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 October 23, 2001. She determined that the appellant (claimant) did not sustain a compensable heart attack on ___________, and that she did not have disability. On appeal, the claimant urges that these determinations are contrary to the great weight of the evidence presented. The respondent (self-insured) urges affirmance.
DECISION
Affirmed.
Section 408.008 provides:
A heart attack is a compensable injury under this subtitle only if:
(1)the attack can be identified as:
(A)occurring at a definite time and place; and
(B)caused by a specific event occurring in the course and scope of the employee’s employment;
(2)the preponderance of the medical evidence regarding the attack indicates that the employee’s work rather that the natural progression of a preexisting heart condition or disease was a substantial contributing factor of the attack; and
(3)the attack was not triggered solely by emotional or mental stress factors, unless it was precipitated by a sudden stimulus.
In determining whether the work is a substantial contributing factor to a heart attack, the medical evidence must be compared or weighed as to the effect of the work and the natural progression of a preexisting heart condition. However, the existence of risk factors, such as family history, gender, smoking, cholesterol, and hypertension, is not part of the equation of weighing the employee’s work and preexisting heart condition or disease because, while such risk factors could contribute to preexisting heart condition or disease, their mere existence does not equate to a preexisting condition or disease. Texas Workers’ Compensation Commission Appeal No. 91046, decided December 2, 1991; Texas Workers’ Compensation Commission Appeal No. 93402, decided June 17, 1993. While the claimant’s testimony is probative as to the events leading up to the heart attack, medical evidence must establish whether the work was a substantial contributing factor when balanced against the natural progression of a preexisting heart condition or disease. Texas Workers’ Compensation Commission Appeal No. 93582, decided August 23, 1993. Whether a claimant has sustained a compensable heart attack is generally a question of fact for the hearing officer to decide.
The claimant had the burden of proving that her heart attack was a compensable injury in accordance with the statutory criteria. Johnson v. Employers Reinsurance Corporation, 351 S.W.2d 936 (Tex. Civ. App.-Texarkana 1961, no writ). Section 410.165(a) provides that the hearing officer is the sole judge of the weight and credibility of the evidence. This includes medical evidence. Texas Employers Insurance Association v. Campos, 666 S.W.2d 286 (Tex. App.-Houston [14th Dist.] 1984, no writ). In her role as fact finder, the hearing officer was charged with evaluating the evidence and determining what facts have been established. She found that the preponderance of the medical evidence indicates that the natural progression of a preexisting heart condition or disease was a substantial contributing factor to the claimant’s heart attack, rather than her work. We will reverse a factual determination of a hearing officer only if that determination is 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); Pool v. Ford Motor Company, 715 S.W.2d 629, 635 (Tex. 1986). Applying this standard of review to the record of this case, we find the medical evidence sufficient to support the determination that the claimant did not sustain a compensable heart attack on ___________, and, consequently, did not have disability.
For the foregoing reasons, we affirm the decision and order of the hearing officer.
The true corporate name of the self-insured is (SELF-INSURED) and the name and address of its registered agent for service of process is
SUPERINTENDENT
(ADDRESS)
(CITY), TEXAS (ZIP CODE).
Gary L. Kilgore
CONCUR:
Susan M. Kelley – Appeals Judge
Michael B. McShane – Appeals Judge