August 28, 2015
August 28, 2015
Freshly returned from summer recess, the Supreme Court of Texas met in conference this week and issued one new opinion today involving the sufficiency of evidence for lifetime income benefits under the Texas Labor Code.
Dallas National Insurance Company v. De La Cruz, Case No. 13-0814: http://www.txcourts.gov/media/1053580/130814.pdf
In this case, De La Cruz had sustained injuries to her back and left knee resulting from a workplace fall in February 2004. Despite several surgeries, De La Cruz “continued to experience pain and numbness in her legs and continued to seek treatment for back and knee pain.” In 2009, she filed a claim with the Division of Workers’ Compensation for lifetime income benefits (LIBs), under section 408.161 of the Texas Labor Code, on the grounds that her February 2004 injury had caused the “total loss of use of both her feet at or above the ankle.” The Division denied De La Cruz’s claim for LIBs at both the initial case hearing and before an appeals panel. On further appeal, a district court judge ruled that De La Cruz’s injury resulted in the “total and permanent loss of use of both her feet at or above the ankle and awarded LIBs.” The Court of Appeals affirmed this ruling.
The Texas Supreme Court, on the other hand, was not swayed by De La Cruz’s claim and disagreed with the district and appeals courts. Based on precedent established in Insurance Company of the State of Pennsylvania v. Muro, the Supreme Court held: “[f]or total loss of use of a member to be compensable, the loss of use must have resulted from injury to the member itself, as opposed to the loss of use resulting from injury to another part of the body.” The Court elaborated further, stating that “pain alone is not an injury under the [Texas Workers’ Compensation] Act because it is not damage or harm to the physical structure of the body.” Although a back injury can result in spinal column damage causing loss of use of lower extremities, as in Hartford Underwriters Insurance Company v. Burdine, the Texas Supreme Court held in the present case that there was insufficient evidence to prove that De La Cruz’s February 2004 back and knee injury had resulted in damage or harm to the physical structure of her feet. In finding such, the Court reversed the judgment of the Court of Appeals and rendered judgment denying De La Cruz’s claim for LIBs.
Now that the Court has returned for the new term, check back with us each week for newly-issued opinions in The Bassett Firm’s Texas Supreme Court Weekly Update.