Title: 

APD 031651

Significant Decision

Date: 

August 6, 2003

Issues: 

SIBS-5th Quarter

Table of Contents

APD 031651

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 May 21, 2003. The hearing officer decided that the appellant (claimant) is not entitled to supplemental income benefits (SIBs) for the fifth, sixth, and seventh quarters. The claimant appeals, contending that he was entitled to SIBs for the relevant quarters based on a total inability to work in any capacity. The respondent’s (carrier) response was not received until August 1, 2003, and is untimely.

DECISION

Affirmed.

Eligibility criteria for SIBs entitlement are set forth in Section 408.142(a) and Tex. W.C. Comm’n, 28 TEX. ADMIN. CODE § 130.102 (Rule 130.102). The SIBs criterion in issue is whether the claimant made a good faith effort to obtain employment commensurate with his ability to work during the qualifying periods for the fifth, sixth, and seventh quarters. The claimant contends that he had no ability to work during the qualifying periods in dispute. Rule 130.102(d)(4) provides that an injured employee has made a good faith effort to obtain employment commensurate with the employee’s ability to work if the employee has been unable to perform any type of work in any capacity, has provided a narrative report from a doctor which specifically explains how the injury causes a total inability to work, and no other records show that the injured employee is able to return to work. Rule 130.102(e) provides in part that, except as provided in subsection (d)(1), (2), (3), and (4) of Rule 130.102, an injured employee who has not returned to work and is able to return to work in any capacity shall look for employment commensurate with his or her ability to work every week of the qualifying period and document his or her job search efforts.

The hearing officer considered the evidence and found that the claimant had an ability to work during the relevant qualifying periods and that he did not attempt, in good faith, to obtain employment commensurate with his ability to work during the relevant qualifying periods. The hearing officer determined that the claimant failed to provide a narrative report from a doctor that specifically explains how the injury caused a total inability to work and that there was a medical report that showed that the claimant was able to “return to work in a light duty position” with restrictions. Further, the evidence does not reflect that the claimant documented a job search each week of the relevant qualifying periods.

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. We conclude that the hearing officer’s decision is supported by sufficient evidence and that it is not so against the great weight and preponderance of the evidence as to be clearly wrong and unjust. Cain v. Bain, 709 S.W.2d 175, 176 (Tex. 1986).

Accordingly, the hearing officer’s decision and order are affirmed.

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

JEFF W. AUTREY

400 WEST 15TH STREET, SUITE 710

FIRST STATE BANK TOWER

AUSTIN, TEXAS 78701.

Thomas A. Knapp

CONCUR:

Elaine M. Chaney – Appeals Judge

Chris Cowan – Appeals Judge