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Latest Cases

Chandra v. Leonardo DRS, Inc.

The Sixth Court of Appeals (Texarkana) reviewed the lower court’s actions in granting Defendant’s traditional and no-evidence summary judgment. The traditional portion argued, in part, that Plaintiff’s claims were barred by the exclusive remedy provisions of the Texas Workers’ Compensation Act. The Court of Appeals found the lower court’s actions were proper but only discussed the no-evidence summary judgment.

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Berkel & Company Contractors, Inc. v. Lee

The Texas Supreme Court reaffirmed that, while a narrow common-law exception to the exclusive remedy in fatal work-related injuries exists, the exception requires that “the employer must believe that its actions are substantially certain to result in a particular injury to a particular employee, not merely highly likely to increase overall risks to employees in the workplace.” The Court specifically rejected a localized-area test which would implicitly define intent to include knowledge of dangerous conditions that will eventually cause an injury, if that knowledge is specific to a particular time and small class of individuals.

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Kasper v. Ryder Integrated Logistics, Inc.

The U.S. District Court for the Western District of Texas found that the Texas Workers’ Compensation Act does not create a non-subscriber cause of action against an employer, but merely modifies aspects of it. Thus, the Court concluded that Plaintiff’s non-subscriber negligence claim against Defendant arises from Texas common law and may be removed to Federal Court.

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Thomas v. PFG Transco, Inc.

The U.S. District Court for the Eastern District of Texas found that the defendant-employer in a non-subscriber case is entitled to receive a dollar-for-dollar credit in an amount equal to plaintiff’s settlement with co-defendants pursuant to Texas Civil Practice and Remedies Code § 33.012. The Court further found that the defendant-employer is entitled to receive an offsetting credit for payments made pursuant to a wage replacement and medical expense reimbursements plan.

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In re Sentry Insurance

The Eleventh Court of Appeals (Eastland) found that the lower court did not have jurisdiction over disputed medical bills because the injured worker failed to exhaust his administrative remedies under “old-law.” Specifically, the Court stated that the injured worker was required to submit to the Division any claim that the insurance carrier delayed the payment of, or refused to pay, any medical expenses for services provided. The Court did find that the lower court had jurisdiction as to common law and statutory claims related to performance under the CSA, request for an accounting of the attorney’s fees paid pursuant to the CSA, and request for enforcement of the CSA on the ground that medical services are still required.

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Menchaca vs. Insurance Company of the State of Pennsylvania

The First Court of Appeals (Houston) found that the trial court is “limited to issues decided by the appeals panel and on which judicial review is sought.” The court further found that because the record contains no evidence of causation, the trial court did not err in granting a no-evidence summary judgment motion as to extent of injury claims.

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Latest Decisions

APD 201337

The Appeals Panel remanded the case back to the administrative law judge because the administrative law judge’s statements that certain medical records did not mention the compensable injury was a misstatement of the evidence.

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APD 201401

The appeals panel remanded the case back to the administrative law judge to consider whether the claimant had good cause for failing to attend the contested case hearing.

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APD 201283

The appeals panel remanded the decision because the administrative law judge did not consider all of the conditions which comprise the compensable injury when making her determination of disability.

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APD 201244-s

The appeals panel issued an S-case remanding the matter back to the administrative law judge. The appeals panel found that when a designated doctor issues simultaneous valid certifications while assessing extent-of-injury, Rule 130.12 applies, even when neither party raised an extent-of-injury dispute at the contested case hearing. Because rule 130.12 applied, the appeals panel determined that neither certification became final. The appeals panel also found that the administrative law judge did not abuse his discretion in denying the carrier’s continuance request for an RME because the carrier waited over eight months after the designated doctor’s exam to request the RME.

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APD 201179

The appeals panel remanded the case back to the administrative law judge to make a necessary finding on direct result for the fourth quarter of supplemental income benefits.

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APD 201172

The appeals panel rendered a new decision that the claimant was entitled to the second quarter of supplemental income benefits. The administrative law judge found that the claimant failed to make the required number of job searches for two weeks during the qualifying period. The appeals panel noted that the two weeks were at a time that the work search compliance standards for supplemental income benefits were suspended due to the public health disaster pursuant to Commissioner’s Bulletin # B-0012-20.

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