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DeLeon v. Royal Indemnity Co.

The trial court determined that an injured worker had been assigned no valid impairment rating upon which to base impairment income benefits under the Texas Workers' Compensation Act. The absence of a valid impairment rating that had been submitted to the agency does not deprive a reviewing court of subject matter jurisdiction. The Workers' Compensation Act permits a court to remand to the Workers' Compensation Division if it decides that the worker has no valid impairment rating. The case is reversed and remanded to the trial court with instructions that the court remand the case to the division. Texas Supreme Court, No. 10-0319, 11-16-2012.

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In this case, the trial court determined that an injured worker had been assigned no valid impairment rating upon which to base impairment income benefits under the Texas Workers’ Compensation Act, TEX. LAB. CODE §§ 401.001–506.002. The court of appeals affirmed. ___ S.W.3d ____. In doing so, the court noted that “no mechanism exists in the [Workers' Compensation] Act to remand matters back to [the Department of Insurance's Workers' Compensation Division].” ___ S.W.3d at___. We reverse and remand to the trial court with instructions to remand to the Division.

Severiano DeLeon suffered a back injury while in the course and scope of his employment. More than a year later, he had spinal fusion surgery. DeLeon’s employer’s workers’ compensation insurance carrier, Royal Indemnity Co., paid medical benefits, but contested the extent of his entitlement to impairment income benefits. Section 408.123 of the Labor Code requires that an impairment rating be based upon the Guides to the Evaluation of Permanent Impairment published by the American Medical Association. TEX. LAB. CODE § 408.123. The designated doctor appointed by the Division determined that DeLeon had an impairment rating of twenty percent. The doctor based that decision on two Advisories issued by the Division to guide the calculation of impairment ratings for workers who had undergone spinal surgery and who had not had pre-operative spinal flexion x-rays. The hearing officer accepted the designated doctor’s rating and the Division’s appeals panel upheld the examiner’s decision.

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