Recent Workers' Compensation Cases and the Impact on System. Participants

Transcription

1 Recent Workers' Compensation Cases and the Impact on System Participants

2 Wide Range of Cases Course and Scope Impairment Rating Lifetime Income Benefits Supplemental Income Benefits Death Income Benefits Intoxication Defense Causation Analysis Attorney Fees Procedural Issues

3 Course and Scope of Employment American Home Insurance Co. v. De Los Santos, 2012 WL (Tex. App. San Antonio, Jan. 18, 2012) Was injury that was sustained while driving home from work in a company owned truck in the course and scope of employment?

4 Course and Scope of Employment Zurich American Insurance Co. v. McVey, 339 S.W.3d 724 (Tex. App. Austin, 2011) Was survivor of employee who was killed in a car accident while en route to an overnight conference at the employer s request entitled to workers compensation benefits?

5 Course and Scope of Employment Leordeanu v. American Protection Ins. Co., 330 S.W.3d 239 (Tex. 2010) Was injury sustained in motor vehicle accident between a business meeting and a work errand (storage unit), which is on the way home, in the course and scope of employment?

6 Impairment Rating State Office of Risk Management v. Joiner, 2012 WL (Tex. App. Texarkana, March 21, 2012) Is impairment rating invalid if it is not as of the date of maximum medical improvement? Is carrier prevented from raising the failure to follow the AMA Guidelines if that issue is not raised in its request for review?

7 Impairment Rating State Office of Risk Management v. Rodriguez, 335 S.W.3d 439 (Tex. App. El Paso, 2011), pet. Filed Nov. 9, Does the court have jurisdiction if only one valid impairment rating exists?

8 Lifetime Income Benefits Liberty Mutual Ins. Co. v. Adcock, 353 S.W.3d 246 (Tex. App. Fort Worth, 2011), pet. filed Jan. 18, Can Carrier contest lifetime income benefits entitlement after an earlier finding of lifetime income benefits entitlement but also after new evidence of no permanent loss of use?

9 Lifetime Income Benefits Insurance Co. of Pennsylvania v. Muro, 347 S.W.3d 268 (Tex. 2011) To be entitled to lifetime income benefits, does claimant have to sustain injury to one of the enumerated body parts in ?

10 Lifetime Income Benefits Region XIX Service Center v. Banda, 343 S.W.3d 480 (Tex. App. El Paso, 2011), pet. Filed May 2, Is expert medical testimony required to prove total loss of use to be entitled to lifetime income benefits?

11 Supplemental Income Benefits Escalante v. State Office of Risk Management, 2011 WL (Tex. App. El Paso, Aug. 24, 2011) Is the opinion of the DARS counselor regarding satisfactory participation with DARS binding on the fact finder?

12 Death Income Benefits Continental Casualty Ins. Co. v. Lavender, 2011 WL (Tex. App. Fort Worth, June 9, 2011) Does death income beneficiary become ineligible by virtue of common law marriage?

13 Intoxication Dallas National Ins. Co. v. Lewis, 2011 WL (Tex. App. Hous. [1 st Dist.] June 16, 2011) Is expert testimony necessary to prove intoxication?

14 Causation Continental Casualty Ins. Co. v. Baker, 355 S.W.3d 375 (Tex. App. Hous. [1 st Dis.] 2011) Does producing cause standard apply to extent of injury disputes?

15 Causation State Office of Risk Management v. Adkins, 347 S.W.3d 394 (Tex. App. Dallas, 2011) Is expert testimony required to establish an aggravation of a preexisting medicla condition? Is IRO report sufficient to prove causation?

16 Attorney Fees Commerce & Industry Ins. Co. v. Ferguson-Stewart, 339 S.W.3d 744 (Tex. App. Hous. [1 st Dist.] 2011) If Claimant fails to submit attorney fee issue to the jury, has he waived the right to those fees?

17 Attorney Fees Austin ISD v. Manbeck, 338 S.W.3d 147 (Tex. App. Austin, 2011), pet. filed Jul. 06, Is the Claimant entitled to attorney fees for time spent collecting attorney fees?

18 Procedure Smith v. Travelers Casualty and Surety Co., 327 S.W.3d 775 (Tex. App. Eastland, Oct. 7, 2010) Does the filing of an amended petiion satisfy the requirement under to file a petition within 45 days of the appeals panel decision? Does the issue of collateral estoppel involve an issue of compensability or income benefits?