Opinion

Accident Fund Insurance Company of America and Texas Cotton Ginners' Trust v. Texas Department of Insurance, Division of Workers' Compensation

Court
Texas Supreme Court
Filed
Feb 7, 2025
Status
Published
Cited by
0 cases
Authority
More cited than 36.4%

The opinion

Supreme Court of Texas

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No. 23-0273

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Accident Fund Insurance Company of America

and Texas Cotton Ginners’ Trust,

Petitioners,

v.

Texas Department of Insurance,

Division of Workers’ Compensation,

Respondent

═══════════════════════════════════════

On Petition for Review from the

Court of Appeals for the Third District of Texas

═══════════════════════════════════════

and

══════════

No. 23-0950

══════════

Accident Fund General Insurance Company,

Petitioner,

v.

Rodrigo Mendiola,

Respondent

═══════════════════════════════════════

On Petition for Review from the

Court of Appeals for the Thirteenth District of Texas

═══════════════════════════════════════

JUSTICE YOUNG, joined by Justice Sullivan, concurring in the

denial of the petitions for review.

These two petitions—coincidentally filed by two subsidiaries of

the same parent company—are unrelated to each other but bear several

important similarities. Both raise significant statutory-interpretation

questions; both implicate (albeit in different ways) the proper role of

administrative agencies as compared to the courts; and both involve

issues that this Court may well need to address in a future case. But

the most important similarity is that neither petition offers the Court a

suitable vehicle to engage in such review now. I therefore concur in the

denial of both petitions for review.

The petition process is somewhat opaque, and it is understandably

frustrating to receive a denial without explanation—especially after

going through the process of full merits briefing, as with one of these

cases. But providing such an explanation is typically not feasible. For

one thing, the motivations of the members of the Court may well vary or

even conflict; for another, our docket is such that investing the time and

resources to explain every discretionary determination would undermine

the Court’s ability to discharge its duties without a concomitant benefit

to the bar or the lower courts. But a brief explanation as to these two

cases strikes me as warranted. I therefore write separately to explain

why the petitions raise significant legal issues and to emphasize that

denying review does not suggest that those issues are settled. To the

contrary, in a proper future case, I can readily imagine voting to grant

a petition.

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I

The petitions each challenge an aspect of Texas’s nearly billion-

dollar workers’ compensation program. I begin with the broader facial

challenge to a rule promulgated under that program, then turn to a

challenge to the specific award of benefits to a single claimant.

A

In No. 23-0273, the court of appeals rejected a facial challenge to a

rule promulgated by the Department of Insurance. Tex. Dep’t Ins. v.

Accident Fund Ins. Co., No. 03-21-00074-CV, 2023 WL 2286662 (Tex.

App.—Austin Feb. 28, 2023). The challenged rule is codified at 28 Tex.

Admin. Code § 130.102(d)(1)(D) and governs eligibility for “supplemental

income benefits,” which provide longer-term support to injured workers—

specifically, a fixed income for those with an impairment rating of 15%

or greater. See Tex. Lab. Code § 408.142(a)(1).

To protect the integrity of the benefits fund and preserve its

availability for the deserving, the legislature has established eligibility

criteria. As relevant here, the statute requires beneficiaries to provide

evidence of “active work search efforts documented by job applications

submitted by the recipient.” Id. § 408.1415(a)(3) (emphasis added). The

department’s implementing rule requires evidence only of “job

applications,” 28 Tex. Admin. Code § 130.102(d)(1)(D), without any

reference to their having been “submitted by the recipient” of the benefits,

see Tex. Lab. Code § 408.1415(a)(3).

Accident Fund argues that this inconsistency between the statute

and the rule is fatal to the latter. At first glance, it is easy to see why.

