Justice David Gunn
The Houston [1st] Court of Appeals has reversed a trial court order dismissing a pro se plaintiff’s attempt to appeal the administrative determination of his workers’ compensation claim and remanded to allow him an opportunity to amend his petition.
Esdras Nehemias Pineda Orellana v. National Specialty Insurance Company (No. 01-24-00383-CV; April 9, 2026) arose from a dispute over workers’ compensation benefits. Plaintiff, who owned a construction and remodeling business that subscribed to workers’ compensation insurance, suffered a foot injury at work. He received medical care and returned to work. On his first day back, he hurt his back. His doctors treated him by various means, and an MRI scan of his lumbar spine showed early degenerative disc disease. He filed workers’ compensation claims for both injuries. The insurer paid benefits for the foot injury for about 18 months. It refused to pay benefits for the back injury. After an unsuccessful dispute resolution process, an ALJ decided both claims against Plaintiff in May 2023. A DWC appeals panel allowed those decisions to become final in July 2023. Plaintiff filed suit shortly thereafter. The insurer filed a plea to the jurisdiction on the basis that Plaintiff’s petition did not specify the determinations of the appeals panel that aggrieved him, in addition to other defects. The trial court granted the plea. Plaintiff appealed.
In a decision by Justice Gunn, the court of appeals reversed and remanded. Plaintiff argued that his petition was sufficient, and that if it wasn’t, any jurisdictional defects were curable on remand to permit him to amend the petition. Acting pro se, Plaintiff used a “Small Claims Petition” to initiate his lawsuit, naming the insurer as defendant, listing its address and agent for service of process, and his own contact information. His factual allegations stated that he twice got hurt at work. He sought $1 million for his ankle injury and another $1 million for his back injury. The petition included nothing about the administrative process, particularly about the ALJ’s decision and subsequent appeal to the Appeals Division. Consequently, his petition did not “affirmatively demonstrate that he exhausted his administrative remedies before seeking judicial review, nor does it demonstrate that he was aggrieved by a final decision of the Appeals Panel” (citations omitted).
At the same time, the court opined, the peititon did not “affirmatively demonstrate incurable defects in jurisdiction.” As the court observed, the insurer’s plea to the jurisdiction attached evidence reflecting that Plaintiff exhausted his administrative remedies and was aggrieved by the Appeals Panel determination. It also included the ALJ’s two written decisions in the matter, as well as Plaintiff’s request for Appeals Panel review. The court thus concluded that because the jurisdictional defects in Plaintiff’s petition could be cured, the case should be remanded to give him the chance to amend his pleadings.
