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

Case No. 03-05-00189-CV
Regular Panel Decision
Mar 21, 2008

Texas Department of Insurance, Division of Workers' Compensation v. Insurance Council of Texas, Texas Mutual Insurance Company, Texas Property and Casualty Insurance Guaranty Association, and Envoy Medical Systems, Inc.

The Texas Department of Insurance, Division of Workers' Compensation (the "Division") promulgated a rule (28 Tex. Admin. Code § 133.309) to create a less expensive alternative review procedure for workers' compensation claims concerning the necessity of medical treatment. The Insurance Council of Texas, Texas Mutual Insurance Company, Texas Property and Casualty Insurance Guaranty Association, and Envoy Medical Systems, L.P. (the "Joint Appellees") challenged the rule's validity in a declaratory judgment action. The district court granted the Joint Appellees' motion for summary judgment, declaring the rule invalid. The appellate court affirmed the district court's judgment, concluding that the rule was not in harmony with relevant governing statutes that allowed for judicial review of medical necessity disputes.

Workers' Compensation LawAdministrative LawJudicial ReviewStatutory InterpretationDeclaratory JudgmentSummary JudgmentMedical Necessity DisputesAlternative Dispute ResolutionAgency Rule ValidityTexas Court of Appeals
References
15
Case No. MISSING
Regular Panel Decision

Texas Department of Criminal Justice v. Simons

The Texas Department of Criminal Justice-Institutional Division (TDCJ) appealed the trial court's denial of its plea to the jurisdiction and no-evidence motion for summary judgment. The case involves Brian Edward Simons, an incarcerated individual who sued TDCJ for injuries. The central legal question is whether TDCJ received "actual notice" of Simons's claim, a requirement under the Texas Tort Claims Act. The court considered the recent amendment to Government Code section 311.034, which makes statutory prerequisites to suit jurisdictional, and applied it retroactively. Analyzing the "subjective awareness" standard for actual notice, the court found that TDCJ's internal investigation, which concluded Simons was at fault, and communications from Simons's legal assistant, did not demonstrate TDCJ had subjective awareness that its own fault contributed to Simons's injury. Consequently, the court held that TDCJ lacked actual notice, reversed the trial court's order, and dismissed Simons's claim for want of jurisdiction.

Texas Tort Claims ActSovereign ImmunityActual NoticeSubjective AwarenessGovernmental Unit ImmunityJurisdictional PrerequisitesRetroactive Application of StatuteProcedural LawSummary Judgment MotionPlea to Jurisdiction
References
14
Case No. 09-06-039 CV
Regular Panel Decision
Jul 27, 2006

Texas Department of Criminal Justice v. Brian Edward Simons

The Texas Department of Criminal Justice (TDCJ) appealed the denial of its plea to the jurisdiction and no-evidence motion for summary judgment in a case brought by Brian Edward Simons for injuries sustained during incarceration. The central legal question involved whether TDCJ had "actual notice" of Simons's claim, specifically subjective awareness of its fault, under the Texas Tort Claims Act. The majority opinion retroactively applied a 2005 amendment to the Government Code, Section 311.034, which makes statutory prerequisites jurisdictional. The court concluded that TDCJ did not have actual notice and reversed the trial court's order, dismissing Simons's claim for lack of jurisdiction. A dissenting opinion challenged the retroactive application of the statute and argued that a genuine issue of material fact existed regarding actual notice.

Texas Tort Claims ActSovereign ImmunityActual NoticePlea to the JurisdictionSummary JudgmentStatutory InterpretationRetroactive ApplicationJurisdictional RequirementsGovernmental ImmunityAppellate Jurisdiction
References
26
Case No. 03-00-00063-CV
Regular Panel Decision
May 31, 2000

Carole Keeton Rylander, Comptroller of Public Accounts for the State of Texas v. Marcie Caldwell Individually and on Behalf of All Others Similarly Situated

Marcie Caldwell filed a class action lawsuit challenging the constitutionality of Texas Government Code section 51.702(b), which mandates a $15 court cost on criminal convictions to supplement judges' salaries in participating statutory county courts. Caldwell alleged this varying cost violated due course of law and equal rights provisions of the Texas Constitution. The Comptroller of Public Accounts, Carole Keeton Rylander, filed a plea to the jurisdiction, claiming sovereign immunity and lack of subject matter jurisdiction. The trial court denied the Comptroller's plea. On appeal, the Court of Appeals affirmed the trial court's decision, ruling that Caldwell's suit was not barred by sovereign immunity as it challenged a state official's actions under an allegedly unconstitutional law, and that exclusive remedies under the Tax Code or Code of Criminal Procedure were inapplicable. The court also found a justiciable controversy existed, as the Comptroller enforces the challenged statute.

