Galindo v. Old Republic Insurance Co.

146 S.W.3d 755, 2004 Tex. App. LEXIS 8805, 2004 WL 2192579
CourtCourt of Appeals of Texas
DecidedSeptember 30, 2004
Docket08-03-00372-CV
StatusPublished
Cited by12 cases

This text of 146 S.W.3d 755 (Galindo v. Old Republic Insurance Co.) is published on Counsel Stack Legal Research, covering Court of Appeals of Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Galindo v. Old Republic Insurance Co., 146 S.W.3d 755, 2004 Tex. App. LEXIS 8805, 2004 WL 2192579 (Tex. Ct. App. 2004).

Opinion

OPINION

SUSAN LARSEN, Justice.

Rito Galindo appeals from a no-evidence summary judgment granted in favor of his employer’s workers’ compensation carrier, Old Republic Insurance Co. Determining that genuine issues of material fact exist, and that summary judgment was therefore granted in error, we reverse and remand.

Facts

The underlying facts in this case are not disputed. In February 1992, while on the job at ASARCO (a copper smelting facility in El Paso), Rito Galindo was exposed to a high concentration of sulfur dioxide gas, resulting in severe pulmonary fibrosis and bronchiolitis obliterans, injuries compensa-ble under Texas Workers’ Compensation laws. Galindo asserted before the Workers’ Compensation Commission that his injuries entitled him to lifetime income benefits (LIBs). After a benefits contested case hearing in October 2000, the hearing officer found:

It is obvious from the medical evidence, observance of the Claimant, the doctor’s testimony and the Claimant’s testimony that he suffers from an extremely severe condition and will not be able to return to any type of work due to that condition which results from the compensable injury. However, the issue is whether or not the Claimant meets the requirements pursuant to § 408.161 to qualify for LIBs.
The Claimant testified that the medication he takes for his condition has resulted in cataracts in both eyes. However, the Claimant has not lost sight in both eyes. Claimant also testified that he has substantial loss of use of his legs and arms due to the loss of strength caused by the lack of oxygen in his blood as a result of the injury. The medical evidence does not sufficiently address Claimant’s loss of use of his legs and/or arms. Claimant does use a wheelchair and gets tired easily from physical exertion but he still maintains use of his arms and legs. Claimant has not experienced paralysis as a result of his injury nor is his condition a result of a spinal injury as required in subsection (5). Claimant also did not sustain an injury to the skull resulting in incurable insanity or imbecility.
The LIBs statute strictly limits the types of injuries that qualify for lifetime benefits. It is unfortunate, as in this case, that a Claimant can sustain such a catastrophic injury causing incapacitation and a permanent inability to work yet he does not qualify for LIBs. Even given a liberal interpretation of the statute, this Claimant does not meet the requirements for LIBs due to the nature of his injury. It seems logical that LIBs would be intended for cases such as this where the Claimant has a high impairment rating, cannot return to work, suffers from a severe and permanent impairment as a result of the compensable injury and is a “pulmonary cripple” and *758 yet this Claimant cannot qualify for lifetime benefits.

The Appeals Panel affirmed the hearing officer’s determination. Claimant then timely filed a petition in district court, again asserting his right to LIBs. Old Republic filed a no-evidence motion for summary judgment under Tex.R. Civ. P. 166a(i), contending that it was entitled to judgment as a matter of law as Galindo had produced no evidence of an injury that would qualify him for lifetime income benefits under the Texas Labor Code. Galindo responded with medical affidavits, but the trial court granted summary judgment in favor of Old Republic. This appeal follows.

Standard of review for no-evidence summary judgment

After an adequate time for discovery, a defendant may move for summary judgment claiming there is no evidence of one or more essential elements of a claim on which the plaintiff would have the burden of proof at trial. Tex.R. Civ. P. 166a(i); Marsaglia v. University of Texas, El Paso, 22 S.W.3d 1, 8 (Tex.App.-El Paso 1999, pet. denied). The motion must state the elements as to which the movant contends there is no evidence. Id. A no-evidence summary judgment is essentially a pretrial directed verdict, and we apply the same legal sufficiency standard that we apply in reviewing a directed verdict. Id. A no-evidence summary judgment is properly granted if the nonmovant fails to bring forth more than a scintilla of evidence to raise a genuine issue of material fact as to an essential element of the claim. Id. at 4. Less than a scintilla of evidence exists when the evidence is “ ‘so weak as to do no more than create a mere surmise or suspicion’ ” of a fact, and the legal effect is that there is no evidence. Id. (quoting Kindred v. Con/Chem, Inc., 650 S.W.2d 61, 63 (Tex.1983)).

Statutory requirements for Lifetime Income Benefits

In his sole issue on appeal, Galindo contends that genuine issues of material fact exist as to his entitlement to LIBs, precluding summary judgment. Old Republic responds by citing the statute which sets out eligibility for lifetime benefits, observing that the list of eligible conditions is exclusive, and urging that Galindo does not, as a matter of law, fall within any listed condition.

The statute under which Galindo seeks lifetime benefits reads as follows:

(a) Lifetime income benefits are paid until the death of the employee for:
(1) total and permanent loss of sight in both eyes;
(2) loss of both feet at or above the ankle;
(3) loss of both hands at or above the wrist;
(4) loss of one foot at or above the ankle and the loss of one hand at or above the wrist;
(5) an injury to the spine that results in permanent and complete paralysis of both arms, both legs, or one arm and one leg; or
(6) an injury to the skull resulting in incurable insanity or imbecility.
(b) For purposes of Subsection (a), the total and permanent loss of use of a body part is the loss of that body part. Tex. Lab.Code Ann. § 408.161(a)(b) (Vernon 1996).

Old Republic’s no-evidence summary judgment motion challenges Galindo’s claim to LIBs as “the plaintiff has produced no evidence of an injury which would qualify him for lifetime income benefits under the Texas Labor Code.” The carrier contends that because Galindo’s injuries result from *759 pulmonary disability, because he retains some use of his extremities nor has he lost his sight, he cannot qualify for LIBs. The carrier further urges that nothing in the medical affidavits submitted by Galindo raises a fact issue on his entitlement to lifetime benefits.

Clearly, if Galindo has raised a fact question on his entitlement to LIBs, it must rest on section 408.161(b), which equates total and permanent loss of use of a body part with loss of that body part.

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Cite This Page — Counsel Stack

Bluebook (online)
146 S.W.3d 755, 2004 Tex. App. LEXIS 8805, 2004 WL 2192579, Counsel Stack Legal Research, https://law.counselstack.com/opinion/galindo-v-old-republic-insurance-co-texapp-2004.