Opinion issued February 4, 2014

In The

Court of Appeals 

For The 

First District of Texas 

————————————

NO. 01-12-00216-CV

———————————

HAND & WRIST CENTER OF HOUSTON, P.A. AND SCA HOUSTON 

HOSPITAL FOR SPECIALIZED SURGERY, L.P., Appellants

V.

MAINTENANCE SUPPLY HEADQUARTERS, L.P., Appellee

On Appeal from the 334th District Court

Harris County, Texas

Trial Court Case No. 2010-38690

MEMORANDUM OPINION

Hand & Wrist Center, P.A. and SCA Houston Hospital for Specialized 

Surgery, L.P. appeal the trial court’s order granting summary judgment in favor of 

Maintenance Supply Headquarters, L.P., on their breach of contract claim. In three 
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issues, appellants contend that the trial court erred in granting summary judgment 

because (1) Maintenance Supply failed to prove each element of its affirmative 

defense of estoppel; (2) the “exclusive remedies” provision of section 408.001(a) 

of the Labor Code1 does not apply to health care providers; and (3) its conclusion 

that the “exclusive remedies” provision applies to health care providers is contrary 

to clear legislative intent. For the reasons stated below, we reverse and remand.

Background

While working at Maintenance Supply on June 29, 2009, Daniel Contreras 

injured his hand. The assistant operations manager, Edward Gurka, initially took 

Contreras to one clinic for medical treatment but was directed to another clinic—

Hand & Wrist. Once there, Gurka, in his capacity as “OP Manager,” signed a 

Letter of Guarantee which stated in pertinent part, as follows:

Maintenance Supply Headquarters (hereafter called “the Company”) 

desires that Daniel Contreras (hereafter called “the Patient”) receive 

medical care for injuries sustained on or about 06-29-09. In that 

regard, the Company hereby agrees to the following. The Company 

guarantees that it will pay Hand & Wrist Center of Houston, P.A., 

SCA Houston Hospital for Specialized Surgery, L.P., and Gulf 

Anesthesia Associates, P.A. (hereafter called “the medical care 

providers”) their usual and customary fees for medical care rendered 

to the Patient. Payment will be made within 30 days after receiving 

notice. This Letter of Guarantee may be canceled only with 30 days 

written notice by either party.

The Medical Providers will not seek additional payment from the 

Company under this Letter of Guarantee if 1) payment is made by an 

 1 TEX. LAB. CODE ANN. § 408.001(a) (West 2006).
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insurance carrier in accordance with the Texas Department of 

Insurance-Division of Worker’s Compensation statutory fee schedule, 

or 2) payment is made under terms of a Certified Health Care 

Network’s contracted fee schedule, 3) payment is made by a Third 

Party Administrator’s Provider Agreement, if any are in effect, or 4) 

the Company has workers’ compensation insurance with Texas 

Mutual Insurance Company.

Payment will be made even if the injury is determined to have 

occurred while the Patient was not at work, or if the injury is not 

reported to the insurance carrier (if any), or if a claim is not filed with 

the insurance carrier, by the Employer, in a timely fashion. Payment 

will be made even if the patient tests positive for drugs or alcohol at 

the time of the injury.

Any dispute regarding this Letter of Guarantee will be resolved in a 

Court of Harris County, Texas. Because the Company agrees to pay 

these fees if and when there is no insurance coverage, then lack of 

insurance is not a defense to payment of the fees. This Letter of 

Guarantee is effective upon the date appearing below. This agreement 

may only be modified or terminated in writing. This agreement is an 

enforceable contract.

Hand & Wrist and SCA Hospital billed $3,612.62 and $19,138.30, respectively, for 

Contreras’s medical care.

Shortly after his surgery, Contreras received notice from Maintenance 

Supply’s workers’ compensation insurance carrier, Hartford Casualty Insurance 

Company, that his claim for workers’ compensation benefits, including medical 

benefits, was denied due to a positive drug screen at the time of the injury. On 

October 3, 2010, following a contested case hearing, the Texas Department of 

Insurance Division of Workers’ Compensation also concluded that the injury was 
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not compensable because of Contreras’s intoxication and that Hartford was 

absolved of liability for the claim.

