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

Case No. Docket No. 2016-07-0889, State File No. 57742-2015
Regular Panel Decision
Jul 27, 2017

Kelly, Shameeka v. Regency Retirement Villiage

Shameeka Kelly, an employee of Regency Retirement Village, filed a request for an Expedited Hearing seeking medical and temporary disability benefits for an alleged injury to her left shoulder, low back, and neck sustained on July 26, 2016. Regency contended that the medical evidence did not establish the injury arose out of her employment and that she refused a light-duty position. The Court found that Ms. Kelly failed to provide sufficient evidence to demonstrate that her injury arose primarily out of her employment. Consequently, the Court denied her requests for further medical and temporary disability benefits, scheduling a Scheduling (Status) Hearing for October 26, 2017.

Workers Compensation ClaimExpedited HearingMedical Benefits DenialTemporary Disability BenefitsCausationPre-existing ConditionsLight Duty OfferNurse Practitioner TestimonyOrthopedic EvaluationHerniated Disc
References
4
Case No. MISSING
Regular Panel Decision
Apr 15, 2011

Drummond v. New York City Employees' Retirement System

The petitioner initiated an Article 78 proceeding to challenge the Board of Trustees of the New York City Employees’ Retirement System's decision, which adopted the Medical Board's recommendation to deny the petitioner's application for disability retirement. The Supreme Court, Kings County, denied the petition and dismissed the proceeding. On appeal, the judgment was affirmed. The court upheld the Medical Board's determination, finding it to be supported by credible evidence and not arbitrary or capricious, despite conflicting medical conclusions from the petitioner's treating physicians. It was reiterated that resolving such medical conflicts falls solely within the Medical Board's authority, and external findings from the Workers’ Compensation Board or Social Security Administration are not binding on the Medical Board.

Disability retirementNew York City Employees’ Retirement SystemMedical BoardArticle 78 proceedingAdministrative CodeCredible evidenceArbitrary and capriciousTreating physiciansWorkers’ Compensation Board findingsSocial Security Administration findings
References
9
Case No. MISSING
Regular Panel Decision

Borenstein v. New York City Employees' Retirement System

This appeal addresses the proper standard for judicial review of a determination by the New York City Employees’ Retirement System (NYCERS) Medical Board regarding an applicant's physical disability for city-service. The respondent, an Assistant Deputy Warden, sought accidental disability retirement benefits after sustaining injuries at Rikers Island, but the Medical Board repeatedly found her not medically disabled despite conflicting medical opinions. While the Supreme Court initially dismissed her petition, the Appellate Division reversed, granting her pension. The Court of Appeals, however, reversed the Appellate Division, upholding the Medical Board’s determination as it was based on 'some credible evidence' and was not arbitrary or capricious. The court emphasized that the Medical Board has the authority to resolve conflicting medical evidence and that judicial review should not substitute its judgment for the Board's.

Judicial reviewDisability benefitsAccidental disabilityNYCERSMedical BoardCPLR Article 78Substantial evidenceArbitrary and capriciousAdministrative lawConflicting medical evidence
References
12
Case No. MISSING
Regular Panel Decision

Christian v. New York City Employees' Retirement System

F. Christian sought accident disability retirement from the New York City Employees’ Retirement System for cataracts linked to a 1975 line-of-duty injury. Despite three ophthalmologists' reports indicating a causal link or aggravation of a pre-existing condition, the medical board denied the application twice, citing insufficient proof and without providing a basis for rejecting the medical evidence. The dissenting opinion by Justice Fein argued that the board's decision was arbitrary and capricious, advocating for a modification of the judgment to mandate reconsideration by the medical board. The dissent proposed that the medical board review all existing and new medical evidence and clearly state the reasons for its conclusions, emphasizing that the board members were not ophthalmologists and did not examine the petitioner.

Disability retirementCataractsLine of duty injuryMedical evidenceCausal relationshipAggravationPre-existing conditionMedical board reviewArbitrary and capriciousRemand
References
4
Case No. MISSING
Regular Panel Decision

Vargas v. New York City Employees' Retirement System

The petitioner sought accidental disability retirement benefits from the New York City Employees’ Retirement System. The Board of Trustees denied the application based on the Medical Board's determination. The petitioner appealed a Supreme Court judgment that had denied the petition and dismissed the proceeding. The appellate court affirmed the judgment, finding that the Medical Board's determination was conclusive as it was supported by credible evidence and was not irrational. The court emphasized that the resolution of conflicting medical opinions falls within the Medical Board's purview and that a Workers’ Compensation Board disability determination does not dictate the Medical Board’s findings.

Disability benefitsRetirement SystemAccidental disabilityMedical BoardCredible evidenceIrrational determinationAdministrative reviewAppellate procedurePension fundCPLR Article 78
References
10
Case No. 03-98-00617-CV
Regular Panel Decision
Jul 15, 1999

Deborah K. Nordyke v. Employees Retirement System of Texas

Deborah K. Nordyke, a licensed vocational nurse, applied for occupational disability retirement benefits from the Employees Retirement System of Texas (ERS) after an on-the-job injury. Her application was denied by the ERS medical board, which found no permanent incapacity, a decision later upheld by an Administrative Law Judge and the trial court. Nordyke appealed to the Third District Court of Appeals in Austin, raising issues regarding the sufficiency of evidence and the validity of an ERS administrative rule defining "incapacity from the further performance of duty." The appellate court reviewed the medical evidence presented, which indicated a lack of objective proof for permanent disability. The court affirmed the trial court's judgment, concluding that the ERS's denial was supported by substantial evidence and that the administrative rule was a reasonable and valid exercise of statutory authority, aligning with the legislative intent for disability retirement.

