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

Case No. 06-11-00094-CV
Regular Panel Decision
Jan 13, 2012

Christopher Castleberry v. New Hampshire Insurance Company

Christopher Castleberry appealed the dismissal of his case against New Hampshire Insurance Company. Castleberry sustained a work-related back injury in 2009, for which he received worker's compensation benefits. The insurer later contested coverage for medications for depression, chronic pain syndrome, chronic myofascial pain, and erectile dysfunction. The Division of Workers’ Compensation Review Board ruled that the compensable injury did not extend to these ailments. Castleberry sought judicial review, but the trial court granted the insurer's plea to the jurisdiction and dismissed the entire suit. The appellate court affirmed the dismissal of claims for depression, chronic pain syndrome, or myofascial pain syndrome, but reversed the judgment concerning the claim for medication for erectile dysfunction, remanding that issue for further proceedings.

Workers' CompensationJudicial ReviewPlea to JurisdictionAdministrative RemediesMedical BenefitsErectile DysfunctionChronic PainDepressionMyofascial PainAppellate Court
References
3
Case No. No. M2018-01696-COA-R3-CV; No. 15-4-IV
Regular Panel Decision
Dec 07, 2020

American Board of Craniofacial Pain v. American Board Of Orofacial Pain

This case involves an appeal concerning a failed merger between two professional dental associations, American Board of Craniofacial Pain (ABCP) and American Board of Orofacial Pain (ABOP). ABCP sued ABOP, alleging a breach of an agreement to merge formed through email exchanges and seeking specific performance and damages. The Chancery Court for Davidson County granted summary judgment to ABOP, finding no meeting of the minds and thus no enforceable contract. The Court of Appeals of Tennessee affirmed this decision, concluding that the parties’ objective manifestations showed a lack of mutual assent because an essential term (disposition of intellectual property) was not agreed upon and they intended to reduce the agreement to a formal Memorandum of Understanding, which was never finalized. The court also agreed that specific performance was not an available remedy due to the incompleteness of the purported contract.

Contract DisputeMerger NegotiationsCorporate MergerDental ProfessionMutual AssentSpecific Performance DenialSummary Judgment AffirmationTennessee Court of AppealsContract FormationLack of Agreement
References
26
Case No. 06-11-00094-CV
Regular Panel Decision
Jan 13, 2012

Clyde Washington v. State

Christopher Castleberry appealed the dismissal of his case against New Hampshire Insurance Company, concerning a dispute over workers' compensation benefits for prescribed medications. Castleberry suffered a work-related back injury in 2009. The insurer later contested medications for depression, chronic pain syndrome, chronic myofascial pain, and erectile dysfunction. The Division of Workers' Compensation Review Board ruled against Castleberry regarding these ailments. The trial court subsequently granted the insurer's plea to the jurisdiction and dismissed the entire suit. The appellate court affirmed the dismissal of claims related to depression, chronic pain, and myofascial pain due to a lack of exhausted administrative remedies. However, it reversed and remanded the claim for erectile dysfunction medication, finding that the trial court improperly dismissed this issue, for which jurisdiction existed.

Workers' CompensationJurisdictionPlea to the JurisdictionAdministrative ReviewMedical BenefitsErectile DysfunctionChronic PainDepressionRemandAppellate Procedure
References
15
Case No. ADJ1088522 (RIV 0015524)
Regular
Jan 03, 2013

SAMANTHA VAN DUINHOVEN vs. SPA HOTEL & CASINO, CALIFORNIA CASUALTY, Administered by GAB ROBINS NORTH AMERICA

This case involved an applicant who claimed industrial injury to her neck, back, left shoulder, psyche, and associated chronic pain syndrome, resulting in a finding of permanent total disability. The defendant sought reconsideration, arguing the medical evidence did not support injury to the low back or a diagnosis of chronic pain syndrome. The Appeals Board reversed the findings on the low back and chronic pain syndrome, finding no substantial evidence to support them. Consequently, the applicant's permanent disability award was amended to 70%, based on ratings for her neck, left shoulder, and psyche.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardPermanent Total DisabilityChronic Pain SyndromeAgreed Medical EvaluatorQualified Medical EvaluatorMedical Record ReviewIndustrial InjuryPermanent Disability Indemnity
References
0
Case No. ADJ605947 (MON 0274664)
Regular
Feb 02, 2009

LESLIE CELLUCCI vs. FLORENCE MACHINE PRODUCTS, STATE COMPENSATION INSURANCE FUND

This case concerns a workers' compensation claim for injuries to the applicant's hands, upper extremities, and neck, resulting in chronic pain syndrome and a sleep disorder. The defendant disputed the extent of permanent disability and the diagnoses of chronic pain syndrome and sleep disorder. The Appeals Board affirmed the finding of industrial injury and the 85% permanent disability rating, including the diagnoses of chronic pain syndrome and sleep disorder. The Board also granted reconsideration to amend the award to include a life pension for the applicant, as required by law for an 85% permanent disability finding.

Workers' Compensation Appeals BoardLeslie CellucciFlorence Machine ProductsState Compensation Insurance FundADJ605947Opinion and Order Granting ReconsiderationFindings and AwardPermanent DisabilityChronic Pain SyndromeSleep Disorder
References
0
Case No. 2024 NY Slip Op 00599 [224 AD3d 428]
Regular Panel Decision
Feb 06, 2024

Matter of New Millennium Pain & Spine Medicine, P.C. v. Garrison Prop. & Cas. Ins. Co.

