Texas Department of Insurance, Division of Workers' Compensation v. Linda Green

ACCEPTED 01-15-00321-CV FIRST COURT OF APPEALS HOUSTON, TEXAS 6/15/2015 6:17:53 PM CHRISTOPHER PRINE CLERK DOCKET NO. 01-15-00321-CV _____________________________________ FILED IN IN THE COURT OF APPEALS 1st COURT OF APPEALS HOUSTON, TEXAS FOR THE FIRST DISTRICT OF TEXAS 6/15/2015 6:17:53 PM HOUSTON, TEXAS CHRISTOPHER A. PRINE _____________________________________ Clerk TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS’ COMPENSATION, Appellant, v. LINDA GREEN Appellee. On Appeal from The 133rd Judicial District Court of Harris County, Texas Cause No. 2010-25688 RESPONDENT’S BRIEF David Brenner State Bar No. 2958020 Elizabeth Brenner State Bar No. 24040570 Belinda May Arambula State Bar No. 24060241 BURNS ANDERSON JURY & BRENNER, L.L.P. P.O. Box 26300 Austin, Texas 78755-6300 (512) 338-5322 (telephone) (512) 338-5363 (facsimile) Attorneys for Zurich American Insurance Company ORAL ARGUMENT REQUESTED TABLE OF CONTENTS Page INDEX OF AUTHORITIES.................................................................................... iv STATEMENT REGARDING ORAL ARGUMENT ............................................. vi ISSUE PRESENTED .............................................................................................. vii ISSUE ONE ............................................................................................................ vii Does the Declaratory Judgment Act confer jurisdiction on a court to address an issue that (1) was not timely and properly presented to the appeals panel, and (2) is statutorily subject to the judicial review process under the Texas Labor Code? ............................................................................ vii STATEMENT OF FACTS ........................................................................................1 SUMMARY OF THE ARGUMENT ........................................................................4 ARGUMENT AND AUTHORITIES ........................................................................5 ISSUE ONE (Restated) ..............................................................................................5 Does the Declaratory Judgment Act confer jurisdiction on a court to address an issue that (1) was not timely and properly presented to the appeals panel, and (2) is statutorily subject to the judicial review process under the Texas Labor Code? ...............................................................................5 A. Standard of Review ...............................................................................5 B. The Texas Labor Code limits suits for judicial review to those issues addressed by the appeals panel after the exhaustion of administrative remedies.........................................................................5 C. The Declaratory Judgment Act cannot be utilized to expand the scope of judicial review.........................................................................8 CONCLUSION ........................................................................................................12 ii PRAYER ..................................................................................................................12 CERTIFICATE OF SERVICE ................................................................................14 CERTIFICATE OF COMPLIANCE .......................................................................15 APPENDIX ..............................................................................................................16 iii INDEX OF AUTHORITIES Page Cases Beacon Nat’l Ins. Co. v. Montemayor, 86 S.W.3d 260 (Tex. App.—Austin 2002, no pet.). ..............................................8 Ben Robinson Co. v. Texas Workers’ Comp. Comm’n, 934 S.W.2d 149 (Tex. App.—Austin 1996, writ denied) ......................................8 BHP Petroleum Co. Inc. v. Millard, 800 S.W.2d 838 (Tex. 1990) ..................................................................................9 ESIS, Inc., Serv. Contractor v. Johnson, 908 S.W.2d 554 (Tex. App.