PJC General Negligence 2024

PJC 20.4

W ORKERS ’ C OMPENSATION —T IMELINESS OF R ESPONDING

PJC 20.4 Claim for Compensation to the Division—Question PJC 20.4A Claim for Compensation to the Division—Question— When Claimant Appeals QUESTION ______ Did Paul Payne file a claim with the Texas Department of Insurance, Divi sion of Workers’ Compensation, within one year of the date of his injury? Answer “Yes” or “No.” Answer: _______________ PJC 20.4B Claim for Compensation to the Division—Question— When Carrier Appeals QUESTION ______ Did Paul Payne fail to file a claim with the Texas Department of Insurance, Division of Workers’ Compensation, within one year of the date of his injury? Answer “Yes” or “No.” Answer: _______________ COMMENT When to use. PJC 20.4 should be used if there is a dispute about whether the worker filed a claim with the Division of Workers’ Compensation of the Texas Depart ment of Insurance (DWC) and the carrier has disputed the claim. Burden of proof. The burden of proof should be placed appropriately in accor dance with the decision of the appeals panel. See PJC 15.1. Source of question and instruction. PJC 20.4 is based on Tex. Lab. Code §§ 409.003, 409.004. Evidence of more than one injury. If there is evidence of more than one injury, the date of the injury inquired about should be included in the question. Failure to file employer’s first report of injury. If an employer or the employer’s insurance carrier has been given notice or has knowledge of an injury to or the death of an employee and the employer or insurance carrier fails, neglects, or refuses to file the report required under Tex. Lab. Code § 409.005, the period for filing a claim for compensation under sections 409.003 and 409.007 does not begin to run

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