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Texas Workers' Compensation Appeals Panel Decision 110391

Case Conclusion Date: 01.01.2012

Practice Area: Workers compensation

Outcome: Hearing Officer found the compensable injury was not a cause of the death; however, the Carrier had waived their right to dispute the Death benefits and thusly the spouse and the decedent's dependent child were entitled to Death benefits.

Description: Injured Employee died one year post injury, spouse filed claim for Death benefits. Carrier failed to file a denial of the Death benefits claim within 60-days, although they had denied the injury previously. At the time of the death there was no issue regarding compensability of the original injury. Insurance Carrier argued they were not required to dispute the Death benefits claim as they had originally denied the compensable injury a year previous. Additionally, Carrier argued the spouse could not demonstrate the compensable injury was a cause of the injured employee's death. Claimant argued, the Texas Labor Code and Texas Administrative Code has separate and distinct requirements for disputing a Death benefits claim and as the Carrier did not dispute the Death benefits claim in a timely manner, they had waived their right to do so. Oddly, this seems to have been a case of first impression.

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