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

Case No. 01-15-00374-CV
Regular Panel Decision
Jul 27, 2015

the Upper Trinity Regional Water District and Texas Commission on Environmental Quality v. National Wildlife Federation

This case involves an appeal filed by the National Wildlife Federation (Appellee) against the Upper Trinity Regional Water District and the Texas Commission on Environmental Quality (Appellants). The appeal concerns the District Court's judgment of March 6, 2015, which reversed and remanded TCEQ's decision to grant Water Use Permit No. 5821 to the Upper Trinity Regional Water District. The core issue is TCEQ's alleged failure to properly implement Texas Water Code Section 11.085 (l)(2), which requires stringent water conservation and efficiency for interbasin water transfers. The Appellee argues that TCEQ improperly relied on a voluntary guide (Report 362) instead of fulfilling legislative directives for robust conservation standards, and that the District's water conservation plan lacks adequate implementation and enforcement mechanisms, thus failing to meet the 'highest practicable levels of water conservation and efficiency achievable' as mandated by law.

Water ConservationInterbasin TransferEnvironmental LawAdministrative LawAppellate ReviewTexas Water CodeWater Use PermitDrought Contingency PlanRegulatory ComplianceBest Management Practices
References
25
Case No. ADJ2855195 (MF); ADJ965274
Regular
Jan 23, 2012

MARCELO RUEDA vs. ALL LABOR TIRES, STATE COMPENSATION INSURANCE FUND

The State Compensation Insurance Fund petitioned for reconsideration of awards made to Marcelo Rueda, arguing that Agreed Medical Examiner (AME) reports by Drs. Hyman and Sanders lacked substantial evidence. Specifically, the Fund disputed impairment ratings for hypertension, upper digestive tract issues, and sleep disorders, as well as the carpal tunnel syndrome diagnosis. The judge recommended denying the petition, finding that the AME reports provided reasoned medical opinions supported by the AMA Guides and clinical judgment. The Workers' Compensation Appeals Board granted reconsideration to further review the complex factual and legal issues involved.

Petition for ReconsiderationAgreed Medical ExaminerAMA GuidesPermanent DisabilityHypertensionUpper Digestive Tract ImpairmentSleep DisorderCarpal Tunnel SyndromeSubstantial EvidenceClinical Judgment
References
2
Case No. ADJ7873101
Regular
Apr 11, 2017

SHERY FRANKLIN vs. STATE OF CALIFORNIA

The Workers' Compensation Appeals Board (WCAB) granted reconsideration and rescinded the prior award, finding that the administrative law judge erred in several permanent disability ratings. Specifically, the WCAB will allow for further proceedings to re-rate permanent disability, incorporating the agreed medical examiner's findings for hypertension and sleep disorder, and rating psyche disability without apportionment. Issues regarding the method of rating cervical spine disability, industrial injury to the upper digestive tract, and entitlement to a Labor Code section 4658(d) increase will also be further developed and decided. The WCAB affirmed the findings on temporary disability and further medical treatment.

WCA BReconsiderationIndustrial InjuryPermanent DisabilityApportionmentAgreed Medical EvaluatorAMEWhole Person ImpairmentWPISleep Disorder
References
11
Case No. MISSING
Regular Panel Decision

Sivel v. Readers Digest, Inc.

The case concerns a diversity action where defendants moved for summary judgment regarding plaintiff Sivel's claims of breach of an oral employment contract and misrepresentation against Reader's Digest and its executives. Sivel alleged that he was orally assured permanent employment in the United States and termination only for serious cause, which he argued limited Reader's Digest's right to fire him "at-will." The court denied the defendants' motion for summary judgment on the breach of contract claim, reasoning that Sivel's testimony, if credible, could establish an express agreement overriding the at-will presumption under New York law. However, summary judgment was granted to the defendants on the misrepresentation claims, as the court found these allegations to be inextricably linked to the alleged contract terms and thus enforceable only through a contract action.

Employment ContractAt-Will EmploymentSummary JudgmentBreach of ContractMisrepresentationOral AgreementEmployee HandbookNew York LawFraudulent InducementJob Security
References
13
Case No. ADJ9391561 ADJ8266496
Regular
Apr 12, 2019

HENDRIKUS ANTONIUS BENNINK vs. CITY OF FRESNO

This case involves a police officer claiming industrial injuries to multiple body parts, including orthopedic and digestive systems, in addition to previously resolved cardiovascular and hearing claims. The Workers' Compensation Appeals Board (WCAB) affirmed the trial judge's decision, finding that the applicant did not sustain industrial injuries to his neck, upper extremities, back, legs, or digestive system. This decision was based on substantial evidence from Qualified Medical Examiners (QMEs) who concluded these conditions were degenerative and non-industrial. The WCAB found no error in the QMEs' reasoning or the applicant's failure to prove industrial causation for these specific injuries.

