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

Case No. 03-99-00293-CV
Regular Panel Decision
Feb 10, 2000

Texas Property and Casualty Insurance Guaranty Association v. Jack M. Webb, as Special Deputy Receiver of Employers Casualty Co. Jack M. Webb, as Special Deputy Receiver of Employers National Insurance Co.

This case involves an appeal from a summary judgment concerning the claims priority scheme within the Texas Insurance Code's liquidation statute. The appellant, Texas Property and Casualty Insurance Guaranty Association (TPCIGA), challenged the classification of its claims for defense costs incurred in defending liability and workers' compensation claims under policies of insolvent insurers. TPCIGA argued these costs should receive Class 1 priority as claims-handling expenses, while appellees contended they were Class 2 payments of policyholder claims. The court concluded that, prior to a 1995 amendment to the statute, such defense costs were properly classified as Class 2 claims. Therefore, the district court's judgment classifying them as Class 2 was affirmed.

Insurance LawClaims PriorityLiquidation StatuteTexas Insurance CodeGuaranty ActPolicyholder ClaimsDefense CostsStatutory InterpretationSummary JudgmentReceivership
References
22
Case No. 03-97-00567-CV
Regular Panel Decision
Jul 30, 1998

Memorial Medical Center of East Texas v. James A. Howard, Special Deputy Receiver of Texas Employers' Insurance Association and Texas Property and Casualty Insurance Guaranty Association

Memorial Medical Center of East Texas appealed a summary judgment granted in favor of James A. Howard, Special Deputy Receiver of Texas Employers' Insurance Association, and Texas Property and Casualty Insurance Guaranty Association. Memorial sought a declaration that the appellees were obligated to reimburse defense costs incurred in a separate suit brought by its employees. The trial court granted the appellees' motions for summary judgment without specifying the grounds. The appellate court affirmed the trial court's judgment, holding that both the Receiver and the Association were statutorily precluded from defending Memorial or reimbursing its defense costs under relevant provisions of the Texas Insurance Code.

Summary judgmentInsurance CodeDuty to defendReimbursementImpaired insurerReceivershipGuaranty AssociationAppellate reviewStatutory interpretationWorkers' compensation insurance
References
11
Case No. MISSING
Regular Panel Decision
May 24, 1995

Claim of Shoemaker v. Manpower, Inc.

The case concerns an appeal from a Workers' Compensation Board decision regarding the employment status of a claimant who was injured while working at Westwood Pharmaceuticals. The claimant was generally employed by Manpower, Inc., a temporary employee supplier. Westwood contended that it was the claimant's special employer, limiting her remedy to workers' compensation. The Board initially found that Westwood's control was insufficient to establish a special employment relationship, ruling Manpower as the sole employer. Both Westwood and Manpower appealed this decision. The Appellate Division reversed the Board's findings, concluding that the evidence demonstrated Westwood exercised exclusive control and supervision over the claimant's activities, thereby establishing a special employment relationship. The matter was remitted to the Board for further proceedings consistent with this Court's decision.

Special EmploymentTemporary EmployeeWorkers' CompensationEmployer LiabilityControl TestDual EmploymentAppellate ReviewRemittalSubstantial EvidencePersonal Injury
References
8
Case No. 13-17-00346-CV
Regular Panel Decision
May 09, 2019

Audrey Nickerson v. Julio Pineda and Unique Employment, LLC, Unique Employment Services, Unique Employment I, LTD, D/B/A Unique Employment Services

Audrey Nickerson, an employee of the City of Corpus Christi, sued Julio Pineda, a temporary worker, and Unique Employment Services for negligence after Pineda, operating a City-owned backhoe, caused an injury. Appellees filed a plea to the jurisdiction, which the trial court granted. The appellate court affirmed the dismissal of claims against Pineda, determining he qualified as a government employee under the Texas Tort Claims Act and was therefore immune from suit. However, the court reversed the dismissal of claims against Unique Employment Services, concluding that the borrowed-employee doctrine, on which Unique relied, is an affirmative defense to liability and not a jurisdictional matter properly addressed in a plea to the jurisdiction. The case against Unique was remanded for further proceedings.

Plea to the JurisdictionGovernmental ImmunityTexas Tort Claims ActElection of RemediesBorrowed Employee DoctrineNegligenceTemporary StaffingVicarious LiabilityAppellate ReviewSubject Matter Jurisdiction
References
35
Case No. MISSING
Regular Panel Decision

Graziano v. 110 Sand Co.

The case involves an injured truck driver, originally employed by Horan Sand & Gravel, who was assigned to work at 110 Sand Company's site. After sustaining injuries on the job, he accepted workers' compensation benefits from Horan. Subsequently, he and his wife filed a personal injury lawsuit against 110 Sand. 110 Sand moved for summary judgment, arguing the plaintiff was its 'special employee' and thus, the acceptance of workers' compensation benefits from Horan barred the lawsuit against them. The Supreme Court granted this motion, a decision which the appellate court affirmed. The appellate court agreed that the evidence supported the finding of a special employment relationship, and under Workers' Compensation Law, an injured worker who accepts benefits from their general employer is precluded from suing their special employer for the same injuries.

