LUMBERMENS MUTUAL CASUALTY CO., Petitioner, v. Stan MANASCO, Respondent.
No. 97-1005.
Supreme Court of Texas.
Argued March 31, 1998. Decided June 23, 1998.
971 S.W.2d 60
That this case involves child support issues does not alter our conclusion. The Probate Code affirmatively grants probate courts the authority to order child support payments after balancing the child‘s interests with the ward‘s interests. See
Accordingly, we hold that a statutory probate court has authority under Probate Code section 608 to transfer to itself from district court a divorce proceeding when one party to the divorce is a ward of the probate court. Because the court of appeals exceeded its mandamus power when it disturbed the probate court‘s judgment absent an abuse of discretion, exercise of our mandamus authority is proper. See Johnson v. Fourth Court of Appeals, 700 S.W.2d 916, 917 (Tex.1985, orig.proceeding). We therefore conditionally grant the writ of mandamus, which will issue only if the court of appeals does not vacate its mandamus judgment.
Jacqueline M. Stroh, Donald Francis Lighty, Beaumont, for Petitioner.
Mike Jacobellis, Beaumont, for Respondent.
ABBOTT, Justice, delivered the opinion of the Court, in which PHILLIPS, Chief Justice, GONZALEZ, HECHT, ENOCH, OWEN, BAKER and HANKINSON, Justices, join.
The issue in this case is whether a workers’ compensation claimant who failed to appeal his original impairment rating can reopen the issue months later by arguing, under Texas Labor Code section 410.307, that a “substantial change of condition” has occurred. The trial court granted summary judgment for the workers’ compensation insurance carrier, concluding that the issue could not be reopened. The court of appeals reversed. Manasco v. Lumbermens Mutual Cas. Co., 951 S.W.2d 286 (Tex. App.—Beaumont 1997) We hold that a claimant may not use section 410.307 to reopen his impairment rating after his time for appeal has lapsed. We therefore re-
I
In 1989, the Legislature enacted the Texas Workers’ Compensation Act to restructure the workers’ compensation system. See Texas Workers’ Compensation Comm‘n v. Garcia, 893 S.W.2d 504, 510 (Tex.1995). The 1989 Act mandates a three-stage hearing process to resolve disputed claims: 1) a benefit review conference; 2) a contested case hearing; and 3) an administrative appeal. The benefit review conference is a nonadversarial, informal proceeding aimed at resolving disputed issues by mutual agreement.
If disputed issues remain after the benefit review conference, the parties may elect to arbitrate or proceed to a contested case hearing.
Any party may appeal the hearing officer‘s decision to a panel of the Texas Workers’ Compensation Commission.
Stan Manasco injured his back at work on January 20, 1992. He filed a claim for workers’ compensation and received temporary benefits for fourteen months. On October 23, 1992, Manasco‘s treating physician, Dr. Davis, certified that Manasco had reached maximum medical improvement and assigned him a thirty percent impairment rating. Lumbermens Mutual Casualty Company, the workers’ compensation carrier for Manasco‘s employer, disputed the thirty percent impairment rating and requested that the Texas Workers’ Compensation Commission designate a doctor to determine Manasco‘s rating. The Commission appointed Dr. Holmes, who eventually reported that Manasco had reached maximum medical improvement and had an impairment rating of seven percent. After the subsequent benefit review conference failed to resolve the dispute over Manasco‘s impairment rating, a contested case hearing was held on September 20, 1993. Manasco did not have counsel at the hearing, but relied on an ombudsman‘s services.
On September 22, 1993, the hearing officer found for Lumbermens, concluding that the seven percent impairment rating that Dr. Holmes—the Commission‘s designated doctor1—assigned had not been overcome by the great weight of contrary medical evidence. See
Three months after that contested case hearing became final, Dr. Heilman—the neurosurgeon recommended by Dr. Holmes—recommended that Manasco have surgery. On January 26, 1994, Dr. Heilman operated on Manasco‘s back. Believing that his condition had worsened after the surgery, Manasco requested a second conference and hearing. Manasco contended that he had experienced a “substantial change of condition,” under Texas Labor Code section 410.307, and that additional evidence should be considered on the issues of maximum medical improvement and impairment rating to increase his benefits. At the second contested case hearing on June 28, 1994, the hearing officer concluded that the prior determination of Manasco‘s impairment rating was final and could not be reopened. Manasco appealed to the Commission appeals panel, which affirmed the hearing officer‘s decision. Manasco then filed suit in district court, seeking judicial review of the Commission‘s decision. See
In the district court, the parties filed cross motions for summary judgment. Manasco argued that his impairment rating and maximum medical improvement determinations should be modified based on evidence of his “substantial change of condition” under section 410.307. In opposition, Lumbermens contended that section 410.307 was an evidentiary tool that allowed additional medical evidence to be introduced at trial, rather than a substantive provision allowing a claimant‘s impairment rating to be reopened after a final decision had been rendered. The district court granted Lumbermens’ summary judgment motion, and Manasco appealed.
