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

Case No. ADJ3496351 (SAC 0319422)
Regular
Sep 27, 2010

SANDRA L. BOYD vs. COUNTY OF SACRAMENTO

This case concerns whether lien claimant MBM Boutique Acupuncture could bill for multiple units of electro-acupuncture (CPT code 97801) per session. The defendant, County of Sacramento, argued that under the Official Medical Fee Schedule (OMFS), 97801 is an untimed code billable only once per session. The Appeals Board reversed the WCJ's decision, finding the defendant's expert bill reviewer's unrebutted testimony established 97801 as an untimed code, limiting reimbursement to one unit per session. Therefore, the defendant's payment was deemed reasonable and consistent with the OMFS, and the lien claimant was awarded nothing further.

Official Medical Fee ScheduleOMFS97801timed proceduresuntimed proceduresdeputy sheriffacupuncturereimbursementbill reviewerunit per session
References
2
Case No. 13-10-00247-CV
Regular Panel Decision
Jul 29, 2010

Unit Texas Drilling, LLC, Unit Drilling Company and Cliff Welker v. Caesar Morales, Jr. and Rhonda Morales

This memorandum opinion from the Thirteenth District of Texas Court of Appeals addresses an appeal by Unit Texas Drilling, LLC, Unit Drilling Company, and Cliff Welker. They sought to reverse a trial court's order denying their motion to compel arbitration in a personal injury suit filed by Caesar Morales, Jr. and Rhonda Morales. The Moraleses' claims arose from Caesar's on-the-job injury while working for Unit Texas, a non-subscriber to the Texas Workers Compensation Act, and concerned a mandatory 'Occupational Injury Benefit Plan' with an arbitration clause. The appellate court found that the Federal Arbitration Act applied, the arbitration agreement was valid and enforceable, and rejected the appellees' defenses, including arguments related to the McCarran-Ferguson Act, Texas Labor Code provisions, unconscionability, and failure of consideration. Consequently, the court reversed the trial court's order and remanded the case for further proceedings.

Arbitration AgreementFederal Arbitration ActTexas Workers Compensation ActNon-subscriber EmployerMotion to Compel ArbitrationUnconscionability DefenseMcCarran-Ferguson ActIllusory PromiseContractual DisputesEmployment Law
References
46
Case No. 1:96-CV-337
Regular Panel Decision
Dec 28, 1998

Saint Paul Fire & Marine Insurance v. United States

Seaman Christopher Gray sustained injuries at the Chickamauga Lock and Dam. Serodino, Inc., Gray's employer, and its insurer, Saint Paul Fire and Marine Insurance Company, initiated a lawsuit against the United States of America and the United States Army Corps of Engineers, seeking contribution or indemnity related to Gray's injuries. The plaintiffs asserted admiralty jurisdiction over their claims. The United States filed a Motion for Summary Judgment, contending that the court lacked subject matter jurisdiction. The court determined that the plaintiffs failed to comply with the administrative filing requirement of the Admiralty Extension Act and that Gray's underlying admiralty claim against Serodino did not confer admiralty jurisdiction over the plaintiffs' claims against the United States. Consequently, the court granted the United States's Motion for Summary Judgment, citing a lack of subject matter jurisdiction.

Admiralty jurisdictionSovereign immunitySuits in Admiralty ActAdmiralty Extension ActContributionIndemnificationSummary judgmentJones ActMaritime lawNavigable waters
References
18
Case No. MISSING
Regular Panel Decision
Mar 27, 1985

United States v. $100 in United States Currency

The United States initiated an in rem forfeiture action against $100,000 in U.S. currency, alleging it originated from illegal drug transactions. Claimants Jose Martinez-Torres and Nancy Medina asserted the funds were legitimate lottery winnings. The government sought summary judgment, arguing issue preclusion from a prior Nebbia bail hearing where Medina's lottery claim was found incredible. The Court granted partial summary judgment for the government, establishing probable cause for forfeiture. However, it denied the application of offensive collateral estoppel for full summary judgment, citing the distinct procedural environment and limited scope of the Nebbia hearing, and ruled that claimants are entitled to a plenary trial to prove the legitimate source of the funds.

ForfeitureDrug Trafficking ProceedsCollateral EstoppelIssue PreclusionSummary JudgmentProbable CauseIn Rem ForfeitureBail HearingDue Process ConcernsPuerto Rican Lottery
References
8
Case No. MISSING
Regular Panel Decision

Olveda v. United States

Plaintiff Mr. Olveda filed a Federal Tort Claim Action against the United States after being exposed to plutonium while employed by Dow Chemical Company, an independent contractor managing the Rocky Flats Plant in Colorado. The United States moved for summary judgment, asserting immunity as a 'statutory employer' under Colorado law. The court found that under Colorado Revised Statute § 8-48-101, the United States, by ensuring workmen's compensation insurance for Dow's employees (as an allowable cost under its contract with Dow), qualified as a statutory employer. This status grants immunity from common law tort suits. Citing various Colorado and federal precedents, the court affirmed that the 'statutory employer' doctrine applies to the United States in the same manner as a private individual. Therefore, Mr. Olveda is limited to his workmen's compensation claim, and the court granted summary judgment to the United States.