—Fort Worth 1995, writ denied) ..............................6 Harris County Emergency Serv. Dist. No. 1 v. Miller, 122 S.W.3d 218 (Tex. App.—Houston [1st Dist.] 2003, no pet.) .........................7 MBM Fin. Corp. v. Woodlands Operating Co., L.P., 292 S.W.3d 660 (Tex. 2009) ................................................................................11 Strayhorn v. Raytheon E-Sys., Inc., 101 S.W.3d 558 (Tex. App.—Austin 2003, pet. denied) .......................................8 Texas Dep’t of Ins., Div. of Workers’ Comp. v. Lumbermens Mut. Cas., 212 S.W.3d 870 (Tex. 2006) ................................................................................10 Texas Liquor Control Bd. v. Canyon Creek Land Corp., 456 S.W.2d 891 (Tex. 1970) ................................................................................11 Texas Mun. Power Agency v. Pub. Util. Comm’n, 100 S.W.3d 510 (Tex. App.—Austin 2003) ........................................................12 Trinity Universal Ins. Co. v. Day, 155 S.W.3d 337 (Tex. App.—El Paso 2004, pet. denied) .....................................5 Universal Printing Co. v. Premier Victorian Homes, Inc., 73 S.W.3d 283 (Tex. App.—Houston [1st Dist.] 2001, pet. denied) .....................9 iv Weaver v. E-Z Mart Stores, Inc., 942 S.W.2d 167 (Tex. App.—Texarkana 1997, no pet.) .......................................8 Young Chevrolet, Inc. v. Texas Motor Vehicle Bd., 974 S.W.2d 906 (Tex. App.—Austin 1998, pet. denied) ...................................8, 9 Statutes TEX. LAB. CODE § 410.251 ........................................................................................5 TEX. LAB. CODE § 410.302 ........................................................................................6 v STATEMENT REGARDING ORAL ARGUMENT Respondent requests oral argument because of the complexity of the factual and legal issues presented for review. Respondent believes oral argument would assist this Court in resolving the conflicting authority on the issues. vi ISSUE PRESENTED ISSUE ONE Does the Declaratory Judgment Act confer jurisdiction on a court to address an issue that (1) was not timely and properly presented to the appeals panel, and (2) is statutorily subject to the judicial review process under the Texas Labor Code? vii DOCKET NO. 01-15-00321-CV _____________________________________ IN THE COURT OF APPEALS FOR THE FIRST DISTRICT OF TEXAS HOUSTON, TEXAS _____________________________________ TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS’ COMPENSATION, Appellant, v. LINDA GREEN Appellee. On Appeal from The 133rd Judicial District Court of Harris County, Texas Cause No. 2010-25688 TO THE HONORABLE JUSTICES OF THE FIRST COURT OF APPEALS: Zurich American Insurance Company (“Zurich”) requests that this Court reverse the Trial Court’s Order Denying Appellant’s Plea to the Jurisdiction. STATEMENT OF FACTS This lawsuit is a judicial review proceeding that arises out of a workers’ compensation claim filed by Linda Green (“Green”) with the Texas Department of Insurance, Division of Workers’ Compensation (“DWC”). Following a December 10, 2009 contested case hearing, the only issue to be decided was: “Does the 1 compensable injury of August 2, 2005 sustained by the claimant extend to include the left ankle fracture, compression fracture L1 and T12-L2 conditions on or after 7/29/09?”1 The hearing officer decided that the compensable injury of August 2, 2005 sustained by the claimant does not extend to include the left ankle fracture, compression fracture L1 and T12-L2 conditions on or after 7/29/09.2 No other issues were decided by the hearing officer. Specifically, there was no challenge or issue relating to the validity of the injurious practice defense. Green filed a request for review to the DWC appeals panel.3 In her request for review, Green did not challenge the hearing officer’s consideration of her injurious practices.4 Green limited her request for review to certain findings of fact, conclusions of law, and evidentiary issues, but it is completely devoid of a challenge to the defense of injurious practices.5 On April 22, 2010, Green filed an original petition seeking judicial review of four issues never decided by DWC.6 First, whether the claimant did not comply with physical therapy on several occasions; second, removal of cast; third, medication; and fourth, hindered recovery. No other issues were raised by judicial review and no relief was specifically requested of the trial court. Again, 1 CR 7. 