Texas high court hears dispute over whether workers' comp agency must decide if an injury was in the course and scope of employment

WACO, Texas — The Supreme Court of Texas heard oral argument in UT Rio Grande Valley v. Oteca about whether the Division of Workers’ Compensation must decide, before a district court can resolve a negligence suit, whether an injury occurred in the course and scope of employment.

The issue could determine whether injured plaintiffs who sue tortfeasors may be forced first into the administrative workers’ compensation process. That route can bar common-law claims if the Division finds the injury compensable, and the question presented could affect procedural strategy and timing for both injured workers and employers.

At the argument, counsel for the petitioner said the Legislature intended the Division to have exclusive jurisdiction over entitlement to workers’ compensation benefits and related coverage questions. “The question before the Court today is whether an injured employee can circumvent the Texas Workers’ Compensation Act when she sues her subscribing employer in negligence while there is a question of whether the injury that she sustained occurred in the course and scope of her employment,” Ms. Tripp, counsel for the petitioner, told the court. She argued the Division has the expertise to decide those questions and that the Texas Labor Code’s exclusive-remedy provision — Texas Labor Code section 406.034 — bars common-law claims if the Division later determines the injury was work related.

Responding for the respondent, Mr. Messina said the suit before the district court was a negligence action against a police officer, not an action against the employer. “Miss Oteca did not bring suit against her employer. She brought suit against a police officer who was negligent and caused her some very severe personal injuries,” Mr. Messina said. He said the practical sequence in the record — a carrier denial letter followed later by acceptance — matters for whether a plaintiff must exhaust the administrative process before proceeding in court.

The justices pressed both sides on statutory text and consequences. Several justices asked whether the Labor Code contains an explicit ouster of district-court jurisdiction, and whether the statute’s administrative-review scheme (including Texas Labor Code section 410.251 and the modified de novo standard on judicial review) implies that the Division should resolve course-and-scope questions first. The petitioner pointed to multiple appellate decisions and the court’s own precedents as support for an administrative-first approach; the respondent emphasized that a plaintiff’s common-law negligence claim does not inherently seek workers’ compensation benefits and that requiring immediate administrative resolution could prejudice plaintiffs or create unfair tactical results.

Counsel and justices explored practical hypotheticals — for example, coworkers injured while off duty on a weekend trip — to test whether any party could force a claimant into the Division when the claimed conduct was plainly outside employment. The court also discussed administrative mechanics: whether an insurer’s early denial (noted in the record as a PLN1 denial dated 33 days after the incident) obligates a plaintiff to open an administrative claim to obtain a final negative finding and whether an employer or carrier can later request a hearing to assert coverage.

During argument the petitioner noted statutory penalties for frivolous administrative filings, citing Texas Labor Code provisions addressing sanctions; the respondent noted an adjuster’s discretion in accepting or denying a claim and that the initial carrier position can change when new evidence appears in litigation. The transcript record identifies the injury date in the pleadings as May 11 and a carrier denial letter dated June 14; counsel discussed a Rule 11 substitution that brought the employer into the case as a party and other administrative steps the parties pursued during discovery.

After extensive questioning, the court heard both sides and the case was submitted. The justices did not announce a decision at argument.