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

Case No. 08-11-00264-CV
Regular Panel Decision
Oct 08, 2014

Maria G. Thompson/Luis Marioni, D.C. v. Jaime Stolar, M.D., Alivio Medical Center, Alivio Treatment Centers, P.A. and Luis Marioni, D.C./Maria G. Thompson

This multi-party appeal originated from a medical and chiropractic malpractice lawsuit filed by Maria G. Thompson against Dr. Jaime Stolar, Dr. Luis Marioni, and Alivio Medical Center and Alivio Treatment Centers, P.A. Thompson alleged negligence resulting in severe knee injuries, including infection and fusions, following injections and treatment. A jury found Dr. Stolar and Dr. Marioni negligent, awarding damages. On appeal, the court reversed the judgment against Dr. Marioni due to insufficient evidence of causation but affirmed the judgment against Dr. Stolar. The court also upheld the denial of Thompson's claims regarding damages and apparent agency against Alivio.

Medical MalpracticeChiropractic MalpracticeKnee InjuryKnee InfectionSpontaneous FusionSurgical FusionNegligenceCausationDamages AssessmentApparent Agency
References
48
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. 13-09-00350-CV
Regular Panel Decision
Jan 21, 2010

Gulf Coast Medical Center, LLC, Tony Todd, Crna, Dan Madsen, M.D. and South Texas Medical Clinics, P.A. v. Jacqueline Temple and Marcus Banks, Individually and as Representatives of the Estate of Markasia Banks, a Minor Child

Appellants, Gulf Coast Medical Center, LLC, Tony Todd, CRNA, Dan Madsen, M.D., and South Texas Medical Clinics, P.A., appealed the trial court's denial of their motions to dismiss. The underlying suit was filed by appellees Jacqueline Temple and Marcus Banks, alleging negligence in the care and treatment of their deceased minor child, Markasia Banks. The core issue on appeal was the appellees' failure to timely serve an expert medical report as required by the Texas Civil Practice and Remedies Code. The Court of Appeals determined that the appellees' claims were 'health care liability claims' and that the expert report was indeed untimely, and that an abatement due to a failure to provide medical authorization did not extend the deadline. The court also affirmed the constitutionality of the expert report requirement. Consequently, the appellate court reversed the trial court's judgment, granted the appellants' motions to dismiss, and remanded the case for the award of attorney's fees and costs to the appellants.

Health Care Liability ClaimExpert Medical ReportMotion to DismissTimeliness of ReportAbatementMedical MalpracticeNegligenceDue ProcessTexas ConstitutionAppellate Review
References
32
Case No. 2016-08-1486
Regular Panel Decision
Nov 30, 2018

Nance, Amy v. JCSD Emergency Medical Group d/b/a Medic One Response

Ms. Nance, an emergency medical technician, injured her left upper extremity while moving a patient. After conservative treatment, she was diagnosed with cubital tunnel syndrome and later recommended for a cervical spine evaluation by Dr. Cole. Medic One denied the requested benefits, claiming misrepresentation and non-work-related activity. The Court found Ms. Nance likely to prevail for medical benefits, ordering Medic One to authorize a cervical spine evaluation and allow her to select a specialist. However, Ms. Nance was not found eligible for temporary disability benefits due to insufficient medical proof of disability.

Workers' CompensationMedical BenefitsTemporary Disability BenefitsCubital Tunnel SyndromeCervical Spine EvaluationMedical MisrepresentationCausal ConnectionExpedited HearingPermanent ImpairmentTreating Physician
References
3
Case No. 2019-03-0154
Regular Panel Decision
Aug 01, 2019

Adams, Terry V. v. East Tennessee Personal Care Service, LLC

The employee, Terry V. Adams, was injured in a car accident while transporting a client for East Tennessee Personal Care Service (ETPCS). Despite reporting the accident and requesting medical attention due to a pre-existing condition, ETPCS significantly delayed authorizing treatment and paying her emergency room bills. Ms. Adams filed a Petition for Benefit Determination, arguing unreasonable delay. The Court found ETPCS failed to timely provide medical treatment and pay bills, referring the case for penalties and ultimately ordering ETPCS to provide ongoing medical treatment to Ms. Adams.

Medical BenefitsExpedited HearingDelayed TreatmentPenalty AssessmentCar AccidentPersonal AideEmployer LiabilityPre-existing ConditionMRIPhysical Therapy
References
2
Case No. 2017-02-0591 / 78125-2017
Regular Panel Decision
Feb 11, 2020

Kinsler, Matthew v. Rogers Development and Williams Construction

Matthew Kinsler, an employee, suffered a testicular injury after falling ten feet through a floor. Initially, his employer, Williams Construction, and later the general contractor, Rogers Development, did not provide treatment for this specific injury despite Kinsler's persistent complaints. Rogers Development denied providing a panel of physicians, citing a lack of constant requests and expert medical evidence linking the condition to work. The Court, however, found that Kinsler's early complaints and ongoing intermittent pain, coupled with the absence of a definitive medical opinion, indicated a likelihood of prevailing at trial. Consequently, the Court granted Kinsler's request for medical treatment, ordering Rogers Development to provide a panel of urologists for evaluation and necessary treatment.

