PJC General Negligence 2024

W ORKERS ’ C OMPENSATION —L IFETIME I NCOME B ENEFITS

PJC 25.3

PJC 25.3 Accrual Date—Question If you answered “Yes” to Question [ 25.2A ], then answer the following ques tion. Otherwise, do not answer the following question. QUESTION ______ On what date did the condition found by you in response to Question ______ begin? Answer with a date in the blank below. Answer: _______________ COMMENT When to use. Lifetime income benefits (LIBs) accrue and become payable on the date that the injured employee suffers from one of the conditions listed in Tex. Lab. Code § 408.161(a) or Tex. Lab. Code § 408.161(b). PJC 25.3 should be used if there is a dispute about the beginning date of a qualifying condition listed in Tex. Lab. Code §408.161(a). PJC 25.4 should be used if there is a dispute about the permanence of a qualifying condition listed in Tex. Lab. Code §408.161(a). The question may be revised to track the statutory language for the particular qualifying condition under consideration. Source of question and instructions. Tex. Lab. Code §408.161(a)(2)–(5) refers to the loss of certain enumerated members. Such losses, by their nature, are perma nent. Tex. Lab. Code § 408.161(b) provides that the total and permanent loss of use of a body part is the loss of that body part. Thus, a claim for LIBs under a total loss of use theory requires a finding (or conclusive evidence) that any such total loss of use be permanent. Region XIX Service Center v. Banda , 343 S.W.3d 480, 485 (Tex. App.—El Paso 2011, pet. denied). The Texas Workers’ Compensation Act does not define “per manent” for purposes of Tex. Lab. Code § 408.161. The Code states that “[a]n employee is entitled to timely and accurate income bene fits as provided in this chapter” and further requires that income benefits be paid weekly without action by the commissioner. Tex. Lab. Code §408.081(a), (b). LIBs are to be paid when the permanent loss of use of certain body parts occurs. Tex. Lab. Code § 408.161. Thus, when viewed in context, the statute requires that carriers begin paying benefits to employees once eligibility is established. There is no restriction on when such eligibility may be established. Rather, the statute contemplates that when ever a compensable injury leads to a qualifying permanent loss of use, eligibility occurs and the employee becomes entitled to permanent LIBs. Tex. Lab. Code § 408.161(a); Liberty Mutual Insurance Co. v. Adcock , 412 S.W.3d 492 (Tex. 2013).

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