Title: 

APD 020089

Significant Decision

Date: 

February 21, 2002

Issues: 

Disabilty/Existence-Duration, Existence of Compensable Inj

Table of Contents

APD 020089

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 October 16, 2001. The appellant (claimant) appeals the hearing officer’s determinations that the claimant did not sustain a compensable injury on _____________, or on any other relevant date, and that the claimant has not had disability because of a compensable injury occurring on _____________, or on any other relevant date. The respondent (carrier) responded.

DECISION

The hearing officer’s decision, as reformed herein, is affirmed.

The disputed issues before the hearing officer were whether the claimant sustained a compensable injury on _____________, and whether the claimant has had disability resulting from the claimed injury of _____________. Although there was discussion at the CCH regarding adding as a party to the proceedings the carrier for the claimant’s 1995 injury, that was not done, and there was no disputed issue before the hearing officer with regard to the 1995 injury.

The claimant testified that while he was performing his job duties on _____________, he was injured when he pulled on bars and fell backwards. Section 401.011(10) defines a “compensable injury” as “an injury that arises out of and in the course and scope of employment for which compensation is payable under this subtitle.” The claimant had the burden to prove that he was injured during the course and scope of his employment. Johnson v. Employers Reinsurance Corporation, 351 S.W.2d 936 (Tex. Civ. App.-Texarkana 1961, no writ). Conflicting evidence was presented with regard to the claimed work-related injury of _____________. The hearing officer is the sole judge of the weight and credibility of the evidence. Section 410.165(a). As the finder of fact, the hearing officer resolves the conflicts in the evidence and determines what facts have been established. The finder of fact may believe that a claimant has an injury, but disbelieve that the injury occurred at work as claimed. Johnson, supra. The hearing officer was apparently not persuaded by the conflicting evidence that the claimant was injured at work as claimed on _____________. Without a compensable injury, the claimant would not have disability as defined by Section 401.011(16).

In order that the hearing officer’s decision not be misconstrued to be a decision on the compensability of the 1995 injury, we reform the hearing officer’s Findings of Fact Nos. 5 and 6, Conclusions of Law Nos. 3 and 4, and the decision to delete the words “or on any other relevant date.” We also reform the hearing officer’s order to delete the reference to “carrier 2,” whom the hearing officer identified as the insurance carrier for the 1995 injury, and to specifically reference the claimed date of injury of _____________, and the name of the employer’s workers’ compensation insurance carrier on that date. As reformed, the aforementioned findings, conclusions, decision, and order state as follows:

FINDINGS OF FACT

5.Claimant did not sustain a compensable injury due to pulling on bars on _____________.

6.Claimant has not been unable to obtain and retain employment at his preinjury wage because of a compensable injury occurring on _____________.

CONCLUSIONS OF LAW

3.Claimant did not sustain a compensable injury on _____________.

4.Claimant has not had disability because of a compensable injury occurring on _____________.

DECISION

Claimant did not sustain a compensable injury on _____________. Claimant has not had disability because of a compensable injury occurring on _____________.

ORDER

Zurich American Insurance Company is not liable for benefits for the claimed injury of _____________, and it is so ordered.

As reformed herein, the hearing officer’s decision and order are affirmed.

The true corporate name of the insurance carrier is ZURICH AMERICAN INSURANCE COMPANY and the name and address of its registered agent for service of process is

GEORGE MICHAEL JONES

9330 LBJ FREEWAY, SUITE 1200

DALLAS, TEXAS 75243.

Robert W. Potts – Appeals Judge

CONCUR:

Gary L. Kilgore – Appeals Judge

Terri Kay Oliver – Appeals Judge