 |
 |
to fill out a simple form to connect to Employee Leasing Services in your area.
|
|
|
|
|
St. Paul Fire and Marine Insurance Company v. Texas Workers' Compensation Commission5/15/1997
Filed: May 15, 1997
This case involves St. Paul Fire and Marine Insurance Company's ("St. Paul's") challenge to the constitutionality of the immediate payment and reimbursement scheme of the Texas Workers' Compensation Act. See Tex. Lab. Code Ann. Section(s) 409.023(a), 410.032, 410.169, & 410.205 (West 1996). Because the cause does not present a justiciable controversy, we will vacate the trial court's judgement and dismiss the cause without reaching St. Paul's seven points of error.
BACKGROUND
This dispute arises out of two alleged workplace injuries. Martha Oviedo and Phillip Williams alleged they suffered injuries while working and, in separate proceedings, made claims for workers' compensation benefits. The employers' insurance company, St. Paul, disputed the validity of Oviedo's and Williams' claims.
The Texas Labor Code provides the process by which disputes over injured employees' claims are resolved. See Tex. Lab. Code Ann. 410.001-.308 (West 1996) (the "Code"). The Code provides a four-tiered system of dispute resolution, the first step of which is a benefit review conference ("BRC") conducted by a benefit review officer. See Section(s) 410.021, 022. The purpose of a BRC is to: (1) ensure that the parties to a dispute understand their rights and the procedures applicable to the enforcement of their rights, (2) delineate disputed issues, and (3) resolve disputes when possible. Section(s) 410.021. If any issues remain unresolved, a benefit review officer may issue an interlocutory, binding order requiring an insurance company to pay benefits to an injured worker pending further proceedings. 410.032(a).
Parties dissatisfied with the result of a BRC may proceed to the second step of the scheme, a contested-case hearing before a hearing officer. See Section(s) 410.151, .152. In a contested-case proceeding, parties conduct limited discovery and present evidence in an attempt to resolve remaining issues. See Section(s) 410.158-.166. After a contested-case hearing, the hearing officer decides whether benefits are due, and if so, the amount of benefits due. Section(s) 410.168. The hearing officer's decision is final unless a party appeals, and the decision is binding during the pendency of any appeal. Section(s) 410.169.
If a party to a contested case decides to appeal the hearing officer's decision, it avails itself of the third step in the process, review by the appeals panel. See Section(s) 410.202, .203. An appeals panel resolves the appealed issues and renders a decision. Section(s) 410.204. An appeals panel decision is final unless a party timely appeals for judicial review in district court, the fourth step in the administrative scheme. Section(s) 410.205(a), (b). An appeals panel decision is binding during the pendency of any appeal for judicial review. Id. The Workers' Compensation Commission may impose administrative penalties upon any party that fails to comply with an order to pay benefits. See Section(s) 415.002(17), .021(a) (West 1996).
A party wrongfully ordered to pay benefits may be reimbursed under limited circumstances. Specifically, a party ordered to pay by a benefit review officer may seek reimbursement of funds paid in accordance with that order if the order is subsequently modified or reversed. Section(s) 410.032(b). Similarly, a party ordered to pay by an appeals panel may seek reimbursement of funds paid in accordance with the panel's order if the order is subsequently modified or reversed. 410.205(c). However, the Code makes no provision for reimbursement of funds paid pursuant to a hearing officer's contested-case decision that is reversed or modified. St. Paul complains primarily of this
Page 1 2 3 Texas Employee Leasing Services
Employee Leasing Services
|
| |
to fill out a simple form to connect to Employee Leasing Services in your area.
|
|