The statutory criteria, including the requirement to produce job

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applications, clearly limit the universe of potential beneficiaries. For any

limitation to matter, it presumably operates to exclude some applicants

from benefits that they would receive if the limit did not exist. Applied

here, the statute denies benefits to applicants who meet every other

requirement but who cannot produce job applications demonstrating

their active search for work. Accident Fund argues that by removing the

requirement that applications be “submitted by the recipient,” the rule

has lowered the bar that the legislature set, thus expanding availability

for supplemental income benefits beyond what the statute authorizes.

According to Accident Fund, removing the submission requirement

allows nearly any inquiry (including a call that merely asks if a business

is even hiring) to qualify as a job application.

Accident Fund’s initial premise is surely correct: a stroke of the

department’s rulemaking pen cannot nullify any condition that the

legislature imposes on the entitlement to benefits. “Given the vast power

allocated to governmental agencies in the modern administrative state,”

our exercise of “judicial oversight . . . represents an important check on

government power that might otherwise exist without meaningful

limits.” Nat’l Ass’n of Indep. Insurers v. Tex. Dep’t of Ins., 925 S.W.2d

667, 670 (Tex. 1996). On its face, then, Accident Fund’s petition appears

to implicate weighty questions for our attention, potentially rising to the

level of unauthorized assumption of legislative power by an executive-

branch agency.

The nature of Accident Fund’s challenge, however, prevents us

from reaching the question presented. Where a party brings a facial

challenge of this sort, it must show that the rule’s text is invalid—in this

4

case, that the rule is inherently incompatible with the enabling statute.

See Tex. Bd. of Chiropractic Exam’rs v. Tex. Med. Ass’n, 616 S.W.3d 558,

570 (Tex. 2021) (citing Tex. Gov’t Code § 2001.038(a)). No arbitrary hoop

to clear, this limitation recognizes that “facial challenges threaten to

short circuit the democratic process by preventing duly enacted laws from

being implemented” legally. Moody v. NetChoice, LLC, 603 U.S. 707, 723

(2024) (citation and internal quotation marks omitted). This logic applies

perforce to facial rule challenges: striking down rules in toto risks

treading on the legislature’s and executive’s authority to respectively

make and enforce the law.

Accident Fund defends its challenge by suggesting that it would

violate the statute if actions like merely phoning a business to ask if it is

hiring satisfy the statute’s “submitted by the recipient” requirement. But

neither do such acts clearly fall within the meaning of “job application,”

a term used in both the statute (§ 408.1415(a)(3)) and the rule

(§ 130.102(d)(1)(D)). Assuming that it would be an error for the

department to approve a claim after such a desultory effort to satisfy the

requirement for benefits, would the “submitted by the recipient”

requirement be what makes that approval an error? Or would it be an

overbroad reading of “job application”? I see no clear articulation of how

the rule necessarily requires deviation from what the statute requires—

in other words, the parties offer no example of a case that would

inexorably yield one result under the statute but another under the rule.

At the very least, therefore, this facial challenge to the rule is not one that

clearly warrants this Court’s further review.

Of course, if the department ever orders an insurer to pay benefits

5

authorized by the rule but forbidden by the statute, that order will be

subject to challenge. If the insurer prevails, the resulting precedent

would compel the department to follow the statute, which I take to be

Accident Fund’s real goal in this case. The pending petition, by contrast,

involves a theoretical challenge—there may never be any actual case in

which the rule’s omission of the statutory language has an effect that

contravenes the statute.

Accordingly, scrutiny of the rule by this Court at this stage would

be of relatively little benefit and might do some harm. My vote may have

been different if Accident Fund had shown why the rule, as drafted, would

inescapably violate the statutory mandate—and I would likely vote to

grant a petition brought by Accident Fund or any insurer able to show in

a specific case that the application of the rule has violated the statutory

mandate. If a case like that arises, we can resolve it on a good record; if

one never comes, then it would confirm the wisdom of declining to take it

on as a facial challenge.

B

Accident Fund’s other petition does challenge a specific award of

benefits, but denial of the petition is again appropriate. In No. 23-0950,

Accident Fund General Insurance Co. v. Mendiola, Accident Fund

challenges an award of “lifetime income benefits” to Rodrigo Mendiola.

