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

Case No. NO. 03-06-00631-CV
Regular Panel Decision
Mar 26, 2009

Samuel Campos v. Texas Property & Casualty Insurance Guaranty Association for Reliance National Indemnity Company, an Impaired Carrier

Samuel Campos, an employee, was injured on the job, leading to disputes over his impairment rating and reimbursement for travel expenses. The Texas Workers’ Compensation Commission affirmed a designated doctor's 6% impairment rating and denied travel expenses, which Campos challenged in court. The case involved the Texas Property & Casualty Insurance Guaranty Association (TPCIGA) because Campos's employer's insurer became impaired. Initially filed in Winkler County, the case was transferred to Travis County, where TPCIGA was granted summary judgment. The Third District Court of Appeals reversed the summary judgment, ruling that the Workers' Compensation Act's specific mandatory venue provision, which places venue in the county of the employee's residence at the time of injury (Winkler County), overrides the Guaranty Act's general venue provision, which would place it in Travis County. The court remanded the case with instructions to transfer it to Winkler County.

Workers' CompensationVenue DisputeMandatory VenueStatutory ConstructionTexas Labor CodeTexas Insurance CodeImpairment RatingTravel Expenses ReimbursementJudicial ReviewAppellate Procedure
References
12
Case No. 03-08-00483-CV
Regular Panel Decision
Mar 19, 2010

Texas Property and Casualty Insurance Guaranty Association for Reliance National Insurance Company, an Impaired Company v. Doris J. Toberny

Doris J. Toberny, an exhibit decorator, injured her back on the job in May 2000, leading to spinal-fusion surgery that also corrected pre-existing scoliosis. Initially, her employer's insurer, Texas Property and Casualty Insurance Guaranty Association for Reliance National Insurance Company ('the Company'), paid for the surgery. However, in December 2001, the Company disputed the claim, asserting the injury was only a lower back strain and not the cause of her scoliosis. After a designated doctor assigned Toberny a 25-percent impairment rating in 2002, the Company paid supplemental income benefits for eight quarters. Three years later, in September 2005, the Company sought to dispute her impairment rating and discontinue benefits, claiming her pre-existing conditions were not compensable. The Division of Workers’ Compensation and the district court found that the Company had waived its right to contest the impairment rating under former rule 130.102(g) due to late dispute filing, and affirmed Toberny's 25-percent impairment rating and entitlement to benefits. The Texas Court of Appeals affirmed the trial court's judgment, upholding the validity of rule 130.102(g) and the finding of waiver, thus confirming Toberny's impairment rating and attorney's fees.

Workers' CompensationImpairment Rating DisputeSupplemental Income BenefitsWaiver DoctrineCompensability of InjuryExtent of InjuryJudicial Review of Agency DecisionTexas Appeals CourtAdministrative Rule ValidityMaximum Medical Improvement
References
12
Case No. 03-06-00404-CV
Regular Panel Decision
Mar 06, 2007

Johnnie M. Charles v. Texas Property and Casualty Insurance Guaranty Association, on Behalf of Phico Insurance Company, an Impaired Carrier

This case involves a restricted appeal filed by Johnnie M. Charles from a trial court's order dismissing her cause without prejudice. Charles initially appealed a Texas Workers' Compensation Commission decision regarding her impairment rating. After a venue transfer to Travis County, her case was dismissed for failure to pay filing fees. A nunc pro tunc order was later issued to correct a clerical error in the cause number of the original dismissal order. Charles appealed, citing errors in the dismissal, the lack of a court reporter, and the original hearing. The appellate court affirmed the dismissal, ruling that Charles's challenges to the original dismissal were untimely and that no error occurred in the nunc pro tunc order, which merely corrected a clerical error without altering the original judgment's substance.

restricted appealdismissal without prejudicenunc pro tunc orderclerical errorwant of prosecutionappellate jurisdictiontimeliness of appealTexas Rules of Civil ProcedureTexas Rules of Appellate Procedureworkers' compensation
References
13
Case No. ADJ3600842 (SDO 0363689)
Regular
Jan 27, 2010

THEMAS POULIN vs. COUNTY OF SAN DIEGO

This case involves an applicant who sustained an industrial injury to his heart and hypertension. The initial award granted 65% permanent disability, which the defendant challenged, arguing the assigned Whole Person Impairment was disproportionately high and that Diminished Future Earning Capacity should be zero. The Appeals Board rescinded the original award and returned the matter for a new decision. This is because the trial judge had not yet considered the implications of the recent en banc decisions in *Almaraz II* and *Ogilvie II* regarding the rebuttability of scheduled permanent disability ratings and the evaluation of Diminished Future Earning Capacity. The Board noted concerns about the assigned impairment rating in light of the applicant's return to work and potential future earning capacity.

Workers' Compensation Appeals BoardDeputy SheriffIndustrial InjuryHeart ConditionHypertensionPermanent DisabilityWhole Person ImpairmentAgreed Medical EvaluatorReconsiderationAlmaraz
References
5
Case No. 06-01-00121-CV
Regular Panel Decision
Sep 17, 2002

Pacific Employers Insurance Company v. Jimmy I. Brown

This case involves an appeal by Pacific Employers Insurance Company, a workers' compensation carrier, against Jimmy I. Brown, an injured worker, regarding an impairment rating. Pacific disputes the trial court's judgment of a seventeen percent impairment rating, arguing it conflicts with the trial court's findings of fact stating a thirteen percent rating. The appellate court examines the applicability of various Texas Rules of Civil Procedure concerning findings of fact and judgments, and the requirements for assigning impairment ratings under the Texas Workers' Compensation Act. The court ultimately reverses the trial court's judgment and remands the case for a new trial due to the conflict between the judgment and the findings of fact, and to ensure compliance with statutory notice requirements for the TWCC. The court also discusses the legal basis for impairment ratings, emphasizing that a trial court must adopt a specific rating assigned by a doctor in the case.

