Arnold & Placek wins summary judgment in judicial review case affirming the principle that an alleged beneficiary must diligently pursue her claim for workers’ compensation benefits.

Written by A&P News on November 11th, 2015. Posted in Judicial Review

269th Judicial District, Harris County, Texas

Arnold & Placek, P.C. won summary judgment, ending a plaintiff’s lawsuit for judicial review of a Division of Workers’ Compensation’s decision. The plaintiff claimed to be a beneficiary entitled to death benefits as a common-law spouse, but she never filed a claim for workers’ compensation benefits until a year after the filing deadline. The plaintiff and her team of lawyers asserted a wide variety of legal and equitable theories in the judicial review suit, including that “good cause” excused her late filing because they “had to” litigate probate and wrongful-death claims before proceeding with a workers’ compensation claim.

Arnold & Placek, P.C. filed a motion for summary judgment because none of the plaintiff’s theories satisfied the standard for good cause, which exists only when a beneficiary has exercised the degree of diligence that an ordinarily prudent person would have exercised under similar circumstances. Arnold & Placek also asserted that the claimant’s representation by counsel defeated the reliance element of her estoppel claim. The district court agreed and dismissed the plaintiff’s suit. Texas Mutual was represented by Scott Placek and Matthew Foerster of Arnold & Placek. Matthew Foerster argued the summary judgment motion for the carrier.

Arnold & Placek Obtains Dismissal of Claims for Death Benefits on Plea to Jurisdiction.

Written by A&P News on October 15th, 2015. Posted in Judicial Review

Arnold & Placek, P.C. today obtained a dismissal of all of a plaintiff’s claims for death benefits against Texas Mutual in Harris County Probate Court. The claimant originally filed for workers’ compensation death benefits after the decedent was killed when he fell from a ladder while cleaning gutters at a residence. Texas Mutual disputed the claim on the basis that the decedent was not in the course of employment to Texas Mutual’s policyholder, but rather was employed by a co-worker’s side business which performed handyman services. At the time of the accident, the decedent was performing those services while working on the residential premises of the policyholder’s owner. Texas Mutual prevailed at the Division of Workers’ Compensation.

After the claimant appealed to the probate court, Arnold & Placek filed a plea to the jurisdiction on behalf of Texas Mutual, arguing that the probate’s court is limited to only certain matters related to the decedents estate. Arnold & Placek further argued that the judicial review action, which by law can only be brought by the purported beneficiary, was wholly unrelated to any claim by the estate– therefore, the probate court had no jurisdiction over the plaintiff’s claims against Texas Mutual. The court agreed and dismissed all the claims against the insurer. The probate court litigation was handled by Scott Placek, Kyle Jones and Jonathan Chaltain. Kyle Jones argued the plea the jurisdiction for Texas Mutual.

Texas Supreme Court Upholds Eastland Mandamus

Written by A&P News on April 13th, 2012. Posted in Appeals, Judicial Review

The Texas Supreme Court today denied the Motion for Rehearing of Amerimex Drilling I, Ltd. in its request for mandamus review of the Eastland Court of Appeals decision in In re Texas Mutual Ins. Co.. In 2010, the Eastland Court of Appeals granted the petition for writ of mandamus filed by Arnold & Placek on behalf of Texas Mutual, holding that employers do not have a general right of standing to intervene in judicial review suits by their employees. The Eastland Court held that standing in a workers’ compensation suit must have a statutory basis. Accordingly, the Eastland court instructed the trial judge to dismiss Amerimex’s petition in intervention.

Amerimex then filed a petition for writ of mandamus asking the Supreme Court to reinstate their suit. The Supreme Court denied the petition on September 30, 2011, and denied the motion for rehearing today. Texas Mutual was represented by Scott Placek and Scott Arnold of Arnold & Placek, and by the firm of Graves, Dougherty, Hearon and Moody.

Arnold & Placek, P.C. Obtains Judgment that Impairment Benefits Cannot be Awarded for Post Traumatic Stress Disorder

Written by A&P News on April 11th, 2011. Posted in Judicial Review

274th District Court, Comal County

Arnold & Placek, P.C. today obtained a complete summary judgment on Texas Mutual’s appeal from an adverse decision of the Division of Workers’ Compensation in this judicial review action.  The claimant filed for workers’ compensation after witnessing the aftermath of a break in at the animal shelter where she was employed.  Texas Mutual accepted the claim and the claimant was eventually diagnosed with Post Traumatic Stress Disorder (“PTSD”). A designated doctor gave her a 35% whole person impairment rating based solely on her PTSD. The DWC upheld the designated doctor’s determination.

On appeal to the district court, Arnold & Placek filed a motion for summary judgment on behalf of Texas Mutual, arguing that it was impermissible for the DWC to award any impairment rating for PTSD.  The court agreed and, in granting a full judgment for Texas Mutual, held that a claimant’s impairment rating, by statute, must be based on the American Medical Association’s guidelines, and those guidelines specifically state that it is not possible to assign an impairment rating for mental disorders such as PTSD.  Thus, the Court held that her impairment rating was 0%, as found by a second doctor that had evaluated the claimant.  Kyle Jones argued and obtained the summary judgment for Texas Mutual.

Arnold & Placek, P.C. Secures Another Dismissal on Mandamus

Written by A&P News on November 12th, 2010. Posted in Appeals, Judicial Review

11th Court of Appeals, Eastland, Texas

In an opinion handed down earlier today, the Eastland Court of Appeals granted the Petition for Writ of Mandamus filed by Arnold & Placek on behalf of its client, Texas Mutual Insurance Company. The case, In re Texas Mutual Ins. Co., et al, arose out of a suit for judicial review in the 188th District Court for Howard County. The employer intervened into an existing judicial review suit, attempting to seek review of DWC determination of non-compensability for other employees in the same accident. After Judge Robert Moore denied Texas Mutual’s Plea to the Jurisdiction, mandamus proceedings were instituted. The 11th Court of Appeals held that an employer has no standing to challenge the denial of compensability by their carrier, or to appeal a determination of non-compensability at the DWC. As a result, the court dismissed the petition in intervention of Amerimex Drilling I, Ltd., and ordered the trial court to dismiss the intervention by December 1, 2010.

This case is significant because it is the first case to directly examine the full scope of an employer’s standing to contest DWC determinations. The Eastland court looked first and foremost to the plain language of the statute to determine that no general standing exists for employers. In its opinion, the Eastland court considered, and rejected, each of the major arguments typically asserted by employers who attempt to institute judicial reviews. They further distinguished the Tyler Asphalt case, that many employers improperly rely upon for the proposition that payment of workers’ compensation premium establishes general standing for the employer to litigate claims before the DWC and in district court. The full opinion is available here.