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Texas Workers' Compensation Insurance Fund v. Martinez8/23/2000
The Texas Workers' Compensation Insurance Fund (hereafter the carrier) appeals from a summary judgment affirming a ruling by the Texas Workers' Compensation Appeals Panel. The panel had issued a ruling affirming the ruling of the hearing officer, holding that the insurance carrier had waived its opportunity to contest the compensability of Martinez's injury. The carrier contends that the trial court erred by granting summary judgment to the claimant because Martinez did not conclusively establish his right to summary judgment through his affirmative defenses of estoppel or waiver.
Martinez was injured in 1993, in the course and scope of his employment, when he was exposed to hydrogen sulfide gas. At a benefit review conference held five years ago, on December 7, 1995, Martinez and the carrier's representative agreed in writing that his injuries "included his lungs, heart, throat, left leg and back." (Emphasis added.) They also agreed that the carrier failed to timely dispute the injury and waived the right to do so.
Nevertheless, a year later, the carrier completed a form disputing Martinez's claim. In that document, the carrier claimed that it had now discovered that Martinez had a congenital heart condition, hypertrophic obstructive cardiomyopathy-hereafter HOC-that was not related to his chemical exposure, and sought to be relieved of its previous waiver. However, it is undisputed that, well before the benefits review conference, Martinez had previously been diagnosed with a heart condition identified as idiopathic hypertrophic subaortic stenosis-hereafter IHSS. The hearing officer held that the new claim was merely the same heart condition described by a different name and that the carrier had thus agreed to waive its right to contest Martinez's work-related injury in connection with the heart condition-by whatever name. The appeals board affirmed the officer's decision.
The carrier filed a petition for review with the district court. Martinez responded with a motion seeking summary judgment arguing that the carrier's claim was subject to estoppel or waiver in accordance with its written waiver. The trial court agreed and rendered summary judgment in Martinez's favor.
To prevail on a motion for summary judgment, a movant must establish that there is no genuine issue as to any material fact and that the movant is entitled to judgment as a matter of law. Tex. R. Civ. P. 166a(c). Summary judgment for a defendant is proper when the defendant negates at least one element of each of the plaintiff's theories of recovery or pleads and conclusively establishes each element of an affirmative defense. Science Spectrum, Inc. v. Martinez, 941 S.W.2d 910, 911 (Tex. 1997); Wornick Co. v. Casas, 856 S.W.2d 732, 733 (Tex. 1993).
The movant has the burden of showing that there is no genuine issue of material fact and that it is entitled to judgment as a matter of law. Nixon v. Mr. Property Management Co., 690 S.W.2d 546, 548-49 (Tex. 1985). However, once the movant establishes that it is entitled to summary judgment, the burden shifts to the non-movant to show why summary judgment should not be granted. Casso v. Brand, 776 S.W.2d 551, 556 (Tex. 1989). In reviewing a summary judgment, we accept all of the non-movant's proof as true and indulge every reasonable inference in the non-movant's favor. Science Spectrum, 941 S.W.2d at 911. All doubts about the existence of a genuine issue of material fact must be resolved against the movant. Johnson County Sheriff's Posse, Inc. v. Endsley, 926 S.W.2d 284, 285 (Tex. 1996).
When a party seeks judicial review of a decision of the commission appeals panel, the only issues before the trial court are those d
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