This case involves two appeals by New Millennium Pain & Spine Medicine, P.C. against Garrison Property & Casualty Insurance Company and GEICO Casualty Company. New Millennium sought to vacate master arbitration awards that denied its claims for no-fault benefits for medical services. The Supreme Court denied these applications. The Appellate Division, First Department, affirmed the Supreme Court's decisions, stating that an arbitrator's award will not be set aside unless it is irrational. The court also addressed the argument regarding a 20% wage offset in no-fault benefits, finding it unavailing under Insurance Law § 5102 (b). Ultimately, New Millennium was not entitled to attorneys' fees as it was not the prevailing party.

No-fault benefitsarbitration awardvacaturinsurance lawwage offsetappellate reviewmedical servicesno-fault policy exhaustionattorneys' feesCPLR Article 75
References
8
Case No. MISSING
Regular Panel Decision
Jun 25, 2001

Claim of Ritton v. AT&T—New York

Claimant appealed an amended Workers' Compensation Board decision concerning her disability rate. She had established occupational diseases including bilateral carpal tunnel syndrome, myofascial pain syndrome, thoracic outlet, and neck, arm, and shoulder injuries. Initially receiving total disability benefits, the Board later found only a mild to moderate disability for the period from March 1998 to September 1999, crediting the employer's physician, Syed Ehtisham, over the claimant's physician, Michael Lax. The court affirmed the Board's decision, finding substantial evidence to support the mild to moderate disability finding and upholding the Board's authority in resolving conflicting medical opinions.

Workers' CompensationDisability BenefitsCarpal Tunnel SyndromeMyofascial Pain SyndromeThoracic Outlet SyndromeMedical TestimonyConflicting Medical EvidenceAppellate ReviewCredibility DeterminationOccupational Disease
References
2
Case No. MISSING
Regular Panel Decision

Matter of Bland v. Gellman, Brydges & Schroff

This case involves consolidated appeals from several decisions by the Workers’ Compensation Board concerning a claimant. The appeals address issues such as a variance request for aquatic therapy for thoracic outlet syndrome, the causal relationship of fibromyalgia and myofascial pain syndrome, the degree of partial impairment and loss of wage-earning capacity, entitlement to Botox therapy for migraines, and reimbursement for medical and travel expenses. The Court affirmed the Board's findings regarding the application of Shoulder Injury Medical Treatment Guidelines, the denial of aquatic therapy, the lack of causal relationship for fibromyalgia, the 50% loss of wage-earning capacity, and the denial of reconsideration for medical/travel expenses and labor market attachment. One appeal related to fibromyalgia care and Botox therapy was dismissed as the claimant was no longer aggrieved.

Workers' CompensationAppellate ReviewAquatic TherapyThoracic Outlet SyndromeFibromyalgiaMyofascial Pain SyndromeWage-Earning CapacityMedical Treatment GuidelinesVariance RequestReconsideration
References
23
Case No. MISSING
Regular Panel Decision

Charter Oak Fire Insurance Co. v. Levine

This is an appeal in a worker's compensation case where the Appellant, Charter Oak (the carrier), challenged a jury verdict finding the Appellee, Levine (the worker), suffered a total and permanent incapacity due to an injury on April 11, 1984. The carrier argued there was no or insufficient evidence to support the jury's finding of total and permanent disability. The court reviewed conflicting testimony, including Levine's description of persistent back pain and limitations, and medical expert opinions from Dr. Moore, an orthopedic surgeon, who diagnosed myofascial pain syndrome and aggravated scoliosis. The court also addressed the exclusion of evidence regarding subsequent injuries. The appellate court affirmed the jury's findings, concluding there was sufficient probative evidence to support the verdict, and reformed the judgment to include 10% interest from the date of signing.

Total and Permanent IncapacityJury Verdict ReviewSufficiency of EvidenceNo Evidence PointFactual Insufficiency PointMedical TestimonyBack InjuryScoliosis AggravationMyofascial Pain SyndromeAppellate Review
References
17
Case No. MISSING
Regular Panel Decision

City of Laredo v. Garza

Juan Garza Jr., a groundskeeper for the City of Laredo, suffered an on-the-job injury, sustaining a broken kneecap and ankle. The core dispute centered on whether additional injuries, including L4-L5 and L5-S1 herniated discs, L5-S1 radiculopathy, and complex regional pain syndrome, were compensable, with administrative and district court decisions differing. The City of Laredo appealed the district court's finding for Garza, arguing a lack of legally sufficient expert medical evidence to establish causation for the complex back and pain conditions. The appellate court ruled that expert medical testimony was necessary for these conditions, especially given the delayed reporting of symptoms and conflicting medical opinions. Consequently, the court reversed the trial court's judgment, determining that Garza's compensable injuries do not include the disputed back and pain syndrome conditions due to insufficient causation evidence.

CausationExpert Medical TestimonyLay TestimonyHerniated DiscsRadiculopathyComplex Regional Pain SyndromeOn-the-job InjuryTemporal ProximitySufficiency of EvidenceDegenerative Injury
References
11
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