Court Affirms Carrier’s Extent of Injury Argument
The Amarillo Court of Appeals has affirmed a trial court’s ruling that found an injured worker’s compensable injury did not extend to and include Chronic pain, facet arthrosis, disc pathology, fibromyalgia, hyper reflexive, sleep problems and osteoporosis. The Division had found that the disputed conditions did not arise out of or naturally flow from the compensable injury. The claimant exhausted his administrative remedies and sought judicial review of the Division’s determination.
On judicial review the claimant also tried to pursue extra contractual (bad faith) claims. In Taylor v. Lubbock Regional MHMR, et al., (No. 07-13-00381-CV, October 7, 2015) the court of appeals rejected those claims:
It appears the cause of action Taylor alleges against Specialty Services is not recognized by Texas law. See Texas Mutual Insurance Co. v. Ruttiger, 381 S.W.3d 430, 433 (Tex. 2012) (op. on reh’g) (concluding “claims against workers’ compensation insurers for unfair settlement practices may not be made under the Insurance Code, but . . . claims under the Insurance Code may be made against those insurers for misrepresenting provisions of their policies,” and holding “an injured employee may not assert a common-law claim for breach of the duty of good faith and fair dealing against 7 a workers’ compensation carrier”); Holmes v. Zurich Am. Ins. Co., 421 S.W.3d 766, 769 (Tex. App.—Dallas 2014, pet. denied) (recognizing Ruttiger’s preclusion in context of claim that third-party administrator breached duty of good faith and fair dealing).
The carrier then filed a no-evidence summary judgment motion on the extent of injury issues. The court granted that motion. The appellate court affirmed the trial court’s ruling:
because we find no evidence of causation in the summary judgment record, we conclude the trial court properly granted summary judgment in favor of MHMR. See McClure v. Amerisure Ins. Co., No. 02-07-00035-CV, 2008 Tex. App. LEXIS 6242, at *8-11 (Tex. App.—Fort Worth Aug. 14, 2008, no pet.) (mem. op.) (finding in injured worker’s extentof-injury case trial court correctly granted carrier’s no-evidence motion for summary judgment when, after carrier’s evidentiary objection was sustained, summary judgment record contained no evidence of causation).
FOLIO