Workers' CompensationImpairment RatingJudicial ReviewAppellate ProcedureFindings of FactConclusions of LawJudgment ConflictReversal and RemandTreating PhysicianDesignated Doctor
References
9
Case No. 2021-06-1175
Regular Panel Decision
Aug 22, 2023

Matthews, Savitri v. Family Dollar Stores of Tennessee, LLC

The employee, Savitri Matthews, suffered a mental injury after being held at gunpoint during a store robbery at Family Dollar Stores. Her claim was accepted, and she received treatment from Dr. Greg Kyser, who assigned a ten percent impairment rating. Two other psychiatrists, Dr. Stephen Montgomery and Dr. Melvin Goldin (from the MIRR), also provided impairment ratings. The trial court concluded the employee sustained an impairment consistent with the 10% ratings from Dr. Kyser and Dr. Goldin and determined she was entitled to increased benefits due to a lower post-injury wage rate. The employer appealed. The Appeals Board affirmed the trial court's order, finding the employer failed to rebut the presumption of correctness of the medical impairment ratings and that the employee's post-injury wages were indeed lower.

Workers' CompensationMental InjuryArmed RobberyPTSDImpairment RatingWage LossIncreased BenefitsAppeals BoardPsychiatric EvaluationMedical Impairment Rating Registry
References
13
Case No. 03-08-00532-CV
Regular Panel Decision
Jan 27, 2010

Severiano DeLeon v. Royal Indemnity Company

This is a workers’ compensation case where the insurance carrier, Royal Indemnity Company, contested the impairment rating assigned to the claimant, Severiano DeLeon, by the Texas Department of Insurance, Division of Workers’ Compensation. The impairment rating was based on advisories issued by the Division, which were subsequently determined by the Court of Appeals to be invalid. The district court held that the assigned impairment rating was invalid, and the Court of Appeals affirmed this judgment. The court concluded that the 20% impairment rating assigned to DeLeon was invalid because it was improperly based on the invalid and withdrawn Division Advisories.

Workers' CompensationImpairment RatingSpinal FusionAMA GuidesMaximum Medical ImprovementAdministrative LawJudicial ReviewUltra Vires ActMedical EvaluationTexas Labor Code
References
9
Case No. 2017-01-0638
Regular Panel Decision
Sep 06, 2019

Rollins, Mark A. v. Scenic City Concrete Pumping, LLC

Mark A. Rollins, an employee, filed a request for an expedited hearing to compel his employer, Scenic City Concrete Pumping, LLC, to authorize a referral to Dr. Jerry Smith for a second impairment rating. Mr. Rollins had previously been rated at four-percent impairment by Dr. Benji Miller after a work-related ankle fracture. Dr. Matthew Buchanan subsequently referred Mr. Rollins to Dr. Smith for an impairment rating, a referral not authorized by the employer. The Court determined that the Workers' Compensation Law only mandates employer authorization for referrals for medical treatment, not for impairment ratings disputed by the employee. Consequently, the Court denied Mr. Rollins's request.

Impairment RatingMedical ReferralsExpedited HearingTreatment AuthorizationOrthopedic InjuryAnkle FractureMaximum Medical ImprovementPhysician PanelStatutory InterpretationEmployer Medical Responsibility
References
0
Case No. 13-99-746-CV
Regular Panel Decision
Aug 31, 2001

Colonial Casualty Insurance Company v. Garcia, Osler G.

Osler G. Garcia, an employee, sustained a compensable injury to his cervical spine and back while working. His workers' compensation claim resulted in a dispute over his impairment rating. The hearing officer and TWCC Appeals Panel found his impairment rating to be seventeen percent as determined by the designated doctor, Dr. Rodney Simonsen. Colonial Casualty Insurance Company, the employer's insurer, sought judicial review, challenging the finding of a cervical spine injury and the seventeen percent impairment rating. The trial court affirmed the commission's findings, and on appeal, the Court of Appeals affirmed the trial court's judgment, finding sufficient evidence to support both the cervical injury and the impairment rating based on Dr. Simonsen's reports.

Workers' CompensationImpairment RatingCervical Spine InjuryBench TrialMedical EvidenceAMA GuidesAppellate ReviewSubstantial EvidenceTrial Court AffirmanceDesignated Doctor
References
7
Case No. MISSING
Regular Panel Decision

Bell v. Zurich American Insurance Co.

Bettie Bell appealed a partial summary judgment granted to Zurich American Insurance Company in a workers' compensation case concerning her impairment rating. Bell sustained a back injury and her treating physician, Dr. Bernie McCaskill, rated her impairment at 10 percent, while a designated doctor, Dr. Stuart Small, rated it at 20 percent based on an invalid Division Advisory. The trial court set aside Dr. Small's rating and ordered him to re-evaluate, but this court found that the labor code does not permit such reconsideration. The court affirmed the invalidity of the 20 percent rating and, finding Dr. McCaskill's 10 percent rating to be the only valid evidence, reversed the trial court's judgment in part and rendered judgment assigning Bell a 10 percent impairment rating. A motion for rehearing raising jurisdictional and other arguments was denied.

Impairment RatingAMA GuidesSummary JudgmentJudicial ReviewAppellate ProcedureAdministrative LawStatutory InterpretationMedical Expert TestimonyTexas Labor CodeInsurance Law
References
17
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