Supreme Court Declines to Hear Two Comp Cases, But Hears Arguments in a Third

The Texas Supreme Court turned down two appeals arising out of workers’ comp claims last week. On November 15, 2019, the Court denied petitions for review in Holt, Dixon, Nations & Acevedo v. Texas Dept of Ins., et al., No. 19-0255 and State Office of Risk Management v. Martinez, No. 19-0559. Both cases addressed substantive and procedural aspects of the Texas workers’ comp system.

In Holt, Third Court of Appeals issued an opinion that affirmed the constitutionality of the attorneys’ fees provisions of the Texas Workers’ Compensation Act, while also addressing a plethora of other substantive and procedural issues. The court considered a number of other constitutional challenges to the Act and resolved each of them against the claimants who brought them.

The Martinez decision involved the compensability of an injury that was alleged to have happened in the employee’s own kitchen. In Martinez, the court concluded that “under the facts presented in this case Martinez’s home [was] not a location that can give rise to a workers’ compensation claim.”

Constitutionality of Attorneys’ Fees System

The attorneys’ fees challenge in Holt is among the Austin court’s most important holdings.

We next address appellants’ challenges to the statutory provisions limiting the awarding of attorney’s fees in the workers’ compensation context. Appellants complain of section 408.221, which provides that “an attorney’s fee may not exceed 25 percent of the claimant’s recovery” unless the carrier seeks judicial review and loses, and that the attorney’s fees “shall be paid from the claimant’s recovery.” Tex. Lab. Code § 408.221(b), (h). Appellants urge that they as claimants are on unequal footing to insurance carriers and assert that injured workers such as themselves “are unable to procure services through financial payment of an attorney even if a claimant could afford such, and this prohibits meaningful remedies being accorded to injured workers whose benefits are greatly reduced under [the Act].” However, appellants are represented by counsel in this appeal, they were represented by the same attorney in the trial court, and Holt and Acevedo, at least, were assisted at the administrative level by an ombudsman, as provided for by chapter 404 of the labor code. See id. §§ 404.101 (Office of Injured Employee Counsel shall through ombudsman program provide assistance to claimants during benefits disputes), .105 (office through ombudsman program may appear in administrative proceeding to assist claimant); see generally id. § 404.001-.155 (“Office of Injured Employee Counsel”). They thus have not shown that they have been harmed by the 25 percent cap.

Further, the supreme court has already considered the Act’s limitation on attorney’s fees, noting that the Act capped such fees at 25 percent of the claimant’s recovery and holding:

Requiring an attorney to charge a reasonable fee is a valid exercise of the Legislature’s police power. The fee limitations under the Act apply to both sides to the controversy, except for the 25 percent cap. This distinction is not irrational, however, as the Legislature could have concluded that injured employees must ultimately be guaranteed at least 75 percent of the benefits provided if they are to maintain the support of themselves and their families.

Nothing in the record establishes that the fee limitations are so egregious that they will result in a claimant being denied needed legal representation. Although there was testimony that some attorneys no longer accept compensation cases under the Act, there was no showing of any claimant who could not obtain counsel. Based on this record, we hold that the fee limitations do not facially violate the guarantee of due course of law or equal protection.

Texas Workers’ Comp. Comm’n v. Garcia, 893 S.W.2d 504, 533 (Tex. 1995). Based on this record, we will not revisit the supreme court’s conclusions in Garcia.

Course and Scope for a State Employee’s Home-Based Injury

The court’s denial of the petition for review leaves standing the ruling of the San Antonio Court of Appeals that a state employee’s alleged injury while working from home did not occur while in the course and scope of her employment.

The State Office of Risk Management had argued that Martinez violated a state statute by failing to obtain permission to work at home, which, SORM argued, removed her from the course and scope of her employment at the time of her injury. The Fourth Court of Appeals agreed with SORM that the claim was not compensable.

Section 401.011(12) provides a definition of course and scope of employment that includes an activity conducted on the premises of the employer and may include activities conducted at other locations. Sections 658.010 and 659.018 then limit where those activities may be conducted at other locations by providing that a state employee may work at his home if he obtains prior written authorization. We do not see these statutes as irreconcilable, and even if they were, sections 658.010 and 659.018 would control because section 401.011(12) is merely a general definition while sections 658.019 and 659.018 are specific as to where a state employee may conduct state business. See TEX. GOV’T CODE ANN. § 311.026.

For the reasons stated above, we hold that sections 658.010 and 659.018 of the Government Code limit a state employee’s scope of employment by mandating that the state employee obtain prior written authorization before working at home. Accordingly, assuming Martinez failed to obtain prior written approval from her supervisor before working at home, her injury is not compensable.

The summary judgment record includes Martinez’s testimony from the benefit review conference where Martinez unequivocally testified she did not obtain prior approval before working from home. As it is undisputed that Martinez did not comply with sections 658.010 and 659.018 of the Government Code before working from home, she was not acting within the scope of her employment when she was injured. Therefore, she did not sustain a compensable injury.

Sheriff Deputy’s Fatal Drive Home

On November 5, 2019, the Supreme Court heard arguments in a course and scope case involving a fatal motor vehicle accident incurred by a deputy sheriff. The underlying decision, which the Court agreed to review, is County of El Paso v. Orozco, No. 08-15-00079-CV, decided December 21, 2016. There, the court considered a petition for review filed by the deputy sheriff’s widow which claimed that he had died in the course and scope of his employment for the County. The court of appeals had held that the employee had not been acting in the course and scope of his employment when he died in an automobile accident while traveling home from an “extra-duty” assignment in a marked patrol unit. The court’s decision is pending but not expected before the end of the year.