Affirming the Corpus Christi Court of Appeals, the Texas Supreme Court has held that district courts, rather than the Workers’ Compensation Division, have subject-matter jurisdiction over a determination of whether an injury is work-related for purposes of workers’ compensation.
The University of Texas Rio Grande Valley v. Rita Oteka (No. 23-0167; June 13, 2025) arose from injuries suffered by a UTRGV faculty member when she was struck by a vehicle driven by a university police officer while walking back to her car after commencement ceremonies. The university’s, which self-insures for workers’ comp, notified its third-party administrator, which denied comp benefits because Oteka sought treatment under her own insurance, presented no supporting medical evidence, and her injury didn’t arise in the course and scope of employment. Oteka never filed a claim with the division based, she alleged, on the university’s determination that she wasn’t entitled to comp benefits. A year after the accident, Oteka sued the police officer for negligence. The university responded by asserting the exclusive-remedy defense, for the first time “plac[ing] in dispute whether Oteka’s injury occurred in the course and scope of her employment and was thereby work-related.”
The parties filed cross motions for summary judgment. Before the district court ruled on the motions, the university decided that Oteka’s injury was work-related and that it would pay her comp benefits. The following day, it filed a plea to the jurisdiction on the basis that the Workers’ Compensation Division had exclusive jurisdiction to determine course and scope. And because Oteka never filed a compensation claim with the division for a ruling on course and scope, she didn’t exhaust her administrative remedies and her claim must be dismissed. The district court denied the plea, and the court of appeals affirmed. The university sought review.
In an opinion by Justice Devine, SCOTX affirmed. The intermediate courts of appeals, he observed, have divided over the question of whether the DWC’s exclusive jurisdiction to determine compensability “encompasses exclusive jurisdiction to determine whether an injury or death occurred in the course and scope of employment.” In order to show that an administrative agency has such exclusive jurisdiction, the party asserting it “must demonstrate that the Legislature divested the court of subject-matter jurisdiction by vesting exclusive jurisdiction with an agency.” This showing must be “compelling” because the Texas Constitution expressly vests the courts with jurisdiction, which can only be delegated to an agency by explicit legislative authority.
Turning to the workers’ compensation statute, Justice Devine didn’t find anything in the statute to that effect. “Significantly,” he opined, “the Act lacks a procedural mechanism for the employee or employer to obtain a course-and-scope finding from the Division without the employee first filing a compensation claim.” While the statute sets out a specific dispute resolution process, it “does not authorize [an informal benefit review] conference without a disputed workers’ compensation claim. And by and large, the other dispute-adjudication steps are predicated on an initial benefit-review conference.” Additionally, the claims process must be initiated by the employee. In this case, the university’s position held that “the employee would have to succeed in defeating her own compensation claim to exhaust her administrative remedies and pursue her lawsuit for a nonwork-related-injury.” The court thus ruled that the DWC does not have exclusive jurisdiction to determine course-and-scope 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.”
Justice Devine reassured everybody that the decision does not in any way erode the exclusive-remedy defense. We agree. This case presents unusual facts (and perhaps questionable good faith on the university’s part). Unquestionably, the Legislature did not create a “gotcha” that allows an employer to deny benefits on the basis of a non-work related injury, reverse course when it gets sued, and then win the case because the employee, who never thought she was entitled to comp benefits in the first place, didn’t file a claim in the first place.