A Texas Workers’ Compensation Update from Downs & Stanford, P.C.
Each month, our team of experienced attorneys monitor developments across the Texas Workers’ Compensation system to bring you concise, practical updates that help you manage risk, control costs, and navigate claims with confidence.
We are excited to bring back our monthly Lunch & Learn program designed to help you stay current on key industry topics while earning continuing education (CE) credit. Each session delivers practical insights you can apply immediately, and you will walk away with CE credit for your participation.
The first 25 adjusters to sign up will be in the course. Once you have registered, you will receive confirmation for the Webinar. The Zoom link will be emailed the Monday before each Webinar. Please note that if you have taken the course before in the last two years, you will not be eligible for credit again per 28 Texas Administrative Code Section 19.1010(7)(c).
Join us on April 10, 2026, from 12:00 P.M. to 1:00 P.M. for a brand-new course to discuss: From Hearing to Appeal: The Judge’s Role in Texas Workers’ Compensation with Britt Clark and Kara Squier – two former Administrative Law Judges
The Division of Workers’ Compensation (DWC) recently released their Rates of Texas Work Related Injuries and Illnesses report, which provides a snapshot of injury frequency in Texas.
For 2024, there were 172,800 total recordable non-fatal cases, which represents an incidence rate of 1.7 cases per 100 full time employees. This is the lowest rate in 10 years and is substantially below the national rate of 2.3 cases per 100 employees.
DWC also released the current quarterly interest rate, and for the time period between 4/1/26 through 6/30/26, the interest rate is 7.14%. DWC does have an interest rate calculator that can be found on their website to determine interest on late or delayed payments.
In their ongoing attempt to provide additional services to adjusters statewide, DWC is releasing their “CompCourse” Webinars on demand, at no cost to those seeking CE credit. These self-paced courses only require an adjuster to answer a short quiz after watching the previously recorded webinar to earn 1 hour of self-study CE credit.
There are currently courses on Employer responsibilities in the Texas Workers’ Compensation system, Understanding Workers’ Compensation Disputes, WC Compliance 101, Presiding Officer Directives, and other courses. For those of you needing an hour or two to ensure license compliance, this appears to be a quick and easy way to get your hours.
One of the easiest ways to determine what DWC is looking at from a disciplinary standpoint is to review the disciplinary orders issued by the DWC. For 2026, much as it has been in the past few years, it is clear that the focus is on timely payment of benefits. There was a $6,800 administrative penalty against a Carrier on January 16, 2026, for failing to timely pay medical bills, a $5,500 penalty for failing to timely pay pursuant to a Designated Doctor’s report, and a $2,000 consent order for failing to timely pay Supplemental Income Benefits and Impairment Income Benefits.
While the vast majority of fines and orders are against Carriers, a health system was fined $3,000 for sending bills to a workers’ compensation claimant on multiple occasions, even after being told that he was seen pursuant to a workers’ compensation claim.
Check out the links below for CompCourse Webinars and Disciplinary Orders:
Author: R. Christopher Esson
Here are the highlights, the lowlights, and the “well, that’s interesting” moments from recent Texas Workers’ Compensation Decisions.
Antonio Munoz Aserradero, LLC v. Thomas, 2026 Tex. App. LEXIS 2261 (Tex. App.—Tyler Mar. 11, 2026, no pet. h.)
DECISION: A potential employer who said, “[W]e will try you out. If you like it, we will talk about employment. For now, we will train you, and if you don’t like it, it is like you have never even been here.” The worker was injured just after lunch. The IC paid income and medical benefits. He reported to the medical providers that he was injured while working and selected “WC” as the type of insurance. The court held that absent a conversation about remuneration, the worker was not an employee upholding a jury verdict of $4.5 million against the employer.
WHAT THIS MEANS FOR YOU: The exclusive remedy provisions are watered down. I don’t know if the court would have reached the same decision if the worker was arguing for WC coverage.
Torres v. Ten Hagen Excavating, Inc., 2026 Tex. App. LEXIS 2129 (Tex. App.—Dallas Mar. 6, 2026, no pet. h.)
DECISION: The IW was directing traffic on a work site when struck by a vehicle and died. The beneficiaries sued his employer (among others) for gross negligence, based largely on the OSHA report, for the employer’s failure to provide safety vests and the lack of a training program for traffic control procedures. But the court found the OSHA report and the beneficiaries did not show how such failures demonstrated an extreme risk of serious injury the defendant knew of and consciously was indifferent to the safety and welfare of others.
WHAT THIS MEANS FOR YOU: Facts that support a negligence claim are not enough to prove gross negligence.
Juarez v. Tex. Mut. Ins. Co., 2026 Tex. App. LEXIS 1869 (Tex. App.—Waco Feb. 26, 2026, no pet. h.)
DECISION: A pro se IW nonsuited his action against the employer. He subsequently sought judicial review of a DWC decision regarding his MMI/IR. The court clerk believed the worker was trying to appeal his previous lawsuit versus his employer. The court agreed that the worker was trying to seek judicial review and returned the pleading to the district court for further actions.