Workers' CompensationMedical BenefitsExpedited HearingTesticular InjuryPanel of PhysiciansUrologistsEmployer ResponsibilityMedical TreatmentCausationTennessee Court of Workers' Compensation Claims
References
1
Case No. 2015-03-0709
Regular Panel Decision
May 25, 2016

Carter, Jack v. Labor Finders of Tennessee, Inc.

Jack Carter, an employee of Labor Finders of Tennessee, Inc., sustained a right knee and ankle injury while working. He initially received treatment from Dr. Grant Shirley, who diagnosed derangement of the knee and traumatic arthropathy of the ankle. Later, he was evaluated by orthopedic specialist Dr. Michael T. Casey, who, after an MRI and injection, concluded he had nothing further to offer surgically and declared Mr. Carter at maximum medical improvement. Mr. Carter sought further medical evaluation, arguing he was not seeking a second surgical opinion but ongoing treatment for his persistent pain. The Workers' Compensation Judge denied the employer's motion for involuntary dismissal and, finding that Mr. Carter was likely to prevail on the merits, granted his request for a return appointment with Dr. Shirley to pursue further necessary medical treatment.

Workers' Compensation ClaimExpedited HearingMedical TreatmentKnee InjuryAnkle InjuryPhysician DesignationOrthopedic CareMaximum Medical ImprovementSecond Medical OpinionReferral of Physician
References
3
Case No. MISSING
Regular Panel Decision

Claim of Cummins v. North Medical Family Physicians

A claimant sustained a work-related back injury and sought continued medical treatment, which was initially authorized. Disputes over authorization led the claimant to retain an attorney. A Workers’ Compensation Law Judge authorized continued medical treatment but denied counsel fees, stating no "money passing" occurred. The Workers' Compensation Board upheld this decision. The claimant appealed, arguing the Board unconstitutionally applied Workers’ Compensation Law § 24, misinterpreted the statute regarding fee payment from medical benefits, and abused its discretion. The appellate court affirmed the Board's decision, ruling that counsel fees must be paid from "compensation," defined as a money allowance, and medical benefits are not considered "compensation" for this purpose, thus finding no abuse of discretion.

Workers' CompensationCounsel FeesAttorney FeesMedical TreatmentStatutory InterpretationConstitutional LawLienCompensation DefinitionAppellate ReviewBoard Decision
References
3
Case No. 2016-01-0716
Regular Panel Decision
Mar 27, 2017

Lane, Thomas v. Cleveland Utilites

This Expedited Hearing Order addresses Thomas Lane's claim for medical benefits related to a November 20, 2015 spinal injury at Cleveland Utilities. Mr. Lane, who also had a 2007 spinal injury at the same employer, sought treatment for his condition. The Court considered medical opinions from Drs. Folsom and Broadstone regarding the causation of his current spinal issues. Finding that the 2015 work injury aggravated a pre-existing condition, the Court concluded that Mr. Lane is likely to prevail at trial. Consequently, Cleveland Utilities and its carrier are ordered to process medical charges and authorize ongoing treatment by Dr. Paul Broadstone for the 2015 work injury.

Workers' CompensationSpinal InjuryMedical BenefitsAggravation of Pre-existing ConditionCausationExpedited HearingOrthopedic CareSciaticaRadiculopathyTennessee Law
References
9
Case No. 2016-03-0449
Regular Panel Decision
Oct 03, 2016

Rodgers, Katherine v. NHC Healthcare

Katherine Rodgers, an employee, filed an Expedited Hearing Request seeking temporary disability benefits and reimbursement for unauthorized medical expenses after a work-related right shoulder injury. The employer, NHC Healthcare, and its carrier, Premier Group Insurance, had provided authorized medical panels, but Rodgers sought additional treatment without their authorization due to ongoing pain. The Court found that Rodgers' decision to seek unauthorized care was not reasonable, as she failed to properly notify her employer and did not establish the necessity and reasonableness of the associated charges. Furthermore, the Court concluded that she was not entitled to temporary disability benefits because no authorized medical provider had taken her completely off work, and she did not substantiate her claims regarding work restrictions. Consequently, the Workers' Compensation Judge denied Ms. Rodgers' claims for both unauthorized medical treatment expenses and temporary disability benefits.

Workers' CompensationTemporary Disability BenefitsMedical ExpensesUnauthorized TreatmentExpedited HearingWork InjuryShoulder InjuryCertified Nursing AssistantEmployer ObligationsEmployee Responsibilities
References
7
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