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

Case No. 07-05-0268-CV
Regular Panel Decision
Apr 11, 2006

State Office of Risk Management v. Rachel Herrera and Texas Municipal League Intergovernmental Risk Pool

The State Office of Risk Management (SORM) appealed the dismissal of its attempt to judicially review a Texas Worker’s Compensation Commission appeals panel ruling. The trial court had dismissed SORM's petition for lack of jurisdiction, asserting it was not timely filed within 30 days. SORM argued that the dispute concerned compensability, which allowed for a 40-day filing period under the Labor Code. The Court of Appeals determined that the core issue of identifying the responsible employer for death benefits, thereby defining the course and scope of employment, constituted a matter of compensability. Consequently, SORM had 40 days to file. The appellate court reversed the trial court’s order of dismissal and remanded the case for further proceedings.

Worker's CompensationJudicial ReviewJurisdictionTimelinessCompensabilityCourse and Scope of EmploymentDeath BenefitsTexas Labor CodeGovernment CodeAppeals Court
References
3
Case No. 03-98-00169-CV
Regular Panel Decision
Jun 17, 1999

Texas Workers' Compensation Commission and Subsequent Injury Fund v. Texas Municipal League Intergovernmental Risk Pool

The Texas Municipal League Intergovernmental Risk Pool (Risk Pool) challenged the constitutionality of specific provisions within the Texas Workers' Compensation Act and related Texas Workers' Compensation Commission (TWCC) rules. These provisions mandated contributions to the Subsequent Injury Fund, which the Risk Pool argued violated constitutional restrictions on political subdivisions lending credit or granting public money, and imposing state ad valorem property taxes. The trial court initially sided with the Risk Pool, declaring the requirements unconstitutional as applied to its members. On appeal, the Court of Appeals addressed the Risk Pool's standing and the core constitutional arguments. The appellate court characterized the mandatory contributions as analogous to a custodial escheat statute, where the state assumes custody of unclaimed death benefits rather than gaining absolute ownership. Consequently, the court reversed the trial court's judgment, concluding that the Risk Pool failed to meet its burden for an "as applied" constitutional challenge, notably by not asserting a limitations defense.

Workers' Compensation ActSubsequent Injury FundDeclaratory JudgmentConstitutional ChallengeAs-Applied ChallengeAssociational StandingAcceptance of Benefits DoctrineEscheat LawCustodial EscheatUnclaimed Death Benefits
References
18
Case No. 07-07-0288-CV
Regular Panel Decision
May 28, 2009

State Office of Risk Management v. Rachel Leigh Herrera, Victoria Danielle Herrera, Matthew Ryen Herrera, Kelcey Mercedes Dena Herrera, Care'n Destiny Herrera, Beneficiaries of Jose Arturo Herrera, And Texas Municipal League Intergovernmental Risk Pool

The State Office of Risk Management (SORM) appealed the trial court's dismissal of its lawsuit seeking judicial review of an appeals panel decision, which found SORM responsible for paying death benefits to the beneficiaries of deceased police officer Jose Herrera. Officer Herrera died in the line of duty, and SORM denied liability, arguing he was employed by the City of Friona, a self-insured entity, not the State. The trial court dismissed SORM's suit because SORM failed to timely name the City of Friona as a defendant within the statutory 40-day period. The appellate court affirmed the dismissal, ruling that the City of Friona was an indispensable party and the 40-day limitations period was not tolled for misidentification of parties. The court also upheld the award of attorney's fees to certain Herrera defendants, deeming SORM's claims against them to be without foundation.

Workers' CompensationJudicial ReviewInsurance Carrier LiabilitySubject Matter JurisdictionIndispensable PartyAttorney's FeesStatutory BeneficiariesMisidentification of PartiesAppellate Court DecisionTexas Labor Law
References
20
Case No. 03-17-00352-CV
Regular Panel Decision
Aug 22, 2018

Vista Medical Center Hospital Vista Healthcare, Inc. And Surgery Specialty Hospital, Inc.// State Office of Risk Management v. State Office of Risk Management// Vista Medical Center Hospital Vista Healthcare, Inc. And Surgery Specialty Hospital, Inc.

This case involves cross-appeals stemming from a dispute over the appropriate reimbursement for medical services provided by Vista Medical Center Hospital and its affiliates to injured employees covered by the State Office of Risk Management (SORM) under Texas workers’ compensation statutes. The district court had affirmed 23 administrative orders that required SORM to make additional payments to Vista, a decision which SORM challenged on appeal citing insufficient evidence. Vista, in turn, cross-appealed the district court's denial of prejudgment interest. The appellate court found substantial evidence supported the administrative law judges' conclusion that SORM's original reimbursement model was unfair and unreasonable, and that Vista's proposed methodology was valid. Consequently, the court affirmed the district court's judgment but modified it to include the prejudgment interest that Vista was statutorily entitled to.