ADJ9391561ADJ8266496Industrial injuryCardiovascular systemHearing lossOrthopedic injuryDigestive systemQMESubstantial evidenceCausation
References
0
Case No. 2018-02-0409
Regular Panel Decision
May 16, 2019

Jones, Katelyn v. Upper East Tennessee Human Development Agency

Katelyn Jones, a family resource specialist, sought medical and temporary disability benefits for a left knee injury sustained from a fall at work during an engagement activity. Her employer, Upper East Tennessee Human Development Agency (UETHDA), denied the claim, asserting an idiopathic injury. At an expedited hearing, the Court examined whether Ms. Jones could likely establish her entitlement to benefits at trial. The Court found insufficient evidence from Ms. Jones to prove a work hazard caused her fall, therefore concluding she would likely not prevail on the merits. Consequently, the Court denied her requested relief for benefits at this time.

Workers' CompensationKnee InjuryIdiopathic InjuryExpedited HearingMedical BenefitsTemporary Disability BenefitsCausationEmployment HazardTennessee LawFall at Work
References
4
Case No. ADJ6908002
Regular
Oct 09, 2013

ALVA VALDIVIESO vs. HARMAN MANAGEMENT (KFC), TRISTAR RISK ENTERPRISE MANAGEMENT

This case involves a workers' compensation claim for injuries to the applicant's right wrist/hand, psyche, digestive system, and neck. The applicant was awarded 60% permanent disability, but the defendant petitioned for reconsideration, disputing the neck injury finding, applicant's credibility, and the disability calculation. The Appeals Board found issues with the medical evaluator's permanent disability calculations and explanations, particularly concerning the right upper extremity impairment. Consequently, the Board deferred the issue of permanent disability to allow for further development of the record at the trial level.

Workers' Compensation Appeals BoardReconsiderationFindings and AwardPermanent DisabilityWCJIndustrial InjuryPanel Qualified Medical ExaminerAgreed Medical EvaluatorWhole Person ImpairmentAMA Guides
References
9
Case No. MISSING
Regular Panel Decision

Stromski v. Jefferson Auto Body

The claimant, an auto body repairer for 27 years, sought workers' compensation benefits for stomach cancer, attributing it to occupational exposure to chromium and talc. The Workers’ Compensation Board denied his claim, concluding that his disease was not causally related to his occupation after resolving conflicting expert medical testimony against him. The Board credited the carrier's expert, an internal medicine specialist, who testified that studies only link a specific type of chromium to carcinogenicity in the upper respiratory tract, not stomach cancer. This expert testimony successfully rebutted the statutory presumption of compensability under Workers’ Compensation Law § 21. The appellate court affirmed the Board's decision, emphasizing that resolving conflicts in medical testimony, particularly regarding causation, falls within the Board's province. Additionally, the claimant's appeal from the denial of reconsideration was deemed abandoned.

Occupational DiseaseStomach CancerCausationMedical Expert TestimonyChromium ExposureTalc ExposureBurden of ProofStatutory PresumptionAppellate ReviewBoard Decision Affirmed
References
4
Case No. ADJ7311200
Regular
Aug 03, 2017

SEAN HARRIS vs. COAST CRANE COMPANY, EMPLOYERS INSURANCE OF WAUSAU, THUNDER MACHINE WORKS, AIX INSURANCE COMPANY, AEROTEK, ALLEGIS GROUP INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA

This case concerns a petition for reconsideration by defendant Wausau regarding an arbitrator's findings that applicant sustained industrial injury to his pulmonary system and upper extremities during a cumulative period. Wausau argued the claim was time-barred and that liability for upper extremity injury was improper. The Board denied Wausau's petition, finding Wausau failed to meet its burden of proof on the statute of limitations defense. The Board also determined that applicant properly amended his claim for upper extremities and that apportionment of liability based on days worked was appropriate.

Workers' Compensation Appeals BoardCoast Crane CompanyEmployers Insurance of WausauThunder Machine WorksAIX Insurance CompanyAerotekAllegis Group Insurance Companycumulative injurypulmonary systemupper extremities
References
10
Case No. ADJ602790 (STK 0179563)
Regular
Jul 17, 2012

TRACEE MAWYER vs. GALLO GLASS COMPANY

This case involves Tracee Mawyer's workers' compensation claim against Gallo Glass Company for cumulative trauma injuries. The Appeals Board granted reconsideration, reversing the trial judge's denial of injury to applicant's bilateral upper extremities, specifically carpal tunnel syndrome. The Board found Dr. Clayman's reports sufficiently supported an industrial injury to the upper extremities and awarded additional temporary disability for the period following carpal tunnel surgery. The case was returned for a new permanent disability rating for the upper extremity injuries.

Cumulative traumabilateral upper extremitiescarpal tunnel release surgerytemporary disabilitypermanent disability ratingreconsiderationDr. Claymanneck injuryshoulder injuryspine injury
References
0
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