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 August 21, 2012, in [City], Texas, with [hearing officer] presiding as hearing officer. The hearing officer determined that: (1) the compensable injury of [date of injury], does not extend to bilateral shoulder sprain and right ankle sprain; (2) the appellant (claimant) reached maximum medical improvement (MMI) on May 7, 2011; and (3) the claimant’s impairment rating (IR) is zero percent. The hearing officer’s decision is based on the premise that the claimant failed to appear for the CCH, and did not respond to the Texas Department of Insurance, Division of Workers’ Compensation (Division) 10-day letter, and failed to offer evidence in support of his claim.
The claimant appealed the hearing officer’s decision, contending that he had responded to the 10-day letter and had been advised over the telephone by a Division employee that his claim would be put back on the docket. The respondent (self-insured) responded, urging affirmance of the hearing officer’s decision and contending that the claimant had failed to provide any evidence of good cause for his failure to attend the CCH on August 21, 2012.
DECISION
Reversed and remanded.
The claimant did not appear at the CCH that was convened on August 21, 2012. The self-insured, who was present at the CCH presented evidence in the form of a designated doctor’s report and evidence of the designated doctor’s appointment to determine MMI, IR, the extent of the compensable injury and the claimant’s disability.
The hearing officer sent a 10-day letter dated August 21, 2012, to the claimant, advising the claimant that he could contact the Division office within 10 days of the date of the letter to request that the hearing be reconvened to permit the claimant to present evidence on the disputed issues and to show good cause why he had failed to attend the August 21, 2012, CCH. The hearing officer found that the claimant failed to appear for the August 21, 2012, CCH and did not respond to the Division’s letter offering him the opportunity to have the hearing rescheduled and that the claimant did not have good cause for failing to appear at the CCH. The hearing officer then entered an order adverse to the claimant on all the issues.
The claimant, in his appeal, attached a copy of a Dispute Resolution Information System note indicating that the claimant had contacted the Division by telephone on August 27, 2012, and had spoken to a Division employee, stating that he wanted to pursue his claim, and that the Division employee had responded that the claimant’s claim would be put back on the docket. The claimant’s contact on August 27, 2012, with the Division was within 10 days of August 21, 2012, the date of the 10-day letter. The evidence establishes that the claimant timely responded to the hearing officer’s 10-day letter, requesting the Division reschedule the CCH. The self-insured, in its response, contended that since the claimant had failed to provide any evidence that he had good cause for his failure to attend the CCH, the hearing officer’s decision and order should be upheld.
In Appeals Panel Decision (APD) 071706, decided November 15, 2007, the Appeals Panel noted that the purpose of the 10-day letter process is to give the non-appearing party the opportunity to meaningfully participate in the dispute resolution process. See also APD 101780, decided February 14, 2011.
In the present case, the claimant attached to his appeal evidence that, within 10 days of the August 21, 2012, 10-day letter he had requested the CCH be reconvened. We reverse the hearing officer’s finding that: (1) the claimant did not respond to the Division’s letter offering him the opportunity to have the hearing rescheduled; and (2) the claimant did not have good cause for failing to appear at the CCH. We also reverse the hearing officer’s determination that: (1) the compensable injury of [date of injury], does not extend to bilateral shoulder sprain and right ankle sprain; (2) the claimant reached MMI on May 7, 2011; and (3) the claimant’s IR is zero percent.
The case is remanded to allow each party an opportunity to meaningfully participate in the dispute resolution process and to present evidence if they wish on the disputed issues. As a separate issue, the hearing officer will determine whether the claimant had good cause for not attending the August 21, 2012, CCH. See APD 101780, supra.
The hearing officer is to reconvene the hearing, conduct a good cause inquiry, make a finding on whether there was good cause, allow the parties to present evidence regarding the disputed issues, and make such findings and conclusions of law on the disputed issues that are supported by the evidence.
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 hearing officer, 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 (a self-insured governmental entity) and the name and address of its registered agent for service of process is
CITY CLERK
[ADDRESS]
[CITY], TEXAS [ZIP CODE].
Thomas A. Knapp
CONCUR:
Cynthia A. Brown – Appeals Judge
Margaret L. Turner – Appeals Judge