GQ Corner

Q: I received an email from the claimant’s attorney where she asked that I stop removing attorney’s fees from the claimant’s benefit checks. She said she would waive any unpaid fees. Can I stop ordered attorneys’ fees based on her email?

A: No. The fee orders are DWC orders, and you have to comply with them in the absence of an agreement or an order that overrides the earlier order. The email from the claimant’s attorney is insufficient. The claimant’s attorney can sign a DWC-24 waiving the fees, or what typically happens is the claimant’s attorney can request to withdraw the fee applications, and the DWC will issue a letter withdrawing the fee orders.

Q: DWC issued an order on our request for contribution and indicated we could decrease IIBs and SIBs due to a prior impairment rating from a compensable injury to the same body part. The order is dated 4-12-16 but what is the effective date that I decrease benefits pursuant to the order?

A: The Appeals Panel has previously held that an insurance carrier may only recoup overpayments on IIBs and SIBs that accrue on or after the date the carrier files the request for contribution that is eventually approved by the Division. APD 050523-s. The effective date is therefore the day the carrier filed its request for contribution.

Q: Claimant #1 died at work when a piece of equipment fell on him. The injured worker began yelling, vomiting, and blood began to come out of his mouth. 911 was called out and he was taken to the hospital where he was pronounced dead. I recently received a claim from one of his co-workers, claimant #2, who is alleging he sustained emotional distress as a result of witnessing the accident. Would his claim for emotional stress be covered under workers’ compensation?

A:  It may be covered as a compensable injury. It is well-settled law that a mental injury resulting from repetitive mental trauma is not compensable under Texas law. In order to establish a compensable mental trauma injury, the claimant must show that the injury arises in the course and scope of employment and can be traced to a definite time, place and cause. In this instance, it is plausible that this claimant may have some issues and his problems may be traceable to a definite time, place, and cause. Claimant #2 will need to present medical evidence to support that he sustained a mental trauma injury and that witnessing this accident was a producing cause of that condition.