Court Identifies Pleading Rules for Old Law Claims

The Corpus Christi Court of Appeals has reiterated that there is a difference in pleading rules for old law claims than those that apply to new law claims. In Guerra v. ACE American Insurance Co., No. 13-17-00652-CV (Corpus Christi, June 6, 2019), the court considered a claimant’s appeal from a judgment following jury verdict in a claim with a date of injury prior to January 1, 1991.

The 1989 reforms to the Texas Workers’ Compensation Act resulted in a two tracks of workers’ compensation claims: old law claims and new law claims. Claims with an injury date prior to January 1, 1991, are considered old law claims. The claimant’s case in this appeal is an old law claim.

Claimant’s compensable injury was resolved by an agreed judgment in 1996, with the specific agreement that the carrier would be responsible in the future for “all reasonable and necessary medical expenses incurred as a result of treatment by Dr. Gilbert Meadows of San Antonio, Texas, only.”

In 2015 the claimant and carrier disagreed over the carrier’s response to refuse to reimburse the claimant for a total of $4,062.75 for: (1) treatment by Misty Durbin, a chiropractor; (2) an orthopedic bed; (3) orthopedic shoes and socks; and (4) travel expenses. The carrier filed suit to set aside the Division’s award of benefits in the case. The trial court granted the carrier’s motion to realign the parties, designating the claimant as the plaintiff and the carrier as the defendant and the case proceeded to trial.

Following a jury verdict and judgment in favor of the carrier, the claimant appealed, arguing, among other things, that the trial court erred in realigning the parties. The claimant argued that under Texas Labor Code § 410.303, the party appealing the final decision of the Division bears the burden of proof by a preponderance of the evidence. The carrier argued that this new law provision did not apply to the claim because Guerra’s injury occurred prior to January 1, 1991. The court agreed with the carrier:

The current version of the TWCA was enacted in 1989, and the implementing legislation provided that the Division “shall process claims for injuries occurring before January 1, 1991, in accordance with the law in effect on the date that the injury occurred, and the former law is continued in effect for this purpose.” Act of Dec. 11, 1989, 71st Leg., 2d C.S., ch. 1, § 17.18, 1989 Tex. Gen. Laws 122, 122; see City of Houston v. Rhule, 417 S.W.3d 440, 442 (Tex. 2013) (“The statute in effect at the time of injury controls.”); Nat’l Union Fire Ins. Co. of Pittsburgh, Pa. v. Reyna, 897 S.W.2d 777, 778 (Tex. 1995) (per curiam) (applying the version of the TWCA in effect at the time of the injury, not the version in effect at the time of suit). Article 8307, § 5 of the old law provided in part that, if a party seeks judicial review of a Board order, “the court shall . . . determine the issues in such cause, instead of the Board, upon trial de novo, and the burden of proof shall be upon the party claiming compensation.” Act of Mar. 28, 1917, 35th Leg., R.S., ch. 103, 1917 Tex. Gen. Laws 269, 269 (repealed 1989); see Martinez v. Second Injury Fund of Tex., 789 S.W.2d 267, 276 (Tex. 1990).

The court of appeals affirmed the judgment of the trial court.