The court of appeals reversed the trial court‘s judgment. It concluded that section 410.307 permits the district court to consider evidence of a substantial change of condition even though a claimant previously did not file a timely notice of appeal. 951 S.W.2d at 286. We granted Lumbermens’ petition for review on the issue of whether Manasco was entitled to reopen the determination of his impairment rating despite his failure to appeal the September 22, 1993 hearing officer‘s decision.
III
Under section 410.169 of the Act, the hearing officer‘s decision is final absent a timely appeal.
The court of appeals held that the district court could consider evidence of Manasco‘s substantial change of condition under section 410.307, even though he did not appeal his original impairment rating. Section 410.307 states, “evidence of the extent of impairment is not limited to that presented to the commission if the court, after a hearing, finds that there is a substantial change of condition.”
Based on the wording and placement of section 410.307 in the statutory framework, it is clear that section 410.307 is a rule of evidence that applies only in the judicial review of a properly appealed impairment rating decision. Section 410.307 is in the subchapter governing judicial review and is placed immediately after the provision governing the general rules of evidence for judicial review. Section 410.307 is an exception to the general rules of evidence in section 410.306, which states that “evidence shall be adduced as in other civil trials.”
The review provided by section 410.307 is available only to those parties who have already appealed the contested case hearing officer‘s decision to an appeals panel and wish to appeal the panel‘s decision to a court. The party must exhaust administrative remedies before seeking judicial review.
Manasco contends that section 410.307 is a “safety valve” provision, which allows a party another hearing at any time upon discovery of a substantial change of condition, without regard to whether the party has exhausted his administrative remedies. He argues that restricting the “substantial change of condition” provision to only those claims that are in the appeals process will provide an incentive for parties to appeal merely to preserve the opportunity to argue a potential substantial change of condition if the need later arises. To reach this hypothetical result, Manasco ignores other portions of the Act. A claimant‘s impairment rating is not final, and remains subject to revision, until the claimant reaches maximum medical improvement. Maximum medical improvement is the point when further material recovery or lasting improvement can no
The statutory framework also undercuts the court of appeals’ reasoning that “no one would intentionally want to deprive an injured worker compensation where later there developed a ‘substantial change of condition’ from the original injury.” 951 S.W.2d at 291. If the Legislature had wanted to provide an open-ended means to challenge an impairment rating, it could have done so; instead, the Legislature provided a narrow exception to allow a claimant to present evidence of substantial change of condition that is discovered for the first time during the appeal process. Courts should not interpret a statute to provide broader rights than the Legislature intended.
The clear wording of section 410.307 dictates that Manasco‘s attempt to reopen his impairment rating must fail. Manasco failed to appeal the impairment rating decided by the contested case hearing officer on September 22, 1993. Thus, he failed to exhaust administrative remedies, and the September 22, 1993 impairment rating of seven percent became final. See
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We hold that Manasco cannot reopen his impairment rating under Texas Labor Code section 410.307 because he failed to timely appeal the original impairment rating. We therefore reverse the court of appeals’ judgment and render judgment that Manasco take nothing on his claim. Because of our holding, we do not reach Lumbermens’ other points of error.
SPECTOR, J., filed a dissenting opinion.
SPECTOR, Justice, dissenting.
The Court holds today that an injured worker who fails to appeal an impairment rating and a finding of maximum medical improvement may not re-open the issue by presenting evidence of “change of condition.” Although it is well settled that workers’ compensation legislation is remedial and should be construed in favor of the worker, Lujan v. Houston Gen. Ins. Co., 756 S.W.2d 295, 297 (Tex.1988), the Court‘s judgment comports with a narrow reading of Texas Labor Code Section 410.307. Because I would hold that an injured worker can re-open his claim based on evidence of “change of condition,” I dissent.
I also write to emphasize that the Worker‘s Compensation Act that became law in 1989 is riddled with procedural pitfalls where a worker may unwittingly waive rights. In creating disincentives for attorneys to represent injured workers in the administrative process, the role of the Commission‘s ombudsman has become crucial. Yet, the record here suggests that ombudsmen may not adequately “assist unrepresented claimants ... to protect their rights in the workers’ compensation system” as they are charged with doing.
Throughout the administrative process, an uninformed worker proceeds at his or her peril. For example, a worker must raise all issues in dispute at the benefit review conference because failure to address an issue may prevent the issue from ever being raised.
Injured workers must rely on ombudsmen if fewer attorneys are willing to take workers’ compensation cases under the current Workers’ Compensation Act. See Texas Workers’ Compensation Comm‘n v. Garcia, 893 S.W.2d 504, 533 (Tex.1995). Thus, it is imperative that the ombudsmen fully inform unrepresented claimants of the consequences of their decisions at each step in the administrative adjudication process.