Southern Insurance Co. v. Brewster

249 S.W.3d 6, 2007 WL 1953903
CourtCourt of Appeals of Texas
DecidedAugust 6, 2007
Docket01-06-00029-CV
StatusPublished
Cited by51 cases

This text of 249 S.W.3d 6 (Southern Insurance Co. v. Brewster) 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
Southern Insurance Co. v. Brewster, 249 S.W.3d 6, 2007 WL 1953903 (Tex. Ct. App. 2007).

Opinion

OPINION

SHERRY RADACK, Chief Justice.

Appellant, Southern Insurance Company, sought judicial review in the trial court of a decision of the appeals panel of the Texas Workers’ Compensation Commission (TWCC). 1 On modified de novo review, the trial court resolved cross-motions for traditional summary judgment to confirm the duty imposed on Southern to pay benefits to appellee, Michael Brewster. 2 Southern (the carrier) provides worker’s compensation insurance coverage to Brewster’s employer, Spectrum Corporation. Brewster is a service technician for Spectrum (the employer), which installs and repairs electronic scoreboards for sports stadiums. The carrier and Brewster filed cross-motions for summary judgment, and the carrier brings this appeal to challenge the summary judgment rendered in favor of Brewster. Brewster has filed a motion to dismiss the appeal for want of jurisdiction, which has been ordered taken with this case.

We deny the motion to dismiss and affirm.

Facts and Procedural Background

On September 13, 2000, Brewster sustained neck injuries when an 18-wheeler truck rear-ended Brewster’s vehicle as he was driving on Highway 59. The carrier stipulates that the collision occurred while Brewster was in the course and scope of employment. Brewster reported the accident to his work supervisor, but no worker’s compensation claim was pursued with the carrier. 3 Brewster sought medical at *9 tention instead through his group insurance coverage. He continued to work, while undertaking physical therapy treatment, but his neck pain continued, and an MRI examination of his cervical spine, performed on April 3, 2001, showed that Brewster had herniated cervical discs and a disc protrusion. While continuing to work and to receive treatment, he learned in June 2001 that he would likely require surgery. In June 2001, Brewster sued the driver and owner of the 18-wheeler.

But Brewster sustained another injury before the scheduled surgery. On July 5, 2001, while he was pulling a cable through a conduit at a worksite, the cable snapped, and Brewster fell. He immediately felt burning pain all along his spine. He received pain medication at a hospital emergency room and sought medical attention several times during the following week for neck and back pain. Brewster sought medical assistance from a chiropractor, Dr. Al-Sahli, who ultimately concluded that Brewster had aggravated the neck injury he sustained in the automobile collision and ordered him not to work.

On July 11, 2001, Brewster filed with the TWCC a “TWCC-41” notice of claim of an injury to his “back and neck.” In this notice, Brewster stated that the date of injury was July 5, 2001, and that July 6, 2001 was the first work day that he missed. On July 16, 2001, an adjuster for carrier took a statement from Brewster by recorded telephone interview. During the interview, in response to the adjuster’s questions about prior injuries, Brewster described the back and neck injuries sustained in the rear-end collision and replied that the injuries were work-related in response to the adjuster’s inquiry. 4

On September 17, 2001, the carrier submitted a “TWCC-21” Notice of Refused/Disputed Claim to the TWCC. This notice recites that the carrier first received written notice of Brewster’s claim on July 16, 2001. The carrier’s notice (1) challenged whether the July 5, 2001 incident was the producing cause to the injuries to Brewster’s “back/right shoulder and right knee” and (2) denied the back, right shoulder, and right knee in its [sic] entirety. 5 The carrier investigated and eventually agreed to compensate Brewster, but limited payments to treatment for his back injuries and did not compensate for any injuries to his neck from that point forward.

With the diagnosis that the July 5, 2001 injury had aggravated the September 13, 2000 injury to his neck, Brewster filed with the TWCC a “TWCC-41” notice of claim for injuries arising from the September 2000 automobile collision. 6 Brewster filed this notice on October 26, 2001, and thus beyond the one-year anniversary of the collision on September 13, 2000, the date of the injury from the truck collision. Brewster’s notice stated that the date of his injury was September 13, 2000 and restated that July 6, 2001 was the first work day that Brewster had missed. He described back and neck injuries, headaches, *10 and nose bleeds arising from the collision with the 18-wheeler truck on September 13, 2000. It is undisputed that Brewster’s TWCCM1 notice was not timely under Tex. Lab.Code ÁNN. § 409.003 (Vernon 2006) (imposing duty on employee or person acting on employee’s behalf to file claim for compensation for injury not later than one year after injury); cf, Tex. Lab. Code Ann. § 409.001(a) (Vernon 2006) (imposing duty on employee to report injury to employer within 30 days of injury). The carrier has not challenged whether Brewster complied with the 30-day deadline of section 409.001(a).

On February 25, 2002, the employer filed a “First Report of Injury” to notify the carrier of Brewster’s September 2000 collision and his resulting injury to Brewster’s “shoulder.” The carrier concedes that it did not respond timely to this notice. See Act of May 12, 1993, 73rd Leg., R.S., ch. 269, § 1, 1119 Tex. Gen. Laws 987, 1195 (amended 2003) (former version) (imposing duty on carrier to either (1) begin paying benefits or (2) provide notice of refusal to pay benefits within seven days of receiving “written notice of an injury”) (current version at Tex. Lab.Code Ann. § 409.021(a) (Vernon 2006); see also 25 Tex. Reg. 2096 (to be codified at 28 Tex. Admin. Code § 124.3(a)(2)(B)(3)) (proposed 2000) (amended 2004) (former version) (describing essentially same duties). 7 It is also undisputed that the carrier did not assert that the employer’s notice of Brewster’s September 13, 2000 injury was not timely. Instead, on March 22, 2002, the carrier filed with the TWCC a “TWCC-21” Notice of Refused or Disputed Claim” reporting that the carrier had denied owing Brewster any benefits arising from the September 2000 collision, as follows:

Carrier admits that claimant was involved in an accident in [the] course and scope of employment on 09/13/2000. The claimant did not sustain any disability as there was no lost time from employment. Carrier denies any and all disability and impairment due to the date of injury of 9/13/2000. Carrier raises issues of extent and duration.

The TWCC received this notice on March 25, 2002.

A. Administrative Review Process

Brewster requested administrative review process to challenge the carrier’s decision to refuse to pay benefits for his neck injuries.

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Bluebook (online)
249 S.W.3d 6, 2007 WL 1953903, Counsel Stack Legal Research, https://law.counselstack.com/opinion/southern-insurance-co-v-brewster-texapp-2007.