Workers' CompensationMedical ReimbursementAdministrative LawAppellate ReviewSubstantial EvidencePrejudgment InterestTexas LawHealthcare ProvidersInsurance DisputesFee Guidelines
References
23
Case No. MISSING
Regular Panel Decision

Texas Municipal League Intergovernmental Risk Pool v. Burns

The City of the Colony and Texas Municipal League Intergovernmental Risk Pool (TML Risk Pool) appealed the trial court's dismissal of their appeal regarding a workers' compensation benefits award to Brandon Burns. Appellants challenged the timeliness of the City's intervention, TML Risk Pool's standing, and the award of attorney's fees. Brandon Burns cross-appealed on attorney's fees. The appellate court affirmed the trial court's judgment, concluding that the City's petition in intervention was untimely, TML Risk Pool lacked standing as it was not an 'insurance carrier' under the labor code, and the attorney's fees awards were proper. The cross-appeal on attorney's fees was also overruled as Burns failed to show how the trial court's actions resulted in an improper judgment.

Appellate ReviewStandingInterventionTimelinessEquitable TollingAttorney's FeesJurisdictionSelf-InsuranceGovernmental EntityTexas Labor Code
References
25
Case No. 13-04-663-CV
Regular Panel Decision
Jan 04, 2007

Synagro of Texas - CDR, Inc. v. AON Risk Services of Texas, Inc.

Synagro of Texas-CDR, Inc. appealed the amount of damages awarded to Aon Risk Services of Texas, Inc. on its breach of contract counterclaim. Synagro, a waste management company, challenged the sufficiency of the evidence supporting the $250,863.49 awarded to Aon Risk, an insurance broker, for unpaid insurance premiums and commissions. Synagro argued that Aon Risk had not paid the amount to the insurer and that a statute of limitations defense could be raised. The Court of Appeals found Synagro's arguments regarding limitations and mitigation efforts to be misplaced, as they pertained to Aon Risk's potential actions, not Synagro's. The court concluded that the evidence was legally and factually sufficient to support the damages awarded and affirmed the trial court's judgment.

AppealBreach of ContractDamagesInsurance BrokerSufficiency of EvidenceStatute of LimitationsMitigation of DamagesContract PriceLost ProfitsTexas Law
References
8
Case No. MISSING
Regular Panel Decision

Hull-Hazard, Inc. v. Roberts

Justice Levine dissents from the majority's decision, which annulled the respondent's determination that held Hull Corporation jointly liable with Hull-Hazard, Inc., for violations of Labor Law § 220. Levine argues for a liberal construction of Labor Law § 220, citing its remedial and protective purposes for workers' rights. He emphasizes the extensively interlocking relationship between Hull Corporation and Hull-Hazard, Inc., highlighting shared ownership, officers, managerial staff, and employee benefit plans. According to Levine, Hull Corporation, as a successor employer, should not be permitted to evade liability given its clear knowledge and use of Hull-Hazard's resources, drawing parallels to federal labor law on successor liability. He concludes that the imposition of joint liability was rational and should have been confirmed. The overall determination was modified by annulling the finding of a willful violation of Labor Law § 220 (2) and the joint liability of Hull Corporation, and then confirmed as modified.

Joint LiabilitySuccessor EmployerLabor Law ViolationsCorporate InterlockingDissenting OpinionConcurring OpinionRemedial LegislationUnfair Labor PracticesAnnulment of DeterminationWillful Violation
References
5
Case No. MISSING
Regular Panel Decision

Texas Workers' Compensation Commission and Subsequent Injury Fund v. Texas Municipal League Intergovernmental Risk Pool

This case involves a dispute between the Texas Municipal League Intergovernmental Risk Pool (Risk Pool) and the Texas Workers’ Compensation Commission (TWCC) and the Subsequent Injury Fund (Fund). The Risk Pool challenged the constitutionality of provisions in the Texas Workers’ Compensation Act and TWCC rules requiring it to contribute unclaimed death benefits to the Fund. While the trial court found these provisions unconstitutional, the appellate court reversed, holding that the scheme functions as a custodial escheat, not a transfer of title, and thus does not violate the Texas Constitution. The court also noted that the Risk Pool failed to assert a limitations defense, thereby not meeting the burden for an "as applied" constitutional challenge.

Workers' Compensation ActSubsequent Injury FundDeclaratory JudgmentConstitutional LawEscheat StatutesCustodial TakingAssociational StandingPublic FundsPolitical SubdivisionsUnclaimed Death Benefits
References
26
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. NO. 14-05-00819-CV
Regular Panel Decision
May 15, 2007

Norma Hunt v. State Office of Risk Management

Norma Hunt appealed a judgment in a workers' compensation case where a jury found she did not sustain a compensable psychological injury. Hunt had previously suffered physical injuries from a fall at work. She later developed depression and panic attacks, arguing these psychological conditions were compensable as a result of her original physical injury. The State Office of Risk Management disputed the compensability of the psychological component. The trial court rendered judgment in favor of Risk Management, and the appellate court affirmed, concluding that the evidence was legally and factually sufficient to support the jury's verdict that Hunt's compensable injury did not include a psychological component.

Workers' CompensationPsychological InjuryDepressionPanic AttacksCompensabilityPreexisting ConditionFactual SufficiencyLegal SufficiencyDirected VerdictCausation
References
8
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