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Gulf Insurance v. Hennings

Court of Appeals of Texas, Tenth District, Waco
Jul 11, 2007
No. 10-06-00192-CV (Tex. App. Jul. 11, 2007)

Opinion

No. 10-06-00192-CV

Opinion delivered July 11, 2007.

Appeal from the 393rd District Court Denton County, Texas, Trial Court No. 2003-60010-393.

Before Chief Justice Gray, Justice Vance, and Justice Reyna (Chief Justice Gray dissenting).


OPINION


This is a workers' compensation case of first impression involving a professional athlete, as that term is defined by section 406.095(a) of the Texas Labor Code. TEX. LAB. CODE ANN. § 406.095(a) (Vernon 2006). Because we determine that a professional athlete who accepts the benefits available under his contract or collective bargaining agreement cannot recover under our compensation law, we reverse the judgment of the trial court and render a take-nothing judgment.

The provisions of the Labor Code providing Workers' Compensation benefits will be referred to as "the Act."

Background

The facts are largely undisputed. Chad Hennings was a defensive lineman for the Dallas Cowboys Football Club, Ltd. from 1992 through March of 2001. In October 2000, he suffered a neck injury during a game. Dr. Andrew Dossett and Dr. Dan Cooper, the team physicians, evaluated the injury. Following several MRI exams, they concluded that Hennings had sustained an injury to his spinal cord at the C3-4 level. The third and fourth segment of a cervical disc had degenerated and was pressing on his spinal column. In November 2000, he underwent surgery for cervical fusion at the C3-4 disc space. Upon release from the hospital, Hennings was required to wear a neck brace for six weeks and was unable to play for the remainder of the season.

The Cowboys notified the National Football League (NFL) that Hennings was on the injured reserve list as of November 8, 2000, and estimated that it would take six months for him to regain "game condition." This estimate was certified by Dr. Cooper. In January, Hennings began rehabilitation and working out in the team weight room.

Following consultation with his doctor and family, Hennings decided to retire in June 2001. He testified that he was not prohibited from playing in the NFL but that he chose not to return because of the risk of injury. He continued working with a physical therapist for eight weeks after he was released from Dr. Dossett's care upon his retirement. The team paid his medical expenses in the total amount of $38,921.98, and at the time of trial, Hennings had not seen a doctor in two years.

On March 7, 2001, however, the Cowboys terminated Hennings' contract and issued a "Notice of Termination" letter to the NFL. The Notice indicated that the reason for termination was that his "skill or performance [had] been unsatisfactory as compared to that of other players competing for positions on the Club's roster." Hennings received two payments from the team after his termination: $87,500 as severance pay based on his years in the league, and $225,000 as provided by the "injury-protection clause" of the NFL Collective Bargaining Agreement.

Compensation Proceedings

Because he believed that he is entitled to lifetime medical benefits under the Act, medical benefits having expired when his employment contract with the Dallas Cowboys was terminated, Hennings filed an application for compensation benefits.

An administrative judge determined, after a contested case hearing, that Hennings is not barred from pursuing workers' compensation benefits although he received benefits under a professional athlete's contract and collective bargaining agreement. Gulf Insurance Company appealed to a Texas Workers' Compensation Commission appeals panel, which affirmed the decision of the administrative judge. Gulf Insurance Company then filed suit in the 393rd Judicial District of Denton County, seeking judicial review of the panel's decision. After a trial, a jury found that Hennings was disabled as the result of a compensable injury and that the benefits available under his contract and collective bargaining agreement were not equal to or greater than the benefits available under the Texas Workers' Compensation Act. Gulf Insurance Company now appeals that judgment, and Hennings appeals that portion of the trial court's judgment that limited his temporary income benefits to fifteen weeks.

Professional Athletes

Section 406.095 of the Act pertaining to professional athletes provides:

a) A professional athlete employed under a contract for hire or a collective bargaining agreement who is entitled to benefits for medical care and weekly benefits that are equal to or greater than the benefits provided under this subtitle may not receive benefits under this subtitle and the equivalent benefits under the contract or collective bargaining agreement. An athlete covered by such a contract or agreement who sustains an injury in the course and scope of the athlete's employment shall elect to receive either the benefits available under this subtitle or the benefits under the contract or agreement.

b) The commissioner by rule shall establish the procedures and requirements for an election under this section.

TEX. LAB. CODE ANN. § 406.095 (Vernon 2006).

The Texas Department of Insurance, Division of Workers' Compensation, adopted Rules 112.401 and 112.402 to implement section 406.095. Rule 112.401(a) provides:

(a) A professional athlete employed by a franchise with workers' compensation insurance coverage and subject to the Texas Labor Code, § 406.095, shall elect to receive either the benefits available under the Act or the equivalent benefits available under the athlete's contract or collective bargaining agreement. The election shall be made not later than the 15th day after the athlete sustains an injury in the course and scope of employment. If the athlete fails to make an election, the athlete will be presumed to have elected the option which provides the highest benefits.