2 Id. 3 Appendix No. 1. 4 Id. 5 Id. 6 CR 1. 2 specifically, there was no objection or request for declaratory relief sought with respect to the injurious practices. On September 12, 2011, after the statute of limitations for judicial review proceedings expired, Green filed an amended petition, for the first time seeking review of the DWC’s decision and a declaratory action.7 Through the declaratory action, Green, for the first time, complained that the DWC hearing officer inappropriately permitted the defense of injurious practices. Zurich filed a Plea to the Jurisdiction challenging the trial court’s authority to entertain Green’s declaratory judgment action.8 The DWC intervened in the litigation, also challenging the trial court’s authority to entertain a declaratory judgment action.9 After a hearing, the trial court denied both Pleas to the Jurisdiction.10 Zurich filed an Original Petition for Writ of Mandamus on December 3, 2012.11 This Court issued a Memorandum Opinion denying the Writ on October 22, 2013.12 DWC filed a second Plea to the Jurisdiction addressing Green’s request for declaratory judgment and attorneys’ fees under the Uniform Declaratory Judgment Act “(UDJA”) on February 11, 2015.13 A hearing on the second Plea to the Jurisdiction was held on March 2, 2015; the trial court denied 7 See CR 17. 8 Appendix No. 2. 9 CR 23. 10 CR 50. 11 Appendix No. 3. 12 Appendix No. 4. 13 CR 54. 3 TDI-DWC’s plea.14 DWC then filed an accelerated appeal on March 23, 2015.15 SUMMARY OF THE ARGUMENT In workers’ compensation cases, judicial review is limited to issues decided by the appeals panel, and a party may not seek review on issues the party did not present to the appeals panel. A trial court may not enlarge this scope of review by considering issues, or evidence probative of issues, that were not determined by the DWC appeals panel. Nor may a party circumvent the statutorily mandated limitations by asserting a declaratory judgment action. When a statute provides an avenue for attacking a final agency order, a declaratory judgment action directed at that order will not lie. This is so because a party is generally not entitled to redundant remedies. When both the underlying suit and the declaratory judgment action attack the validity of an administrative order, the court should dismiss the request for declaratory relief for want of jurisdiction. Green never challenged the availability of the defense of injurious practices at the administrative level. It was not until the pendency of judicial review that Green, for the first time, sought a declaration that the defense of injurious practices was invalid. The declaratory judgment action is not properly before the trial court. Therefore, the trial court erred in denying DWC’s Plea to the Jurisdiction. 14 CR 107. 15 CR 108. 4 ARGUMENT AND AUTHORITIES ISSUE ONE (Restated) Does the Declaratory Judgment Act confer jurisdiction on a court to address an issue that (1) was not timely and properly presented to the appeals panel, and (2) is statutorily subject to the judicial review process under the Texas Labor Code? A. Standard of Review A plea to the jurisdiction is a dilatory plea used to contest the trial court’s authority to determine the subject matter of the cause of action.16 The purpose of a dilatory plea is not to review the case on the merits, but to establish a reason why the merits should never be reached.17 Whether a trial court properly denies a plea to the jurisdiction is a question of law examined under a de novo standard of review.18 B. The Texas Labor Code limits suits for judicial review to those issues addressed by the appeals panel after the exhaustion of administrative remedies. The Texas Labor Code provides that a party that has exhausted its administrative remedies under this subtitle and is aggrieved by a final decision of the appeals panel may seek judicial review.19 The Texas Labor Code limits the issues that can be raised on judicial review at trial to those issues decided by the appeals panel, as follows: “(b) A trial under this subchapter is limited to issues 16 Trinity Universal Ins. Co. v. Day, 155 S.W.3d 337, 339 (Tex. App.