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Lifetime income benefits case can't be reopened: Texas high court

Posted On: Sep. 3, 2013 12:00 AM CST

Lifetime income benefits case can't be reopened: Texas high court

Liberty Mutual Insurance Co. and the Texas Division of Workers' Compensation cannot reopen a case in which an injured employee awarded lifetime income benefits, Texas' Supreme Court has ruled.

The divided court's opinion in Liberty Mutual Insurance Co. v. Ricky Adcock shows that Mr. Adcock suffered an injury in 1991. In 1997, an appeals panel determined he was entitled to lifetime income benefits because evidence showed he permanently lost all use of his right hand and wrist, along with his right foot.

More than 10 years later, Liberty Mutual sought a new case hearing regarding Mr. Adcock's continuing eligibility for the lifetime income benefits because the insurer believed he may have regained the use of his extremities.

A hearing officer for the Texas Department of Insurance's Division of Workers' Compensation determined that the insurer could reopen the benefits determination case, but then concluded that Mr. Adcock remained entitled to lifetime income benefits based of his loss of use of extremities.

The Division of Workers' Compensation then intervened, arguing that it had jurisdiction to reopen lifetime benefit determinations.

But a trial court granted Mr. Adcock's motion for summary judgment and Texas' Court of Appeals for the 2nd District based in Fort Worth affirmed. It found that the Texas Legislature in 1989 specifically removed a procedure to reopen lifetime income benefit determinations from the Texas Workers' Compensation Act.

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In its ruling Friday, the Texas Supreme Court justices ruled 6-3 to uphold the appeals court finding, ruling that the Division of Workers' Compensation had no jurisdiction to reopen the case.

“We will not judicially engraft into this comprehensive (workers compensation) statute a procedure the legislature deliberately removed,” Justice Eva M. Guzman wrote for the majority.

The dissenters argued that the law implied the Division of Workers' Compensation's authority to reopen lifetime income benefit determinations.

But the majority said that if the legislature determined employers and employees are best served by allowing the reopening of such cases, it could craft a review procedure within the act for doing so.

“This court, however, must avoid such policy determinations,” Justice Guzman wrote.