Osie Rush v. Ace American Insurance Company

CourtCourt of Appeals of Texas
DecidedJuly 9, 2019
Docket01-18-00402-CV
StatusPublished

This text of Osie Rush v. Ace American Insurance Company (Osie Rush v. Ace American Insurance Company) 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
Osie Rush v. Ace American Insurance Company, (Tex. Ct. App. 2019).

Opinion

Opinion issued July 9, 2019

In The

Court of Appeals For The

First District of Texas ———————————— NO. 01-18-00402-CV ——————————— OSIE RUSH, Appellant V. ACE AMERICAN INSURANCE COMPANY, Appellee

On Appeal from the 12th District Court Grimes County, Texas Trial Court Case No. 33532

MEMORANDUM OPINION

Appellant, Osie Rush, challenges the trial court’s judgment, rendered after a

jury trial, in favor of appellee, Ace American Insurance Company (“Ace”), in Rush’s

suit for judicial review of the decisions of the Texas Department of Insurance, Division of Workers’ Compensation (“DWC”).1 In three issues, Rush contends that

the trial court erred in granting Ace a directed verdict and excluding certain

evidence.

We affirm.

Background

Rush claimed that, on November 4, 2013, he sustained an electrical shock

injury in the course and scope of his employment at Trinity Industries, Inc.

(“Trinity”). Following a benefit review conference,2 the DWC held a contested case

hearing on June 25, 2015 (the “June 25, 2015 hearing”)3 to determine (1) whether

Rush’s compensable injury4 sustained on November 4, 2013 extended to and

included “a cervical strain, [a] right shoulder strain, disc protrusions at C3 through

C6, tendinosis and a partial thickness tear of the right shoulder[,] and memory loss”

1 See TEX. LAB. CODE ANN. §§ 410.251–.308 (“A party that has exhausted [his] administrative remedies . . . and that is aggrieved by a final decision of the appeals panel may seek judicial review . . . .”). 2 See id. §§ 410.021–.034 (“A benefit review conference is a nonadversarial, informal dispute resolution proceeding . . . .”). 3 See id. §§ 410.151–.169 (“Contested Case Hearing”). 4 Ace considered Rush’s compensable injury to be an electrical shock injury and subsequent redness of his left fifth finger that occurred on November 4, 2013. See id. § 401.011(10) (“Compensable injury means an injury that arises out of and in the course and scope of employment for which compensation is payable . . . .” (internal quotations omitted)).

2 and (2) whether Rush sustained disability5 resulting from his November 4, 2013

injury, and if so, for what period of time. The hearing officer found:

1. Rush’s “cervical strain, right shoulder strain, disc protrusions at C3 through C6, tendinosis and . . . partial thickness tear of the right shoulder[,] and memory loss were neither caused nor aggravated and did not raise out of or naturally flow from [his] compensable injury of November 4, 2013[]”;

2. “The preponderance of the evidence [was] contrary to Dr. Carter’s opinion on extent of injury[]”; and

3. Rush “did not establish that he was unable to obtain and retain employment at wages equivalent to his pre-injury wage as a result of [his] compensable injury of November 4, 2013 during the period beginning November 5, 2013 and continuing through the date of the June 25, 2015 hearing.”

The hearing officer then concluded that Rush’s “compensable injury of November

4, 2013 d[id] not extend to and include a cervical strain, [a right shoulder strain],

disc protrusions at C3 through C6, tendinosis and a partial thickness tear of the right

shoulder[,] or memory loss” and Rush did not sustain “disability resulting from the

November 4, 2013 compensable injury during the period [of time] beginning [on]

November 5, 2013 and continuing through the date of the June 25, 2015 hearing.”6

5 See id. § 401.011(16) (“Disability means the inability because of a compensable injury to obtain and retain employment at wages equivalent to the pre[-]injury wage.” (internal quotations omitted)). 6 See id. § 410.169 (“A decision of an administrative law judge . . . is final in the absence of a timely appeal by a party . . . .”).

3 Rush appealed the hearing officer’s decision to an administrative appeals panel.7 On

September 28, 2015, the appeals panel upheld the hearing officer’s decision.

Following a second benefit review conference,8 the DWC held another

contested case hearing on April 13, 2016 (the “April 13, 2016 hearing”)9 to

determine (1) whether Rush’s “compensable injury of November 4, 2013 extend[ed]

to and include[d] bilateral carpal tunnel syndrome”; (2) whether Rush had “reached

maximum medical improvement,”10 and if so, when; (3) Rush’s impairment rating;11

and (4) whether Rush sustained disability resulting from the November 4, 2013

compensable injury during the period of time beginning on June 26, 2015 and

continuing through the date of the April 13, 2016 hearing. The hearing officer found:

1. Rush’s “[b]ilateral carpal tunnel syndrome was not caused by, and did not naturally flow from [his] November 4, 2013 compensable injury[]”;

7 See id. §§ 410.201–.209 (“Appeals judges, in a three-member panel, shall conduct administrative appeals proceedings.”). 8 See id. §§ 410.021–.034. 9 See id. §§ 410.151–.169. 10 See id. § 401.011(30) (“Maximum medical improvement means the earlier of: (A) the earliest date after which, based on reasonable medical probability, further material recovery from or lasting improvement to an injury can no longer reasonably be anticipated; (B) the expiration of 104 weeks from the date on which income benefits begin to accrue; or (C) the date determined as provided by [Texas Labor Code] [s]ection 408.104.” (internal quotations omitted)). 11 See id. § 401.011(24) (“Impairment rating means the percentage of permanent impairment of the whole body resulting from a compensable injury.” (internal quotations omitted)).

4 2. “Dr. Bajwa certified that [Rush] reached maximum medical improvement on April 9, 2014 with a 0% impairment rating; his certification [was] not contrary to the preponderance of the other medical evidence[]”; and

3. Rush’s “November 4, 2013 compensable injury was not a cause of [his] inability to obtain and retain employment at wages equivalent to his pre-injury wage during the period from June 26, 2015 through the date of the [April 13, 2016] hearing.”

The hearing officer thus concluded that Rush’s “compensable injury of November

4, 2013 d[id] not extend to and include bilateral carpal tunnel syndrome”; Rush

reached maximum medical improvement on April 9, 2014; Rush’s “impairment

rating [was] 0%”; and Rush did not sustain disability resulting from the November

4, 2013 compensable injury during the period of time beginning on June 26, 2015

and continuing through the date of the April 16, 2016 hearing.12 Rush appealed the

hearing officer’s decision to an administrative appeals panel.13 On July 15, 2016,

the appeals panel upheld the hearing officer’s decision.

Rush then appealed the administrative appeals panels’ decisions to the trial

court.14 In his first amended petition, Rush alleged that on November 4, 2013, he

worked as “a burner” for Trinity at its facility in Navasota, Texas. According to

12 See id. § 410.169. 13 See id. §§ 410.201–.209. 14 See id. §§ 410.251–.308 (“A party that has exhausted [his] administrative remedies . . . and that is aggrieved by a final decision of the appeals panel may seek judicial review . . . .”).

5 Rush, as part of his job, he “operated a computerized machine which fabricated large

metal objects” and frequently “use[d] a portable electrical powered magnet to move

[the] large metal objects.” On November 4, 2013, while making a large metal plate,

Rush “needed to move the portable electrical [powered] magnet.” He “attempted to

cut off the power to the magnet,” but, unknown to him, the magnet remained

powered. “At some point, [Rush] attempted with both hands to unplug the electrical

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