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

Case No. No. 13-7019
Regular Panel Decision

Lopez v. Portfolio Recovery Associates, LLC (In re Lopez)

This case is a Memorandum Opinion concerning Plaintiff Marcos F. Lopez's application for compensation and reimbursement of expenses for attorney's fees incurred during a motion for sanctions against Portfolio Recovery Associates, LLC (PRA). The plaintiff's counsel, Kellett & Bartholow PLLC, sought $176,967.50 in fees and $2,023.41 in expenses, but PRA opposed the amount. The court determined the reasonableness of attorney's fees using the lodestar method, which involved calculating prevailing hourly rates and reasonable hours, and considering Johnson factors. The court allowed fees for defending PRA's motion for leave to appeal but disallowed fees for prosecuting the fee application itself, for issues on which the plaintiff did not prevail, for vague time entries, and for certain interoffice communications. Ultimately, the court granted in part and denied in part the application, awarding Applicant $117,760.60 in fees and $2,194.64 in expenses, totaling $119,952.24.

Attorney's FeesSanctionsDiscovery ViolationsLodestar MethodBankruptcy LawConsumer LawBilling JudgmentHourly RatesExpenses ReimbursementInterlocutory Appeal
References
38
Case No. MISSING
Regular Panel Decision

Standard Fire Insurance Co. v. Morgan

Jimmie Morgan was injured while working for Jim Walters Homes, leading to a workers' compensation claim against their insurer, The Standard Fire Insurance Company. Morgan sought additional compensation and medical benefits, resulting in a jury award. On appeal, the Supreme Court of Texas affirmed the findings of good cause for Morgan's late claim filing and upheld the calculation of her average weekly wage and compensation benefits. However, the Court reversed the appellate court's decision regarding prejudgment interest on medical expenses, ruling that such interest is not recoverable under the Workers' Compensation Act.

Workers' CompensationPrejudgment InterestMedical ExpensesTimely ClaimGood CauseAverage Weekly WageTexas LawInsurance ClaimAppellate ReviewStatutory Interpretation
References
8
Case No. 06-03-00135-CV
Regular Panel Decision
Dec 08, 2004

Pat Forth, Individually and on Behalf of Others Similarly Situated v. Allstate Indemnity Company

Pat Forth sued Allstate Indemnity Company after her daughter's automobile accident, alleging Allstate arbitrarily paid only a portion of medical expenses using a computerized database (MBRS) and an eighty-fifth percentile standard, rather than 'reasonable' expenses. Forth initially sought both retrospective relief for past claims and prospective relief to enjoin future use of MBRS, but later removed requests for monetary damages. The trial court dismissed the suit for lack of standing. On appeal, the court held that Forth lacked standing for prospective relief because she was no longer an Allstate insured. However, the appellate court found Forth had standing for retrospective relief regarding her past claims, asserting that an injury existed due to Allstate's alleged failure to pay reasonable expenses as per the policy. Consequently, the trial court's dismissal was vacated regarding past claims and remanded for further proceedings.

StandingDeclaratory JudgmentInjunctive ReliefInsurance LawPersonal Injury Protection (PIP)Medical ExpensesClass ActionAppellate ProcedureSubject Matter JurisdictionMootness
References
13
Case No. MISSING
Regular Panel Decision

Standard Fire Insurance Co. v. Stigger

This worker's compensation case concerns an appeal by Standard Fire, the carrier, against a judgment rendered in favor of Stigger, the claimant, by a county court at law of Dallas County. The Industrial Accident Board initially awarded Stigger $2,377.62, but after a jury trial initiated by Standard Fire to set aside the award, the court rendered a judgment for Stigger in the amount of $34,692.21. Standard Fire appealed, arguing that the trial court exceeded its jurisdictional limits and erred in not reducing the judgment to conform to Stigger's pleadings. The appellate court affirmed the trial court's decision, holding that once jurisdiction is lawfully acquired, subsequent events do not defeat it, and a court can grant complete relief even if the judgment exceeds the initial jurisdictional limits, especially in worker's compensation cases.

Worker's CompensationJurisdiction LimitsCounty Court at LawAmount in ControversyAppellate ReviewTexas Civil StatutesJudicial EconomyPleading ConformityDisability BenefitsIndustrial Accident Board
References
10
Case No. ADJ7112948
Regular
Mar 30, 2017

LYLE BYNUM vs. VALLEJO TRANSIT, ACE AMERICAN INSURANCE, BROADSPIRE

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a prior award. The Board issued a Notice of Intention to Impose Sanctions against the defendant's attorney and insurance company for alleged bad faith actions. These actions included filing a petition for reconsideration with inaccurate and unsupported references to evidence, misrepresenting medical opinions, and asserting meritless contentions. The WCAB is considering sanctions of up to $2,000 and reasonable expenses due to these alleged violations of labor code and board rules.

Workers' Compensation Appeals BoardPetition for ReconsiderationSanctionsLabor Code § 5813Cal. Code Regs. tit. 8 § 10561Findings and AwardWCJBus DriverBack InjuryLeft Lower Extremity Injury
References
0
Case No. 126300 R.D.
Regular Panel Decision

Bazner v. American States Insurance Co.

