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 November 3, 2025, in (city), Texas, with (administrative law judge) presiding as the administrative law judge (ALJ). The ALJ resolved the disputed issue by deciding that the respondent (claimant) sustained a compensable injury on (date of injury). The appellant (carrier) appealed, disputing the ALJ’s determination. The appeal file does not contain a response from the claimant to the carrier’s appeal.
DECISION
Reversed and remanded.
The claimant testified she injured her right knee on (date of injury), when she tripped over a rug, fell forward, and landed on her knees. The claimant testified she first sought treatment approximately two weeks later. We note that the evidence contains inconsistencies as to whether the claimant injured her left or her right knee on (date of injury).
The ALJ stated the following in his discussion:
The sole issue is whether the claimant hurt herself in a fall that was witnessed, reported, and videoed. She testified that she did. The insurance carrier is put in a position to attempt to prove a negative, which simply cannot be done in this case. Based upon a review of the entire record, the claimant has met her burden of proof to show that she sustained damage or harm to the physical structure of her body on (date of injury), while at work.
On appeal the carrier contends that the ALJ’s determination is based on a misapplication of the law; specifically, the ALJ placed the burden on the carrier to “prove a negative” and created a presumption of injury that is not permitted by Statute.
In Appeals Panel Decision (APD) 950190, decided March 21, 1995, the Appeals Panel noted that the ALJ stated at the beginning of the CCH that the burden of proof was on the claimant on the issue of injury in the course and scope of employment, but then wrote in his discussion that the carrier failed to meet their burden of disproving the claimant’s assertion that she sustained a compensable injury. The Appeals Panel reversed and remanded the case for the ALJ to make a determination based on the burden of proof being on the claimant to show a compensable injury. In the instant case the ALJ stated on the record that the burden of compensability was on the claimant and noted as such in his discussion. However, by stating that the carrier “is put in a position to attempt to prove a negative, which simply cannot be done in this case,” the ALJ is essentially shifting the burden of proof from the claimant to the carrier on compensability, which is a misapplication of the law in this case. We reverse the ALJ’s determination that the claimant sustained a compensable injury on (date of injury), and we remand the issue of whether the claimant sustained a compensable injury on (date of injury), to the ALJ for further action consistent with this decision.
REMAND INSTRUCTIONS
On remand the ALJ is make findings of fact, conclusions of law, and a decision as to whether the claimant sustained a compensable injury on (date of injury), based on the burden of proof being on the claimant to show a compensable injury. 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 APD 060721, decided June 12, 2006.
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
CORPORATION SERVICE COMPANY
211 EAST 7TH STREET, SUITE 620
AUSTIN, TEXAS 78701-3218.
Carisa Space-Beam
Appeals Judge
CONCUR:
Cristina Beceiro
Appeals Judge
Margaret L. Turner
Appeals Judge