Esdras Nehemias Pineda Orellana v. National Specialty Insurance Company

Texas Court of Appeals, 1st District (Houston)·Decided April 9, 2026·No. 01-24-00383-CV·Published

Opinion

Opinion issued April 9, 2026

In The

Court of Appeals

For The

First District of Texas

after several months, and it never made payments for the other injury. Dissatisfied with the results of the administrative dispute resolution process, Pineda filed suit. National Specialty filed a plea to the jurisdiction, arguing that Pineda’s suit did not set out the administrative decisions that aggrieved him, nor did Pineda file suit “related to a specific administrative determination.” The trial court granted the plea.

On appeal, Pineda argues that he exhausted his administrative remedies, he was aggrieved by the final administrative decisions, and he should be given an opportunity to amend his pleading to remedy the curable jurisdictional defects.

We reverse and remand.

Background

Pineda owned ENPO Home Improvement, a construction and remodeling company that subscribed to worker’s compensation insurance. On December 13, 2021, Pineda was allegedly carrying sheetrock backwards down a flight of stairs when he missed a step and fell, injuring his foot. After seeking medical care, he returned to work with restrictions. On December 22, 2021, his first day back at work, he was allegedly unloading boxes when he bent down and heard a “pop” in his lower back.

Pineda saw multiple doctors over the next several months, and doctors treated his injuries with a combination of over-the-counter pain medication, prescription medication, physical therapy, and an epidural steroid injection. Pineda’s pain

persisted. An MRI scan of his lumbar spine showed “[e]arly degenerative disc disease” at the “L4-5 level with disc desiccation and minor annular bulging.” Pineda filed worker’s compensation claims for both the December 13 and the December 22 injury. National Specialty—ENPO’s worker’s compensation insurance carrier— paid benefits for the December 13 injury until July 2022, but it ceased paying benefits at that point and refused to pay any benefits for the December 22 injury.

The parties participated in the dispute resolution process mandated by the Texas Labor Code. An administrative law judge decided both claims adversely to Pineda in May 2023, and the Appeals Panel of the Division of Workers’ Compensation allowed the administrative decisions to become final in July 2023.

Pineda, acting pro se, filed suit on August 15, 2023. Using a form entitled “Small Claims Petition,” Pineda alleged the following under “Cause of Action”:

December 13, 2021 I fell down some stairs carrying [sheetrock]

material and hurt my left leg and part of my lower back, then I returned to work December 22[, 20]21 with medical restrictions and hurt my lower back while carrying some boxes with a weight of approximately 20 pounds. [H]erniated disc from returning to work without being ready to return.

These are the only factual allegations in the petition. He alleged no facts relating to the administrative dispute process. On the same day he filed suit, he also filed over 200 pages of documents. These documents primarily consisted of medical records and examination findings, but he also included the two May 2023 decisions from an ALJ relating to his claims.

National Specialty filed a plea to the jurisdiction. It acknowledged that the parties had participated in the administrative dispute process, stating that an ALJ held contested case hearings concerning the two claims and issued decisions on both claims in May 2023, Pineda requested that the Appeals Panel review the decisions, and the Appeals Panel issued notices in July 2023 that it was allowing the ALJ’s decisions to become final.

Nevertheless, it argued that Pineda’s petition was vague and “failed to specifically set forth the determinations of the Appeals Panel by which he was aggrieved and seeking relief from.” It also argued that Pineda “failed to file suit related to a specific administrative decision.” It further argued that the Labor Code contains certain requirements for suits seeking judicial review of administrative decisions relating to worker’s compensation claims, but Pineda failed to identify (1) a specific work-related injury date, (2) a specific Appeals Panel decision, (3) specific determinations made by the Appeals Panel, or even (4) “a general outline of the questions he wants this Court to address and a theory of recovery.” National Specialty argued that these jurisdictional deficiencies justified dismissal of the suit. It attached evidence to its plea, including a May 4, 2023 determination by the ALJ concerning the December 13 injury; Pineda’s request that the Appeals Panel review this decision; a July 19, 2023 notice from the Appeals Panel allowing the decision to become final; a May 5, 2023 determination by the ALJ concerning the December

22 injury; Pineda’s request for review; a July 19, 2023 notice from the Appeals Panel allowing that decision to become final; and Pineda’s petition.

In between the filing of the plea to the jurisdiction and the hearing on the plea, Pineda obtained counsel. Counsel filed an amended petition on Pineda’s behalf on the day of the hearing. The amended petition

AMENDS Plaintiff’s pleadings to assert his claim under EQUITY, since the Court has equity jurisdiction. The denial of relief by the Defendant relates to the mischaracterization of TWO SEPARATE CLAIMS as only a single claim. Plaintiff will consider a refund of court costs as sufficient compensation in this matter.

WHEREFORE, PREMISES CONSIDERED, Plaintiff prays that the Court consider his claim under the Court’s EQUITY jurisdiction.

The amended petition did not address the jurisdictional deficiencies raised by National Specialty in its plea.

The trial court granted National Specialty’s plea to the jurisdiction. This appeal followed.1

1 The trial court granted the plea to the jurisdiction on April 16, 2024. Pineda’s notice of appeal was due by May 16, 2024. See TEX. R. APP. P. 26.1 (providing that notice of appeal generally must be filed within 30 days after judgment is signed); Brumfield v. Williamson, 634 S.W.3d 170, 189 (Tex. App.—Houston [1st Dist.] 2021, pet.

denied) (“Generally, if a party fails to timely file a notice of appeal, we have no jurisdiction to address the merits of the party’s appeal.”). Pineda, acting pro se, filed his notice of appeal on May 22, 2024. This was late, but within the 15-day window in which courts imply a motion for extension of time to file the notice of appeal if the appellant files the notice of appeal and reasonably explains the need for an extension. See TEX. R. APP. P. 26.3; Verburgt v. Dorner, 959 S.W.2d 615, 617 (Tex.

1997); Jones v. City of Houston, 976 S.W.2d 676, 677 (Tex. 1998). We sent a notice to Pineda informing him of the jurisdictional defect and ordering him to provide a reasonable explanation for the untimely filing of his notice of appeal. Pineda

Plea to the Jurisdiction

On appeal, Pineda argues that National Specialty’s plea to the jurisdiction itself and the attached evidence demonstrated that Pineda satisfied the only two statutory jurisdictional requirements: that he had exhausted his administrative remedies and was aggrieved by a final decision of the Appeals Panel. Pineda argues that any jurisdictional defects in his petition are curable, and he requests that this Court remand the case to the trial court to allow him to amend his petition. A. Standard of Review A plea to the jurisdiction challenges subject-matter jurisdiction, or a court’s power to decide a case. Herrera v. Mata, 702 S.W.3d 538, 541 (Tex. 2024) (per curiam); Bland Indep. Sch. Dist. v. Blue, 34 S.W.3d 547, 553–54 (Tex. 2000). Subject-matter jurisdiction is never presumed and cannot be waived. Tex. Ass’n of Bus. v. Tex. Air Control Bd., 852 S.W.2d 440, 443–44 (Tex. 1993).

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Esdras Nehemias Pineda Orellana v. National Specialty Insurance Company, (Tex. Ct. App. 2026).

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