Title: 

APD 012961

Significant Decision

Date: 

January 25, 2002

Issues: 

Unavailable

Table of Contents

APD 012961

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 August 9, 2001, with the record closing on October 16, 2001. The hearing officer resolved the disputed issues by concluding that the appellant’s (claimant) impairment rating was 22%; that the claimant is not entitled to supplemental income benefits (SIBs) for the first or second quarter; that the claimant timely filed her application for SIBs for the second quarter; and that the respondent (carrier) did not waive the right to dispute the second quarter. The claimant appealed the SIBs determinations, contending that she had no ability to work during the qualifying periods in question. The determinations regarding the impairment rating (IR) were not appealed and the parties stipulated at the CCH that the application for the second quarter was timely and the application was timely disputed. The appeals file does not contain a response to the claimant’s appeal from the carrier.

DECISION

Affirmed.

The claimant contends that the hearing officer erred in determining that she is not entitled to first and second quarter SIBs. She asserts that she had no ability to work during the qualifying periods for the first and second quarters and that she sustained her burden in meeting the direct result criteria required by statute.

The hearing officer did not err in determining that the claimant was not entitled to first and second quarter SIBs. Sections 408.142(a) and 408.143 provide that an employee is entitled to SIBs upon the expiration of the impairment income benefit (IIBs) period if the employee has: (1) an IR of at least 15%; (2) not returned to work or has earned less than 80% of the employee’s average weekly wage as a direct result of the impairment; (3) not elected to commute a portion of the IIBs; and (4) made a good faith effort to obtain employment commensurate with his or her ability to work.

The parties stipulated that: (1) the claimant sustained a compensable injury on __________; (2) the claimant did not commute any of his IIBs; (3) the qualifying period for the first quarter was from November 4, 2000, to February 2, 2001; (4) the qualifying period for the second quarter started February 3, 2001, and ended May 4, 2001; and (5) the claimant made no efforts to obtain employment during the qualifying periods for the first or second quarter.

The claimant testified that she was born with cerebral palsy and that her position with the employer at the time of her injury was her first paying job. She testified that she was unable to return to work because of pain but that she was able to drive. The designated doctor in a report dated April 4, 2000, stated that all of the claimant’s restrictions were a function of her cerebral palsy, and that it was less medically probable that the compensable injury caused the noted cervical changes. The report additionally stated that the claimant did not complain of cervical spine pain until mid or late 1999 and that her increasing spasticity and functional decline appears to have been a natural progression of her cerebral palsy.

The hearing officer found that the claimant had the same ability to work that she had prior to the compensable injury. The hearing officer was not persuaded that the claimant met her burden of proving direct result and his determination in that regard is not so against the great weight of the evidence as to compel its reversal on appeal. The hearing officer is the sole judge of the weight and credibility of the evidence (Section 410.165(a)) and, as the trier of fact, resolves the conflicts and inconsistencies in the evidence, including the medical evidence (Texas Employers Insurance Association v. Campos, 666 S.W.2d 286 (Tex. App.-Houston [14th Dist.] 1984, no writ). In view of the evidence, and applying our standard of review, we find sufficient evidence to support the hearing officer’s findings.

The decision and order of the hearing officer are affirmed.

The true corporate name of the insurance carrier is TRINITY UNIVERSAL INSURANCE COMPANY OF KANSAS, INC. and the name and address of its registered agent for service of process is:

RONALD I. HENRY

10000 NORTH CENTRAL EXPRESSWAY

DALLAS, TEXAS 75230.

Gary L. Kilgore – Appeals Judge

CONCUR:

Thomas A. Knapp – Appeals Judge

Robert W. Potts – Appeals Judge