SIGNIFICANT CASES

Hospitals v. Continental Casualty Company, 109 S.W.3d 96 (Tex. App.-Austin 2003, pet. denied).

As counsel for Continental Casualty Company, we successfully challenged the Texas Workers' Compensation Commission's refusal to apply its own one-year statute of limitations rule to medical disputes filed by Texas hospitals as a result of the prior invalidation of the agency's 1992 Hospital Fee Guideline. The Third Court of Appeals in Austin held that insurers had a vested right to rely on this rule as a defense against claims brought more than one year after the date of service and this right could not be waived by the Commission by entering into a settlement agreement with the hospitals. The Court's decision resulted in the dismissal of approximately 16,000 claims for additional payment filed against Texas workers' compensation insurers. Those claims were estimated to total approximately $280 million dollars, including claims for interest.

See A Landmark Decision for Administrative Law, DOCKET CALL, Winter 2004-05, at 28.

Skilled Craftsmen of Texas, Inc. v. Texas Workers' Compensation Comm'n, 158 S.W.3d 89 (Tex. App.-Austin 2003, pet. dism'd).

On behalf of Skilled Craftsmen of Texas, Inc., we obtained a declaration from the Third Court of Appeals in Austin that the Texas Workers' Compensation Commission's Hazardous Employer Program is pre-empted by federal law. After the company was designated as a "hazardous employer" by the Workers' Health and Safety Division of the Commission, we filed a declaratory judgment action against the Commission seeking a declaration that the state's Hazardous Employer Program was preempted by the federal Occupational Safety and Health Act (OSHA). Finding that the Hazardous Employer Program implicitly regulated workplace safety issues and, thus, was preempted by OSHA, the Court stated, "The Program intimidates and coerces private employers to take action to correct occupational health and safety issues in order to reduce workplace injuries." The Court's decision effectively eliminated the program as applied to private employers in Texas.

Mid Century Ins. Co. v. Texas Workers' Compensation Comm'n, 187 S.W.3d 754 (Tex. App.-Austin 2006, no pet.).

As counsel for Mid-Century Insurance Company (one of the member companies of the Farmers Insurance Group of companies), we filed suit for declaratory judgment against the Texas Workers' Compensation Commission to challenge the validity of Commission rule 131.1(b) regarding payment of Lifetime Income Benefits ("LIBs"). Under the rule, when an injured employee became eligible for LIBs, insurers were required to pay LIBs retroactively back to the employee's original date of disability rather than from the date of eligibility for LIBs forward. In cases where there was a long period between the date of disability and the development of a LIB-qualifying condition, the rule resulted in substantial overpayments to injured employees. On behalf of Mid-Century, we argued that the Commission exceeded its statutory authority in adopting the rule. The Third Court of Appeals in Austin agreed and declared the rule invalid.

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