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Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. 03-22-00241-CV
Regular Panel Decision
Oct 31, 2023

Texas Political Subdivisions Joint Self-Insurance Fund v. Texas Department of Insurance - Division of Workers' Compensation and Commissioner Cassie Brown in Her Official Capacity

The Texas Political Subdivisions Joint Self-Insurance Fund (TPS Fund) appealed the denial of its plea to the jurisdiction and summary-judgment motion by the 455th District Court of Travis County. The TPS Fund, a self-insured governmental entity, was assessed administrative penalties totaling $132,500 by the Texas Department of Insurance–Division of Workers’ Compensation for violations of the Texas Labor Code related to nonpayment or late payment of workers’ compensation benefits. The TPS Fund asserted governmental immunity from these penalties. The Court of Appeals reviewed the legislative history and prior common law, including Texas Workers’ Comp. Comm’n v. City of Eagle Pass, to determine if immunity was waived. It concluded that the 2019 amendment to Labor Code Section 504.053(e) merely codified existing law, which had already established a clear waiver of immunity for such regulatory actions against self-insured political subdivisions. Therefore, the appellate court affirmed the trial court’s order, holding that the TPS Fund’s governmental immunity is waived for the administrative penalties.

Workers' CompensationGovernmental ImmunityAdministrative PenaltiesTexas Labor CodeSelf-InsurancePolitical SubdivisionsStatutory InterpretationAppellate ReviewRegulatory AuthoritySovereign Immunity
References
13
Case No. 13-17-00655-CV
Regular Panel Decision
Sep 26, 2019

Texas Political Subdivisions Property/Casualty Joint Self Insurance Fund v. Pharr-San Juan-Alamo ISD

This case concerns an insurance-coverage dispute between an insurance fund (appellant) and an independent school district (appellee) regarding an automobile liability policy. The central issue is whether a golf cart involved in an accident is classified as a "covered auto" or "mobile equipment," which impacts the insurer's duties to defend and indemnify. The trial court initially ruled in favor of the school district, finding a breach of duty. However, the appellate court reversed and remanded the judgment, concluding that neither party had successfully met its summary judgment burden and identifying a material factual dispute concerning the golf cart's design.

Insurance coverageAutomobile liabilityGolf cart classificationDuty to defendDuty to indemnifySummary judgmentAppellate reviewContract interpretationTexas Transportation CodeDeclaratory judgment
References
40
Case No. MISSING
Regular Panel Decision

Ben Bolt-Palito Blanco Consolidated Independent School District v. Texas Political Subdivisions Property/Casualty Joint Self-Insurance Fund

This case addresses an insurance coverage dispute between Ben Bolt-Palito Blanco Consolidated Independent School District (Ben Bolt) and the Texas Political Subdivisions Property/Casualty Joint Self-Insurance Fund (the Fund). Ben Bolt sued the Fund after a claim for extensive water and mold damage was denied, leading the Fund to assert governmental immunity. The Supreme Court of Texas determined that the Fund is a distinct governmental unit, thereby entitled to governmental immunity. However, the Court concluded that Section 271.152 of the Local Government Code provides a clear and unambiguous statutory waiver of the Fund’s immunity from suit for breach of contract claims in this context. Consequently, the Supreme Court reversed the court of appeals' judgment and remanded the case to the trial court for further proceedings.

Governmental ImmunityInsurance CoverageSelf-Insurance FundPolitical SubdivisionsInterlocal Cooperation ActBreach of ContractStatutory WaiverTrial Court JurisdictionDe Novo ReviewTexas Law
References
15
Case No. MISSING
Regular Panel Decision

Texas Workers' Compensation Commission v. City of Eagle Pass/Texas Municipal League Workers' Compensation Joint Insurance Fund

The Texas Workers’ Compensation Commission appealed a district court judgment that reversed a Commission order assessing penalties against the City of Eagle Pass and Capital Metro Transportation Authority for late benefit payments. The district court had ruled that these political subdivisions were immune from administrative penalties due to sovereign immunity, which the Legislature had not expressly waived. The appellate court disagreed, holding that political subdivisions do not possess independent sovereignty and therefore have no sovereign immunity against the State from which they derive their existence. Furthermore, the court found that the Labor Code, specifically after its 1993 codification incorporating the Code Construction Act's definition of "person," clearly authorizes the Commission to assess administrative penalties against political subdivisions as "persons." Consequently, the appellate court reversed the trial court's judgment and rendered judgment in favor of the Commission, reinstating the penalties.

Sovereign ImmunityAdministrative PenaltiesWorkers' Compensation ActPolitical SubdivisionsGovernmental ImmunityStatutory ConstructionLabor CodeInsurance CarriersSelf-InsuranceCode Construction Act
References
13
Case No. MISSING
Regular Panel Decision

Texas Municipal League Intergovernmental Risk Pool v. Texas Workers' Compensation Commission

The Texas Municipal League Intergovernmental Risk Pool, representing numerous self-insured political subdivisions, challenged specific sections of the Texas Labor Code and associated administrative rules. These provisions require workers' compensation insurance carriers, including the Risk Pool, to pay death benefits (in cases where no legal beneficiary exists) into the Subsequent Injury Fund. This fund is then used to compensate workers who sustain second injuries and to reimburse other insurance carriers. The Risk Pool contended that these mandates violate Article III, Section 52(a) of the Texas Constitution, which restricts political subdivisions from lending credit or granting public money to individuals or private corporations without a pre-existing legal obligation. While the trial court initially agreed with the Risk Pool, the court of appeals reversed this decision, and the Supreme Court subsequently affirmed that reversal. Justice Owen dissents from this judgment, arguing that the challenged funding mechanism is unconstitutional, as it compels political subdivisions to fund compensation for non-employees and to reimburse private carriers, citing the precedent set in *City of Tyler v. Texas Employers’ Insurance Association*.

