Bradford E. Larimore v. Employees Retirement System of Texas

Court of Appeals of Texas·Decided March 24, 2006·No. 03-04-00220-CV·Published

Opinion

TEXAS COURT OF APPEALS, THIRD DISTRICT, AT AUSTIN



ON MOTION FOR REHEARING EN BANC



NO. 03-04-00220-CV

Bradford E. Larimore, Appellant



v.



Employees Retirement System of Texas, Appellee



FROM THE DISTRICT COURT OF TRAVIS COUNTY, 200TH JUDICIAL DISTRICT

NO. GN302090, HONORABLE DARLENE BYRNE, JUDGE PRESIDING

O P I N I O N


We withdraw the prior opinion and judgment dated January 20, 2006, and the following opinion is substituted.

Larimore appeals the judgment of the district court, which affirmed a final order by the Employees Retirement System of Texas Board of Trustees (the "Board") denying his application for occupational disability benefits. (1) In four issues on appeal, Larimore contends that the Board erred in adopting findings of fact and conclusions of law different from the ones proposed by the administrative law judge ("ALJ"), that the Board's order was not supported by substantial evidence, and that he is entitled to attorney's fees and costs of court. We will affirm the judgment of the district court.



BACKGROUND

Larimore was employed by the Texas Department of Corrections as a corrections officer. In December 1998, as he was going up a flight of stairs in a corrections unit, Larimore slipped on the stairs and "did the splits" but was able to grab the handrail and prevent himself from falling down the stairs. He pulled himself up and claims he immediately felt pain in his lower and upper back. As a result of the slip, Larimore sustained an injury to his back. Larimore was ultimately diagnosed as suffering from radiculopathy (pain radiating into his extremities resulting from the back injury) and from disc protrusions or herniations in his cervical spine at vertebrae C4-5 and in his lumbar spine at vertebrae L3-4 and L4-5. Larimore applied to the Employees Retirement System ("ERS") for occupational disability retirement benefits. (2) See Tex. Gov't Code Ann. §§ 811.001-815.512 (West 2004).

Larimore's application for benefits was governed by former section 811.001(12) of the government code, which defined an occupational disability as a disability arising "from an injury or disease that directly results from a specific act or occurrence determinable by a definite time and place and directly results from a risk or a hazard peculiar to and inherent in a duty that arises from and in the course of state employment." See Act of May 23, 2001, 77th Leg., R.S., ch. 1231, § 1, 2001 Tex. Gen. Laws 2827, 2827; Act of May 24, 2003, 78th Leg., R.S., ch. 842, § 4, 2003 Tex. Gen. Laws 2633, 2636 ("former Tex. Gov't Code § 811.011(12)"). The Medical Board certified that Larimore was permanently impaired and unable to further perform his job requirements due to cervical, thoracic, and lumbar spondylosis (degeneration of the spine). See Tex. Gov't Code Ann. § 814.203. The Medical Board also concluded that the injury he sustained at the Stevenson unit was not the primary cause of Larimore's incapacity. Rather, the Medical Board concluded Larimore's incapacity resulted from a pre-existing condition suffered in an automobile collision (3)

and from arthritis. It concluded that the most recent injury aggravated the pre-existing condition and would not, on its own, have rendered Larimore permanently incapacitated.

The ERS Executive Director denied Larimore's application for benefits on the grounds that Larimore's injury did not satisfy the requirements specified in former government code section 811.001(12). The Executive Director stated that, based on the conclusions of the Medical Board, "ERS is unable to conclude that [Larimore's] disability directly results from a specific act or occurrence determinable by a definite time and place" as required by statute. Larimore appealed the decision of the Executive Director to the Board, and a hearing was held before an ALJ. See Tex. Gov't Code Ann. §§ 815.001, .101 (stating Board is responsible for general administration of retirement system). In her proposal for decision, the ALJ recommended that Larimore's appeal be granted, that he should be awarded disability benefits, and that the evidence indicated that the at-work injury was the primary cause of Larimore's disability.

After the ALJ issued her proposal, ERS Staff filed a list of exceptions to the proposal and subsequently filed alternative findings and conclusions, which were ultimately adopted by the Board. The Board determined that Larimore did not prove that the injury he sustained from his fall was the primary cause of his disability. In its order, the Board denied Larimore's claim for occupational disability retirement benefits and adopted the alternate findings and conclusions submitted by ERS staff. (4)

Larimore appealed to the district court, which affirmed the decision of the Board. See Tex. Gov't Code Ann. § 815.511(f) (allowing aggrieved party to appeal decision to district court for judicial review under substantial evidence review). This appeal followed.



DISCUSSION

On appeal, Larimore contends that (1) the Board erred by adopting the alternative findings and conclusions proposed by ERS staff; (2) the Board's order was not supported by substantial evidence; (3) the Board did not have the authority to reject the findings and conclusions in the ALJ's proposal because they were supported by substantial evidence; and (4) the district court erred by not allowing him to recover attorney's fees, costs of court, and interest.



Alternative Findings and Conclusions

In his first issue on appeal, Larimore contends the Board erred in adopting the findings and conclusions proposed by the ERS staff because (1) none of the requirements of section 67.91(b) of title 34 of the administrative code were met; (2) the Board abused its discretion; (3) the Board acted arbitrarily and capriciously; (4) the Board breached its fiduciary and contractual duties in light of previous cases before this Court; and (5) the Board's actions were legally reprehensible and actionable.

Larimore contends that the at-work injury was the primary cause of his disability; that, prior to his injury, he had been able to perform all of his job responsibilities and was not disabled; and that prior to the accident there was no evidence of an injury to his lumbar spine, particularly the disc protrusions or herniations of vertebrae L3-4 and L4-5.

The legislature has limited the discretion of the Board to modify recommendations of an ALJ in a contested case hearing by enacting section 815.511 of the government code. Although the code specifically grants the Board the power to "modify, refuse to accept, or delete any proposed finding of fact and conclusion of law contained in a proposal for decision submitted by an [ALJ]," the statute requires the Board to state its reasoning for the changes in writing and allows the Board to adopt rules governing its review of contested case hearings. Tex.

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