PJC General Negligence 2024

PJC 25.4

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

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). See also Mid-Century Insurance Co. v. Texas Workers’ Compensation Commission , 187 S.W.3d 754, 759 (Tex. App.—Austin 2006, no pet.), in which the court stated: The legislature specifically reserved [lifetime income benefits] for seven enumerated categories of injurious conditions that include both immedi ately qualifying injuries and those evolving or deteriorating over time. It further provided that LIBs are payable “for” those conditions . . . [and] become payable if and when an employee becomes eligible to receive them . . . . Once an employee is adjudicated eligible to receive LIBs, . . . LIBs should be paid retroactively to the date the employee first became eligible. Mid-Century Insurance Co. , 187 S.W.3d at 759. First responders serious bodily injury qualifier. The 2023 addition of a serious bodily injury qualifier for first responders appears to have created an exception to the Texas Supreme Court’s holding in Adcock that a carrier may not reopen the issue of a claimant’s entitlement to LIBs once the claimant has been determined entitled by the agency or a court. See PJC 25.9 comment regarding periodic review of continuing entitlement under Tex. Lab. Code § 408.1615(b).

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