Sovereign ImmunityJurisdictionConstitutional LawGovernment CodeCourt CostsDeclaratory ReliefInjunctive ReliefClass ActionDue Course of LawEqual Rights
References
20
Case No. 03-99-00502-CV
Regular Panel Decision
May 31, 2000

Clayton Miller, D/B/A Trucks, Etc. v. Bell County, Texas, and Dan Smith, Sheriff of Bell County, Texas

Clayton Miller, operating as Trucks, Etc., sued Bell County, Texas, and Sheriff Dan Smith for damages. Miller claimed agents of the Bell County Sheriff's Department negligently released a truck he held title to, in violation of the Texas Code of Criminal Procedure. The district court granted summary judgment to the appellees based on sovereign and official immunity. The appellate court affirmed the district court's judgment, stating that Miller failed to establish legislative permission to sue for damages, and merely alleging a violation of law does not waive sovereign immunity for a tort claim seeking damages.

Sovereign ImmunityOfficial ImmunitySummary JudgmentTort ClaimNegligenceTexas Code of Criminal ProcedureTexas Civil Practice and Remedies CodeAppellate ReviewGovernmental ImmunityDamages Claim
References
15
Case No. 03-06-00257-CV
Regular Panel Decision
Jun 17, 2009

Greg Abbott, in His Official Capacity as Attorney General of Texas v. GameTech International, Inc. Anthony J. Sadberry, in His Official Capacity as Executive Director of the Texas Lottery Commission And Texas Lottery Commission

Greg Abbott, as Attorney General of Texas, appealed a summary judgment that deemed settlement letters between GameTech International, Inc., and the Texas Lottery Commission exempt from disclosure under the Texas Public Information Act (PIA). The Attorney General contended that no other law rendered these communications confidential. The appellate court examined whether the confidentiality provisions of the Governmental Dispute Resolution Act and the civil practice and remedies code applied to informal settlement negotiations. It concluded that these statutes only cover communications made within statutorily defined alternative dispute resolution procedures, which the exchanged settlement offers were not. Furthermore, the court found no common-law privilege protecting settlement negotiations or a corporate right to privacy. Consequently, the court reversed the district court's judgment, ruling that the settlement letters are not exempt from PIA disclosure requirements.

Public Information ActOpen Records RequestSettlement NegotiationsConfidentiality ExceptionStatutory ConstructionGovernmental Dispute ResolutionAlternative Dispute ResolutionCorporate Right to PrivacySummary Judgment AppealTexas Court of Appeals
References
26
Case No. 03-19-00185-CV
Regular Panel Decision
Mar 05, 2020

Texas Department of Insurance v. Texas Association of Health Plans

The Texas Department of Insurance appealed the denial of its plea to the jurisdiction against the Texas Association of Health Plans. The Association filed claims challenging Department rules under the Administrative Procedure Act (APA) and the constitutionality of Texas Insurance Code provisions under the Uniform Declaratory Judgments Act (UDJA). The Department argued sovereign immunity barred both claims. The appellate court affirmed the trial court's decision, ruling that the APA's waiver of immunity extends to associational plaintiffs and that the UDJA claim constituted a viable constitutional challenge not precluded by the redundant remedies doctrine.

