This appeal arises pursuant to the Texas Workers’ Compensation Act, TEX. LAB. CODE ANN. § 401.001 et seq. (1989 Act). A contested case hearing (CCH) was held on May 12, 1998. With respect to the issues before him, the hearing officer determined that respondent’s (claimant) “current contact dermatitis condition is the direct result of the compensable injury sustained on _________,” and that claimant had disability beginning February 17, 1998, and continuing to the date of the CCH.
Appellant (carrier) appeals, citing several Appeals Panel decisions and court cases, essentially arguing that claimant has failed to prove “that the compensable injury of _________, caused the claimants outbreak of contact dermatitis in February of 1998.” Carrier requests that we reverse the hearing officer’s decision and render a decision in its favor. Claimant responds, urging affirmance.
DECISION
Affirmed.
The basic underlying facts are relatively undisputed. Claimant had been a transmission mechanic for 30 years. He testified that he began to have problems with his hands swelling, itching, and turning red with fissures around _________. Claimant reported the condition to the employer automobile agency, who sent claimant to Dr. T. Dr. T, in an Initial Medical Report (TWCC-61) dated December 12, 1997, listing a “(incorrect date of injury)” date of injury noted that claimant had his hands in solvents “and had a reaction in which he developed severe burning, erythema, swelling of the hand and forearms.” Claimant was given medications, ointments and creams to apply. Carrier apparently accepted liability for a compensable contact dermatitis case. Dr. F, in a handwritten note of December 11, 1997, also notes “presents [with] both hands red and swollen c/o burning pain itching” and concluded “[r]eaction to solvent/transmission fluid.” Claimant had follow-up visits on December 15, 19, 23, and 29, 1997, when claimant was referred to Dr. G, a dermatologist. Claimant returned to work on December 29, 1997, with instructions to wear gloves (whenever possible according to claimant), wash his hands after exposure and use moisturizing creams. Dr. G, in a progress note dated January 5, 1998, stated “fissured area became secondarily infected,” discussed use of a “barrier cream,” use of “cotton lined rubber gloves” and recommended a “moisture lotion after washing hands and . . . anytime solvents are handles [sic].” Claimant testified that he did the best he could; that initially he was given latex gloves but that they tore and subsequently was given rubber dish washing gloves which made transmission work extremely difficult. Claimant demonstrated how the rubber gloves would become twisted in the transmission and presented statements from two transmission companies saying transmission work with gloves was either “impossible” or “very difficult.” There is no evidence claimant was given the cotton-lined gloves recommended by Dr. G.
Claimant testified after the treatment by Dr. G his hands improved but then he had a “flare-up” and he returned to Dr. T. Dr. T, in a note dated February 16, 1998, noted “f/u dermatitis of hands seen [at] . . . hospital 2-14-98.” Dr. T noted the date of injury to be “(incorrect date of injury)” and stated “unable to work [with] solvent exposure.” In a February 24, 1998, note, Dr. T writes “agree [with] prohibitions of exposure with initiating chemical – indefinite” (emphasis in the original). Carrier, in a Payment of Compensation or Notice of Refused/Disputed Claim (TWCC-21) dated February 25, 1998, disputed compensability based on “claimant’s wilful attempt to injure himself.” The last paragraph also states that carrier disputes continued medical treatment, “also disputes extent and duration” and “disputes claim in its entirety.” Dr. T, in a report dated March 9, 1998, states:
This individual has been treated on a recurrent basis for work related dermatitis to his hand with initial visit noted on 12-11-97. He has been noted with persistent recurrent dermatitis as it relates to exposure to solvents in the course of his working with transmissions. In addition to our care, he has been treated and managed with concurrent findings by [Dr. G], Dermatology.
In view of his problems being specifically related to exposure to solvents at work, he was advised in avoiding all contact with irritating substances. Utilization of personal barriers could be considered in this regard including use of cotton lined rubber gloves. On last visit of 2-24-98, he indicated his inability to perform his work with gloves. In that situation, he would need to seek alternate work placement away from irritating and provoking chemicals.
