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 December 18, 2024, in (city), Texas, with (administrative law judge) presiding as the administrative law judge (ALJ). The ALJ resolved the disputed issues by deciding that: (1) the respondent (claimant) is entitled to supplemental income benefits (SIBs) for the eighth quarter, July 10, 2024, through October 8, 2024; and (2) the claimant is entitled to SIBs for the ninth quarter, October 9, 2024, through January 7, 2025. The appellant (carrier) appealed the ALJ’s determinations regarding entitlement to SIBs for the eighth and ninth quarters. The claimant responded, urging affirmance of the appealed determinations.
DECISION
Reversed and remanded.
The parties stipulated, in part, that the claimant sustained a compensable injury on (date of injury); the ALJ in Docket No. (Seq. 01) determined that the claimant reached maximum medical improvement (MMI) on the statutory MMI date of October 19, 2021, and the claimant’s impairment rating (IR) is 17%; the claimant has not commuted any portion of the impairment income benefits; the qualifying period for the eighth quarter of SIBs was from March 28, 2024, through June 26, 2024; the qualifying period for the ninth quarter of SIBs was from June 27, 2024, through September 25, 2024; and during the qualifying periods for the eighth and ninth quarters of SIBs, the minimum number of job contacts required by the Texas Workforce Commission (TWC) for (County), the claimant’s county of residence, was three.
Eligibility criteria for SIBs entitlement are set forth in Section 408.142. Section 408.142 as amended by the 79th Legislature, effective September 1, 2005, references the requirements of Section 408.1415 regarding work search compliance standards. Section 408.1415(a)(3) states, in part, that the Texas Department of Insurance, Division of Workers’ Compensation (Division) commissioner by rule shall adopt compliance standards for SIBs recipients that require each recipient to demonstrate an active effort to obtain employment. To be eligible to receive SIBs under this chapter, a recipient must provide evidence satisfactory to the Division of active work search efforts documented by job applications submitted by the recipient.
Rule 130.102(d)(1)(D) provides that an injured employee can demonstrate an active effort to obtain employment by performing active work search efforts documented by job applications each week during the qualifying period. Rule 130.102(f) provides, in part, that an injured employee shall provide documentation sufficient to establish that he or she has, each week during the qualifying period, made the minimum number of job applications and or work search contacts consistent with the work search contacts established by the TWC.
Discussing the disputed claims for the eighth and ninth quarter SIBs, the ALJ concluded:
The claimant submitted evidence that he made three work search contacts each week during all thirteen weeks of the qualifying period. (County) residents must perform three job searches per week, and the evidence showed the claimant made an active effort to obtain employment.”
The possible conflation of “work search contacts” and “active work search efforts” suggested by this discussion might constitute an error of law per the Third Court of Appeals’ decision in Texas Dep’t of Ins., Div. of Workers’ Comp. v. Accident Fund Ins. Co. of Am., No. 03-21-00074-CV, 2023 WL 2286662 (Tex. App. Feb. 28, 2023, review denied), No. 23-0273, 2025 WL 421009 (Tex. Feb. 7, 2025). Accordingly, we reverse the ALJ’s determinations that the claimant is entitled to SIBs for the eighth and ninth quarters and remand the case back to the ALJ for further consideration and development of the evidence consistent with this decision.
REMAND INSTRUCTIONS
On remand, the ALJ is to determine whether the claimant is entitled to SIBs for the eighth and ninth quarters based on an active effort to obtain employment by performing active work search efforts each week during the qualifying period as required by Section 408.1415(a) and Rule 130.102(d)(1).
Pending resolution of the remand, a final decision has not been made in this case. However, since reversal and remand necessitate the issuance of a new decision and order by the ALJ, a party who wishes to appeal from such new decision must file a request for review not later than 15 days after the date on which such new decision is received from the Division, pursuant to Section 410.202 which was amended June 17, 2001, to exclude Saturdays and Sundays and holidays listed in Section 662.003 of the Texas Government Code in the computation of the 15-day appeal and response periods. See Appeals Panel Decision 060721, decided June 12, 2006.
The true corporate name of the insurance carrier is ACCIDENT FUND INSURANCE COMPANY OF AMERICA and the name and address of its registered agent for service of process is
CT CORPORATION SYSTEM
1999 BRYAN STREET, SUITE 900
DALLAS, TEXAS 75201-3136.
Cristina Beceiro
Appeals Judge
CONCUR:
Carisa Space-Beam
Appeals Judge
Margaret L. Turner
Appeals Judge