DeLeon v. Royal Indem. Co.

Annotate this Case

Petitioner suffered an injury while in the course and scope of his employment. The employer's workers' compensation insurance carrier paid medical benefits but contested the extent of Petitioner's entitlement to impairment income benefits. The Department of Insurance's Workers' Compensation Division determined that Petitioner had an impairment rating of twenty percent. The trial court reversed the agency's decision, ruling that Petitioner had no valid impairment rating. The court of appeals affirmed. While Petitioner's appeal to the Supreme Court was pending, the Court held in American Zurich Insurance Co. v. Samudio that the absence of a valid impairment rating that had been submitted to the agency did not deprive a reviewing court of subject matter jurisdiction. In light of its decision in Samudio, the Court then reversed and remanded to the trial court with instructions that the court remand the case to the Division in light of its determination that Petitioner had no valid impairment rating.

Download PDF

IN THE SUPREME COURT OF TEXAS 444444444444 NO . 10-0319 444444444444 SEVERIANO DELEON, PETITIONER, v. ROYAL INDEMNITY COMPANY, RESPONDENT 4444444444444444444444444444444444444444444444444444 ON PETITION FOR REVIEW FROM THE COURT OF APPEALS FOR THE THIRD DISTRICT OF TEXAS 4444444444444444444444444444444444444444444444444444 PER CURIAM In this case, the trial court determined that an injured worker had been assigned no valid impairment rating upon which to base impairment income benefits under the Texas Workers Compensation Act, TEX . LAB. CODE §§ 401.001 506.002. The court of appeals affirmed. ___ S.W.3d ____. In doing so, the court noted that no mechanism exists in the [Workers Compensation] Act to remand matters back to [the Department of Insurance s Workers Compensation Division]. ___ S.W.3d at___. We reverse and remand to the trial court with instructions to remand to the Division. Severiano DeLeon suffered a back injury while in the course and scope of his employment. More than a year later, he had spinal fusion surgery. DeLeon s employer s workers compensation insurance carrier, Royal Indemnity Co., paid medical benefits, but contested the extent of his entitlement to impairment income benefits. Section 408.123 of the Labor Code requires that an impairment rating be based upon the Guides to the Evaluation of Permanent Impairment published by the American Medical Association. TEX . LAB. CODE § 408.123. The designated doctor appointed by the Division determined that DeLeon had an impairment rating of twenty percent. The doctor based that decision on two Advisories issued by the Division to guide the calculation of impairment ratings for workers who had undergone spinal surgery and who had not had pre-operative spinal flexion x-rays. The hearing officer accepted the designated doctor s rating and the Division s appeals panel upheld the examiner s decision. Royal Indemnity appealed the Division s decision to the trial court. While the appeal was pending, the court of appeals for the Third District decided Texas Department of Insurance Division of Workers Compensation v. Lumbermens Mutual Casualty Co., 212 S.W.3d 870 (Tex. App. Austin 2006, pet. denied). In that case, the court held that the Division acted ultra vires in issuing the Advisories, which provided for the calculation of impairment ratings not based on the Guides, id. at 876 77, and the Division later repealed them, Tex. Dep t of Ins. Commissioner s Bull. No. 3 0033 07 (July 18, 2007). Based on Lumbermens, the trial court reversed the agency s decision and ruled that DeLeon had no valid impairment rating. The court of appeals affirmed. ___ S.W.3d at ___. While DeLeon s appeal to this Court was pending, we handed down our decision in American Zurich Insurance Co. v. Samudio, ___ S.W.3d ____ (Tex. 2012). In Samudio, we held that the absence of a valid impairment rating that had been submitted to the agency did not deprive a reviewing court of subject matter jurisdiction. ___ S.W.3d at ___. We also held that the Workers Compensation Act permits a court to remand to the Division if it decides that the worker has no valid 2 impairment rating. ___S.W.3d at ___. In light of our decision in Samudio, and pursuant to Texas Rule of Appellate Procedure 59.1, without hearing oral argument, we reverse the court of appeals judgment and remand to the trial court with instructions that the court remand the case to the Division in light of its determination that DeLeon has no valid impairment rating. OPINION DELIVERED: November 16, 2012 3

Some case metadata and case summaries were written with the help of AI, which can produce inaccuracies. You should read the full case before relying on it for legal research purposes.

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.