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 March 4, 2024, with the record closing on March 14, 2024, in (city), Texas, with (administrative law judge) presiding as the administrative law judge (ALJ). The ALJ resolved the disputed issues by deciding that: (1) (decedent) did not sustain a compensable injury on (date of injury), resulting in his death; and (2) the claimed injury occurred while the decedent was in a state of intoxication, as defined by Section 401.013, thereby relieving the respondent (carrier) of liability for compensation.
The appellant (claimant beneficiaries) appealed the ALJ’s determinations regarding intoxication and contend that the ALJ failed to make a fact finding regarding the compensability issue. The carrier responded to the appeal, urging affirmance of the appealed determination.
DECISION
Affirmed in part and reversed and remanded in part.
The decedent, a shop hand, was involved in a fatal head-on motor vehicle collision while driving to work on (date of injury).
The ALJ is the sole judge of the weight and credibility of the evidence (Section 410.165(a)) and, as the trier of fact, resolves the conflicts and inconsistencies in the evidence. Texas Employers Insurance Association v. Campos, 666 S.W.2d 286 (Tex. App.-Houston [14th Dist.] 1984, no writ). As an appellate reviewing tribunal, the Appeals Panel will not disturb challenged factual findings of an ALJ absent legal error, unless they are so against the great weight and preponderance of the evidence as to be clearly wrong or manifestly unjust. Cain v. Bain, 709 S.W.2d 175, 176 (Tex. 1986); In re King’s Estate, 150 Tex. 662, 244 S.W.2d 660 (1951).
INTOXICATION
The ALJ’s determination that the claimed injury occurred while the decedent was in a state of intoxication, as defined by Section 401.013, thereby relieving the carrier of liability for compensation, is supported by sufficient evidence and is affirmed.
COMPENSABILITY
Section 410.168 provides that an ALJ’s decision contain findings of fact and conclusions of law, a determination of whether benefits are due, and an award of benefits due. 28 Tex. Admin. Code § 142.16 (Rule 142.16) provides that an ALJ’s decision shall be in writing and include findings of fact, conclusions of law, and a determination of whether benefits are due, and if so, an award of benefits due.
The certified issues before the ALJ in this case included: did the decedent sustain a compensable injury on (date of injury), resulting in his death? In Finding of Fact No. 3, the ALJ states that a post-accident drug screen revealed the presence of cocaine, a controlled substance. In Finding of Fact No. 4, the ALJ states that when the decedent was involved in a motor vehicle accident (MVA) on (date of injury), the decedent did not have the normal use of his mental or physical faculties, resulting from the voluntary introduction into the body of a controlled substance. In Conclusion of Law No. 3 and the Decision section, the ALJ determined that the decedent did not sustain a compensable injury on (date of injury), resulting in his death. During the CCH, the parties litigated whether the decedent was in the course and scope of employment at the time of the MVA as a part of the compensability issue. Although the ALJ made a conclusion of law and decision regarding the issue of compensability, the ALJ failed to make a finding of fact regarding compensability and whether the decedent was in the course and scope of employment at the time of his death.
Because the ALJ’s decision contains insufficient findings of fact regarding the compensability issue, which was an issue properly before the ALJ to resolve, it does not comply with Section 410.168 and Rule 142.16. We therefore reverse the ALJ’s determination that the decedent did not sustain a compensable injury on (date of injury), resulting in his death as being incomplete, and we remand the compensability issue to the ALJ for further action consistent with this decision. See Appeals Panel Decision (APD) 132339, decided December 12, 2013; APD 180839, decided June 4, 2018; and APD 231645, decided December 28, 2023.
SUMMARY
We affirm the ALJ’s determination that the claimed injury occurred while the decedent was in a state of intoxication, as defined by Section 401.013, thereby relieving the carrier of liability for compensation.
We reverse the ALJ’s determination that the decedent did not sustain a compensable injury on (date of injury), resulting in his death as being incomplete, and we remand the compensability issue to the ALJ for further action consistent with this decision.
REMAND INSTRUCTIONS
On remand, the ALJ is to make findings of fact, conclusions of law, and a decision regarding the compensability issue and whether the decedent was in the course and scope of employment at the time of his death that is supported by the evidence and consistent with this decision.
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 ALJ, 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 Texas Department of Insurance, Division of Workers’ Compensation, 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 UNITED STATES FIRE INSURANCE COMPANY and the name and address of its registered agent for service of process is
CT CORPORATION SYSTEM
1999 BRYAN STREET, SUITE 900
DALLAS, TEXAS 75201.
Cristina Beceiro – Appeals Judge
CONCUR:
Carisa Space-Beam – Appeals Judge
Margaret L. Turner – Appeals Judge