—El Paso 2004, pet. denied). 17 Id. 18 Id. 19 TEX. LAB. CODE § 410.251. 5 decided by the appeals panel and on which judicial review is sought.”20 The pleadings must specifically set forth the determinations of the appeals panel by which the party is aggrieved.21 There is no provision in the Texas Workers’ Compensation Act authorizing the trial court to enlarge this scope of review by considering issues, or evidence probative of issues, that were not determined by the DWC appeals panel.22 Texas courts explain that a failure to raise a defense and, by logical extension. a challenge to the defense at any stage of the administrative review process waives the defense and, by extension, a challenge to the defense. 23 In ESIS, Inc. Serv. Contractors v. Johnson, the court explained that the employer’s failure to raise the intoxication defense at the administrative review process waives the defense and the trial court is barred from adjudicating the issue on appeal. The court held that the defense must be raised by the employer at the administrative level in order to be preserved for appeal to the trial court. Green never raised a challenge to the availability or validity of the injurious practice defense at the administrative level. Green never challenged the availability of the defense of injurious practices at the administrative level. It was not until September 13, 2011, during the 20 TEX. LAB. CODE § 410.302. 21 Id. 22 ESIS, Inc., Serv. Contractor v. Johnson, 908 S.W.2d 554 (Tex. App.—Fort Worth 1995, writ denied) 23 Id. at 562. 6 pendency of judicial review, that Green, for the first time, objected to the defense of injurious practices and sought a declaration that the defense is invalid. This issue was not properly before the trial court. The validity of the defense was never raised during the administrative review phase. Issues that were not decided at the contested case hearing, or by the appeals panel, pursuant to section 410.302 of the Texas Labor Code, cannot be raised for the first time at trial. Thus, the trial court lacks jurisdiction to entertain issues not decided by the appeals panel. Moreover, challenges to the defense that are never raised at the administrative level are waived. In Harris Co. Emergency Serv. Dist. v. Miller, the Houston Court of Appeals explained that HCESD’s failure to respond to Miller’s request for review of the contested case hearing officer’s decision to the DWC appeals panel was a failure to exhaust administrative remedies.24 The court held because HCESD failed to establish its right to proceed on judicial review, the trial court should have rendered a take-nothing judgment. The court further noted “[t]he vitality and thoroughness of the agency-review process will fast be diluted if parties are allowed the option to participate or not in the successive phases.” 25 Likewise, here, Green did not raise a challenge to the defense of injurious practices on request for 24 Harris Co. Emergency Serv. Dist. No. 1 v. Miller, 122 S.W.3d 218 (Tex. App.—Houston [1st Dist.] 2003, no pet.) 25 Id. at 225. 7 review to the appeals panel. Green should not be permitted to dilute the agency review process by raising it for the first time under the guise of a declaratory judgment action that challenges the finality of an appeals panel decision. The fact that Green appeared pro se has no impact on the requirements of the review process. Courts have consistently held that pro se litigants must comply with all procedural requirements and are subject to the same standards applicable to a licensed attorney.26 C. The Declaratory Judgment Act cannot be utilized to expand the scope of judicial review. To establish a trial court’s subject-matter jurisdiction to grant relief under the UDJA, a party must plead the existence of an “underlying controversy” within the scope of section 37.004 of the Civil Practice and Remedies Code.27 However, the power of courts to issue declaratory judgments in the face of administrative proceedings is limited.28 When a statute provides an avenue for attacking a final agency order, a declaratory judgment action directed at that order will not lie.29 This is so because a party is generally not entitled to redundant remedies.30 “There is no basis for declaratory relief when a party is seeking in the same action a 26 Weaver v. E-Z Mart Stores, Inc., 942 S.W.2d 167, 169 (Tex. App.