Occupational DisabilityOn-the-Job InjuryAdministrative LawJudicial ReviewSubstantial EvidenceMedical Board DecisionPermanent DisabilityVocational NurseGovernment Employee BenefitsTexas Appellate Court
References
12
Case No. 2-06-016-CV
Regular Panel Decision
Mar 15, 2007

Shioleno Industries, Inc. AND Columbia Medical Center of Arlington Subsidiary, L.P. and Columbia North Texas Subsidiary, GP, LLC D/B/A Medical Center of Arlington v. Columbia Medical Center of Arlington Subsidiary, L.P. and Columbia North Texas Subsidiary, GP, LLC D/B/A Medical Center of Arlington AND Shioleno Industries, Inc.

Shioleno Industries, Inc. appealed a summary judgment granted in favor of Columbia Medical Center of Arlington Subsidiary, L.P. and Columbia North Texas Subsidiary, GP, LLC d/b/a Medical Center of Arlington (the Hospital). The case originated from the Hospital's alleged failure to disclose an employee's positive drug and alcohol test results to Shioleno after an on-the-job injury. Shioleno contended that this omission led to increased workers' compensation premiums and expenses in unemployment benefit disputes. The appellate court affirmed the trial court's judgment, ruling that Shioleno failed to provide a valid authorization for the disclosure of medical information. Consequently, the Hospital had no legal duty to disclose the results and could not be held liable for negligence, breach of contract, or Deceptive Trade Practices Act (DTPA) violations.

Summary JudgmentMedical RecordsDisclosure AuthorizationHealth & Safety CodeNegligenceBreach of ContractDTPADrug TestingAlcohol TestingEmployer Liability
References
13
Case No. 03-17-00357-CV
Regular Panel Decision
Nov 21, 2017

George Allibone, M.D. v. Scott Freshour, in His Official Capacity as the Interim Executive Director of the Texas Medical Board Juanita Garner, Investigator of the Texas Medical Board And the Texas Medical Board

George Allibone, M.D., appealed the denial of his petition for a protective order against an administrative subpoena issued by the Texas Medical Board. The subpoena sought patient medical and billing records for an investigation into complaints against Allibone. He contended the trial court erred by failing to issue findings of fact and conclusions of law and by abusing its discretion in finding the subpoena reasonable and relevant. The appellate court found Allibone waived his complaint regarding missing findings. It also concluded the trial court did not abuse its discretion, citing the Board's need for complete records for investigation and Allibone's failure to prove the unconstitutionality of the statute requiring compliance. The trial court's order was affirmed.

Medical Board InvestigationAdministrative SubpoenaPhysician RecordsConstitutional RightsDue ProcessJudicial Review of Agency ActionAbuse of DiscretionFourth AmendmentTexas LawProfessional Licensing
References
50
Case No. 02-22-00072-CV
Regular Panel Decision
Jul 27, 2023

BioTE Medical, LLC v. John Carrozzella, MD, JCMD Medical Services, Inc., Dan Deneui, and Terri Deneui

This case addresses whether a contractual "residual benefit" clause, requiring a post-termination fee for using a competing treatment method, constitutes a covenant not to compete under Texas law. Appellant BioTE Medical, LLC, licensed a pellet-based bioidentical hormone replacement therapy (BHRT) method. Appellee JCMD Medical Services, Inc., a former customer, terminated its agreement and began using a competitor's BHRT without paying the residual-benefit fee. BioTE Medical sued JCMD for breach of contract. The trial court granted summary judgment to JCMD, finding the clause unenforceable either as a noncompete or a violation of public policy. The appellate court reversed, holding that the residual-benefit clause is not a covenant not to compete as it does not restrict JCMD from competing with BioTE Medical, but rather from using a competitor's product. The court also declined to invalidate the clause on uncodified public policy grounds, deferring to the Legislature's policy determinations.

Contract lawCovenants Not to Compete ActResidual benefit clausePublic policyBioidentical hormone replacement therapy (BHRT)Breach of contractSummary judgmentAppellate reviewTexas lawBusiness and Commerce Code
References
33
Case No. MISSING
Regular Panel Decision
May 12, 1988

Torres v. New York City Employees' Retirement System

The petitioner, a Rikers Island correction officer, sought to annul the New York City Employees’ Retirement System’s denial of his application for accident disability retirement benefits. The Supreme Court affirmed the dismissal of the petition, finding that the Medical Board and Board of Trustees' determination was neither arbitrary nor capricious. The court found that the petitioner's injuries occurred after he completed his tour of duty and signed out, while leaving the premises on a Correction Department bus, not in the actual performance of city service. This decision was based on Administrative Code of the City of New York § 13-168, which requires injury during city service for eligibility. The court also clarified that eligibility for workers’ compensation benefits was not binding on the Medical Board for accident disability benefits, referencing Administrative Code § 13-176 (c).

accident disability retirementRikers Island correction officercity serviceNew York City Employees’ Retirement SystemMedical BoardBoard of TrusteesCPLR Article 78workers' compensationadministrative coderetirement benefits
References
3
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