Pacific Employers Ins. Co. v. Reynolds
| Decision Date | 29 October 1997 |
| Docket Number | No. 04-96-00915-CV,04-96-00915-CV |
| Parties | PACIFIC EMPLOYERS INSURANCE COMPANY, Appellant, v. Michael REYNOLDS, Appellee. |
| Court | Texas Court of Appeals |
John D. Pringle, Robert R. Graves, Jr., Law Offices of John D. Pringle, Harry Deckard, Joseph A. Pitner, Asst. Atty. Gen., Tort Litigation Div., Austin, for appellant.
Robert P. Wilson, Law Offices of Robert P. Wilson, San Antonio, for appellee.
Before STONE, GREEN and ANGELINI, JJ.
This appeal arises from a grant of summary judgment in favor of Michael Reynolds in a suit brought by Pacific Employers Insurance Company seeking judicial review of a decision from the Appeals Panel of the Texas Workers' Compensation Commission. We find that Pacific Employers filed this suit without exhausting its administrative remedies; therefore, the trial court did not have subject matter jurisdiction over this claim. We accordingly vacate the judgment of the trial court and dismiss the suit.
On October 6, 1991, Michael Reynolds suffered an injury on a loading dock during the course and scope of his employment for Merchants Home Delivery. On October 12, 1991, Reynolds either suffered a second injury or aggravated the first while lifting furniture during his employment. Reynolds began a course of medical treatment, and he received compensation benefits from his employer's insurance carrier, Pacific Employment Insurance Company (Pacific). Approximately eighteen months later, Pacific terminated payment and contested Reynolds' claim for benefits with the Texas Workers' Compensation Commission (TWCC). Pacific argued that Reynolds failed to file a compensation claim within one year after the date of his accident, and was therefore not eligible for benefits. Reynolds argued that he had good cause in failing to file a claim because Pacific continued paying for his medical treatment. The contest hearing judge held that Reynolds had good cause in his failure to file the claim and that Pacific waived its right to contest because it did not do so within sixty days of the claim. Pacific appealed this decision to the TWCC's Appeals Panel.
The Appeals Panel affirmed in part, but reversed and remanded the issue of whether Reynolds had good cause in his failure to file a claim within one year after the accident. Even though the Appeals Panel reversed and remanded part of the case, Pacific filed suit in district court seeking judicial review of the Appeals Panel's decision concerning the affirmed issues. In the meantime, the remanded "good cause" issue went back to the contest hearing judge for findings of fact and conclusions of law. The Appeals Panel subsequently decided that Reynolds did not have good cause in failing to file his claim, and held that Pacific was absolved of liability. At this point, Reynolds filed an amended answer to Pacific's suit in district court and included a counter-claim, allegedly appealing the Appeals Panel's final decision to absolve Pacific of liability. Both parties moved for summary judgment, and the trial court ruled in favor of Reynolds. In seven points of error, Pacific appeals the trial court's decision. The Texas Workers Compensation Commission intervened and argues that Pacific erred in filing suit for judicial review prior to a final disposition of the case by the Appeals Panel. We agree with the Commission's argument.
The Workers' Compensation Act allows for judicial review of claims only after the parties exhaust all administrative remedies. TEX. LAB.CODE ANN. § 410.251 (Vernon 1996). The Code specifically states, "A party that has exhausted its administrative remedies under this subtitle and that is aggrieved by a final decision of the appeals panel may seek judicial review under this subchapter and Subchapter G, if applicable." Id. Applying the law to the facts of present case, we find the lower court lacked jurisdiction to hear either Pacific's initial suit or Reynolds' counter-claim.
The trial court did not have jurisdiction to hear Pacific's suit because Pacific had not exhausted its administrative remedies. See T EX. LAB.CODE ANN. § 410.252 (Vernon 1996). Pacific brought suit for judicial review immediately after the Appeals Panel rendered its first decision. However, Pacific had not been aggrieved by a final decision from the administrative process because the Appeals Panel did not dispose of all issues in the claim. The Appeals Panel did not reach a final disposition of the claim until its second decision was rendered on August 3, 1994. Although the first decision resolved all but one of the contested issues, the second Appeals Panel decision reversed the first and rendered an opinion absolving Pacific of liability because Reynolds failed to file a claim and did not have good cause for his untimeliness.
Pacific argues that the district court had jurisdiction over the affirmed issues from the first Appeals Panel because the new workers' compensation law focuses on the disposition of issues rather than claims. In support of this contention, Pacific relies on language in the Workers' Compensation Act. Section 410.204(a) reads that the Appeals Pa...
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