Two of the Most Important WC Cases You’ve (Probably) Never Heard of
Groundbreaking cases are not always sexy. But the significance of two technically complex cases presently pending before the Texas Supreme Court cannot be understated.
One case, Chicas v. Texas Mutual Insurance Company, is pending on petition for review. This means that the court has not (yet) agreed to hear the case. The second case, State Office of Risk Management v. Martinez, was argued to the court October 12, 2017.
Chicas v. TMI
The issue in Chicas is whether the deadline to file suit for judicial review in a workers’ compensation case is a jurisdictional deadline or a statute of limitations. The intermediate Courts of Appeals are divided in their approach to the question.
Most of these courts have concluded that the issue is one of jurisdiction. But one earlier decision decided otherwise, reasoning that the defense is one of limitations. The Chicas court agreed with this earlier decision.
Both cases rely upon the reasoning of a 17-year-old, non-WC case, called Dubai Petroleum Co. v. Kazi. In Dubai, the Texas Supreme Court partially overruled a very old (1926) case, Mingus v. Wadley, which was a workers’ compensation case. Mingus has been cited for decades for the proposition that the failure of a party to satisfy a statutory prerequisite, such as timely filing a suit for judicial review, is a jurisdictional defect that could be raised at any stage of the proceedings.
Jurisdictional arguments can be raised by a party at any stage of the proceedings (even, for the first time, on appeal). They may be challenged through the extraordinary writ of a petition for writ of mandamus. Defenses based on the statute of limitations must be raised in the pleadings and decided based on a motion for summary judgment.
The Court of Appeals in Chicas wrote:
Texas Mutual contends that the 45-day deadline for seeking judicial review set forth in section 410.252(a) is jurisdictional. The trial court agreed and granted Texas Mutual’s plea to the jurisdiction. In her sole issue on appeal, Bertila contends “[t]he trial court erred in dismissing [her] judicial review claims because the 45-day deadline was tolled while the claims were pending in probate court.” Texas Mutual responds that, because the 45-day deadline is jurisdictional, it cannot be tolled by section 16.064 of the Civil Practices and Remedies Code.
Bertila’s present suit was admittedly filed more than 45 days after the DWC’s decision became final; but, if the 45-day deadline is not jurisdictional and was tolled while her judicial review claims were pending in probate court, then her suit for judicial review would be timely. Thus, the issue presented to this Court is whether the 45-day deadline for filing claims for judicial review of a final DWC decision is a jurisdictional, statutory prerequisite to asserting those claims in district court.
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[I]n 2000, the Texas Supreme Court overruled prior authority, which had held that the failure to comply with statutory prerequisites was always jurisdictional. See Dubai Petroleum Co. v. Kazi, 12 S.W.3d 71, 76 (Tex. 2000) (overruling Mingus v. Wadley, 285 S.W. 1084, 1087 (Tex. 1926)). In Kazi, the Supreme Court considered the jurisdictional nature of a statutory requirement that, in wrongful death suits involving the death of a citizen in a foreign county, the foreign county have “equal treaty rights” with the United States. Id. at 73–74. The supreme court noted that classifying a matter as jurisdictional “opens the way to making judgments vulnerable to delayed attack for a variety of irregularities that perhaps better ought to be sealed in a judgment[,]” and overruled prior case law to the contrary “to the extent that it characterized the plaintiff’s failure to establish a statutory prerequisite as jurisdictional. Id. at 76. Instead, “[t]he right of a plaintiff to maintain a suit, while frequently treated as going to the question of jurisdiction, has been said to go in reality to the right of the plaintiff to relief rather than to the jurisdiction of the court to afford it.” Id. at 76–77.
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After considering (1) the statutory language, (2) the statute’s purpose, (3) the consequences of each interpretation, and (4) whether the statute defines, enlarges, or restricts the class of causes the trial court may decide or the relief that it may award, we conclude that, while the 45-day deadline for filing judicial review claims is mandatory, it is not jurisdictional.
CONCLUSION
Texas Mutual’s plea to the jurisdiction is entirely premised on the assumption that the tolling provision found in section 16.064 does not apply to statutory prerequisites that are jurisdictional, and that the 45-day deadline for filing judicial review claims is jurisdictional. However, we hold that the 45-day deadline for filing judicial review claims found in section 410.252(a) of the Labor Code is not jurisdictional. Therefore, the trial court erred in granting Texas Mutual’s plea to the jurisdiction.
SORM v. Martinez
The issue in Martinez is: what constitutes an issue?
The Texas workers’ compensation system is an issue-driven system. When a dispute is raised by the parties, the Division’s jurisdiction – the power of the agency to decide the dispute – is limited to the issue that the dispute involves. For example, if the parties disagree over a disability issue, the Division may not, on its own, also decide an issue of MMI or impairment rating. And no other issue may be raised later in the process, such as before the Appeals Panel or on judicial review in district court. So the power of the hearing officer to decide an issue restricts the power of the Appeals Panel or a reviewing court to decide any other issue. Issues that are not appealed can become final, while other issues that are appealed can still be challenged.