—Texarkana 1997, no pet.). 27 Strayhorn v. Raytheon E-Sys., Inc., 101 S.W.3d 558, 572 (Tex. App.—Austin 2003, pet. denied). 28 Beacon Nat’l Ins. Co. v. Montemayor, 86 S.W.3d 260, 267 (Tex. App.—Austin 2002, no pet.). 29 Id.; Young Chevrolet, Inc. v. Texas Motor Vehicle Bd., 974 S.W.2d 906, 911 (Tex. App.— Austin 1998, pet. denied); Ben Robinson Co. v. Texas Workers’ Comp. Comm’n, 934 S.W.2d 149, 153 (Tex. App.—Austin 1996, writ denied). 30 See Young Chevrolet, 974 S.W.2d at 911; Ben Robinson, 934 S.W.2d at 153. 8 different, enforceable remedy, and a judicial declaration would add nothing to what would be implicit or express in a final judgment for the enforceable remedy.”31 When both the underlying suit and the declaratory judgment action attack the validity of an administrative order, the court should dismiss the request for declaratory relief for want of jurisdiction.32 Here, Green’s judicial review suit regarding whether her compensable injury was the producing cause of particular injuries after July 29, 2009 was pending before the trial court when Plaintiff amended her petition seeking a declaratory judgment action. To succeed on judicial review, Green must establish that the work injury was the producing cause of her conditions after July 29, 2009. In an effort to avoid this burden, Green artfully, through declaratory judgment action, requested the trial court declare that her injurious practices cannot be a basis for finding the work injury was not the producing cause of her conditions after July 29, 2009. Texas precedent holds that declaratory judgment actions are not available to settle disputes pending before a court.33 Thus, Green cannot artfully plead, through the guise of declaratory judgment action, for the court to rule upon an element of her cause of action that is already pending before the trial court.34 Both statute and case law carve out a limited and precise role for declaratory 31 Universal Printing Co. v. Premier Victorian Homes, Inc., 73 S.W.3d 283, 296 (Tex. App.— Houston [1st Dist.] 2001, pet. denied). 32 See, Young Chevrolet, Inc., 974 S.W.2d at 911. 33 BHP Petroleum Co. Inc. v. Millard, 800 S.W.2d 838 (Tex. 1990). 34 Id. 9 judgments under the UDJA. The UDJA is not meant to supplant other remedies, including the exclusive remedy provision under the Texas Labor Code. Nor is the UDJA meant to address specific agency orders. Zurich anticipates Green will cite to the Lumbermens35 decision for support when, in fact, Lumbermens supports Zurich’s position. The case involved a carrier’s use of declaratory judgment to challenge the Division of Workers’ Compensation’s issuance of advisories. The Lumberman court authorized use of UDJA under this circumstance because the declaratory judgment did not target the appeals panel holding regarding the specific advisory; instead, it complained about the broader concern of the Division’s role in the issuance of advisories.36 At the same time, the court reiterated that a declaratory judgment cannot be used to challenge a specific Division decision.37 Accordingly, “when a statute provides a specific method for attacking an agency order, a declaratory judgment action directed at that order will not lie.”38 Here, the Texas Labor Code provides the exclusive means for challenging the DWC appeals panel finding. Green will also likely cite to MBM Fin. Corp. v. Woodlands Operating Co. for the proposition that the existence of another remedy does not bar a declaratory judgment action. Yet, the Texas Supreme Court, citing the Federal Rules of Civil 35 Texas Dep’t of Ins., Div. of Workers’ Comp. v. Lumbermens Mut. Cas., 212 S.W.3d 870 (Tex. 2006). 