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Case Law Database

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

Case No. 03-13-00300-CV
Regular Panel Decision
Feb 26, 2015

Adrian Tijerina v. Texas Property Casualty Insurance Guaranty Association as Receiver for SIR Lloyd's Insurance Company and the Texas Department of Insurance, Division of Workers' Compensation

Adrian Tijerina appealed the dismissal of his case against the Texas Property Casualty Insurance Guaranty Association (Association) and the Texas Department of Insurance, Division of Workers’ Compensation (Division). Tijerina, who sustained a back injury in 1987, sought to enforce a 1989 judgment for future medical benefits, alleging the Association refused to pay for back surgery and the Division improperly refused jurisdiction. The Ector County court transferred the case to Travis County, and the Travis County district court dismissed it for lack of jurisdiction. The appellate court affirmed the trial court's order, ruling that the venue transfer was proper, Tijerina's claim against the Division was barred by sovereign immunity and failure to exhaust administrative remedies, and his claim against the Association was not ripe because the compensability of the desired surgery had not been determined by the Division.

Workers' CompensationJurisdictionPlea to the JurisdictionVenue TransferAdministrative RemediesRipeness DoctrineSovereign ImmunityDeclaratory JudgmentMedical BenefitsBack Surgery
References
17
Case No. 03-05-00189-CV
Regular Panel Decision
Mar 21, 2008

Texas Department of Insurance, Division of Workers' Compensation v. Insurance Council of Texas, Texas Mutual Insurance Company, Texas Property and Casualty Insurance Guaranty Association, and Envoy Medical Systems, Inc.

The Texas Department of Insurance, Division of Workers' Compensation (the "Division") promulgated a rule (28 Tex. Admin. Code § 133.309) to create a less expensive alternative review procedure for workers' compensation claims concerning the necessity of medical treatment. The Insurance Council of Texas, Texas Mutual Insurance Company, Texas Property and Casualty Insurance Guaranty Association, and Envoy Medical Systems, L.P. (the "Joint Appellees") challenged the rule's validity in a declaratory judgment action. The district court granted the Joint Appellees' motion for summary judgment, declaring the rule invalid. The appellate court affirmed the district court's judgment, concluding that the rule was not in harmony with relevant governing statutes that allowed for judicial review of medical necessity disputes.

Workers' Compensation LawAdministrative LawJudicial ReviewStatutory InterpretationDeclaratory JudgmentSummary JudgmentMedical Necessity DisputesAlternative Dispute ResolutionAgency Rule ValidityTexas Court of Appeals
References
15
Case No. 2017 NY Slip Op 08027 [155 AD3d 900]
Regular Panel Decision
Nov 15, 2017

Poalacin v. Mall Properties, Inc.

The plaintiff, Nelson Poalacin, was injured when he fell from a defective ladder while working at a retail property undergoing refurbishment. He sued multiple defendants, including the property owners (Mall Properties, Inc., KMO-361 Realty Associates, LLC, The Gap, Inc.), the general contractor (James Hunt Construction), and subcontractors (Weather Champions, Ltd., APCO Insulation Co., Inc.), alleging violations of Labor Law §§ 240 (1), 200, and 241 (6), as well as common-law negligence. The Supreme Court initially denied Poalacin's motion for summary judgment on Labor Law § 240 (1) and later granted the defendants' motions to dismiss the complaint. On appeal, the Appellate Division reversed the Supreme Court's orders, granting Poalacin summary judgment on the Labor Law § 240 (1) claim and denying the defendants' motions to dismiss the other Labor Law claims. The court also made declarations regarding indemnification and insurance coverage between the parties, finding Harleysville Insurance's policy was excess to Netherlands Insurance Company's policy, and remitted the matter for judgment entry.

Labor LawConstruction AccidentWorkplace SafetyLadder FallSummary JudgmentIndemnificationInsurance DisputesAdditional InsuredCommon-Law NegligenceThird-Party Action
References
37
Case No. 2014 NY Slip Op 05765
Regular Panel Decision
Aug 13, 2014

Commissioners of State Insurance Fund v. Kaywood Properties, Ltd.

The case involves an appeal by Kaywood Properties, Ltd., from an order denying its motion for summary judgment. The Commissioners of State Insurance Fund sued Kaywood Properties for allegedly unpaid workers' compensation insurance premiums. Kaywood Properties argued it had no employees during the relevant period, thus owing no premiums. The Supreme Court denied their motion, and the Appellate Division affirmed this decision. The Appellate Division found that Kaywood's affidavit contained only conclusory assertions without sufficient evidentiary support to establish its prima facie entitlement to judgment.

Workers' CompensationInsurance PremiumsSummary JudgmentAffirmationAppellate ReviewEmployer LiabilityPayrollEvidentiary SupportConclusory AssertionsSupreme Court
References
6
Case No. 61 AD3d 88
Regular Panel Decision

Lighthouse Pointe Property Associates LLC v. New York State Department of Environmental Conservation

The petitioner, Lighthouse Pointe Property Associates LLC, challenged the New York State Department of Environmental Conservation's (DEC) decision to deny its properties' inclusion in the Brownfield Cleanup Program (BCP) through a CPLR article 78 proceeding. DEC's denial was based on its determination that the properties did not meet the statutory definition of a brownfield site, arguing that contamination levels were minimal and did not complicate redevelopment, with issues primarily stemming from solid waste. Lighthouse presented substantial evidence of contamination, including hazardous wastes exceeding cleanup standards, which had demonstrably hindered redevelopment efforts by impacting financing and regulatory approvals. The Supreme Court initially sided with Lighthouse, but the Appellate Division reversed, deferring to DEC's expertise. The Court of Appeals ultimately reversed the Appellate Division, concluding that DEC's interpretation of "brownfield site" was arbitrarily narrow and contrary to the broad legislative intent of the BCP, thereby reinstating the Supreme Court's judgment to grant Lighthouse's application.