This is unlike old law (cases before January 1, 1991) where a dispute over a single issue gave the Agency the power to decide any other issue that might crop up somewhere in the dispute resolution process. It’s important, therefore, for parties, the Division, and courts to clearly understand what actually constitutes an “issue.”
Edna Martinez was employed as a Child Protective Services Specialist II with the Texas Department of Public and Regulatory Services. On Saturday, June 9, 2001, Martinez was injured when she fell in the kitchen and dining area of her own home. Martinez reported the injury to her employer and filed a claim for workers’ compensation benefits.
After Martinez made the claim, her employer filled out an initial accident report stating, in part, “unknown if accident happened in work area.” Martinez reported that she believed her injuries occurred as a result of slipping on moisture on her kitchen floor Martinez’s fall occurred away from her office, on premises not controlled by her employer. Martinez’ claim was disputed by the State Office of Risk Management, which administers claims reported by state employees.
At a CCH, the issues presented were 1) Did the Claimant sustain a compensable injury on June 9, 2001; and 2) Did the Claimant sustain disability as the result of the June 9, 2001, claimed injury, and if so, for what period(s)? At the CCH, SORM argued that Martinez violated a rule of the employer because she was working at home on the weekend without prior permission, a violation of her employer’s employment policies.
The Hearing Officer found that Martinez did not sustain a compensable injury, and because she did not sustain a compensable injury she did not have disability. The Appeals Panel reversed the Hearing Officer and rendered a decision that Martinez was injured while in the course and scope of her employment. SORM sought judicial review on the same two issues. Subsequently, SORM filed a Motion for Summary Judgment based upon the argument that a compensable injury is precluded because Martinez specifically violated Texas Government Code § 658.010 and § 659.018, which regulates State employee work hours, including the location of where work may be performed. The Court of Appeals decision held that SORM failed to raise this argument at the administrative level and was, therefore, precluded from raising it for the first time on judicial review. Martinez v. State Office of Risk Mgmt., No. 04-14- 00558-CV, 2016 WL 548115 (Tex. App.—San Antonio, February 10, 2016) (mem. op.). One judge filed a concurring and dissenting opinion. Both SORM and Martinez sought review by the Supreme Court.
Texas courts are divided on whether an “issue” under the workers’ compensation act is the issue decided by the Division, such as whether Martinez was injured in the course and scope of her employment, or whether an “issue” is something narrower, like the specific argument why Martinez may not have been in the course and scope of her employment at the time of her injury. If an issue is defined narrowly, a trial court cannot hear new arguments to old issues.
In TIG Premier Ins. Co. v. Pemberton, 127 S.W.3d 270, 276 (Tex. App.—Waco 2003, pet. denied) and Texas Mut. Ins. Co. v. Ochoa, 04-09-00401-CV, 2010 WL 2844464 (Tex. App.—San Antonio July 21, 2010, no pet.), the courts utilized a narrow definition of an “issue” In Pemberton the court held that a workers’ compensation claimant had forfeited his right to challenge the contested case Hearing Officer’s finding of no causal relationship because he did not raise the issue with the Appeals Panel, even though the insurance carrier was the party who appealed. In Ochoa the court concluded that because neither party appealed the Division’s decision on the causation issue – which the Division decided in favor of the carrier – that issue became final and binding. Lopez v. Zenith Ins. Co., 229 S.W.3d 775, 778 (Tex. App. – Eastland 2007, pet. denied) used similar reasoning, holding that a party failed to exhaust administrative remedies by failing to appeal a Hearing Officer’s findings of fact to the Appeals Panel.
In contrast, in Tex. Workers’ Comp. Ins. Fund v. Tex. Workers’ Comp. Comm’n, 124 S.W. 3d 813 (Tex. App.—Austin, 2003, pet. denied) the court explained that “issues” in the context of the Texas Workers’ Compensation Act should be viewed broadly, holding that an “issue” refers to the disputed determinations made by the Hearing Officer in rendering his decision, not any “subarguments” that may have been raised in connection with that issue. This view has been followed in Zurich Am. Ins. Co. v. Debose, 01-13-00344-CV, 2014 WL 3512769 (Tex. App.—Houston [1st Dist.] July 15, 2014, pet. denied) and In re Metro. Transit Auth., 334 S.W.3d 806 (Tex. App.—Houston [1st Dist.] 2011, no pet.).
Martinez is likely to be decided by the court in early 2018. If the court shows interest in Chicas, the next step would be for the court to ask the parties to fully brief the arguments presented. That request could be forthcoming relatively quickly, even as soon as within a matter of weeks.
FOLIO