Mendiola claimed benefits after asphalt from a truck he was driving

spilled into the cabin, resulting in severe burns across the left side of his

body. Mendiola’s left leg was amputated above the knee, and he required

extensive surgeries and skin grafts across his left side. According to

expert testimony, these surgeries left Mendiola’s left hand “so frozen and

6

so [e]ncased by scar that . . . there [is] no function of that hand.” No. 13-

21-00361-CV, 2023 WL 6631948, at *1 (Tex. App.—Corpus Christi–

Edinburg Oct. 12, 2023) (emphasis added). Though Mendiola still has a

left hand in the literal sense, it only functions “like a club.” Id.

In this case, the department initially ruled against Mendiola, and

it was through litigation that he ultimately prevailed. In challenging the

award of benefits as ordered by the district court and affirmed by the

court of appeals, Accident Fund raises a serious legal argument: that the

lower courts improperly ignored a statute in favor of an older, judge-made

standard when determining that Mendiola suffered a loss of his left hand

sufficient to trigger his entitlement to benefits.

The standard that the courts below followed comes from this

Court’s 62-year-old decision in Travelers Insurance Co. v. Seabolt, 361

S.W.2d 204 (Tex. 1962). We there defined “total loss of the use of a

member” to mean that “such member no longer possesses any substantial

utility . . . or [its] condition . . . is such that the workman cannot procure

and retain” employment requiring its use. Id. at 206. Unsurprisingly,

Texas workers’ compensation law has changed dramatically in the six

decades since Seabolt. The statute that Seabolt interpreted no longer

exists. A new, differently worded provision, enacted in 1993 and codified

at Labor Code § 408.161, now governs the award of lifetime benefits. As

pertinent to Mendiola’s case, the statute mandates payment of benefits

for the “loss of one hand at or above the wrist,” while clarifying that “the

total and permanent loss of use of a body part is the loss of that body part.”

Tex. Lab. Code § 408.161(a)(4), (b) (emphasis added).

The parties heavily debate the import of token citations of Seabolt

7

by this Court over the years. But when there is a valid exercise of

legislative authority, it is axiomatic that “the more recent statutory

enactment prevails over an earlier statute,” City of Dallas v. Mitchell,

870 S.W.2d 21, 23 (Tex. 1994), which also means that a newer statute

supersedes case law interpreting or applying an older statute. These

principles create no “conflict.” When the judicial branch authoritatively

determines the meaning of particular statutory language, the legislature

cannot countermand the interpretation—but it can change the law by

enacting a new statute or amending an existing one. When it does so, the

judiciary’s duty is to cheerfully apply the text of the new law rather than

the judicial gloss on an old law.

All this is to say that, to the extent any court cites a judicial

decision like Seabolt in derogation of the plain meaning of current and

controlling statutory law, it does so erroneously. Without taking any view

on whether such an error occurred below, however, I conclude that this

case does not provide a good opportunity to examine Seabolt’s continuing

viability. To see why, consider the purported difference between the

standards in Seabolt and in § 408.161 as it stands today:

• Seabolt provides that “total loss of the use of a member” for

benefits purposes may exist in two situations: first, where the

member “no longer possesses any substantial utility”; and

second, in what the Court referred to as a “broader concept,”

where loss of the member “prevent[s] the workman from

procuring and retaining employment requiring” its use. 361

S.W.2d at 206.

• Today’s § 408.161(b) makes no mention of employment, instead

8

requiring proof of “total and permanent loss of use of a body

part.” Tex. Lab. Code § 408.161(b).

Under either standard, Mendiola’s injury qualifies for benefits. As

the court of appeals described, one result of his injuries is that Mendiola

“drops objects, can only use his left hand as one would [use] a club,” and

“experiences pain after performing tasks” in even this limited way. 2023

WL 6631948, at *5.

