APD 252043
The Appeals Panel affirmed the ALJ’s determination that the claimant was entitled to supplemental income benefits (SIBs) for the first and second quarters, finding reasonable grounds for noncompliance with work search requirements due to timing of the MMI/IR decision and application notice. However, the Panel reversed the award of SIBs for the third quarter, concluding the claimant failed to demonstrate reasonable grounds for not completing required work searches during portions of the qualifying period.
APD 251609
The Appeals Panel reversed the ALJ’s award of first-quarter SIBs because the ALJ made an unappealed finding that the claimant’s underemployment during the qualifying periods was not a direct result of the compensable injury, which legally bars SIBs entitlement for both quarters. Based on that binding finding, the Panel rendered a decision that the claimant is not entitled to first-quarter SIBs.
APD 251015
The Appeals Panel reversed the ALJ’s decision awarding first quarter supplemental income benefits and remanded the case for further findings. Although the claimant showed that his underemployment was due to impairment from the compensable injury, the evidence indicated he did not work during the final week of the qualifying period. The ALJ failed to make findings on whether the claimant had reasonable grounds for not meeting work search requirements during that week.
APD 241388
The Appeals Panel reversed the decision because the Administrative Law Judge inadvertently found that DWC did not have jurisdiction regarding the processing of a DWC-45. The Appeals Panel noted that an administrative law judge does not have the authority to determine whether an approved DWC-45 meets the requirements of Rule 141.1(d).
APD 230331
The Appeals Panel reversed the administrative law judge’s determination that the insurance carrier is relieved of liability for the first quarter of supplemental income benefits because of the claimant’s late filing. The Appeals Panel noted that Texas Labor Code Section 408.143(c), which provides that the claimant’s failure to timely file a DWC-52 relieves the carrier of liability for the period during which the statement is not filed, does not apply to the first quarter.
APD 220930
The Appeals Panel affirmed the Administrative Law Judge’s decision but noted that the Administrative Law Judge incorrectly stated the claimant underwent a total knee replacement instead of a total hip replacement. Under the circumstances of the case, the Appeals Panel found that the typographical error did not affect the outcome of the case.
APD 220237
The Appeals Panel reversed the Administrative Law Judge’s decision to reconstruct the record. The Appeals Panel noted that the number of pages indicated on the exhibit list did not match the number of pages in the exhibits.
APD 210332
The Appeals Panel reversed the decision because the Administrative Law Judge failed to make all necessary findings of fact.
APD 210061
The Appeals Panel reversed the decision of the Administrative Law Judge because the exclusion of the claimant’s DWC-52 for the first quarter of SIBs was in error. The Appeals Panel reasoned that Section 410.163(b) provides, in part, that an Administrative Law Judge shall ensure the preservation of the rights of the parties and the full development of facts required for the determinations to be made. The Appeals Panel concluded that the DWC-52 is an essential Division record necessary for the full development of the record.
APD 201172
The appeals panel rendered a new decision that the claimant was entitled to the second quarter of supplemental income benefits. The administrative law judge found that the claimant failed to make the required number of job searches for two weeks during the qualifying period. The appeals panel noted that the two weeks were at a time that the work search compliance standards for supplemental income benefits were suspended due to the public health disaster pursuant to Commissioner’s Bulletin # B-0012-20.