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The evidence was not conclusive, but it was not required to be. Rather, the `gap' in [the expert]'s analysis was his failure to show how his observations, assuming they were valid, supported his conclusions that [the passenger] was wearing her seat belt or that it was defective." Id. The injury must be the producing cause of the death, and producing cause has been defined as that cause which, in a natural and continuous sequence, produces the death . Crump argues that the "substantial factor" component of the Ledesma definition imposes a higher causation burden upon workers' compensation claimants than what exists at present. We have always required in workers' compensation cases a showing of "unbroken causal connection" between the compensable injury and the claimant's injury or death. It does not demand, nor even imply, a higher standard of legal causation beyond the ordinary sense of the concept.

It was sufficiently reliable to be considered by the jury. The analysis set out in Gammill lends support to the reliability of Daller's expert opinion testimony in this case. Transcontinental argues that the omission of but-for language in the charge submitted by the trial court renders the definition legally incorrect. As we discussed in one workers' compensation case, "to say of a cause of an injury that it is one `but for which the injury would not have happened' is to repeat something already included in the usual and ordinary meaning of the word `cause.'" Id.

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Justice GREEN delivered the opinion of the Court, in which Chief Justice JEFFERSON, Justice HECHT, Justice WAINWRIGHT, Justice MEDINA, and Justice WILLETT joined, and in which Justice JOHNSON and Justice LEHRMANN joined as to Parts I, II, IV and V. Justice GUZMAN did not participate in the decision.

C., Austin, TX, for Amicus Curiae Texas Mutual Insurance Company. Darwin, Public Counsel, Austin, TX, for Amicus Curiae Office of Injured Employee Counsel. Justice JOHNSON filed a concurring opinion, in which Justice LEHRMANN joined.

He applied for and received workers' compensation benefits for the work-related injury. This fee-shifting provision in § 408.221 did not exist until 2001. This multi-faceted review involving both evidentiary and discretionary matters is required by the language of the Act. In concluding that reasonableness and necessity of attorney's fees were matters of fact committed to a jury, we also noted that there are "factors prescribed by law which guide the determination of whether attorney fees are reasonable and necessary." Id. Crump has not pointed us to a reason to exempt § 408.221 from the general rule announced in those cases: "[T]he reasonableness of statutory attorney's fees is a jury question." City of Garland, 22 S. Nor do we see language in § 408.221 that distinguishes it from the language of the statutory regimes to which we applied the general rule in those cases. If the claimant prevails only on some issues, then after the jury's verdict is announced the court will apportion the fees per the factors in subsection (d), and will award reasonable and necessary attorney's fees to the claimant's attorney only for those issues on which the claimant prevails. First, Transcontinental did not procedurally preserve error regarding the "substantial factor" language because it did not request the language in the trial court. Hendrick Mem'l Hosp., , 973 (Tex.1943) ("[A] contractual relation arises under the Workmen's Compensation Law in which the employer, the employee and the insurer are the principal parties."). Corp., , 297 (Tex.1988) ("[W]e have warned that the provisions of the Act `should not be hedged about with strict construction, but should be given a liberal construction to carry out its evident purpose.'" (quoting Yeldell v. & Nursing Ctr., , 75 (1953) ("Since the workman coming under the terms of the Act is denied his common law rights it is held that the Act should be liberally construed in his favor.

But objective evidence of Crump's good health before his injury, his contraction of an infection at the site shortly afterward, and the deleterious effect of the infection on his health reasonably ruled out the possibility that he died solely from the other conditions he suffered. Wolff, Courts generally agreed that the workers' compensation causation standard was not to be as exacting as that of the common law, but no uniform definition of causation in the workers' compensation context emerged. Therefore, we hold that producing cause in workers' compensation cases is defined as a substantial factor in bringing about an injury or death, and without which the injury or death would not have occurred. We held that the use of those terms provides "little concrete guidance" to modern jurors, and a definition that omits either the substantial factor or but—for components "is incomplete." Id. Although, as the dissent points out, our earlier cases did not address the "substantial factor" terminology, there is nothing in those opinions to suggest that cause in fact should not be part of the causal connection analysis. In other words, for an act or event to rise to the level of cause in the legal sense, the act or event must be such that reasonable jurors would identify it as being actually responsible for the ultimate harm. We review de novo the trial court's denial of Transcontinental's request for a jury trial under subsection (c). We look first to the language of the statute.(b) Except as otherwise provided, an attorney's fee under this section is based on the attorney's time and expenses according to written evidence presented to the division or court. Both parties offer legitimate, reasonable interpretations of § 408.221 and subsection (c)'s role within it. Because it is ambiguous, we may turn to extratextual sources.