Carrier contends that claimant did not meet his burden of proof to show that “his compensable injury of _______ was a producing cause of the new outbreak and then current contact dermatitis condition in his hands.” Carrier faults claimant’s testimony and the medical reports as referring only to solvents, fluids, and chemicals and “none identifies any agent, exposure to which is capable of causing an initial outbreak of contact dermatitis immediately, which then clears (and recurs) over a month later.” We do not read any of the medical reports as saying claimant’s condition has cleared. Dr. T’s hand- written note of December 29, 1997 (when claimant was released to work), states “hands worse” and refers claimant to Dr. G. Dr. G, on January 5, 1998, states that a certain cream will be refilled “two to three times a week and follow up is suggested in one month for evaluation.” (Claimant apparently did not keep an appointment on February 2, 1998, but was seen on February 17, 1998, after having been seen in a hospital emergency room on February 14, 1998.) Carrier cites Texas Workers’ Compensation Commission Appeal No. 92187, decided June 29, 1992 (a noxious fume inhalation case); Texas Workers’ Compensation Commission Appeal No. 961433, decided September 6, 1996 (another chemical fume inhalation case); Texas Workers’ Compensation Commission Appeal No. 951553, decided October 31, 1995 (contraction of hepatitis C by a hospital employee as an occupational disease); Texas Workers’ Compensation Commission Appeal No. 950919, decided July 14, 1995 (case where the hearing officer found, and Appeals Panel affirmed, that claimant had sustained an exposure to toxic chemicals using herbicides); Texas Workers’ Compensation Commission Appeal No. 972577, decided January 28, 1998 (actually supplemental income benefits case where a compensable injury gave rise to contact dermatitis); and several other cases, none involving contact dermatitis. The Appeals Panel has on a number of occasions considered contact dermatitis cases including Texas Workers’ Compensation Commission Appeal No. 971338, decided August 28, 1997, where contact dermatitis was claimed secondary to a dog bite where a chemical spray splashed on claimant (and where the chemicals were specifically identified) and Texas Workers’ Compensation Commission Appeal No. 93065, decided March 10, 1993, where the employee came in contact with metal-plated materials and developed contact dermatitis and the Appeals Panel affirmed the hearing officer’s finding of compensability. In these contact dermatitis cases some are more complex than others. In the instant case, the hearing officer made a finding that claimant “cannot identify the solvent causing the contact dermatitis” which is certainly correct as far as the chemical composition or brand name goes. However, both claimant and Dr. T (and Dr. G) are clear that contact with the solvent caused the contact dermatitis. Further, carrier accepted compensability of the _________, contact dermatitis by not contesting compensability of that injury within 60 days. Consequently, claimant only has the burden of proving that the compensable injury was a, not the or only, producing cause of claimant’s flare-up in February 1998. As previously noted there is no indication that the compensable condition had “cleared up,” only that claimant had been returned to work on December 29, 1997, while still getting active treatment from Dr. G, the dermatologist. We mildly disagree with the hearing officer’s Finding of Fact No. 7, where he states that there “is no expert medical evidence establishing a causal relationship between the [c]laimant’s contact dermatitis and the workplace,” noting Dr. T’s report of March 9, 1998. While Dr. T does not identify the chemical composition and/or brand name of the solvent, he definitely provides a causal relationship between the solvent and claimant’s contact dermatitis.
The hearing officer appears to decide the claim based on carrier’s failure to adequately dispute the claimed injury. We note again that carrier had accepted liability for the _________, contact dermatitis; that according to its TWCC-21, it received written notice of that injury on December 12, 1997; and by the TWCC-21, dated February 25, 1998, it disputed “claimant’s current disability” based on claimant’s “wilful attempt to injure himself” by not wearing gloves. Carrier did not pursue that defense at the CCH, but relied instead on the catch-all phrase at the end of the denial that carrier “disputes extent and duration . . . [and] claim in its entirety.” In Texas Workers’ Compensation Commission Appeal No. 980378, decided April 9, 1998, a latex allergy case, carrier, in that case argued that a dispute of “any and all benefits” related to the injury was sufficient to dispute compensability. The Appeals Panel in that case held:
We further note that Section 409.022 requires a carrier’s notice of refusal to pay benefits “must specify the grounds for the refusal.” Also, [Tex. W.C. Comm’n, 28 TEX. ADMIN. CODE § 124.6(a)(9)] Rule 124.6(a)(9) requires a full and complete statement of the grounds for carrier’s refusal to begin payment of benefits and that general statements such as “liability is in question” or “compensability in dispute” are insufficient grounds to dispute. In this case, merely stating that carrier “disputes any and all benefits” does not meet the requirements of Section 409.022 and Rule 124.6(a)(9) requiring a certain degree of specificity.
In this case a dispute of the “claim in its entirety” is insufficient and the only specific ground advanced is the wilful attempt to injure himself, which carrier subsequently abandoned. We further note, even if the TWCC-21 had stated an adequate basis for appeal, it was not timely for the _________, injury.
Upon review of the record submitted, we find no reversible error and we will not disturb the hearing officer’s determinations unless they are 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). We do not so find and, consequently, the decision and order of the hearing officer are affirmed.
Thomas A. Knapp – Appeals Judge
CONCUR:
Philip F. O’Neill – Appeals Judge
Alan C. Ernst – Appeals Judge