Personal InjuryWorkers' CompensationSpecial EmployeeGeneral EmployerSummary JudgmentAppellate ReviewSuffolk CountyNew York LawEmployer LiabilityDerived Claim
References
10
Case No. MISSING
Regular Panel Decision
Dec 08, 1961

SPECIAL PRODUCTS COMPANY OF TENN. v. Jennings

Sixty-two striking employees of Special Products Company claimed unemployment benefits after their jobs were filled during a labor dispute. The Commissioner and Board of Review allowed these claims, a decision upheld by the Chancery Court of Hamilton County. Special Products Company appealed to the Supreme Court of Tennessee, arguing against benefit payments and seeking a non-charge against its experience rating. The Supreme Court affirmed the lower court's decree, ruling that the disqualification for a labor dispute ceased once the strike was abandoned and employees sought re-employment. The Court found that the subsequent unemployment was due to the unavailability of jobs, not the strike itself, thereby entitling the former employees to benefits.

Unemployment BenefitsLabor DisputeStrikeJob ReplacementsEmployment Security ActVoluntary Quitting DisqualificationMisconduct DisqualificationExperience Rating PenaltySupreme Court DecisionStrike Termination
References
5
Case No. WCB Case No. G069 6605
Regular Panel Decision
Aug 24, 2017

The Matter of the Claim of Kanye Khalid Green v. Dutchess County BOCES

This case involves Angel Vazquez, the applicant, and New York City Transit Authority, the employer, with the Commissioner of Taxation and Finance as the Special Funds Conservation Committee. The issue at hand is the employer's request for reimbursement from the Special Funds Conservation Committee under Workers' Compensation Law §15(8)(d). The Board Panel found that the employer failed to demonstrate a good faith effort to resolve the claim prior to the hearing, specifically regarding a claim for an accidental injury. The decision of the Workers' Compensation Law Judge, which denied the employer's request for reimbursement, was affirmed. The Board also noted that the employer's application for review did not comply with the requirements of 12 NYCRR 300.13(b)(1).

Workers' Compensation Law §15(8)(d)Special Funds Conservation CommitteeReimbursement claimGood faith effortAccidental injuryBoard Panel decisionAffirmation of WCJ decision12 NYCRR 300.13(b)(1)Pre-hearing resolutionEmployer liability
References
6
Case No. MISSING
Regular Panel Decision

Claim of Martin v. New York Telephone

This case concerns an appeal from a Workers' Compensation Board decision regarding the liability for benefits. The claimant sustained a left knee injury in 1987 and a reinjury in 1995. A 1998 Section 32 settlement agreement released the employer from future claims for a lump sum, but required it to cover medical treatment. In 2004, the claimant developed a consequential right knee injury. The Workers' Compensation Board ultimately shifted liability for benefits to the Special Fund for Reopened Cases under Workers' Compensation Law § 25-a, citing the passage of statutory timeframes. The Special Fund appealed, challenging its statutory liability and the employer's ongoing responsibility for medical expenses per the settlement. The appellate court affirmed the Board's decision, upholding the applicability of Section 25-a and noting the employer's statutory obligation for medical treatment.

Workers' Compensation Law § 25-aSpecial Fund for Reopened CasesSection 32 Settlement AgreementConsequential InjuryMedical Treatment LiabilityStatutory LiabilitySchedule Loss of UseAppellate ReviewTimelinessBoard Review
References
4
Case No. MISSING
Regular Panel Decision
Oct 07, 2009

Claim of Ceplo v. Raymond Corp.

A claimant sustained a work-related injury in 1998 and received workers’ compensation benefits. In 2002, the self-insured employer sought reimbursement from the Special Disability Fund, citing a prior injury under Workers’ Compensation Law § 15 (8) (d). However, the Workers’ Compensation Board denied the employer's claim for reimbursement, ruling that the required C-250 form had been inadequately completed, specifically lacking crucial details about the prior injury and its associated workers' compensation claim. The employer and its third-party administrator subsequently appealed this decision. The Appellate Division affirmed the Board's determination, emphasizing the necessity of strict adherence to the prescribed regulations for claims seeking reimbursement from the Special Disability Fund.

Workers' CompensationSpecial Disability FundReimbursementForm C-250Prior InjuryStrict ComplianceAdministrative AppealAppellate DivisionEmployer LiabilitySelf-insured
References
3
Case No. MISSING
Regular Panel Decision

Claim of Russo v. M & M Transportation

The claimant, employed by M & M Transportation, sustained back and knee injuries in 1976. The employer's insurance carrier sought reimbursement from the Special Disability Fund, alleging various preexisting conditions under Workers’ Compensation Law § 15 (8). However, the carrier failed to produce medical proof to support its claim of preexisting conditions, even after being directed to do so by the Hearing Officer. Consequently, the Hearing Officer discharged the Special Fund, a decision affirmed by the Workers’ Compensation Board. The appellate court affirmed the Board's decision, citing the carrier's failure to provide clarifying medical proof and finding the Board's denial of reconsideration was neither arbitrary nor capricious. The court emphasized that the existence of a previous disability must be established before addressing the employer's knowledge of such a condition.

Workers' CompensationSpecial Disability FundReimbursement ClaimPreexisting Medical ConditionMedical EvidenceCarrier ObligationsBoard DiscretionDenial of ReconsiderationAppellate ReviewSufficiency of Evidence
References
3
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