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 August 1, 2001. After remand pursuant to Texas Workers’ Compensation Commission Appeal No. 012022, decided October 15, 2001, a new decision was issued on the issue of disability. The new decision also held, in accordance with the Appeals Panel decision, that the appellant (self-insured) had waived the right to dispute compensability. It is this part of the decision that the self-insured has appealed. The respondent (claimant) responds, requesting affirmance.
DECISION
We affirm the hearing officer’s decision.
We incorporate our previous decision in this decision. The self-insured is a small municipality for which the claimant worked. As such, it is defined as an “insurance carrier” in Section 401.011(27).
The claimant’s injury is bilateral carpal tunnel syndrome. The undisputed facts show that the claimant filed an Employee’s Notice of Injury or Occupational Disease and Claim for Compensation (TWCC-41) with the Texas Workers’ Compensation Commission (Commission) in early December 2000; the Dispute Resolution Information System (DRIS) notes for the claim indicate that on December 8, 2000, the Commission created a claim file and printed an “EES-11” notice of the claim to the carrier/self-insured on that date, and mailed the notice to the self-insured on December 11, 2000. An employee of the Commission field office testified that such letters were mailed from Austin, and she further testified that the DRIS entry indicated that the letters were “printed” on December 8 and “mailed” on December 11. No witnesses were brought in from the central office headquarters in Austin to testify about the procedures followed in generation of EES-11 letters.
An adjuster for an association that handled the workers’ compensation insurance claims for the self-insured testified that he had not seen or received any correspondence indicating that a claim was filed until February 27, 2001, and it was on that date that he became the adjuster for the claim. He said that he was contacted on that date by an employee of the Commission, who asked whether the self-insured had disputed the claim, and he then requested that copies of claim information be faxed to him. The adjuster testified that if a phone call had been received previously from the Commission about the claim, no note of the call would have been made because there was not an open claim file established earlier. A Payment of Compensation or Notice of Refused/Disputed Claim (TWCC-21) was filed by the self-insured, and received by the Commission on March 2, 2001.
The carrier argues on appeal as to its efforts to obtain a hard copy of the letter from the Commission; its argument that a letter was never created is based upon the asserted inability to obtain a hard copy of the letter, as well as the fact that one was not in the claims file. That is not the only inference that could be drawn, however, from either of these asserted points; it would be as viable to infer that hard copies are not created for the Commission’s own use because information about the generation and sending of the EES-11, a form letter in substance, is electronically maintained for claims file purposes.
The self-insured also argues that because the DRIS note indicated that a copy was sent to “the carrier,” that this also is proof that a letter was never created or sent because it is a self-insured entity, not an insurance company.. However, this argument fails in light of the definition of “insurance carrier” in the 1989 Act.
As we noted in our previous decision, public officials are presumed to have performed their duties. Sanchez v. Texas Industries, Inc., 485 S.W.2d 385 (Tex. Civ. App.-Waco 1972, writ ref’d, n.r.e.). The presumption arises because the DRIS notation records not only the sending but the creation of the letter. Tex. W.C. Comm’n, 28 TEX. ADMIN. CODE § 102.5(d) (Rule 102.5(d)) states that communications from the Commission which require action by a certain date shall be “deemed” to have been received five days after mailed, unless the great weight of evidence indicates otherwise. It was error for the hearing officer to originally conclude, in the absence of a “great weight” of evidence (which we do not see reflected in the testimony of the adjuster for the association handling coverage), that the Commission did not actually mail notification to the self-insured as was recorded in its records. The hearing officer has properly applied the rule in his remand decision and Section 409.021, and we accordingly affirm the decision and order.
The true corporate name of the insurance carrier is (a self-insured governmental entity) and the name and address of its registered agent for service of process is
MAYOR
(ADDRESS)
(CITY), TEXAS (ZIP CODE).
Susan M. Kelley – Appeals Judge
CONCUR:
Judy L. S. Barnes – Appeals Judge
Robert W. Potts – Appeals Judge