36 Id. at 874. 37 Id. at 875. 38 Id. 10 Procedure, stated, “The existence of another adequate remedy does not preclude a declaratory judgment that is otherwise appropriate.”39 In the next sentence, the Court reiterates the UDJA “cannot be invoked when it would interfere with some other exclusive remedy or some other entity’s exclusive jurisdiction.”40 Any reliance by Green on Texas Liquor Control Board v. Canyon Creek or Texas Mun. Power Agency v. Pub. Util. Comm’n is equally misplaced. In Texas Liquor Control Board, the Texas Supreme Court refused to authorize use of declaratory judgment to circumvent the administrative process for addressing a suspended liquor license.41 Again, the Court explained that an action for declaratory judgment will not be considered when there is another pending action between the parties that will adjudicate the same issues.42 The Austin Court of Appeals also dealt with this issue at length in Texas Mun. Power Agency v. Public Util. Comm’n. The case involved a suit for judicial review in district court challenging an order of the Public Utility Commission (PUC) and a subsequently filed UDJA action asking the court to construe chapters of the Public Utility Regulatory Act. The appeals court allowed both actions to proceed because the UDJA action did not duplicate the issues under judicial 39 MBM Fin. Corp. v. Woodlands Operating Co., L.P., 292 S.W.3d 660, 669 (Tex. 2009)(emphasis added). 40 Id. 41 Texas Liquor Control Bd. v. Canyon Creek Land Corp., 456 S.W.2d 891, 895-96 (Tex. 1970). 42 Id. 11 review–each action sought a distinct type of relief.43 The UDJA action sought a declaration regarding the agency’s authority, generally, under provisions of the regulatory act; while the suit for judicial review sought a ruling on a specific PUC order.44 However, here, the relief Green seeks through declaratory judgment is indistinct from relief available through the administrative process. Green attempts to use declaratory relief to bypass the administrative process by obtaining a ruling on the DWC order. This is not a proper use of a declaratory judgment order. Thus, the declaratory judgment action is not properly before the trial court and this Court should reverse the trial court’s denial of the Plea to the Jurisdiction. CONCLUSION In sum, Green cannot utilize the UDJA as an avenue for relief on the injurious practices issue. The issue was not raised at the administrative level and, thus, it was waived. As Green may not seek relief under the UDJA, her claim regarding the defense of injurious practices is barred. PRAYER WHEREFORE, PREMISES CONSIDERED, Respondent, Zurich American Insurance Company respectfully requests that this Court reverse the trial court’s Order Denying Texas Department of Insurance, Division of Workers’ 43 Texas Mun. Power Agency v. Pub. Util. Comm’n, 100 S.W.3d 510, 519 (Tex. App.—Austin 2003). 44 Id. 12 Compensation’s Plea to the Jurisdiction, and for such other and further relief to which Respondent may be entitled. Respectfully submitted, BURNS ANDERSON JURY & BRENNER, L.L.P. P.O. Box 26300 Austin, Texas 78755-6300 (512) 338-5322 (telephone) (512) 338-5363 (facsimile) /s/ David Brenner David Brenner State Bar No. 02958020 Elizabeth Brenner State Bar No. 24040570 dbrenner@bajb.com Belinda May Arambula State Bar No. 24060241 barambula@bajb.com COUNSEL FOR RESPONDENT 13 CERTIFICATE OF SERVICE This is to certify that a true and correct copy of the foregoing pleading has been forwarded to all parties listed below, on this 15th day of June 2015 in accordance with Rule 9.5 of the Texas Rules of Appellate Procedure. Ken Paxton, Texas Attorney General Charles E. Roy, First Assistant Attorney General James E. Davis Deputy Attorney General for Civil Litigation David A Talbot, Jr. Chief, Administrative Law Division Dennis M. McKinney Assistant Attorney General Office of the Texas Attorney General Administrative Law Division P. O. Box 12548 Austin, TX 78711-2548 Bradley Dean McClellan Law Offices of Richard Pena, P.C. 1701 Directors Blvd. Suite 110 Austin, TX 78744 Raymond L. Kalmans Stephen L. Brochstein Schlanger, Silver, Barg & Paine, LLP 109 North Post