Federal Tort Claims ActStatutory EmployerWorkers' CompensationRadiation ExposurePlutonium ContaminationSummary JudgmentSovereign ImmunityIndependent ContractorColorado Law
References
22
Case No. MISSING
Regular Panel Decision

United States v. Caballero

Saul Caballero, who pleaded guilty to two drug conspiracies (heroin and methamphetamine distribution), objected to an aggravating role enhancement under the Sentencing Guidelines, arguing it would increase his mandatory-minimum sentence and thus require a jury finding beyond a reasonable doubt as per Alleyne v. United States. Following a two-day Fatico hearing, the District Court concluded that the government proved by a preponderance of the evidence that Caballero was a manager or supervisor of the heroin distribution conspiracy, but not the crystal methamphetamine conspiracy. The Court also rejected Caballero's argument that Alleyne mandates a jury to determine safety-valve eligibility, affirming that judicial fact-finding by a preponderance of the evidence for safety-valve criteria is constitutionally permissible as it potentially lessens, rather than increases, the mandatory minimum sentence. Therefore, the defendant's motion for a jury determination was denied.

Sentencing GuidelinesAggravating Role EnhancementMandatory Minimum SentenceSafety Valve EligibilityDrug ConspiracyHeroin DistributionMethamphetamine DistributionPreponderance of EvidenceJury DeterminationConstitutional Law
References
24
Case No. MISSING
Regular Panel Decision

United States v. Pszeniczny

Stanislaw Pszeniczny, an alien previously removed for an aggravated felony, was indicted for illegal reentry into the United States. He moved to dismiss the indictment, arguing his original removal order was invalid because his Notice to Appear (NTA) lacked a specific date and time for his hearing, citing Pereira v. Sessions. The court analyzed conflicting interpretations of Pereira and its applicability to jurisdictional issues versus the "stop-time rule." It also considered the requirements of 8 U.S.C. § 1326(d) for collateral attacks on removal orders. The court ultimately denied Pszeniczny's motion, finding that he received full and timely notice of his hearings and participated fully, with no prejudice or unfairness in the immigration procedure, making the Banegas Gomez v. Barr decision by the Second Circuit applicable and uncontestable.

Immigration LawIllegal ReentryRemoval OrderNotice to AppearJurisdictionDue ProcessCollateral AttackAdministrative RemediesJudicial ReviewAggravated Felony
References
34
Case No. MISSING
Regular Panel Decision

United States Fire Insurance v. Alvarez

United States Fire Insurance Company (U.S. Fire) appealed an order from a Texas trial court that overruled its plea of privilege in a workers’ compensation case. Rosa and Manuel Alvarez had initiated the suit in Webb County to appeal an Industrial Accident Board award. U.S. Fire contended that venue should be in Dallas County, its place of residence, arguing the injured worker, Tranquelino Alvarez, was an exempt farm laborer and not covered by the Texas Workers’ Compensation Act. The plaintiffs asserted that venue was proper in Webb County due to the worker's residence there at the time of injury and death, as per specific provisions of Texas statutes. The appellate court affirmed the trial court's ruling, concluding that proof of a 'covered employee' status was an issue for the trial on the merits, not a prerequisite venue fact in a plea of privilege hearing for a workers' compensation case.

workers' compensationvenueplea of privilegefarm laborer exemptioncovered employeeappellate procedureTexas lawjurisdictionstatutory interpretationIndustrial Accident Board
References
15
Case No. MISSING
Regular Panel Decision

Totten v. United States

This is a wrongful death action brought under the Federal Tort Claims Act. The plaintiff's husband, an Aerojet employee, died in a rocket propellant fire during a post-accident clean-up operation at the United States Air Force Arnold Engineering Development Center. The United States moved for summary judgment, contending it could not be held liable for the negligence of its independent contractor Aerojet and that it was protected by the discretionary function exception of 28 U.S.C. § 2680(a). The Court determined that Air Force personnel, who approved a clean-up plan with a deficient hazard analysis, were performing a discretionary function. Citing Supreme Court precedents like Dalehite and Varig Airlines, the Court ruled that Section 2680(a) protects the United States from liability even if negligence could be proved. Therefore, the motion for summary judgment was granted, and the action was dismissed.

Wrongful DeathFederal Tort Claims ActDiscretionary Function ExceptionSummary JudgmentGovernment LiabilityIndependent ContractorMilitary StandardsHazard AnalysisRocket Propellant FireTennessee Law
References
4
Case No. MISSING
Regular Panel Decision

De Blasio v. United States

This action was brought under the Federal Tort Claims Act by Jean and Clifton DeBlasio against the United States for personal injuries sustained by Jean at the Gateway Sports Center. The plaintiffs alleged negligence due to protruding cement nodules on a sidewalk. The United States moved for summary judgment, asserting it could not be sued for the acts or omissions of its independent contractors. The court found that Shields and Dean Concessions, Inc., which operated the Sports Center, was an independent contractor and that the government lacked day-to-day supervisory control. Consequently, the Federal Tort Claims Act did not apply, and the motion for summary judgment was granted, finding the United States immune from suit.

Federal Tort Claims ActSovereign ImmunityIndependent ContractorSummary JudgmentPersonal InjuryNegligenceGovernment LiabilityConcessionaireNational Park ServiceControl Test
References
7
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