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Davis v. Medical Evaluation Specialist9/7/2000
Appellant appeals a take-nothing summary judgment rendered against her. We reverse the judgment and remand the cause.
Facts
Appellant was hurt at work and filed a worker's compensation claim. Once she reached her "maximum medical improvement," her treating physician, Dr. John Bergeron, examined her and assessed a permanent impairment rating of 17%. The workers' compensation carrier, Connecticut Insurance Company (CIC), then requested a medical examination by the physician of its choice, Dr. Fred DeFrancesco, who performs these examinations at Medical Evaluation Specialists' (MES) facilities. MES is a company that markets a group of independent contractor doctors to insurance companies for the purpose of performing requested medical examinations under the Texas Workers' Compensation Act (TWCA).
After examining appellant, Dr. DeFrancesco gave her a 0% impairment rating. The Texas Workers' Compensation Commission (TWCC) then randomly selected a "designated doctor" to evaluate appellant. The doctor randomly selected was another MES contractor, Dr. John Dozier. He examined appellant and also gave her a 0% impairment rating. As a result of the two opinions from MES-affiliated physicians, the insurance carrier stopped paying benefits to appellant.
Appellant pleaded that local plaintiffs attorneys had detected a bias against claimants by doctors affiliated with MES. For example, appellant's pleadings alleged that when MES physicians were involved, the reports allegedly all read the same, and the result was allegedly almost always a 0% impairment rating. Appellant thus alleged that MES and its physicians were not participating in good faith in evaluating workers' compensation claims. Appellant contends that MES was subverting the TWCA by recruiting physicians who would ignore the American Medical Association (AMA) guidelines and knowingly assign false and fraudulent impairment ratings that would attract insurance company business.
Appellant protested the use of two MES physicians. The TWCC ruled that Dr. Dozier's association with Dr. DeFrancesco through MES "may reasonably be perceived as having the potential to influence the conduct and decision of Dr. Dozier as a designated doctor." The TWCC then designated another doctor to evaluate appellant. CIC then, before the examination by the new designated doctor, paid to appellant all money that had been previously denied. The new designated doctor examined appellant and assigned an impairment rating of 21% under the AMA guides.
MES, Dr. DeFrancesco, and Dr. Dozier moved for summary judgment, claiming absolute derived judicial immunity and qualified "good faith" immunity. The other defendants, CIC and E.B.I. Companies, Inc. (EBI), also sought summary judgment, based upon the Texas Labor Code and immunity derived from the physicians and MES. The trial court granted all motions without specifying grounds.
Analysis
In point of error one, appellant contends it was error for the trial court to grant the summary judgment motions of MES, Dr. DeFrancesco, and Dr. Dozier based upon either absolute derived judicial immunity or qualified "good faith" immunity.
These appellees rely heavily on Delcourt v. Silverman, which held that a party has absolute derived judicial immunity when acting as part of the judicial system or an "arm of the court." See 919 S.W.2d 777, 786 (Tex. App.-Houston [14th Dist.] 1996, writ denied).
We agree with these appellees that TWCC is a quasi-judicial body. See Washburn v. Associated Indem. Corp., 721 S.W.2d 928, 932 (Tex. App.-Dallas 1986), writ ref'd n.r.e., 735 S.W.2d 243 (Tex. 1987). In Delcourt, the court adopted th
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