WHAT THIS MEANS FOR YOU: District court clerks can be confused by pro se IWs too.
Guillen v. Nat’l Am. Ins. Co., 2026 Tex. App. LEXIS 2239 (Tex. App.—Austin Mar. 11, 2026, no pet. h.)
DECISION: The IW sustained a compensable injury in 2001. He has been active in dispute resolution before DWC, Enforcement, and various lawsuits. In this latest case, he sued his former lawyer, employer, and IC. As a pro se with a lay advocate, this latest lawsuit was based on acts that occurred 20 years ago. The court dismissed all claims.
WHAT THIS MEANS FOR YOU: Pro se litigants are often the most difficult and result in expensive litigation.
Okonkwo v. Heiliger (In re Fort Bend Cnty.), 2026 Tex. App. LEXIS 1760 (Tex. App.—Austin Feb. 24, 2026, no pet. h.)
DECISION: The decedent alleged working a 48-hour shift contributed to her death. The ALJ granted the IC’s subpoena for mental health records. The beneficiaries filed a temporary restraining order (TRO) in district court. The defendants sought mandamus. The party contesting the subpoena does not have the option of filing an action in district court until judicial review. The beneficiaries cannot create their own remedy by filing an action in district court, and the district court encroached on DWC’s exclusive jurisdiction when issuing the TRO.
WHAT THIS MEANS FOR YOU: Perhaps suing the ALJ in district court in response to her discovery rulings is not the best strategy.
APD 252109, 2026 TX Wrk. Comp. LEXIS 7
DECISION: The IW suffered a crush injury to the left foot. The ALJ determined the injury extended to, among other things, the 5th metatarsal, but not the 2-4th metatarsals. Neither the DD’s three certifications nor the RME’s three certifications rated the compensable injury.
WHAT THIS MEANS FOR YOU: As the number of conditions rises, it takes a spreadsheet to make sure the ALJ has an adoptable rating.
APD 252043, 2026 TX Wrk. Comp. LEXIS
DECISION: The IW did not receive the D&O regarding MMI/IR until after the qualifying period ended for the first two quarters. The IW therefore did not make any job applications. The AP believed the ALJ could find good cause for failing to submit applications. However, for the 3rd quarter, the IW would not have good cause for his failure to search for work during two weeks when the IW had the MMI/IR decision.
WHAT THIS MEANS FOR YOU: Gives ALJ broader power than they have previously enjoyed to excuse the failure to search for work.
APD 251993, 2026 TX Wrk. Comp. LEXIS 4
DECISION: In the D&O, the ALJ wrote, “The IC is put in a position to attempt to prove a negative, which simply cannot be done in this case.” The AP felt the ALJ was shifting the burden of proof to the IC.
WHAT THIS MEANS FOR YOU: Some employers/carriers feel like the burden of proof lies with them.
APD 251957, 2026 TX Wrk. Comp. LEXIS 6
DECISION: The IW had preexisting cerebrovascular disease and small strokes before the work injury. He did sustain a compensable concussion. The ALJ found a number of symptoms/conditions are related including brain fog, long term memory loss, vertigo, thought disorganization, episodic confusion, and cognitive challenges based in part on the first DD exam where extent was not an issue. In a subsequent DD eval for extent, the DD made several determinations in favor of the IW (which the parties stipulated) and also determined these conditions are not work related. Based on these facts, the AP reversed the ALJ extent determinations.
WHAT THIS MEANS FOR YOU: The DD’s extent evaluation enjoys presumptive weight over other DD evaluations where extent is discussed.
APD 252111, 2026 TX Wrk. Comp. LEXIS 8
DECISION: The DD erred in calculating ROM of the upper extremity. The DD found ROM that were divisible by 5, and the AMA Guides required the DD to round to the nearest 10 degrees. Rounding up or down requires medical discretion meaning the AP cannot recalculate the IR. A LOC is necessary.
WHAT THIS MEANS FOR YOU: DDs still make mistakes rounding ROM of the upper extremity to the nearest 10 degrees.
Author: Stuart Colburn
DWC has stated its position that the prompt payment of medical bills and interest is imperative to DWC’s goal of ensuring that injured employees have access to prompt, high-quality medical care.
Pursuant to Texas Labor Code §408.027 and DWC Rule 133.240 an insurance carrier is required to timely process and take final action on a completed medical bill within 45 days of receiving the bill. Further all payments of medical bills that an insurance carrier makes on or after the 60th day after the date the insurance carrier originally received the complete medical bill shall include interest calculated in accordance with Rule 134.130 without any action taken by the DWC.
Insurance carriers have been issued separate monetary penalties for not paying medical bills timely and for not issuing interest at the same time as for any medical bill paid on or after the 60th day from receipt. Accordingly, it is imperative that all medical bills paid on or after the 60th day after an insurance carrier’s receipt includes payment of interest.