28 TEX. ADMIN. CODE § 112.401(a). Rule 112.402(a) provides:

(a) Medical care available to a professional athlete subject to the Texas Workers' Compensation Act (the Act), Texas Labor Code, § 406.095, is equal to or greater than medical benefits under the Act if:

(1) the athlete is entitled to all health care reasonably required by the nature of the work-related injury as and when needed, including all health care that:

(A) cures or relieves the effects naturally resulting from the work-related injury;

(B) promotes recovery; or

(C) enhances the ability of the employee to return to or retain employment; and

(2) the employer's liability for health care is not limited or terminated in any way by the contract or collective bargaining agreement.

28 TEX. ADMIN. CODE § 112.402(a).

Subsections (b), (c), and (d) of Rule 112.402 provide the tests to determine which income benefits are higher. 28 TEX. ADMIN. CODE § 112.402(b), (c), (d).

Positions on Appeal

Relying on Rule 112.402(a), Hennings argues that he was not required to make an election because the medical benefits provided by his contract were not equal to or greater than the lifetime medical benefits provided under the Act. He argues that because his medical benefits were limited by his contract to "the term of [his] contract as the Club physician may deem necessary," the medical benefits provided by the contract were not equal to or greater than medical benefits as a matter of law. See id. Although we understand that part of his argument, we do not find it to be dispositive.

Gulf Insurance argues that the two types of benefits must be compared together, "not piecemeal." It says Hennings elected (by inaction) the option which provided the "highest benefits" and that the trial court erred, as a matter of law, in determining that Hennings was eligible to receive the benefits under his contract and those provided by the Act.

We agree. A court construes a statute "first, by looking to the plain and common meaning of the statute." Fitzgerald v. Advanced Spine Fixation Systems, 996 S.W.2d 864, 865 (Tex. 1999). If the statutory language is unambiguous, we adopt the plain meaning of the provision's words and terms. Id. Again, Section 406.095 states: "An athlete covered by such a contract . . . who sustains an injury in the course and scope of the athlete's employment shall elect to receive either the benefits available under this subtitle or the benefits under the contract or agreement." TEX. LAB. CODE ANN. § 406.095(a) (emphasis added). "`Benefit' means a medical benefit, an income benefit, a death benefit, or a burial benefit based on a compensable injury." Id. § 401.011(5).

When the athlete fails to make an election, he is presumed to have elected the option for medical and weekly benefits, which provides the highest benefits. Although rule 112.402 provides different tests for determining which medical benefits are higher and which income benefits are higher, the option specified in Section 406.095(a) encompasses both medical and weekly (income) benefits. In our view, it does not allow the athlete to separately choose the higher weekly income benefit and the higher medical benefit.

Furthermore, the Rule speaks to the result. Rule 112.401(b) requires employers of professional athletes to provide a written statement to the athlete that states, in part: "If you elect to receive the benefits available to you under your contract and any applicable collective bargaining agreement, you cannot obtain workers' compensation income or medical benefits if you are injured." Id. 112.401(b) (emphasis added). It is undisputed that Hennings received contractual and collective bargaining benefits.

Summary

Hennings received $225,000 in "injury protection benefits" and medical expenses of $38,921.98 by virtue of his contract with the Dallas Cowboys and a collective bargaining agreement under the National Football League. Having received those benefits, he cannot now recover workers' compensation benefits as well. We sustain Gulf Insurance's first issue. Accordingly, we need not address the remaining issues presented in this appeal.

Conclusion

For the reasons stated, we reverse the judgment of the trial court and render judgment that Chad Hennings take nothing from Gulf Insurance Company.


DISSENTING OPINION

An extensive discussion and analysis of why the majority opinion is wrong will not be provided. It is not necessary. I agree with the hearing examiner, the appeals panel (three members), the jury (12 members), and the trial court. The insurance company, Gulf Insurance Co., chooses to ignore the language of the statute which determines the circumstances under which an injured player must make an election between worker's compensation benefits and player contract benefits. Likewise, the majority has ignored the same language.

The relevant statutes and commission rules are set out in the majority opinion. An election by the player is only necessary if the benefits under the player's contract and Collective Bargaining Agreement equal or exceed the benefits under the Act. By definitions adopted under the commission's regulations, the benefits do not equal or exceed the benefits of the Act if they are limited or terminated in any way by the contract or Collective Bargaining Agreement. Hennings's contract benefits are so limited. Therefore, by definition he was not even put to an election.

I would so hold and proceed to Hennings's issue. Because the majority does not, I dissent. There is no need for me to conduct an analysis of Hennings's issue until the majority opinion is reversed and the proceeding remanded for further review.


Summaries of

Gulf Insurance v. Hennings

Court of Appeals of Texas, Tenth District, Waco
Jul 11, 2007
No. 10-06-00192-CV (Tex. App. Jul. 11, 2007)
Case details for

Gulf Insurance v. Hennings

Case Details

Full title:GULF INSURANCE CO., Appellant v. CHAD HENNINGS, Appellee

Court:Court of Appeals of Texas, Tenth District, Waco

Date published: Jul 11, 2007

Citations

No. 10-06-00192-CV (Tex. App. Jul. 11, 2007)