After Maintenance Supply failed to pay for Contreras’s treatment, appellants 

sued for breach of contract based on the Letter of Guarantee. Maintenance Supply 

filed Defendant’s Motion for Final Summary Judgment on Its Affirmative 

Defenses, arguing that (1) appellants were estopped from suing Maintenance 

Supply because it had workers’ compensation insurance in effect on the date of the 

injury, and (2) recovery of workers’ compensation benefits is the exclusive remedy 

available to appellants.2

 The trial court granted this motion.3 Appellants filed 

motions to reconsider and for new trial; the trial court denied both motions. 

Appellants timely filed this appeal. 

Discussion

Appellants’ first issue contends that the trial court erred in granting 

Maintenance Supply’s summary judgment motion because it failed to prove each 

element of its affirmative defense of estoppel. In their second and third issues, 

appellants argue that summary judgment was improper because the “exclusive 

remedies” provision of Labor Code section 408.001(a) does not apply to health 

 2 Maintenance Supply had previously filed a no-evidence summary judgment 

motion asserting that there was no evidence to support all of the elements of 

appellants’ breach of contract claim. The trial court denied that motion.

3 Maintenance Supply non-suited its counterclaims against appellants.
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care providers, and the trial court’s conclusion that it does is contrary to the 

statute’s clear legislative intent.

A. Standard of Review

We review a trial court’s decision to grant a motion for summary judgment 

de novo. Valence Operating Co. v. Dorsett, 164 S.W.3d 656, 661 (Tex. 2005). A 

defendant is entitled to summary judgment if it conclusively negates an essential 

element of the plaintiff’s case or conclusively establishes all necessary elements of 

an affirmative defense. Cathey v. Booth, 900 S.W.2d 339, 341 (Tex. 1995). The 

movant bears the burden of proof and all doubts about the existence of a genuine 

issue of material fact are resolved against the movant. Nixon v. Mr. Prop. Mgmt. 

Co., 690 S.W.2d 546, 548–49 (Tex. 1985). All evidence and any reasonable 

inferences must be viewed in the light most favorable to the nonmovant. Id. at 

549.

A defendant that moves for summary judgment on an affirmative defense

must establish each element of that affirmative defense. Pustejovsky v. Rapid-Am.

Corp., 35 S.W.3d 643, 646 (Tex. 2000). Summary judgment will be affirmed only 

if the record establishes that the movant conclusively proved all elements of its 

affirmative defense as a matter of law. TEX. R. CIV. P. 166(a); Sci. Spectrum, Inc. 

v. Martinez, 941 S.W.2d 910, 911 (Tex. 1997). When, as here, the order granting 

summary judgment does not state the grounds upon which the trial court ruled, we 
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must affirm if any of the summary judgment grounds is meritorious. See Reaves v. 

Lindsey, 326 S.W.3d 276, 279 (Tex. App.—Houston [1st Dist.] 2010, no pet.). 

B. Analysis

1. Equitable Estoppel

Appellants’ first issue argues that Maintenance Supply failed to present 

conclusive evidence on all of the elements of its affirmative defense of estoppel 

and the grant of summary judgment was error. Specifically, they contend that 

Maintenance Supply presented no evidence showing that appellants made a false 

misrepresentation or concealed material facts, or that Maintenance Supply had no 

knowledge or the means of obtaining knowledge of the material facts.4

Maintenance Supply, however, argued that it was entitled to summary 

judgment on two of its affirmative defenses, including “that Plaintiff[s are] 

estopped from suing Defendant because Defendant had workers compensation 

insurance on June 29, 2009, the date that David [sic] Contreras was injured.” This 

defense derives from section 408.001(a) of the Labor Code, which provides that 

“[r]ecovery of workers’ compensation benefits is the exclusive remedy of an 

employee covered by workers’ compensation insurance coverage or a legal 

 4 The elements of equitable estoppel are (1) a false representation or concealment of 

material facts, (2) made with the knowledge, actual or constructive, of those facts,

(3) to a party without knowledge, or the means of knowledge, of those facts, (4) 

with the intention that it should be acted on, and (5) the party to whom it was 

made relied or acted on it to his prejudice. See Johnson & Higgins of Tex., Inc. v. 

Kenneco Energy, Inc., 962 S.W.2d 507, 515–16 (Tex. 1998).
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beneficiary against the employer or an agent or employee of the employer for the 

death of or a work-related injury sustained by the employee.” TEX. LAB. CODE 

ANN. § 408.001(a) (West 2006). Thus, because Maintenance Supply had workers’ 

compensation coverage at the time of the injury, appellants’ recovery on their 

breach of contract claim was barred because section 408.001(a) provides the 

exclusive remedy in this case. Appellants conflate Maintenance Supply’s 

argument based on “estoppel by statute” with the defense of equitable estoppel, 

which Maintenance Supply neither raised nor relied upon in the court below. 

