GQ Corner
Q. The claimant was murdered at work on 7/14/2018. Contact letters and a PLN-12 were sent to her Estate as last known address. Messages were also left for the claimant’s boyfriend, who was also an employee, but did not receive a call back from him. The funeral home was contacted to have the family call me back. The funeral home representative advised they made contact with the father, who advised he would give me a call. I never received a call from him. On 6/10/2019, payment was issued to the Subsequent Injury Fund through TDI. Today, I am being contacted by the sister of the deceased asking about benefits. Not sure what we need to do or what to tell her. I understand that the parents may be entitled to 104 weeks, but why would they be entitled to 364 weeks?
A. You need to pick up your investigation as to the beneficiaries again. Who are the potential beneficiaries? Call the sister and find out whether she was dependent upon the employee at the time of the death. See if she can get you the father’s contact information. Dad may be entitled to at least 104 weeks of benefits, possibly the entire 364. Is mom still alive? If so, what is her contact information? Finally, find out from the sister whether the boyfriend was a live-in or not. Did they have plans to marry? There is a mechanism to pull the money back from SIF if one of the family members demonstrates entitlement. See Rules 132.10 (g) and 116.11.
Q. Claimant is an Animal Control Officer with the City. On 7/9/20, she was putting cows behind a fence and was stung by a bee or wasp on her left hand. She did not see the insect, but immediately felt the sting. She was seen at the hospital and was treated & released to full duty. She reached MMI on 7/10/20 with no IR. Do I have any basis to deny this claim?
A. These questions are notoriously fact-intensive, but I think this may very well be deemed compensable because the claimant, an Animal Control Officer, is ostensibly at greater risk for this type of injury than the general public by virtue of the employment. Basically, my impression is that there is a good chance that the Division would find a causal nexus between the employment and the sting under these circumstances. Fortunately, it should be a very low exposure case regardless. I have included below a snippet from the DWC Appeals Panel Decision Manual regarding insect bites should you find it instructive. Insect bites and stings have been held not to be acts of God and have been held to be compensable when causation is established. It is not enough to show that the injury occurred while in the course and scope of employment. The IW must also prove that the injury was of such kind and character as had to do with and originated in the employer’s work, trade, business or profession. Standard Fire Ins. Co. v. Cuellar, 468 S.W.2d 880 (Tex. Civ. App.-San Antonio 1971, writ ref’d n.r.e.). To show causation, the IW must prove that the conditions and obligations of the employment placed the IW in harm’s way. Texas Workers’ Comp. Ins. Fund v. Simon, 980 S.W.2d 730 (Tex. App.-San Antonio 1998, no writ.). The IW was employed as a school bus driver and sustained injuries when she was bitten on the knee by a brown recluse spider while driving her route. The Hearing Officer (HO) found the injury to be compensable because the IW’s employment as a school bus driver put her at a greater risk of being bitten by a brown recluse spider than the general public. The HO may consider factors such as the remote location of the bus barn in which the school buses were stored and the fact that the school bus door remained open at night while parked in the barn. From these facts, the HO could conclude that the IW’s employment as a school bus driver put her at a greater risk of being bitten by a brown recluse spider than the public at large. APD 020446.
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