Title: 

APD 012866

Significant Decision

Date: 

January 15, 2002

Issues: 

Unavailable

Table of Contents

APD 012866

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 30, 2001. With respect to the issues, the hearing officer determined that the respondent/cross-appellant (claimant) is entitled to supplemental income benefits (SIBs) for the seventh quarter and that the appellant/cross-respondent (carrier) is relieved of liability for the seventh quarter SIBs because of the claimant’s failure to timely file an application for seventh quarter SIBs.

The carrier appeals the hearing officer’s determinations contending that the hearing officer erred in her determination that the claimant is entitled to SIBs for the seventh quarter. The claimant also appeals, essentially contending that the hearing officer’s determination with respect to the carrier being relieved of liability is against the great weight and preponderance of the evidence.

DECISION

We affirm in part and reverse and render in part.

SIBs FOR THE SEVENTH QUARTER

The carrier contends that the hearing officer’s conclusion of entitlement to SIBs is inconsistent with the findings that the claimant had some ability to work but did not look for work. While the carrier is correct that the hearing officer determined that the claimant failed to establish entitlement to SIBs pursuant to Tex. W.C. Comm’n, 28 TEX. ADMIN. CODE § 130.102(d)(4) (Rule 130.102(d)(4), that does not preclude the claimant from establishing entitlement to SIBs pursuant to other subdivisions of the Rule. In Texas Workers’ Compensation Commission Appeal No. 001536, decided August 9, 2000, the Appeals Panel held that Rule 130.102(d) is written so that fulfillment of any one subdivision of subsection (d) may be viewed as meeting a good faith search for employment. Rule 130.102(e) provides, in pertinent part, that “[e]xcept as provided in subsection (d)(1), (2), (3), and (4) of this section, 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 [emphasis supplied].” A claimant need not satisfy Rule 130.102(e) if such claimant has satisfied one of the good faith elements in Rule 130.102(d). See Texas Workers’ Compensation Commission Appeal No. 000321, decided March 29, 2000. In the present case, the claimant presented evidence that he is entitled to SIBs based upon his involvement with the Texas Rehabilitation Commission (TRC). The hearing officer made a determination that the “Claimant was enrolled in, and satisfactorily participated in, a full time vocational rehabilitation program sponsored by the [TRC] during the seventh quarter qualifying period.” We note that there was no appeal of the finding. Such a finding supports entitlement to SIBs under Rule 130.102(d)(2). The hearing officer did not err in finding that the claimant is entitled to SIBs for the seventh quarter. We note also that this determination was not appealed. We affirm this portion of the hearing officer’s determinations.

RELIEF OF LIABILITY

The claimant appeals the hearing officer’s determination that the carrier is relieved of liability because the claimant failed to timely file his application for seventh quarter SIBs. The parties stipulated that the seventh quarter began on July 27, 2001, and ended on October 25, 2001. Rule 130.105 provides that “an injured employee who does not timely file an Application for [SIBs] with the insurance carrier shall not receive [SIBs] for the period of time between the beginning date of the quarter and the date on which the form was received by the insurance carrier. . . .” The hearing officer determined that the claimant filed his Application for SIBs on July 31, 2001. The hearing officer erred in determining that the carrier is relieved of liability for the entire seventh quarter because of the late filing of the application. We reverse that decision and render a new decision that the carrier is relieved of liability for seventh quarter SIBs only for the period from July 27, 2001, until July 31, 2001.

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

CT CORPORATION

350 NORTH ST. PAUL

DALLAS, TEXAS 75201.

Michael B. McShane – Appeals Judge

CONCUR:

Susan M. Kelley – Appeals Judge

Thomas A. Knapp – Appeals Judge