Title: 

APD 012799

Significant Decision

Date: 

December 28, 2001

Issues: 

Unavailable

Table of Contents

APD 012799

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 22, 2001. The hearing officer resolved the disputed issues by deciding that the appellant (claimant) is not entitled to supplemental income benefits (SIBs) for the first and second quarters. The claimant appealed and the respondent (carrier) responded.

DECISION

The hearing officer’s decision is affirmed.

The hearing officer did not err in determining that the claimant is not entitled to SIBs for the first and second quarters. 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 dispute is whether the claimant made a good faith effort to obtain employment commensurate with his ability to work during the qualifying periods for the first and second quarters. The claimant contended that he had no ability to work during the relevant qualifying periods. It is undisputed that the claimant did not work or look for work during the relevant qualifying periods.

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 claimant’s treating doctor reported that the claimant is unable to work in any capacity due to post-surgery complications. Reports from two other doctors who examined the claimant and a report of a functional capacity evaluation that was done in the qualifying period for the first quarter showed that the claimant had some ability to work.

The hearing officer found that during the relevant qualifying periods the claimant had an ability to work and that he did not in good faith seek any employment during those qualifying periods. The hearing officer concluded that the claimant is not entitled to SIBs for the first and second quarters. The hearing officer is the sole judge of the weight and credibility of the evidence. Section 410.165(a). As the trier of fact, the hearing officer resolves the conflicts in the evidence and determines what facts have been established. The hearing officer’s decision is supported by sufficient evidence and 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 (Tex. 1986).

The hearing officer’s decision and order are affirmed.

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

DOROTHY C. LEADERER

1999 BRYAN STREET

DALLAS, TEXAS 75201.

Robert W. Potts

CONCUR:

Susan M. Kelley – Appeals Judge

Thomas A. Knapp – Appeals Judge