"An expert witness may testify regarding `scientific, technical, or other specialized' matters if the expert is qualified and if the expert's opinion is relevant and based on a reliable foundation." Mack Trucks, Inc. Tamez, , 726-27 (Tex.1998) (deeming expert testimony based on the latter considerations unreliable when "there is simply too great an analytical gap between the data and the opinion proffered") (citing Gen. Here, we are considering the reliability of a treating physician's opinion based on a particular diagnostic methodology—differential diagnosis. Yet a medical causation expert need not "disprov[e] or discredit[ ] every possible cause other than the one espoused by him." Viterbo v. Still, if evidence presents "other plausible causes of the injury or condition that could be negated, the [proponent of the testimony] must offer evidence excluding those causes with reasonable certainty." Merrell Dow Pharm., Inc. There is no dispute that these conditions, except the fungal infection, all preceded Crump's May 2000 work-related injury. The trial court in that case had given the products liability pattern jury charge definition: "`Producing cause' means an efficient, exciting, or contributing cause that, in a natural sequence, produces the incident in question. Crump asserts that the Ledesma definition of producing cause has no place in workers' compensation law. The element common to both proximate cause and producing cause is actual causation in fact. The court of appeals favored Crump's plain language argument and held that the trial court did not err in denying Transcontinental's request to submit the issue to a jury. In construing another provision of the Workers' Compensation Act, we set out the scope of our inquiry: The meaning of a statute is a legal question, which we review de novo to ascertain and give effect to the Legislature's intent. Crump correctly notes that § 408.221 makes no mention of a jury.

This is a routine diagnostic method used in internal medicine whereby a treating physician formulates a hypothesis as to likely causes of a patient's presented symptoms and eliminates unlikely causes by a deductive process of elimination. All of these were other plausible causes of Crump's death. In a recent products liability case, however, we held that what had been "a frequently submitted definition of `producing cause' should no longer be used." Ford Motor Co. Because we have not addressed the "substantial factor" terminology from products liability law in the context of workers' compensation cases, we must decide whether our holding in Ledesma applies here. Cause in fact is established when the act , 798-99 (Tex.2004). This requires proof that an act or omission was a substantial factor in bringing about injury which would not otherwise have occurred.") (citations omitted). However, the inclusion of but-for language in producing cause definitions has long been considered useful, serving "to direct the jury's attention to the importance of unbroken causal connection between the injury and the disability or death." Id.; see also Wichita County v. The producing cause definition submitted in this case lacked the but-for component. Where text is clear, text is determinative of that intent. If the carrier appeals multiple issues and the claimant prevails on some, but not all, of the issues appealed, the court shall apportion and award fees to the claimant's attorney only for the issues on which the claimant prevails. Transcontinental focuses on the first words in subsection (b): "Except as otherwise provided." Id. It argues that subsection (c) represents an exception to the general rule set out in subsections (a) and (b), where a claimant's attorney's fees are paid out of the claimant's benefit recovery and a court decides those fees.

After a series of increasingly serious health complications which required repeated, lengthy hospitalizations, Crump died in January 2001 at age forty-three. Finding the court of appeals' categorization of the issues useful, we address each in turn. Co., , 516-17 (Tex.2007) (discussing the avenues of judicial review). In this situation, the claimant's attorney's fees are not limited to 25% of the claimant's recovery, but only by reasonableness and necessity. Prior to 2001, the only attorney's fee award mechanism was the one in subsection (b), described in the paragraph above, where the claimant always pays his own attorney's fees regardless of the outcome of the carrier's appeal. Applying that general rule here, we conclude that the carrier is entitled to submit the issue of the reasonableness and necessity of a claimant's attorney's fees, where disputed, to a jury, which will consider subsection (d)'s factors. It requested the following definition: "`Producing Cause' means that cause which in a natural and continuous sequence, produces death, and without which, the death would not have occurred." (Tex. De La Lastra, , 920-21 (Tex.1993) (appellate argument that maritime law preempted state law was not preserved because of failure to bring issue to trial court's attention, despite assertion that law changed during appellate process). The terms of worker's compensation insurance policies include provisions of the worker's compensation statutes. ("The provisions of the Workmen's Compensation Law become part of the contracts executed pursuant to it by those who bring themselves within the scope of its operation."). Because employees covered by worker's compensation are denied their common law right to sue their employers for work-related injuries, the worker's compensation statutes are construed liberally in favor of the worker. A liberal interpretation will award him the greatest benefits the nature of his injuries will sustain.") (citations omitted); Lumberman's Reciprocal Ass'n v.

His wife, Joyce Crump, applied for workers' compensation death benefits, alleging that the May 2000 injury was a producing cause of her husband's death. Producing cause was the only issue submitted to the jury at trial. CODE § 410.303 ("The party appealing the decision [of the appeals panel] on an issue [regarding compensability or eligibility for or the amount of income or death benefits] has the burden of proof by a preponderance of the evidence."); Morales v. Thus, Transcontinental, the insurance carrier, was the plaintiff at trial; Crump, the claimant, was the defendant. Co., , 516 (Tex.2007) ("[T]he appealing party bears the burden of proof by a preponderance of the evidence. These fees are not subtracted from the claimant's recovery, but are paid by the carrier on top of the claimant's benefits award. For this reason, Motley and Hatton do not control in this case—they addressed this other statutory scheme, and could not have contemplated the fee-shifting mechanism presented in subsection (c). 2007), was not decided until after this case was tried, so it is hard to fault Transcontinental for not presenting the issue. Further, Transcontinental maintained in the court of appeals that "precedent required the [trial] court" to give the instruction it requested. Worker's compensation claims are contractual in nature. If an employee is covered by worker's compensation insurance, then those benefits are the exclusive remedy of the employee and the employee's beneficiaries against the employer if a work-related injury causes the employee disability or death, except a claim for exemplary damages is available if death is caused by the employer's intentional act or omission or gross negligence.




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