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Injured restaurant worker denied lifetime comp benefits

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An injured Texas worker who suffered a back injury cannot receive lifetime workers compensation benefits because evidence failed to show that her claim was directly related to her work accident, the Texas Supreme Court has ruled.

Gloria De La Cruz worked as a cook for a Kona Kreek restaurant in El Paso, Texas, and injured her left knee and back after falling at work in February 2004, court records in Dallas National Insurance Co. v. Gloria De La Cruz show. She received workers comp benefits from the restaurant's insurer, Dallas National Insurance Co. in Dallas.

Ms. De La Cruz was released for light-duty work in March 2004, but was soon taken off of work by her doctors after she could not perform modified duties. Court filings show she underwent back surgery and knee surgery, but continued to experience pain and numbness in her legs.

Ms. De La Cruz petitioned the Texas Division of Workers' Compensation for lifetime income benefits in 2009, claiming that her 2004 injury caused the total, permanent loss of the use of her feet based on her continued pain, according to filings. The workers comp division denied Ms. De La Cruz's petition.

However, a Texas district court ruled on appeal that Ms. De La Cruz was due lifetime benefits, and the Texas Court of Appeals affirmed that ruling in 2013, records show. The appellate court said Ms. De La Cruz's injuries to her feet were shown in medical records and testimony, including her use of a cane and documented complaints of pain radiating to her toes. Dallas National appealed that ruling.

The Texas Supreme Court overturned the appellate court's ruling Friday. The high court found that injured workers can only receive lifetime comp benefits for body parts that were directly injured in the worker's accident.

“For 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 ruling reads. “Further, pain alone is not an injury under the (workers comp law) because it is not damage or harm to the physical structure of the body.”

While evidence showed that Ms. De La Cruz's back injury affected her legs, the high court found that records showing “damage or harm to the physical structure of De La Cruz's feet” only came from “piecemeal, unexplained statements in various medical records.”