Texas ConstitutionPolitical SubdivisionsWorkers' CompensationSubsequent Injury FundSelf-InsuranceDeath BenefitsConstitutional LawPublic FundsIntergovernmental Risk PoolStatutory Interpretation
References
4
Case No. MISSING
Regular Panel Decision

Kim Burt v. Andrews County Hospital District D/B/A Permian Regional Medical Center

Kim Burt, the appellant, filed a lawsuit against her former employer, Andrews County Hospital District, alleging retaliatory discharge under the Texas Labor Code and intentional infliction of emotional distress after a worker’s compensation claim. Burt appealed the trial court's summary judgment in favor of the Hospital. The appellate court addressed the Hospital’s challenge to subject matter jurisdiction. Citing *Travis Central Appraisal District v. Norman*, the court noted that governmental immunity for political subdivisions against retaliatory discharge claims under Chapter 451 of the Texas Labor Code was not waived. Concluding that the Hospital is a political subdivision enjoying governmental immunity, the appellate court vacated the trial court's judgment and dismissed the case due to a lack of subject matter jurisdiction.

Retaliatory DischargeGovernmental ImmunitySubject Matter JurisdictionSummary JudgmentTexas Labor CodePolitical SubdivisionWorker's CompensationAppealVacated JudgmentDismissal
References
7
Case No. MISSING
Regular Panel Decision
Apr 12, 2011

Drayton v. METROPLUS HEALTH PLAN, INC.

Plaintiffs Kenneth Drayton and Florence Celestin brought a putative class action against MetroPlus Health Plan, Inc. and New York City Health and Hospitals Corporation (HHC) alleging failure to pay overtime in violation of the FLSA and New York Labor Law. Defendants moved to dismiss the New York Labor Law claim, asserting they are 'political subdivisions' of New York State and thus exempt from its overtime provisions. The Court, in a Memorandum Order dated April 12, 2011, granted the defendants' motion, concluding that HHC and MetroPlus perform essential governmental functions and receive substantial public funding. This classification means they are considered political subdivisions under New York Labor Law. Consequently, the plaintiffs' claim under New York Labor Law was dismissed with prejudice.

Overtime WagesWage and HourFair Labor Standards ActNew York Labor LawPolitical Subdivision ExemptionPublic Benefit CorporationGovernment EntityMetroPlus Health PlanNew York City Health and Hospitals CorporationEmployment Law
References
11
Case No. MISSING
Regular Panel Decision

Cromwell v. New York City Health & Hospitals Corp.

Plaintiff Jerome Cromwell sued the New York City Health and Hospitals Corporation (HHC) and its CEO, Alan D. Aviles, alleging unpaid wages for work performed before and after scheduled shifts and during breaks. Cromwell sought overtime and gap-time pay under both the Fair Labor Standards Act (FLSA) and New York Labor Law (NYLL). Defendants moved to dismiss the NYLL claims, asserting that HHC is a political subdivision of New York State and therefore exempt from NYLL wage provisions. The Court conducted a particularized inquiry into HHC's nature, considering its essential public function, substantial public funding, and classification as a public employer under other state and federal laws. Ultimately, the Court granted the defendants' motion, ruling that HHC is a political subdivision for NYLL purposes and dismissing Cromwell's NYLL claims with prejudice.

Wage disputeOvertime payGap-time payFair Labor Standards ActNew York Labor LawPolitical subdivisionPublic employerMotion to dismissGovernmental immunityPublic benefit corporation
References
25
Case No. MISSING
Regular Panel Decision

Polite v. Casella

Plaintiff Roseann Polite filed a complaint in May 1995, alleging federal and state causes of action against Daniel Casella, Harvey Singer, Lynn Smith, Broome County Department of Social Services (DSS), and Broome County, stemming from the termination of her parental rights. Claims against Singer and Casella were previously dismissed. Defendants Smith, DSS, and Broome County moved to dismiss the remaining complaint in its entirety. The Court dismissed several counts based on federal statutes (FA-ACWA and Social Security Act) for lacking a private cause of action, and other counts for failing to state a claim against the specific defendants. However, the Court determined that the plaintiff adequately stated a claim under 42 U.S.C. § 1983 for a Fourteenth Amendment due process violation against Smith, DSS, and Broome County. Consequently, the defendants' motion to dismiss the complaint in its entirety was denied, and the court retained jurisdiction over the plaintiff's state law claims.

Parental RightsDue ProcessFourteenth AmendmentSection 1983Motion to DismissSubject Matter JurisdictionFailure to State a ClaimDeliberate IndifferenceFoster CareChild Welfare
References
11
Case No. MISSING
Regular Panel Decision
Oct 11, 1972

Claim of Palmer v. Candies

This case concerns an appeal by an employer and its insurance carrier from a Workmen’s Compensation Board decision, filed May 12, 1972, and amended October 11, 1972. The central issue was the use of the appropriate multiplier for compensation benefits under subdivisions 1, 2, and 3 of section 14 of the Workmen's Compensation Law, specifically challenging the Board's use of a 245 multiplier under subdivision 3. The employer's factory closed three months annually, leading the claimant to work approximately 167 days in the preceding year. The Board concluded that neither subdivision 1 nor 2 applied, prompting the resort to subdivision 3. The appellants contended that subdivision 3's 200-day multiplier was a maximum, a contention rejected by the court, which clarified that 200 is a minimum. The decision of the Workmen's Compensation Board was affirmed.

Workers' Compensation LawWage CalculationMultiplierSection 14Subdivision 3Appellate ReviewCompensation BenefitsSeasonal EmploymentDaily MultiplierLegal Interpretation
References
1
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