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

Case No. 2019-03-1529
Regular Panel Decision
Mar 08, 2024

Alvarez, Toriba v. LFC Enterprises, Inc.

Ms. Toriba Alvarez sustained a left-ankle injury in February 2019 while working for LFC Enterprises, Inc., which was accepted as compensable. She received various treatments, including a peripheral nerve block that provided significant relief for three months. However, LFC Enterprises denied subsequent authorizations for further nerve blocks and a peripheral nerve stimulator trial based on utilization review findings. The Court, giving greater weight to the pain management provider's recommendations over utilization review, ruled that Ms. Alvarez is likely to prevail on her entitlement to the peripheral nerve block. Consequently, LFC Enterprises is ordered to authorize the peripheral nerve block, and a scheduling hearing is set for June 7, 2024.

Workers' CompensationAnkle InjuryNerve BlockPain ManagementUtilization ReviewTreatment AuthorizationMedical NecessityExpedited HearingDenial of BenefitsEmployee Rights
References
1
Case No. 05-13-00748-CV
Regular Panel Decision
Oct 09, 2015

Parallel Networks, LLC v. Jenner & Block LLP

Parallel Networks, LLC appealed a trial court's judgment affirming an arbitration award in favor of Jenner & Block, LLP. Parallel argued the termination provision of the contingent fee agreement was unconscionable and against public policy, and that Jenner abandoned its client. The arbitrator found Jenner had just cause to terminate representation due to unpaid expenses and that the termination fee provision was enforceable. The arbitrator also found Jenner was entitled to recover $3,000,000 under quantum meruit or breach of contract, plus a percentage of future settlement proceeds. The Court of Appeals affirmed the trial court's judgment, rejecting Parallel's arguments and finding no error in the arbitrator's decision or exclusion of evidence.

Arbitration AwardAttorney FeesContingent Fee AgreementContract TerminationQuantum MeruitPublic PolicyUnconscionabilityLegal MalpracticeBreach of Fiduciary DutyPatent Infringement Litigation
References
13
Case No. 2017 NY Slip Op 08303
Regular Panel Decision
Nov 28, 2017

Prevost v. One City Block LLC

Plaintiff Ronald Prevost, a laborer, was injured after slipping on a loose sprinkler pipe at a construction site owned by One City Block LLC. He and his wife sued One City for common-law negligence and Labor Law violations. One City then commenced a third-party action against Island Fire Sprinkler, Inc., the subcontractor responsible for installing the sprinkler system, seeking contractual and common-law indemnification and alleging breach of contract for failure to procure insurance. The Supreme Court denied various summary judgment motions. On appeal, the Appellate Division modified the order, granting One City's motion for summary judgment dismissing the Labor Law § 200 and common-law negligence claims, and granting One City's claim for contractual indemnification by Island Fire. The court also denied Island Fire's motion for summary judgment dismissing One City's claim against it for contractual indemnification and breach of contract for failure to procure insurance. Finally, the Appellate Division affirmed the denial of One City's motion for post-note-of-issue discovery seeking additional independent medical examinations of plaintiff.

Construction accidentLabor LawPremises liabilitySummary judgmentContractual indemnificationBreach of contractInsurance procurementPost-note-of-issue discoveryIndependent medical examinationAppellate procedure
References
16
Case No. MISSING
Regular Panel Decision

H & R BLOCK, LTD. v. Housden

H&R Block, Ltd. sued former employees in state court for breaching non-compete covenants. The defendants counterclaimed, alleging Fair Labor Standards Act (FLSA) violations against H&R Block and four other entities. Two of these counterclaim defendants, not H&R Block, removed the case to federal court based on a federal question. The original defendants moved to remand, arguing FLSA cases are not removable and counterclaim defendants lack standing. The court denied the motion to remand, ruling that FLSA cases are removable and that counterclaim defendants, if not original plaintiffs and if the counterclaim is separate and independent, have standing to remove. The court found the FLSA claim to be separate and independent from the original non-compete claim.

RemovalFederal Question JurisdictionFair Labor Standards ActFLSANon-compete ClauseCovenant Not to CompeteCounterclaimStanding to RemoveFederal District CourtFifth Circuit Precedent
References
24
Case No. ADJ8115084
Regular
Jun 02, 2014

MARY HAYWORTH vs. KCI HOLDINGS USA, INC., FIDELITY AND GUARANTY INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration, rescinding a prior finding that the applicant failed to establish a plainly erroneous fact in an Independent Medical Review (IMR) determination. The Board found the IMR decision was based on a plainly erroneous mistake of fact because it evaluated a request for dorsal medial branch block injections as though it were a request for facet injections, which are different procedures. Consequently, the medical treatment dispute is remanded to the Administrative Director for review by a different independent review organization or reviewer.