Sovereign immunityAdministrative Procedure ActDeclaratory Judgments ActAssociational standingConstitutional challengePlea to the jurisdictionTexas Insurance CodeHealth plans regulationAppellate reviewStatutory interpretation
References
39
Case No. 03-03-00436-CV
Regular Panel Decision
May 20, 2004

Texas Medical Association Texas AFL-CLO Patient Advocates of Texas Allen J. Meril, M.D. And L. E. Richey v. Texas Workers Compensation Commission Richard F. Reynolds, Executive Director And Texas Association of Business

The Texas Court of Appeals, Third District, at Austin, affirmed a district court's judgment upholding the validity of the 2002 medical fee guidelines promulgated by the Texas Workers' Compensation Commission. Appellants, including the Texas Medical Association and Texas AFL-CIO, challenged the guidelines on substantive grounds (unlawful delegation of power to CMS and arbitrary/capricious rulemaking) and procedural grounds (failure to consult the Medical Advisory Committee and inadequate reasoned justification/public notice). The appellate court found no unlawful delegation of power, that the Commission's decision was not arbitrary and capricious, and that the Commission substantially complied with the reasoned-justification requirement of the APA. The court also found no requirement to consult the Medical Advisory Committee for initial fee guidelines and that a new public notice and comment period was not required.

Workers' Compensation LawMedical ReimbursementFee GuidelinesAdministrative Procedure ActAgency RulemakingDelegation DoctrineArbitrary and CapriciousJudicial ReviewTexas LawHealth Policy
References
43
Case No. 03-13-00077-CV
Regular Panel Decision
Feb 25, 2015

Texas State Board of Examiners of Marriage and Family Therapists Charles Horton in His Official Capacity Sandra DeSobe in Her Official Capacity, and Texas Association of Marriage // Cross-Appellant,Texas Medical Association v. Texas Medical Association// Texas State Board of Examiners of Marriage and Family Therapists Charles Horton in His Official Capacity Sandra DeSobe in Her Official Capacity, and Texas Association of Marriage

The amicus brief, submitted by The Association of Marital and Family Therapy Regulatory Boards (AMFTRB), urges the Third Court of Appeals to grant en banc reconsideration and reverse a panel's decision that found 22 TEX. ADMIN CODE §801.42(13) invalid. The brief argues that Licensed Marriage and Family Therapists (LMFTs) are fully qualified, trained, and tested to perform diagnostic assessments within their therapeutic role. It asserts that diagnosis alone, in the context of marriage and family therapy, does not constitute the practice of medicine under the Texas Medical Practice Act, and preventing LMFTs from performing these assessments would effectively prohibit their professional practice and create a shortage of mental health professionals in Texas. The AMFTRB also highlights that the legislature did not intend for LMFTs to be supervised by physicians and that the structure of the Occupations Code supports marriage and family therapy as a stand-alone profession. Additionally, the brief questions the qualification of the Texas Medical Association's expert witness due to prior ethical lapses.

Marriage and Family TherapyDiagnostic AssessmentMedical Practice ActOccupations CodeRegulatory BoardsLicensureScope of PracticeMental Health ServicesTexasAccreditation
References
9
Case No. 03-00-00370-CV
Regular Panel Decision
Dec 21, 2000

Texas General Indemnity Company v. Texas Workers' Compensation Commission Todd Brown in His Official Capacity as Executive Director of the Texas Workers' Compensation Commission And Michael L. MacIk

Texas General Indemnity Company (TGI) filed a declaratory judgment action in Travis County challenging the validity of Rule 130.8 of the Texas Workers' Compensation Commission (TWCC). The district court granted TWCC's plea to the jurisdiction and dismissed TGI's suit, also conditionally denying TGI's summary judgment motion and granting TWCC's. TGI appealed, arguing mandatory jurisdiction in Travis County and that Rule 130.8 conflicted with the Labor Code. The appellate court affirmed the dismissal, applying res judicata due to a prior adverse ruling against TGI on the same issue in Texas Gen. Indem. Co. v. Eisler. Additionally, the court affirmed the conditional judgment, concluding Rule 130.8 is a valid exercise of the Commission's rulemaking authority and does not conflict with the Texas Labor Code.

Administrative Rule ChallengeDeclaratory JudgmentWorkers' Compensation BenefitsImpairment Income BenefitsRes JudicataCollateral EstoppelStatutory InterpretationRulemaking AuthorityTexas Administrative Procedure ActLabor Code
References
31
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