Rosendo Morales v. Texas Department of Insurance-Division of Workers' Compensation, and Commissioner Ryan Brannan, in His Official Capacity
03-14-00808-CV
Tex. App.
May 27, 2015

Background

  • Claimant Rosendo Morales suffered a compensable work injury (11/22/2010), received a multi‑level cervical fusion before reaching statutory MMI, and disputes the DWC-designated doctor’s 13% whole‑person impairment rating.
  • Morales exhausted administrative remedies: a DWC contested‑case hearing resulted in the designated‑doctor rating and a final administrative decision adverse to Morales.
  • Morales sued in Bell County district court seeking: (a) judicial review of the DWC decision and (b) declaratory relief that the Labor Code and the AMA Guides require consideration of pre‑MMI spinal surgery when assigning impairment ratings.
  • The DWC and the Commissioner intervened and filed pleas to the jurisdiction asserting sovereign immunity; the district court granted those pleas and dismissed DWC and the Commissioner.
  • Morales appealed the interlocutory dismissal, arguing (1) declaratory relief under the UDJA is available to construe statutes and bind the agency when the agency’s interpretation violates statute, and (2) the DWC and Commissioner are necessary parties to make any declaration enforceable.

Issues

Issue Plaintiff's Argument Defendant's Argument Held (as argued by appellant)
Whether district court has jurisdiction to hear a UDJA declaratory action challenging DWC statutory interpretation after exhaustion of administrative remedies Morales: UDJA permits statutory construction claims; DWC and Commissioner are necessary parties so declarations are enforceable and immunity is waived in this context DWC: sovereign immunity bars UDJA suits against the agency; judicial review under Chapter 410 is the exclusive remedy Appellant urges reversal: declaratory relief is proper after administrative exhaustion; DWC and Commissioner are necessary parties or ultra vires official suits lie against commissioner
Whether pre‑MMI spinal surgery must be considered in impairment ratings under Labor Code and AMA Guides Morales: pre‑MMI spinal fusion and its effects must be considered when certifying an impairment at MMI; DWC’s use of Lumbermens dicta to exclude such surgeries is erroneous DWC/Carrier: reliance on prior decisions (Lumbermens) and agency practice to exclude or limit consideration of pre‑MMI surgery in some ratings Appellant contends the law and AMA Guides permit (and in some models require) considering pre‑MMI surgery; resolution requires declaratory ruling
Whether the DWC may be dismissed as a party in a declaratory action that seeks to bind the agency’s interpretation Morales: Texas jurisprudence (Leeper/DeQueen, Lumbermens, Nat’l Am.) supports joining the agency for statutory construction claims; UDJA §37.006 requires joinder of affected parties DWC: agency immunity and propriety of Chapter 410 review limit such actions against agency Appellant argues the agency is a proper/necessary party and the dismissal was error
Proper judicial review route and venue when declaratory relief overlaps Chapter 410 remedies Morales: Chapter 410 review exists but does not preclude UDJA actions; venue is the claimant’s county under §410.252 DWC/Carrier: Chapter 410 procedures control and may limit declaratory actions or affect venue Appellant asserts Chapter 410 does not preclude a UDJA claim and venue requirements do not defeat joinder of DWC

Key Cases Cited

  • Brooks v. Northglen Ass'n, 141 S.W.3d 158 (Tex. 2004) (UDJA party‑joinder and declaratory‑relief principles)
  • Tex. Dep't of Ins., Div. of Workers' Comp. v. Lumbermens Mut. Cas. Co., 212 S.W.3d 870 (Tex. App.—Austin 2006) (district court jurisdiction under UDJA to construe workers’ comp statutes)
  • Nat'l Am. Ins. Co. v. Tex. Prop. & Cas. Ins. Guar. Ass'n, 208 S.W.3d 523 (Tex. App.—Austin 2006) (discussing interplay of UDJA and workers’ comp statutory rights)
  • Tex. Lottery Comm'n v. First State Bank of DeQueen, 325 S.W.3d 628 (Tex. 2010) (UDJA suits to construe statutes and joinder of governmental entities)
  • Tex. Nat. Res. Conservation Comm'n v. IT‑Davy, 74 S.W.3d 849 (Tex. 2002) (private parties may seek declaratory relief against state officials acting beyond authority)
  • Tex. DOT v. Sefzik, 355 S.W.3d 618 (Tex. 2011) (discussion of UDJA limits and ultra vires claims against officials)
  • Tex. Dep't of Parks & Wildlife v. Miranda, 133 S.W.3d 217 (Tex. 2004) (plea to jurisdiction standards; construe allegations in plaintiff's favor)
  • Tex. Workers' Comp. Ins. Fund v. Tex. Workers' Comp. Comm'n & Watts, 124 S.W.3d 813 (Tex. App.—Austin 2003) (carrier brought UDJA claim against TWCC after exhaustion)
  • Severiano DeLeon v. Royal Indem. Co., 396 S.W.3d 597 (Tex. App.—Austin 2010) (left open the question whether pre‑MMI surgery must be considered in spine impairment ratings)
Read the full case