Walter Bazner, an insulator diagnosed with asbestosis, previously received workers' compensation benefits from L.D. Powell & Company and its insurer, American States Insurance Company, for permanent total disability and medical expenses incurred up to the judgment date. When Bazner incurred additional medical expenses post-judgment, American refused payment, arguing the prior judgment was res judicata and required pre-approval for new expenses. Bazner initiated a new suit, and the trial court sided with him. On appeal, the Supreme Court held that Bazner's claim for future medical expenses was not barred, reiterating that such expenses are recoverable under T.C.A. § 50-6-204 and established procedural rules for seeking them via petition in the original action. The court also found Bazner's decision to seek further medical attention from his treating physician reasonable under the circumstances. The case was remanded for further proceedings regarding future medical payments and related issues.

AsbestosisOccupational DiseaseFuture Medical ExpensesPost-Judgment CareRes Judicata DefenseEmployer Medical AuthorizationInsurance LiabilityStatutory BenefitsAppellate ReviewRemand Order
References
6
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
Case No. MISSING
Regular Panel Decision

Kihl v. Pfeffer

Plaintiff Merryl Kihl was injured in a car accident in 1995, sustaining ankle and C2 vertebra fractures, and subsequently developed chronic pain. She sued Karl O. Pfeffer (driver) and County of Nassau (road design). A jury found both defendants negligent, apportioning 13% fault to Pfeffer and 87% to the County. Kihl was awarded significant damages for past and future pain and suffering, medical expenses, and lost earnings. The County appealed, seeking to reduce the jury's award for future medication expenses via a collateral source hearing under CPLR 4545 (c). The Supreme Court denied the reduction, finding the County failed to establish with "reasonable certainty" that Kihl's husband's health insurance would cover future medication costs, citing factors like Finnell's job insecurity, changing benefits, the strained marriage, and Kihl's uninsurability. The Appellate Division affirmed the judgment, upholding the jury's damage awards and the denial of the collateral source reduction, emphasizing the strict construction of CPLR 4545 (c) and the high "reasonable certainty" standard of proof.

Collateral Source RuleCPLR 4545 (c)Reasonable Certainty StandardFuture Medical ExpensesPersonal Injury DamagesJury VerdictsAppellate ReviewHealth Insurance CoverageSpousal DependencyEconomic Loss
References
62
Case No. MISSING
Regular Panel Decision

In re Relativity Fashion, LLC

This Memorandum Opinion addresses a motion for attorneys' fees and expenses filed by Relativity Media, LLC (and its affiliates RML Distribution Domestic, LLC, Armored Car Productions, LLC, and DR Productions, LLC, collectively 'Relativity') and Mr. Ryan Kavanaugh against Netflix, Inc. The dispute arose from Netflix's refusal to execute 'Date Extension Amendments' related to a License Agreement, prompting Relativity to seek relief under Section 1142 of the Bankruptcy Code. The Court previously ruled that Netflix was barred by res judicata and judicial estoppel from asserting its claimed contractual rights to distribute films before theatrical release. In this opinion, the Court determined that Relativity was the 'prevailing party' under California Civil Code Section 1717 and the License Agreement's fee provision. Consequently, Relativity is entitled to reimbursement for its own reasonable attorneys' fees and litigation expenses. However, the Court denied Mr. Kavanaugh's request for reimbursement of his counsel's fees and expenses, concluding that he was not a party to the License Agreement and did not meet the exceptions for non-signatories to recover fees. The Court awarded Relativity $818,547.48, comprising $795,732.50 in attorneys’ fees and $22,814.98 in litigation expenses, against Netflix.

Attorneys FeesLitigation ExpensesContract LawCalifornia Civil Code Section 1717Bankruptcy Code Section 1142Prevailing PartyLodestar MethodHourly RatesJudicial EstoppelRes Judicata
References
85
Case No. Consolidated Chapter 13 Cases (e.g., 91-20422 to 97-36152)
Regular Panel Decision

In Re Phillips

This Memorandum Opinion and Order addresses objections by chapter 13 trustees to the postpetition claims for attorney's fees and expenses filed by William A. Cohn, an attorney representing numerous chapter 13 debtors. Mr. Cohn had routinely filed these claims under 11 U.S.C. § 1305(a)(2), arguing it served as an alternative to the § 330 procedures for professional compensation. The Court found that § 1305(a)(2) is intended for exigent circumstances where prior trustee approval is impracticable, not for routine legal work, and that Mr. Cohn failed to meet its conditions. It emphasized that § 330, which requires notice, a hearing, and detailed documentation, is the appropriate procedural vehicle for approving attorney's fees to ensure reasonableness and benefit to the debtor. Consequently, the Court disallowed all of Mr. Cohn's postpetition claims filed under § 1305(a)(2), vacated prior administrative orders that had mistakenly allowed these claims, and ordered Mr. Cohn to either file proper § 330(a)(4)(B) applications with full time and expense documentation by July 31, 1998, or disgorge all received postconfirmation fees and expenses by August 14, 1998.

Bankruptcy LawChapter 13 ProceedingsAttorney CompensationPostpetition ClaimsFee ApplicationsDisgorgement of FeesProcedural ComplianceProfessional EthicsJudicial ReviewAdministrative Errors
References
15
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