Brownfield Cleanup ProgramEnvironmental Conservation LawContaminationReal Property RedevelopmentHazardous WasteSolid Waste LandfillSoil Cleanup ObjectivesAppellate ReviewStatutory InterpretationArbitrary and Capricious
References
4
Case No. 03-09-00680-CV
Regular Panel Decision
Aug 28, 2013

National American Insurance Company Texas Department of Insurance, Division of Workers' Compensation Rod Borderlon, in His Official Capacity as Commissioner of the Division of Workers' Compensation And the Subsequent Injury Fund v. Texas Property and Casualty Insurance Guaranty Association for Paula Insurance Company, an Impaired Carrier

MISSING

Workers' CompensationInsurance LawAppellate CourtGuaranty AssociationImpaired CarrierTexas LawThird District
References
0
Case No. 14-08-00493-CV
Regular Panel Decision
Jun 21, 2009

BACM 2002 PB2 Westpark Dr LP, Houston Parkwest Place Ltd, as the Property Owners and the Property Owners v. Harris County Appraisal District and the Appraisal Review Board of Harris County Appraisal District

This appeal concerns a lawsuit where a former property owner initiated judicial review of an ad valorem tax valuation protest by the county appraisal district. A subsequent property purchaser was later included as a plaintiff. The appraisal district challenged the plaintiffs' standing through a plea to the jurisdiction, leading the trial court to dismiss the suit. The appellate court affirmed this dismissal, concluding that neither the initial property owner (BACM 2002 PB2 Westpark Dr. LP) nor the subsequent owner (Houston Parkwest Place Ltd.) possessed the requisite standing to pursue judicial review. Consequently, the trial court was found to lack subject-matter jurisdiction over the dispute.

Property TaxAd Valorem TaxJudicial ReviewStanding DoctrineSubject-Matter JurisdictionPlea to the JurisdictionTexas Tax CodeTexas Rule of Civil Procedure 28Appellate ProcedureProperty Ownership
References
30
Case No. 09-02-018 CV
Regular Panel Decision
Apr 17, 2003

U.S. Restaurant Properties Operating, L.P. and U.S. Restaurant Properties, Inc. v. Motel Enterprises, Inc.

Motel Enterprises, Inc. sued U.S. Restaurant Properties Operating L.P. and U.S. Restaurant Properties, Inc. for breach of a put option in a purchase and sale agreement. Motel exercised its right to have USRP purchase a $500,000 promissory note, but USRP refused, claiming the note's maker, Bar S Restaurants, Inc., was in material default on a lease. A jury found no material default and awarded Motel $550,000. On appeal, USRP challenged the sufficiency of evidence, damages, jury instructions, evidentiary rulings, and prejudgment interest. The appellate court affirmed the liability and damages findings, but reversed and remanded for recalculation of prejudgment interest, also modifying the judgment to require Motel to transfer the note to USRP.

Breach of ContractPut OptionPromissory NoteLease AgreementMaterial DefaultSufficiency of EvidenceDamages CalculationJury InstructionsEvidentiary RulingsPrejudgment Interest
References
20
Case No. 03-11-00009-CV
Regular Panel Decision
May 26, 2011

Rod Bordelon, Commissioner of the Texas Department of Insurance, Division of Workers' Compensation And the Texas Department of Insurance, Division of Workers' Compensation v. Brian Fanette

The appellants, Rod Bordelon, Commissioner of the Texas Department of Insurance, Division of Workers' Compensation, and the Texas Department of Insurance, Division of Workers' Compensation, filed a motion requesting the dismissal of their appeal. The Texas Court of Appeals, Third District, at Austin, granted this motion and consequently dismissed the appeal. This decision was made in the case against Appellee Brian Fanette.

Texas Court of AppealsWorkers' Compensation DivisionAppeal DismissalAppellant MotionJudicial DistrictTravis CountyMemorandum OpinionAdministrative AgencyState GovernmentAppellate Procedure
References
0
Case No. MISSING
Regular Panel Decision

Fabijanic v. Sperry Gyroscope Division

Petitioner Nicholas Fabijanic, representing the Engineers Union, sought to compel Sperry Gyroscope Division and Sperry Systems Management Division to arbitrate a grievance concerning a collective bargaining agreement. The dispute arose after Systems' employees, previously working at the Mississippi Test Facility (MTF) on the National Data Buoy Project, were offered employment with Sperry Space Support, another division, which would result in loss of union coverage. The Union contended the agreement should still apply. The court denied the motion, ruling that the employees had voluntarily accepted employment with an autonomous entity not party to the agreement, thus making the grievance non-arbitrable under the existing contract.

ArbitrationCollective Bargaining AgreementGrievanceUnion RepresentationEmployee TransferSperry Rand CorporationNational Labor Relations BoardFederal CourtLabor LawEmployer-Employee Relations
References
3
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