Title: 

APD 000941

Significant Decision

Date: 

June 2, 2000

Issues: 

Disabilty/Existence-Duration, Existence of Compensable Inj

Table of Contents

APD 000941

This appeal arises pursuant to the Texas Workers’ Compensation Act, TEX. LAB. CODE ANN. § 401.001 et seq. (1989 Act). A contested case hearing was held on March 3, 2000. The hearing officer determined that the appellant (claimant) was not injured in the course and scope of her employment on __________, and that since she did not sustain a compensable injury, she did not have disability. The claimant appealed, stated why she thought that she was injured in the course and scope of her employment, and requested that the Appeals Panel reverse the decision of the hearing officer and render a decision in her favor. The respondent (carrier) replied, urged that the evidence is sufficient to support the decision of the hearing officer, and requested that it be affirmed.

DECISION

We affirm.

The claimant testified that she performed maintenance at an apartment complex; that on Friday, __________, she removed a cover of an air conditioning unit that was in the ceiling of a bathroom; that the cover is about three feet by four feet; that removal of that cover exposes a smaller cover that is about two feet by ten inches; that that smaller cover should be attached with screws, but was not; that when the larger cover was removed, one end of the smaller cover fell toward her face; that she panicked and jumped from the small ladder she was standing on; that she landed on her buttocks with one leg under her and the other leg in front of her; and that her back and the back of her head hit a wall in the bathroom. She said she was startled; sat for about a minute; did not feel like she was hurt; and worked about an hour to finish the job so that the apartment would be ready to be occupied. The claimant stated that she went to the management office, that she felt soreness in her buttocks and left hip, that she told (A) what had happened, that they laughed about it, and that she did not report an injury at that time. She testified that later that day she had a disagreement with Ms. S, the manager; quit the job; and at that time did not think she needed medical attention. The claimant said that on Monday she had sharp pains in her back every time she tried to bend down or get back up; that she had obtained a job with another employer, but was not able to work because of the pain; that she asked Ms. R about going to a doctor and was told that she had insurance coverage through the end of the month; and that she went to a doctor, told him what had happened, and was told that Workers’ compensation, and not her health insurance, should be used. The claimant testified that she was not sure of the exact day that she reported the injury to the employer, that she thought that it was about a week after the fall, and that she applied for but did not receive unemployment benefits.

In an Initial Medical Report (TWCC-61) dated September 29, 1999, Dr. P stated a history of the accident consistent with the testimony of the claimant; that this was the initial trauma evaluation for the injury; that she had a __________ back injury that had resolved; that he diagnosed cervical strain, thoracic strain, lumbar strain, sacral contusion, and post traumatic cephalgia; that physical therapy was prescribed; and that she was to remain off work. In a TWCC-61 dated October 5, 1999, Dr. S stated that the claimant presented herself for evaluation and treatment of injuries sustained in a work-related incident that occurred on __________, and stated what the claimant told him. A report of an MRI of the lumbar spine dated February 7, 2000, states that there is no evidence of disc bulge or herniation in the lumbar spine; that there is no spinal canal or foraminal stenosis; that normal hydration of the lumbar discs is present without evidence of disc desiccation; that there is no spondylolysis or spondylolisthesis; and that bilateral flavum hypertrophy at L4-5 is noted.

The burden is on the claimant to prove by a preponderance of the evidence that an injury occurred in the course and scope of employment. Texas Workers’ Compensation Commission Appeal No. 91028, decided October 23, 1991. The testimony of the claimant alone may be sufficient to satisfy the burden of proof. Texas Workers’ Compensation Commission Appeal No. 91013, decided September 13, 1991. The hearing officer is the trier of fact and is the sole judge of the relevance and materiality of the evidence and of the weight and credibility to be given to the evidence. Section 410.165(a). While a claimant’s testimony alone may be sufficient to prove a claim, the testimony of a claimant is not conclusive but only raises a factual issue for the trier of fact. Texas Workers’ Compensation Commission Appeal No. 91065, decided December 16, 1991. The trier of fact may believe all, part, or none of any witness’s testimony because the finder of fact judges the credibility of each and every witness, the weight to assign to each witness’s testimony, and resolves conflicts and inconsistencies in the testimony. Taylor v. Lewis, 553 S.W.2d 153 (Tex. Civ. App.-Amarillo 1977, writ ref’d n.r.e.); Texas Workers’ Compensation Commission Appeal No. 93426, decided July 5, 1993. This is equally true regarding medical evidence. Texas Employers Insurance Association v. Campos, 666 S.W.2d 286 (Tex. App.-Houston [14th Dist.] 1984, no writ). Injury is defined as damage or harm to the physical structure of the body and a disease or infection naturally resulting from such damage or harm. Section 401.011(26). In his Decision and Order, the hearing officer stated that it may be true the claimant fell, but she was not credible that any damage or harm occurred to the physical structure of her body. An appeals level body is not a fact finder, and it does not normally pass upon the credibility of witnesses or substitute its own judgment for that of the trier of fact even if the evidence would support a different result. National Union Fire Insurance Company of Pittsburgh, Pennsylvania v. Soto, 819 S.W.2d 619, 620 (Tex. App.-El Paso 1991, writ denied). The hearing officer’s determination that the claimant did not sustain a compensable injury on __________, is not so against the great weight and preponderance of the evidence as to be clearly wrong or unjust. In re King=s Estate, 150 Tex. 662, 244 S.W.2d 660 (1951); Pool v. Ford Motor Co., 715 S.W.2d 629, 635 (Tex. 1986). Since we find the evidence sufficient to support that determination of the hearing officer, we will not substitute our judgment for his. Texas Workers’ Compensation Commission Appeal No. 94044, decided February 17, 1994.

Disability means the inability because of a compensable injury to obtain and retain employment at wages equivalent to the preinjury wage. Section 401.011(16). Disability, by definition, depends upon there being a compensable injury. Id. Since we have found the evidence to be sufficient to support the determination that the claimant did not sustain a compensable injury, the claimant cannot have disability.

We affirm the decision and order of the hearing officer.

Tommy W. Lueders – Appeals Judge

CONCUR:

Dorian E. Ramirez – Appeals Judge

Elaine M. Chaney – Appeals Judge