Title: 

APD 012582

Significant Decision

Date: 

December 10, 2001

Issues: 

Disabilty/Existence-Duration, Existence of Compensable Inj

Table of Contents

APD 012582

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 October 11, 2001. The hearing officer determined that the claimant (appellant) did not sustain a compensable injury on ___________, and that the claimant did not have disability as she did not sustain a compensable injury.

The claimant appealed, arguing essentially that the hearing officer’s decision is against the great weight and preponderance of the evidence. The respondent (carrier) filed a response urging affirmance.

DECISION

Reversed and rendered.

The claimant testified that on ___________, as she was exiting from the employer’s building, she took a long stride with her left foot over some water at the doorway and heard her right knee pop. The claimant alleged that she injured her right knee and could not work due to the pain. The claimant reported the injury to her employer and sought treatment from the company’s doctor, Dr. P. The medical records in evidence, an MRI of the right knee dated June 21, 2001, showed “a degenerative signal in the posterior horn of the medial meniscus.” Dr. P released the claimant to light duty on June 25, 2001. The claimant testified that she treated with Dr. S, who diagnosed the claimant with a right knee sprain/strain and right knee bursitis. Dr. S placed the claimant off work on June 27, 2001. The claimant testified that she refused to accept modified employment until Dr. S released her to light duty.

Section 401.011(10) provides that a compensable injury is an injury that arises out of and in the course and scope of employment for which compensation is payable under the 1989 Act. Injury and disability determinations can be established by the claimant’s testimony alone, if believed by the hearing officer. Gee v. Liberty Mut. Fire Ins. Co., 765 S.W.2d 394 (Tex. 1989). 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). Where there are conflicts in the evidence, the hearing officer resolves the conflicts and determines what facts the evidence has established. As an appeals body, we will not substitute our judgment for that of the hearing officer when the determination is not so against the overwhelming weight of the evidence as to be clearly wrong and unjust. Cain v. Bain, 709 S.W.2d 175, 176 (Tex. 1986); Texas Workers’ Compensation Commission Appeal No. 950456, decided May 9, 1995.

The hearing officer erred in determining in Finding of Fact No. 2 that the claimant did not sustain an injury to her right knee in the course and scope of employment on ___________. There is no question that the claimant’s injuries arose out of her employment because the employment had a causal connection with her injuries either through her activities, its conditions, or its environments. See Garcia v. Texas Indemnity Insurance Company, 209 S.W.2d 333 (Tex. 1948). From the Statement of the Evidence, it is apparent that the hearing officer considered this to be an idiopathic (of unknown cause) injury, and she went on to state that “[no] instrumentality of the employer was involved.” Previous case law has held that when there is an idiopathic injury, there must be an instrumentality of the employer involved to support compensability of the injury. Garcia , supra.

We conclude that the hearing officer’s apparent belief that this was an idiopathic injury is so against the great weight and preponderance of the evidence as to be clearly wrong or manifestly unjust. The evidence as summarized by the hearing officer indicates there was water in the doorway as the claimant was exiting the employer’s building, the claimant saw the water, and she altered her gait to avoid the hazard. The longer step she took with her left foot resulted in a “pop” in the right knee as the claimant lifted her right foot to take the next step. The mechanics of the injury are plausible and explained by the claimant’s testimony; the injury is not idiopathic or of unknown cause. Further, there was corroborative evidence that three witnesses saw the claimant apparently in pain immediately after the incident and were moved to inquire what was wrong with her because of the way she was moving. Simply put, whether there was, or was not, an instrumentality of the employer was not an issue before the hearing officer since there was no evidence in the record of an idiopathic fall by the claimant. We believe that the hearing officer’s statement that “[no] instrumentality of the employer was involved” indicates that the hearing officer erroneously applied the law to the facts in making her determination that the claimant did not sustain an injury in the course and scope of her employment in ___________.

Accordingly, we reverse the hearing officer’s decision that the claimant did not sustain a compensable injury on ___________, and render a new decision that the claimant did sustain a compensable injury on ___________. Ordinarily, this would require a remand to determine the companion issue of disability, but the hearing officer entered findings that the claimant was unable to obtain and retain employment at wages equivalent to her wage of ___________, from June 17, 2001, through July 2, 2001, but not beyond that time. This determination is sufficiently supported by the evidence, and we are able to render a decision that the claimant had disability from June 17, 2001, through July 2, 2001.

The true corporate name of the insurance carrier is LIBERTY INSURANCE CORPORATION and the name and address of its registered agent for service of process is

CT CORPORATION SYSTEM

350 N. ST. PAUL ST.

DALLAS, TEXAS 75201.

Michael B. McShane – Appeals Judge

CONCUR:

Gary L. Kilgore – Appeals Judge

Robert E. Lang

Appeals Panel

Manager/Judge