker, sustained bilateral knee injuries from a slip and fall during work. The self-insured employer's third-party administrator acknowledged the claim but contested the schedule loss of use and apportionment. A Workers' Compensation Law Judge initially apportioned a significant part of the claimant's knee impairment to preexisting arthritis. However, the Workers’ Compensation Board reversed this, ruling that apportionment was inapplicable since the prior condition was not a compensable injury and the claimant had been fully employed despite it. The Board established the schedule loss of use at 50% for the right leg and 32.5% for the left leg. The employer's subsequent appeal was unsuccessful, and the Board's decision was affirmed.

Workers' CompensationApportionmentSchedule Loss of UsePreexisting ConditionArthritisKnee InjurySanitation WorkerEmployer AppealWorkers' Compensation BoardMedical Report
References
4
Case No. 3-92-298-CV
Regular Panel Decision
Apr 07, 1993

Receiver for Citizen's National Assurance Company, an Impaired Company v. Johnny Ray Hatley

This case involves an appeal by the Receiver for Citizen's National Assurance Company (appellant) against Johnny Ray Hatley (appellee) regarding workers' compensation benefits. Hatley was injured in a truck accident and received a third-party settlement, part of which went to the Receiver. The Receiver had signed a release of all claims and rights but argued that the settlement should be treated as an advance against future workers' compensation benefits under former article 8307, section 6a of the workers' compensation law, contending the release was not legally effective or lacked consideration. The Court of Appeals affirmed the trial court's judgment in favor of Hatley, ruling that the release constituted a specific waiver by the Receiver of its statutory rights and was supported by valid consideration.

Workers' Compensation LawThird-Party LiabilitySettlement AgreementStatutory OffsetContractual ReleaseConsideration in ContractsSubrogation WaiverReimbursement RightsAppellate ReviewTravis County District Court
References
7
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