Author: John V. Fundis
Administrative Law Judges (ALJs) get sued sometimes. The late great Judge Tom Hight used to train younger ALJs that it was a “rite of passage” to get sued. However, usually those lawsuits happen after the ALJ issues a decision. And usually, it is a pro se claimant who does not understand the judicial review process or the immunity provided to ALJs. Good news for ALJs- they generally enjoy immunity. Harlan v. Tex. Dep’t of Ins., No. 01-14-00479-CV, 2016 Tex. App. LEXIS 6660, 2016 WL 3476914, at *2 (Tex. App.—Houston [1st Dist.] June 23, 2016, no pet.) (mem. op.).
It is quite unusual for an ALJ to be sued prior to issuing a decision. In Okonkwo v. Heiliger (In re Fort Bend Cnty.) 2026 Tex. App. LEXIS 1760, Judge Okonkwo with DWC issued a subpoena for mental health records over the claimant’s objection. While the contested case hearing was pending at DWC, the claimant’s widower filed suit against the ALJ seeking a temporary restraining order and eventually an injunction against the enforceability of the subpoena. To quote the all-time classic movie Dodgeball, “It’s a bold strategy Cotton, let’s see if it pays off for him.”
It did initially. The district court judge denied Judge Okonkwo’s plea to the jurisdiction, granted the temporary restraining order and injunction against enforcement of the subpoena, and set the case for trial. The Office of the Attorney General, aided by DWC Legal Services, filed an appeal on behalf of Judge Okonkwo. Fort Bend County, a self-insured for workers’ compensation purposes, also filed an appeal disputing the injunction of the enforcement of the subpoena.
On appeal, the bold strategy did not work. The court of appeals stated the case “presents the jurisdictional question of whether a district court may intervene and enjoin an Administrative Law Judge’s issuance of a discovery subpoena in a contested case about compensability under the workers’ compensation statutory scheme.” The court holds that “because the parties did not follow the procedural steps the Legislature requires for the district court’s involvement in such a question, the district court impermissibly encroached on the agency’s exclusive jurisdiction.” The court then grants mandamus relief and renders judgment dismissing the underlying suit in district court for lack of jurisdiction.
There are several important implications in this case:
1) This decision protects DWC ALJs in the administration of the power granted to them
ALJs have the power to order additional discovery upon a finding of good cause. ALJs have several powers granted by Rule 142.2, including issuing subpoenas, ruling on requests, issuing orders, and taking any other action as authorized by law or as may facilitate the orderly conduct and disposition of the hearing. The Legislature conveyed powers to ALJs as the sole judge of the weight and credibility of the evidence for a reason, and parties should not be permitted to circumvent DWC’s administrative process when aggrieved by the ALJ’s ruling.
2) How the subpoena process at DWC practically works
This case provides an excellent explanation as to how the administrative subpoena process works. If an ALJ issues a subpoena and the person or entity served fails to comply with it, the remedy is for the party requesting the subpoena (or DWC) to file suit under Texas Government Code Section 2001.201(a). Of course, practical considerations including the legal costs and having to presumably abate (if DWC permits) an administrative hearing to compel enforcement of a subpoena must be considered as you ask, “Is this really worth it?” Still, if you ever wondered what it would take to enforce an ALJs subpoena, this case gives you a roadmap.
3) A good discussion of the Oteka Case
The Oteka case is a new Supreme Court case regarding exclusive jurisdiction of DWC. That case held, under facts that can politely be described as “unusual,” that DWC “does not have exclusive jurisdiction to determine whether an injury occurred in the course and scope of employment when (1) the employer raises the issue as an affirmative defense outside the compensability context and (2) the employee’s requested relief does not depend on any entitlement to benefits.” Univ. of Tex. Rio Grande Valley v. Oteka, 715 S.W.3d 734, 744 (Tex. 2025). This statement, if interpreted broadly, could be used to justify new litigation tactics against subscribing employers. But, the facts of Oteka are very strange, involving an initial denial of a claim, which Ms. Oteka never pursued, with the University changing their position and accepting the claim nearly three years after the accident. Thankfully, the Austin Court of Appeals correctly states that Oteka was “an unusual fact pattern, and the supreme court’s holding was expressly limited to the procedural posture of that case.” The court stated that the Okonkwo suit is essentially the very definition of a parallel proceeding occurring at DWC and district court at the same time, which was explicitly disapproved of by the Supreme Court in Oteka.
To conclude, the Okonkwo case specifically states that “the Legislature conferred on an ALJ to decide discovery disputes and evidentiary issues” with citation to Texas Labor Code Sec. 410.165 and Rule 142.2. That is a good result for the system and a reminder to parties to carefully review the administrative process prior to seeking relief in district court.
Author: Britt A. Clark
As you can see DWC and party participants remain most industrious. It would seem that these authors are going to be quite busy. Until next month, may your claims be clear, your defense sound, and your precedents favorable.
Sincerely,
Kara E. Squier, Esquire
Our Attorneys at Downs & Stanford, P.C. are here to help you with your everyday questions with Texas Workers’ Compensation.
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