State News : Texas

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NWCDN Members regularly post articles and summary judgements in workers’ compensations law in your state.  

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SOAH ALJ rejects claimant’s argument that filing deadline is not fair.

There are not many new SOAH decisions these days because there are not nearly as many medical fee disputes as there used to be.  Therefore, when a new SOAH decision comes out it bears mention.  

In SOAH Docket No. 454-22-09437, the Administrative Law Judge held that the claimant was not entitled to reimbursement for his out-of-pocket medical expenses because he did not file his request for medical fee dispute resolution with the Division until about ten months after the filing deadline:  

[Claimant] argues that he has much experience in workers’ compensation—having even written a book on it—and “if someone as well versed in the workers’ compensation system cannot prevail in this matter, what hope does the average injured worker have?” Although the fairness of a labyrinthine workers’ compensation system can be questioned, ultimately its existence and structure is a question for the Texas Legislature and for the Commissioner of Insurance. The ALJ only applies the law as it is. Because [claimant’s] request for resolution was untimely, he is not entitled to reimbursement of his out-of-pocket medical expenses involved in this appeal.

The ALJ’s decision to strictly enforce the Division’s filing deadline should come as no surprise.  As the Texas Supreme Court put it, “A deadline is not something one can substantially comply with. A miss is as good as a mile.” Edwards Aquifer Auth. v. Chemical Lime, Ltd., 291 S.W.3d 392, 403 (Tex. 2009).  The U.S. Supreme Court has explained why filing deadlines must be strictly enforced:

The notion that a filing deadline can be complied with by filing sometime after the deadline falls due is, to say the least, a surprising notion, and it is a notion without limiting principle. If 1–day late filings are acceptable, 10–day late filings might be equally acceptable, and so on in a cascade of exceptions that would engulf the rule erected by the filing deadline; yet regardless of where the cutoff line is set, some individuals will always fall just on the other side of it. Filing deadlines, like statutes of limitations, necessarily operate harshly and arbitrarily with respect to individuals who fall just on the other side of them, but if the concept of a filing deadline is to have any content, the deadline must be enforced. Any less rigid standard would risk encouraging a lax attitude toward filing dates. A filing deadline cannot be complied with, substantially or otherwise, by filing late—even by one day.

United States v. Locke, 471 U.S. 84, 100–101 (1985).

The Supreme Court’s words are important to remember. The Texas workers’ compensation system is replete with deadlines that must be strictly enforced to keep the system running smoothly.  

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