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Click here for the full text of this decision FACTS:Mario Camacho was a rancher with more than 20 years of experience at the time of his injury and a long-term employee of JMR Ranching. In September 1991, Camacho’s horse reared up and struck him in the face. He fell from the horse to the ground. Selma Steele, co-owner of the ranch, received a telephone call about Camacho’s accident and arrived at the scene shortly after the incident. When she arrived, Camacho “had a big knot on his head and a knot over the left eye and his nose was bleeding.” While on the way to Steele’s home in her car, Camacho fell over and appeared to have gone to sleep. Steele took Camacho to the hospital. Initially, Camacho received treatment at the Tomball Regional Hospital Emergency Room. Dr. John Sanders, the emergency room physician, diagnosed Camacho as having suffered a concussion. Sanders ordered the following tests: 1. a CT scan of the head, without contrast, which was reported as normal; 2. a bone scan, which was reported as normal with the exception of degenerative changes in the cervical spine; 3. an x-ray of the nasal bones, which was reported as showing no evidence of fracture; and 4. an x-ray of the cervical spine, which was reported as showing no acute fracture. Dr. Susan Garrison, a physician certified by the American Board of Physical Medicine and Rehabilitation, reviewed Camacho’s records at Liberty Mutual’s request in 2005 to address whether Camacho suffered a skull injury due to his 1991 fall. Garrison, the only medical doctor to testify at trial, stated that Camacho’s tests, X-rays, bone scans and CT scans showed “no evidence of injury to the skull as a result of that accident.” In her opinion, Camacho had a closed head injury but he “did not have an injury to the skull.” Garrison clarified that her opinions were based upon the reports of the tests administered at Tomball Regional, because the actual films of the tests had been destroyed by the hospital. Garrison further testified that because the bone scan was done with contrast material, if Camacho had suffered a bone bruise of the skull, the test “would have lighted up, and it didn’t light up.” Garrison did not see or treat Camacho. Dr. Richard Pollock, a neuropsychologist, testified that he began treating Camacho in 1994. According to Dr. Pollock, Camacho’s hospital records reflected that he suffered a closed head injury in the accident. Pollock categorized Camacho as an incurable imbecile and testified that Camacho’s condition was permanent. Pollock also opined that Camacho “is not capable of living independently.” Camacho testified at trial regarding the effects of his injury on his ability to work and to engage in daily activities of living. He did not testify about how his injury occurred. At the conclusion of the trial, the trial court submitted one issue to the jury accompanied by instructions. The court submitted the following instructions pertinent to this appeal: “You are instructed that the Texas Workers’ Compensation Commission Appeals found that the Plaintiff did not sustain an injury to the skull that resulted in incurable imbecility. The party dissatisfied with the decision of the Appeals Panel may file suit in District Court for Judicial Review. The decisions of the Texas Workers’ Compensation Commission are to be given no special weight. You, as jurors, decide the weight and credibility of the evidence submitted before you.” The jury returned its verdict, finding that Camacho “sustained an injury to his skull that resulted in incurable imbecility.” Subsequently, the trial court awarded Camacho lifetime income benefits in accordance with the jury’s verdict HOLDING:Reversed and remanded. First, Liberty Mutual contended that Camacho failed to present legally sufficient evidence establishing that he suffered a skull injury. Liberty Mutual argued that the lifetime benefits provision in effect at the time, a predecessor to Texas Labor Code �401.011, required Camacho to prove an injury to the bones of his skull in order to recover lifetime benefits. The court stated that “the case before us requires that we interpret the statute’s meaning in its use of the term”skull’ in order to determine whether a blow to the head, which results in imbecility, fulfills the requirements of the statute.” The context of the statute, the court stated, does not limit itself to injuries to the bones of the skull; in fact, an injury to the bones of the skull that did not result in imbecility would not result in the award of lifetime income benefits. Thus, the court stated that the protections of the statute are triggered by two events: a blow to the head and an injury to the brain that results in imbecility or insanity. Accordingly, the court found that the context of the statute supported defining the term “skull” in a manner that includes a blow to the head that causes imbecility. The court then stated that it was undisputed that Camacho suffered a closed head injury. As a result, the court held that “a blow to the head that causes bruising and unconsciousness and results in a diagnosis of a closed head injury” caused “sufficient harm to the skull to meet this statute’s requirement of a skull injury.” Liberty Mutual then asserted that the trial judge improperly instructed the jury to “give no special weight” to the decision of the Texas Workers’ Compensation Commission. The court found that by affirmatively instructing the jury to give the decision “no special weight,” the court effectively instructed the jurors to all but disregard the decision of the appeals panel. The instruction to the jury, the court stated, singled out one piece of evidence admitted at trial and implied that the jury should treat the appeals panel decision differently than it was to treat the other evidence admitted at trial. Thus, the court held that the trial court erred in instructing the jury to give the appeals panel decision no special weight. Moreover, the court found that the erroneous submission of the instruction at issue probably caused the rendition of an improper verdict. OPINION:Horton, J.; Gaultney, Kreger and Horton, JJ.

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