Continental Casualty Company v. Williamson
In Continental Casualty Company v. Williamson, 971 S.W.2d 108 (Tex. App.--Tyler 1998, no pet.), claimant Claude Williamson alleged that on August 10, 1993, he fell down a staircase at work, which replicated a March 1993 injury.
Williamson filed a worker's compensation claim, but Continental did not respond within the sixty-day time frame.
Following the contested case hearing at which Williamson and others testified, the hearing officer entered a Decision and Order, with findings of fact and conclusions of law, including a finding that Williamson willfully intended to injure himself by staging the incident in question but did not sustain an injury.
The hearing officer therefore held that, although the insurance carrier had waived its right to dispute the compensability of Williamson's alleged injury, because Williamson had no injury, he was not entitled to benefits. (Id. at 109-110.)
The Appeals Panel affirmed the hearing officer's findings of fact and conclusions of law, but disagreed with the conclusion that because there was a finding of no injury, Williamson was not entitled to benefits.
The Appeals Panel instead held that Williamson suffered no injury, but because Continental did not timely contest compensability, Williamson's injury was established as a matter of law.
Continental then appealed the Appeals Panel decision to the trial court. The trial court affirmed the decision, which was again appealed to our sister court in Tyler.
The question on appeal was whether an employer's failure to timely contest compensability, when there is no injury, creates a compensable injury as a matter of law.
The Tyler court found that an injury and a compensable injury are two different animals. Continental may have waived its right to contest the compensability of an injury, but it never waived its right to contest the injury itself.
The court therefore held that if a hearing officer determines that there is no injury, and that finding is not against the great weight and preponderance of the evidence, then the carrier's failure to contest compensability cannot create an injury as a matter of a law.
The appellate court reversed the trial court's judgment and rendered judgment in favor of the carrier. (Id. at 111.)