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Texas Court of Appeals Upholds Lower Court Ruling Denying Injured Worker Lifetime Benefits

Recently, the Texas Court of Appeals affirmed a lower court ruling that an injured worker could not receive lifetime workers compensation benefits.

In Menchaca v. Insurance Company of the State of Pennsylvania, Vincente Menchaca was injured on the job in 1994. Though he received workers compensation disability benefits, he was denied lifetime benefits despite claiming that he had total loss of use in both hands at or above the wrist. Menchaca went through the workers compensation administration review process before he brought a lawsuit against his employer’s workers compensation insurance carrier, the Insurance Company of the State of Pennsylvania (ICSP). In the lawsuit, he sought court review of the Texas Department of Insurance Division of Workers’ Compensation decision that he was not entitled to lifetime benefits. After the trial court sided with the Insurance Division, Menchaca appealed.

ICSP filed a motion for summary judgment, arguing that there was no genuine issue of material fact that Menchaca’s hands still possessed “substantial utlity,” and that his ability to gain and keep employment did not depend on the loss of use of his hands. ICSP offered previous testimony from Menchaca stating that he worked for two different attorneys since he left ICSP’s client, and that he stopped working for the second one due to “Army-related injuries” flaring up. Menchaca also allegedly admitted that he walked with a cane using both hands, could write, had a driver’s license, and lived alone, suggesting that whatever his injuries, he could still lead an independent life. Menchaca responded by objecting to the opinion testimony and medical report of ICSP’s medical expert, who evaluated him in May 2010. The trial court ruled in ICSP’s favor, and Menchaca again appealed.

The Court of Appeals examined the trial court’s ruling to find out whether it had erred in determining Menchaca was not entitled to lifetime benefits. For Menchaca to be eligible, he needed to have lost substantial utility in the body parts in question, or they must be in a condition where the person could not procure and retain employment using those body parts.

The Court agreed with ICSP’s claims that Menchaca had substantial utility in both of his hands. Mechaca’s testimony highlighted that he could write, live by himself, and drive a car. He could also use his hands to support himself and walk with a cane. Finally, he was able to grip and sustain “a significant” portion of his weight on his hands. The Court also noted that Menchaca’s employment at his subsequent positions ended due to non-employment-related injuries, such as those he suffered in the Army. Although Menchaca responded on appeal by citing numerous documents in the clerk’s record that supported his issues, he failed to do so at the proper time, in his response to the summary judgment motion. As such, Menchaca was limited in what he could argue.

Because of these reasons, the Court of Appeals affirmed the lower court’s decision finding that Menchaca was not entitled to lifetime benefits.

Those who have been injured in a workplace accident could be entitled to workers compensation, as well as compensation from any third party responsible. The experienced San Antonio personal injury attorneys at Carabin Shaw may be able to help. Call our office today for more information at 1-800-862-1260.

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