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Continental Casualty Co. v. Downs6/6/2002
Argued on October 24, 2001
Justice Hankinson delivered the opinion of the Court, in which Chief Justice Phillips, Justice Enoch, Justice Baker, and Justice O'Neill joined.
Justice Jefferson filed a dissenting opinion, in which Justice Hecht, Justice Owen, and Justice Rodriguez joined.
In this cause we interpret provisions of the Texas Workers' Compensation Act (the Act) governing when a workers' compensation carrier must notify a claimant that the carrier is refusing to pay benefits. See Tex. Lab. Code §§ 409.021, 409.022. The district court granted summary judgment for the carrier on the basis that it had timely contested compensability even though it had not timely notified the claimant that it was refusing to pay benefits. The court of appeals reversed and rendered judgment for the claimant, and remanded the issue of attorney's fees. 32 S.W.3d 260. We conclude that under Texas Labor Code §§ 409.021 and 409.022, a carrier that fails to begin benefit payments as required by the Act or send a notice of refusal to pay within seven days after it receives written notice of injury has not met the statutory requisite to later contest compensability. We accordingly affirm the court of appeals' judgment.
Respondent Mary Ann Downs timely filed a claim for workers' compensation benefits after her husband's fatal heart attack. Petitioner Continental Casualty Company provided workers' compensation insurance to her husband's employer. Continental first notified Downs that it disputed the compensability of her claim forty-eight days after it received notice of the injury. The parties proceeded to a benefit- review conference and then a contested-case hearing at the Texas Workers' Compensation Commission. The hearing officer determined that Downs' husband's heart attack was not compensable and that Continental had timely contested compensability. An appeals panel affirmed that decision. Having exhausted her administrative remedies, Downs sought judicial review in the district court. The parties filed cross-motions for summary judgment, and the court granted summary judgment for Continental, affirming the Commission's decision. Downs appealed, complaining only of the determination that Continental had timely disputed compensability. The court of appeals reversed and rendered judgment in favor of Downs, and it remanded Downs' claim for attorney's fees to the district court. 32 S.W.3d at 264. It held that because Continental had not timely notified Downs of its refusal to pay benefits, it could not contest compensability. Id.
Continental petitioned this Court for review, contending that the court of appeals' interpretation of Labor Code §§ 409.021 and 409.022 deprives carriers of the statutory sixty-day deadline to contest compensability and imposes an additional penalty not reflected in the statutory scheme for failure to meet the seven-day pay-or-dispute deadline. It further argues that the court of appeals' interpretation is contrary to the Commission's interpretation and application of the statutes. Downs responds that the Commission's interpretation is at odds with the language of sections 409.021 and 409.022, and that to read those provisions as Continental proposes would defeat the Legislature's express intent that workers receive either prompt payment or notice of denial of compensation claims.
As we are called upon to interpret what the parties agree are the controlling provisions of the Labor Code, we begin by reviewing the relevant principles of statutory construction. The goal of statutory construction is to give effect to legislative intent. Kroger Co. v. Keng, 23 S.W.3d 347, 349 (Tex. 2000); Texas Water Comm'n v. Brushy Creek Mun. Util. Dist
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