Oak Lane, Ste. 300 Houston, TX 77024 /s/David Brenner David Brenner 14 CERTIFICATE OF COMPLIANCE This brief complies with the type-volume limitation of Texas Rule of Appellate Procedure 9.4 because this brief contains 3,357 words. This brief complies with the typeface requirements of Texas Rule of Appellate Procedure 9.4 because this brief has been prepared in a proportionally spaced typeface using Microsoft Word 2010 in Times New Roman 14 point. /s/ DAVID BRENNER 15 APPENDIX 1. Green’s Request for Review 2. Zurich American Insurance Company’s Plea to the Jurisdiction 3. Zurich American Insurance Company’s Original Petition for Writ of Mandamus 4. First Court of Appeals Memorandum Opinion 5. TEX. LAB. CODE § 410.251 6. TEX. LAB. CODE § 410.302 16 APPENDIX I LINDA GREEN PAGE 02 01/07/2010 16:39 8324525761 2:5 l1mm1a 01/37/2010 99: 4'3 932.15267&) Of:'1:~.t-) Ill" t.~jUrftd ffimpkty4~e ~~c:.;'t• , \llnlorld r'IHa r'Hfl,:·< TEXAS Dlil'AATM:E..NT 01' lNStiM.NCll !J[VISION OF WORRtllS' CO~U>ENSATION jAN Ui Z~!l! aEFORE THl! ,\..!'PEALS PANEL AVSTJN. TEXAS lj : I;«~No, 1/.Z::,t'JS ·!9 ?cH.,z 1·~/"C_t;.ta:;., ~ ~ .... - . 'rO Till: HONORA:all.!i' MliMSE:RS Ol' il:lE AP!'%\LS l'A..''El.. My OP.m~/111·lln !findings <>fl'nct. Col)cl~JS!(lllt oflllw !Qld othar $p<:'Qilk malt<'n ie!lJ«ll;l,z tb.e Dcci$lotl ll!d O!'d~r l~u~ by th~ H<1Sritlg O!llcor tn llli.s llllltlt:'t. 11711 listing tnch ditn~mcut !"fJIWI1•IJt below. 01/07/2010 THU 16:37 [TX/RX NO 67BO] laJ002 PAGE 03 LINDA GREEN Bl/07/2010 16:39 8324525761 q):S~:24 p,m OHJ1-1CIQ l:l 3611763)16 PAGI!; 63 91;B7;~ete aa;49 ea2~s~~7s1 Otfior c.,f ~f!J ure~~ E!l•1pl1;J ( oe Cf.H\11 r.! ~ 1 JAN f) 7 . \lf{:f~Hl~ Hc!f3 Oi!i:~i$ 2i\t(J ~LAJMANI'S 1\&QI.!ULFOJS Rlf/Vft\y TO THE f!OC\ORA.BU ~"lEi\ ERS OE' THE APPeALS PA."-'EI.: My n~~m4' f ::.) .. .hi /'.L<---.. - · r 11111 tile Claim1111t in ti:Ua nmm. t IIUJ tllill$ thill RfL.ttw and othef S[l«r io.lhi• m.tter. ram Ustln1 e~h di~¥~U~11t!JI ~!Giy bel-ow. """'~ u. ~~~ 1dis•~ w!tb Findi!ll off'~! Number~----- bite•~ ----~---·---·--~-------·--~----~ _ _ _ _ _ _ _ _ ,....,......__,Ko- I di~~ wltb Finding of Filet Nlill'lbl!l' _ _ __ -· ) . . ,_, ..... . fTX/RX NO A7A01 ~nn~ 01/07/2010 THU 18 37 LINDA GREEN PAGE 04 01/07/2010 16:39 8324525761 4 !l 1615763;16 01/07/2010 THU 18:87 [TX/RX NO 87801 Gt!004 · Bl/07/2010 16:39 8324525761 LINDA GREEN PAGE 05 03:56:54 ~.m. 01-0HCIO 5 ;I J615763SI6 f1,AI:\1ANU\ REOPE.Sl' FOR REVJE \! ATTAChMENT: Claltnonlll·inda Or~» Carrlerr Zurich Amerio:an Jnsura11ce II f disagree with Finding uf'Fact Number .::l_be.:nps~ Medical from Ortbopnodk C~nl!lr In (claimant exll2) states a cundition ofpareslholas, nurubness QQd pain down loft leg would be JK!rmanent du" to the injlll')' to my t.l vertebJ·I'Ie body aud tile !'11Sidu!tl n~uropothy, (Pg l) slatos l ~IY be n•c~ssar.v h• th~ fi•ture. Also (f.ltdlwmt ~~#5) medical rec.ot'ds from Dr. Ronald Moon from Octllber ZIJ()II tl!rt)ugh March 2009 shows tbe need fo)r .;on tinned lfelltmr.nt and m~dleatlons. (clahn~ltf!J ex#6) Th•rapy ll.e<:ords whi~h .~flOW f WIJS Cd treatment I$ needed and lhnt J have been ~nmpliant. (claimants ex#lO) Medical rep•u1 from deslguat~d d<~etor:tl1S~ssed a 55% Impairment. (clnim~nt.9 exiiU) Medical Report fl-om Dr. William Luphl!lCcl show' tbaH huve contlnutd problems and tbatl need reFerrals !'or treat~nent of my llljurloo. (dnlntant ex#l4)1\tedlcal from Dr. Michael l(eudtic.k stales he r~vlewod my extelJII.Ive records and l'it1d~ I need epidurals o>nd medlmtlmJ,,, HI I dl.'l'l~ with Conclusion of LHl'' Number J..bC<'>luse Medical from Otthopnedlc Center Jn (cllllin~lll e~JI2) ~tate~ n conditio11 of par~Htheias, numbness and pain d()Wlt lefll•g would be permanent due t11 the injury to IIIJ' J,.1 vertebrae body and the residual neuroputhy, (t>g 2) states 1 will bave rltrorlic p~ln, b~ l1') ahrace permanently, ~pg8) notes utber surgery 11.1ny lie I):.:#lOJ Medlcalrtport from designated I doett1r WJIJ<)$-'Itd A 55% lo!pltkm~D.t. (claimants ex#l2) Medical Report {~om Dr. ' Wlll.ilun Lupiuacd shows that l bl!•e ''Ontin"f"/ probl\'hls IU!d tbnt I need ref~rrals fl.lt lfeatment of illy tl!.lmi~s. (clruruant o:xill4) :W:edl