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The Collaborative Clearinghouse for Lawsuits and Other Claims Against ACE Group Insurance Companies

ACE AMERICAN INSURANCE COMPANY v. CRISTINO

ATTENTION: It is possible that this information may no longer be current and therefore may be inaccurate. The index contains both open and closed cases and is not a complete list of cases in which an ACE Insurance Group company is involved. This information is provided to give interested persons an idea of the issues disputed in the indexed cases. For a full understanding of a case, one should read the rest of the court file, including the response. For the most up-to-date and complete information on a case, visit www.pacer.gov or contact the clerk of the relevant court.

Case Number: 
4:12-cv-03736 Search Pacer
ACE Group party(s): 
Court Type: 
Federal
US District Court: 
Southern District of Texas
Date Filed: 
Dec 27 2012

"3.2 Alfonso Cristino alleged his compensable injury extended to and included a left above-knee amputation and an aggravation of pre-existing gangrene and cellulitis in his left foot and/or left big toe. Also in dispute is the impairment rating, whether Alfonso Cristino had disability as a result of the compensable injury, and the dates of such disability. The Benefit Contested Case Hearing Officer determined that Alfonso Cristino's date of injury was November 12, 2008, that Alfonso Cristino's compensable injury extended to and included a left above-knee amputation and an  gangrene and cellulitis in the left foot and/or left big toe, that Alfonso Cristino had a 32 percent impairment rating as a result of the compensable injury, and that Alfonso Cristino was not able to earn his pre-injury wage from November 17, 2008 through November 23, 2010, entitling him to disability income benefits. A copy of the Appeals Panel and Benefit Contested Case Hearing Officer's Decisions are attached as Exhibits "A" and "B," respectively, and incorporated by reference the same as if fully copied and set forth at length.

3.3 Ace is aggrieved by the determinations as listed above, as well as any other Findings of Fact or Conclusions of Law contained in the Decision and Order made to support the disputed issues. Ace would show this Court that the decision is erroneous and, that upon final trial, proper interpretation of the applicable statutes and application of facts to the applicable statutes, that Alfonso Cristino's compensable injury was not a producing cause of and did not extend to and include a left above-knee amputation; an aggravation of pre-existing gangrene and cellulitis in the left foot and/or left big toe; that Alfonso Cristino had a zero percent impairment rating as a result of the compensable injury; and that Alfonso Cristino's compensable injury was not the cause of disability from November 17, 2008 through November 23, 2010. Therefore, based upon a proper review of the law and facts, the Decision and Order of the Division of Workers' Compensation should be reversed and set aside and that final judgment be entered that Alfonso Cristino's compensable injury does not extend to and include a left above-knee amputation, or aggravation of pre-existing gangrene and cellulitis in his left foot and/or left big toe; the impairment rating is not 32 percent, but instead zero percent and Alfonso Cristino did not suffer disability.

WHEREFORE, Plaintiff requests that Defendant be cited to appear and answer, and that on final trial Plaintiff have:
1. Judgment setting aside the Final Decision of the Appeals Panel of the Texas Department of Insurance, Division of Workers' Compensation;
2. Judgment that Alfonso Cristino's compensable injury does not extend to and include a left above-knee amputation; aggravation of pre-existing gangrene and cellulitis in his left foot and/or left big toe; the impairment rating is not 32 percent, but instead zero percent and that Alfonso Cristino did not suffer disability;
3. Judgment that Plaintiff be discharged with the recovery of its costs; and
4. Such other and further relief to which Plaintiff may be justly entitled"

The provided text is an excerpt from a document filed in this case. For a full understanding of the case, one should read the complete court file, including the response.

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