In other words, this case provides no useful opportunity to choose

between apparently competing standards because they do not compete

in this case. Whether the inquiry is about “substantial utility,”

“procuring and retaining employment,” or simply “total and permanent

loss of use,” the facts below clearly show that Mendiola meets the test.

As such, the result here will be the same regardless of whether Seabolt

governs, or whether the statutory language governs, or whether Seabolt

maps closely onto the statute, or whether the current text should be

understood in light of rather than in contradistinction of Seabolt. The

court of appeals rightly affirmed the result, even if its reasoning was

unsound—a question on which I express no view. This Court’s definitive

guidance will be better given when we have a case in which the record

helps us to refine the meaning of the standard that we will direct the

lower courts to follow. This record does the opposite.

The Court therefore properly denies the petition, which raises no

other worthwhile grounds for reversal. But as with Accident Fund’s first

petition, the question raised by this one remains serious. If a future case

arises in which the choice between Seabolt and the current statutory text

is outcome-determinative, this Court’s selection of the proper standard

9

would actually matter—and that will be a case in which the Court could

properly expend the energy to clarify the law. If no such case ever comes

to us, it will mean that the department and the lower courts are already

resolving any potential tension.

II

These cases illustrate that denial of a petition for review does not

necessarily reflect disagreement with the petition’s legal assertions or

suggest that the petition presents matters that are not important to the

jurisprudence of the State. The challenge to the department’s alleged

overbroad reading of “job applications” adequate to warrant supplemental

income benefits would likely merit review, for example, if brought to

challenge a specific award or if brought in the context of a showing that

the rule would clearly mandate unlawful awards. Administrative

agencies in Texas have seemingly never enjoyed the deference once

endorsed by the U.S. Supreme Court, see Chevron, U.S.A., Inc. v. Nat.

Res. Def. Council, Inc., 467 U.S. 837 (1984), although our cases have

occasionally hinted that “the analysis in which we engage is similar,” R.R.

Comm’n of Tex. v. Tex. Citizens for a Safe Future & Clean Water, 336

S.W.3d 619, 625 (Tex. 2011). If ever there were a time to transform

similarity into sameness (a doubtful proposition all along in this context),

it is certainly not now, when the Supreme Court has decidedly abandoned

Chevron as “fundamentally misguided.” See Loper Bright Enters. v.

Raimondo, 603 U.S. 369, 407 (2024). In a future case challenging a

specific award of supplemental income benefits, then, this Court could

(and should) assess critically an agency’s power to rewrite, under the

guise of interpretation, the statutory criteria that limit benefits awards.

10

The same is true of the trial court’s use of the Seabolt standard in

the second petition. Here, the waters are not clouded by agency

authority—the alleged error is one of pure judicial decision-making.

Where judge-made law, even judge-made law from the State’s highest

court, is superseded by valid legislation that adopts a different standard,

the judicial task is clear: applying the plain text of the new law as chosen

by the People’s legislative representatives. Reflexively citing an old

standard may reflect commendable respect for stare decisis, a respect

duly noted by the court of appeals in Mendiola. But stare decisis itself

requires that a precedent yield when it has been “superseded” by “higher

authority,” which includes “an applicable legislative . . . provision.”

Mitschke v. Borromeo, 645 S.W.3d 251, 256–57 (Tex. 2022). Because

Mendiola wins either way, the question presented turns out to be

abstract. If the courts are in fact misidentifying or misapplying the

binding law of the State in material ways, then a future challenge under

§ 408.161 may well warrant review. If no petition alleging such conflict

ever comes, then perhaps Seabolt and the current statute are not actually

at odds after all.

* * *

For the foregoing reasons, I respectfully concur in the denial of the

petitions for review, even as I acknowledge the potentially significant

issues that the petitions raise.

Evan A. Young

Justice

OPINION FILED: February 7, 2025

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This is a copy of a public record, reproduced as it was published. It is not legal advice, and it may not be the version a court would rely on. Check the official source before you cite it.

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