Guadalupe Guerra Jr. v. ACE American Insurance Company as Successor of INA of Texas

Court of Appeals of Texas·Decided June 6, 2019·No. 13-17-00652-CV·Published

Opinion

NUMBER 13-17-00652-CV

COURT OF APPEALS

THIRTEENTH DISTRICT OF TEXAS CORPUS CHRISTI - EDINBURG

GUADALUPE GUERRA JR., Appellant, v.

ACE AMERICAN INSURANCE COMPANY AS SUCCESSOR OF INA OF TEXAS, Appellee.

On appeal from the 319th District Court of Nueces County, Texas.

MEMORANDUM OPINION

Before Chief Justice Contreras and Justices Longoria and Perkes Memorandum Opinion by Chief Justice Contreras

Appellant Guadalupe Guerra Jr., pro se, appeals the trial court’s judgment setting aside a workers’ compensation award pursuant to a suit filed by appellee, ACE American Insurance Company as successor of INA of Texas (ACE). By three issues, Guerra contends the trial court erred by (1) realigning the parties at trial, (2) issuing an erroneous

jury charge, and (3) “allowing opposing counsel to make materially false statements to the jury.” We affirm.

I. BACKGROUND

Guerra was injured in 1990 while working for Reynolds Metals Company, which had workers’ compensation insurance through ACE’s predecessor. Attorneys for Guerra and ACE’s predecessor entered into an “Agreed Final Judgment” on April 19, 1996, providing for a lump sum payment of $50,000 to Guerra in exchange for his release of any claims regarding past medical expenses arising from the workplace injury. The “Agreed Final Judgment” also stated:

With regard to future medical expenses, [ACE] agrees to pay all reasonable and necessary medical expenses incurred as a result of treatment by Dr.

Gilbert Meadows of San Antonio, Texas, only.

1. It is specifically agreed that [ACE] shall not be responsible for any medical treatment incurred in the future by any doctor or health care provider, other than Dr. Gilbert Meadows, unless said expenses were incurred during or as a result of surgery by Dr. Gilbert Meadows.

2. It is agreed, moreover, that [ACE] shall not be responsible for any expenses incurred by any other medical doctor, chiropractor, therapist, or health care provider except as a result of surgery as noted . . . above.

An addendum to the “Agreed Final Judgment” stated:

The term “treatment” means lifetime medical and surgical care. Surgical care shall include all hospital, medical, therapeutic, and pharmaceutical treatment ordered by Dr. Gilbert Meadows, or his surgical assistants under the direction of Dr. Meadows, in order to allow a full recovery from the effects of surgery.

Later in 1996, Guerra underwent spinal fusion surgery performed by Dr. Meadows in San Antonio. Dr. Meadows continued to provide treatment until 2003, when he advised Guerra that he was no longer accepting workers’ compensation patients. Subsequently, Guerra received treatment from Abimael Perez, M.D., a physician located in Corpus

Christi. ACE and its predecessors continued to cover that treatment until January 2013, when Dr. Perez also stopped accepting workers’ compensation patients.

At issue in this case is Guerra’s request in 2015 to be reimbursed a total of $4,062.75 for: (1) treatment by Misty Durbin, a chiropractor; (2) an orthopedic bed; (3) orthopedic shoes and socks; and (4) travel expenses. ACE refused the request, so Guerra filed a claim for compensation with the Texas Department of Insurance, Division of Workers’ Compensation (the Division). On July 21, 2015, the Division issued a final award granting Guerra all of the benefits he requested. ACE then filed the instant suit in district court seeking judicial review of the award.

In December of 2015, ACE filed a motion for no-evidence summary judgment arguing that “[t]here is no evidence of any attempt, much less a successful one, to set aside” the 1996 agreed judgment. The trial court denied the motion but granted permission to appeal under Texas Rule of Civil Procedure 168. See TEX. R. CIV. P. 168. We concluded that the petition for permissive appeal failed to meet the jurisdictional requirements for such an appeal and dismissed it. ACE Am. Ins. Co. v. Guerra, No. 13- 16-00628-CV, 2017 WL 929485, at *2 (Tex. App.—Corpus Christi–Edinburg Mar. 9, 2017, no pet.) (mem. op.) (concluding that the case “does not meet the strict jurisdictional requirements” for permissive appeals provided by statute and rule).

On July 21, 2017, ACE filed a “Motion to Re-Align the Parties” arguing that “[p]ursuant to Article 8307, Section 5, Vernon’s Annotated Civil Statutes, [Guerra] has the burden of proof as he is the party claiming compensation.” The trial court granted the motion on September 12, 2017, and rendered an order stating that Guerra shall be designated as the plaintiff, ACE shall be designated as the defendant, and Guerra “as the

claimant of compensation shall have the burden of proof as required by law.”

A jury trial took place later that day. Guerra, appearing pro se, was the only testifying witness. He explained how he was injured in 1990:

While at work I was assaulted by a co-worker who, I guess, they call it the sucker punch. I never saw it coming. Pulled the chair from underneath me and my back slammed against the—the—the foundation which is concrete slab and the metal control panel against my head and my neck.

Guerra stated that, under the 1996 agreed judgment, he received “lifetime medical plus up to $50,000 for back pay wages.” He testified that, after his surgery, a psychiatrist diagnosed him with post-traumatic stress disorder and depression, so Dr. Meadows prescribed Xanax and Viagra, among other medications. When Dr. Meadows stopped seeing him, Dr. Perez continued the treatment and medications. According to Guerra, Durbin, as a chiropractor, could not prescribe medications but did prescribe orthopedic supplies. Guerra stated that ACE is now “trying to say that they no longer need . . . to be responsible in taking care of me based on whatever.” He further stated: “[A]s far as I know lifetime healthcare and Dr. Gilbert Meadows are not a package deal so I’m still entitled to lifetime healthcare with or without Dr. Gilbert Meadows and that’s what I’m fighting for right now.”

On cross-examination, Guerra acknowledged that he had a “nerve conduction study test” in 2006 which showed no abnormalities. He further conceded that, in 2001, he sent a letter requesting that ACE’s predecessor provide him with a cell phone. The letter explained that “[o]ne of the needs[] of a disabled person is being able to communicate in case of an emergency.” Guerra agreed with ACE’s counsel that, in 2011, he appeared at an informal workers’ compensation conference wearing “foam rubber Crocs.” He further admitted that he was involved in a motor vehicle accident in 2000, and

that he suffered two slip-and-fall accidents at Whataburger and Walmart in 2006 and 2011, respectively.

In closing, Guerra claimed that he was entitled to new orthopedic socks and shoes every six months “according to the workers’ comp law.” He explained: “I understand that Dr. Gilbert Meadows was supposed to be my primary doctor, but I didn’t know anything about that or understood exactly what the contract was saying; only that the lifetime healthcare was there for me when I need healthcare.”

The jury charge asked one question: “Is [ACE] under the Agreed Judgment between the parties dated April 19, 1996, responsible for the medical bills incurred by [Guerra] in 2015 in the amount of $4,062.75?” The charge instructed the jury as follows: “A ‘yes’ answer must be based on a preponderance of the evidence unless you are told otherwise. . . . If you do not find that a preponderance of the evidence supports a ‘no’ answer, then answer ‘yes.’” The jury answered “No.” The trial court then rendered judgment that “[Guerra] take nothing as payment for medical treatment against [ACE].” This appeal followed.

II. DISCUSSION

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Guadalupe Guerra Jr. v. ACE American Insurance Company as Successor of INA of Texas, (Tex. Ct. App. 2019).

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