Workers' Compensation Appeals BoardIndependent Medical ReviewLabor Code Section 4610.5Plainly Erroneous Finding of FactMedical Treatment DisputeUtilization ReviewAdministrative DirectorDorsal Medial Branch BlockFacet InjectionsMTUS Guidelines
References
2
Case No. MISSING
Regular Panel Decision

Block Coal & Coke Co. v. United Mine Workers

This dissenting opinion addresses a claim for unemployment compensation benefits by thousands of coal miners (United Mine Workers of America, District No. 19) against their employers, the Block Coal and Coke Company and other coal operators, for the period of April 1 to May 8, 1939. The core legal question is whether their unemployment stemmed from a 'labor dispute' under Tennessee law, which would disqualify them from benefits. The Commissioner of Labor initially granted benefits, reversed by the Board of Review, then reinstated by the Chancery Court. The coal operators appealed. Justice DeHaven dissents, arguing that the unemployment was due to the expiration of a collective bargaining agreement and ongoing negotiations, not an active labor dispute. He contends that deeming negotiations a dispute would undermine collective bargaining and that the statute requires a localized labor activity like a strike or lockout at the workplace. He concludes that the chancellor's decision to allow benefits should have been affirmed, implying the majority denied the benefits.

Unemployment CompensationLabor DisputeCollective BargainingContract ExpirationStatutory InterpretationTennessee Unemployment Compensation LawWorkers' RightsEmployer-Employee RelationsAppellate CourtDissenting Opinion
References
6
Case No. ADJ2211743 (SBR 0330510)
Regular
Jul 19, 2011

LAURA GIBSON vs. FOREST HOME, INCORPORATED, CHURCH MUTUAL INSURANCE

The Workers' Compensation Appeals Board denied reconsideration of a lien claimant's petition regarding reimbursement for medical treatment. Although the petition was not acted upon within the statutory 60-day period, the Board considered it on its merits due to circumstances beyond the claimant's control. The WCJ's report, which was adopted by the Board, found that the lien claimant failed to meet the burden of proof for treatment beyond a single epidural injection. The Board determined that only charges attributable to a single epidural procedure were reasonable and necessary, excluding other procedures like facet blocks and manipulation under anesthesia.

WORKERS' COMPENSATION APPEALS BOARDLAURA GIBSONFOREST HOMEINCORPORATEDCHURCH MUTUAL INSURANCEORDER DENYING RECONSIDERATIONPetition for Reconsiderationlien claimantdue processWCJ report
References
1
Case No. ADJ3744023
Regular
May 15, 2009

JOSEPH CRABTREE vs. MITCHELL BERMAN CABINET MAKER, STATE COMPENSATION INSURANCE FUND

In this workers' compensation case, the defendant sought reconsideration of an award finding an industrial injury to the applicant's abdomen/groin (hernia) and a resulting peripheral nerve injury causing 24% permanent disability. The defendant argued the peripheral nerve injury was not supported and the disability rating was incorrect due to misapplication of the AMA Guides. The Board denied reconsideration, adopting the judge's report and finding that the medical evidence supported the peripheral nerve injury and the AMA Guides were correctly applied. The Board found the agreed medical evaluator's conclusions were well-reasoned and supported by the evidence.

Workers Compensation Appeals BoardIndustrial InjuryHerniaPeripheral Nerve InjuryPermanent DisabilityAgreed Medical Evaluator (AME)AMA GuidesPetition for ReconsiderationMedical EvidenceWCJ
References
4
Case No. MISSING
Regular Panel Decision

AGRIPINO v. State

Dolores Agripino was convicted of sixteen counts of Practicing Medicine Without a License and eleven counts of Aggravated Assault for injecting mineral oil into over twenty women, causing severe injuries. She appealed her convictions, citing insufficient evidence and an improper denial of her motion to quash the indictment. The appellate court affirmed her convictions, determining that the indictment provided sufficient notice and that charging compensation for the injections constituted practicing medicine without a license under Texas law. The court also found sufficient evidence of reckless conduct, given Agripino continued administering injections despite being aware of the adverse effects experienced by the victims.

Criminal LawPracticing Medicine Without a LicenseAggravated AssaultIllegal Cosmetic InjectionsReckless ConductSufficiency of EvidenceIndictment QuashalAppellate ReviewBodily InjuryFraudulent Medical Services
References
25
Case No. 2019 NY Slip Op 07947 [177 AD3d 679]
Regular Panel Decision
Nov 06, 2019

Gerardi v. I.J. Litwak Realty Ltd. Partnership

Lisa Gerardi, a school bus driver, sustained personal injuries after a fall in a bus terminal parking lot. She initiated a personal injury action against the property owner, I.J. Litwak Realty Limited Partnership, and the lessee, Block 7932, Inc. The defendants moved for summary judgment, asserting that Block 7932, Inc. was an alter ego of Gerardi's employer, thus invoking the Workers' Compensation Law's exclusivity defense. The Supreme Court initially granted their motion. However, the Appellate Division reversed the decision, citing conflicting evidence regarding the actual identity of the plaintiff's employer, which precluded summary judgment for Block 7932, Inc.

Personal injurySummary judgmentWorkers' Compensation LawExclusivity defenseAlter egoEmployer liabilityAppellate reviewConflicting evidenceBus terminalParking lot fall
References
4
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