Because the doctrine of equitable estoppel is inapplicable, we overrule appellants’ 

first issue. 

2. Labor Code Section 408.001(a)

Appellants’ second issue contends that the trial court’s grant of summary 

judgment based on the “exclusive remedies” provision of Labor Code section 

408.001(a) was error because this provision does not apply to health care 

providers. Appellants’ third issue argues that the trial court’s conclusion that the 

“exclusive remedies” provision does apply is contrary to the statute’s clear 

legislative intent. Maintenance Supply maintains that the “exclusive remedies” 

provision applies to health care providers, and that appellants waived their 

legislative intent argument because they failed to raise the issue in the trial court. 

Because these two issues are interrelated, we address them together.
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An appellate court reviews issues of statutory construction de novo. Molinet

v. Kimbrell, 356 S.W.3d 407, 411 (Tex. 2011). We look first to the statutory 

language for the Legislature’s intent, and only if we cannot discern legislative 

intent in the language of the statute itself do we resort to canons of construction or 

other aids. Tex. Lottery Comm’n v. First State Bank of DeQueen, 325 S.W.3d 628, 

639 (Tex. 2010); see Molinet, 356 S.W.3d at 411 (concluding plain meaning of text 

is best expression of legislative intent unless different meaning is apparent from 

context or plain meaning leads to absurd or nonsensical results).

Section 408.001(a) of the Texas Workers’ Compensation Act provides that 

“[r]ecovery of workers’ compensation benefits is the exclusive remedy of an 

employee covered by workers’ compensation insurance coverage or a legal 

beneficiary against the employer or an agent or employee of the employer for the 

death of or a work-related injury sustained by the employee.” TEX. LAB. CODE 

ANN. § 408.001(a) (West 2006) (emphasis added). Section 401.012(a) of the Act 

defines “employee” as “each person in the service of another under a contract of 

hire, whether express or implied, or oral or written.” Id. at § 401.012(a). 

Subsection (b) further defines the term “employee” to include (1) an employee 

employed in the usual course and scope of the employer’s business who is directed 

by the employer temporarily to perform services outside the usual course and 

scope of the employer’s business; (2) a person, other than an independent 
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contractor or the employee of an independent contractor, who is engaged in 

construction, remodeling, or repair work for the employer at the premises of the

employer; and (3) a person who is a trainee under the Texans Work program 

established under Chapter 308. See id. at § 401.012(b). Subsection (c) states that 

“[t]he term ‘employee’ does not include (1) a master of or a seaman on a vessel 

engaged in interstate or foreign commerce; or (2) a person whose employment is 

not in the usual course and scope of the employer’s business.” Id. at § 401.012(c).

The plain language of these provisions evidences clear legislative intent that 

the recovery of workers’ compensation benefits is the exclusive remedy of an 

employee (or the employee’s legal beneficiary) and does not apply to health care 

providers. Moreover, we note that a panel of this Court recently reached the same 

conclusion. In Hand & Wrist Center of Houston, P.A. v. SGS Control Services, 

Inc., 409 S.W.3d 743 (Tex. App.—Houston [1st Dist.] 2013, no pet.), Hand & 

Wrist argued that the trial court erroneously relied on section 408.001 in granting 

the employer’s plea to the jurisdiction because the “exclusive remedies” provision 

applies only to employees and not to health care providers. See id. at 753. The 

Court wrote: “[w]e agree with Hand & Wrist that section 408.001(a) has no 

applicability to this case . . . .” and then explained that although section 408.001 

was inapplicable, it did not change the court’s conclusion that Hand & Wrist was 

required to exhaust its administrative remedies before filing suit. See id. 
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In light of the statute’s plain language, and this Court’s decision in SGS 

Control Services, Inc., we conclude that the “exclusive remedies” provision of 

section 408.001(a) does not apply to health care providers, and therefore appellants 

are not barred from bringing suit against Maintenance Supply to recover payment 

for the medical services rendered in this case. As such, we hold that the trial court 

erred in granting summary judgment to Maintenance Supply on appellants’ breach 

of contract claim. Accordingly, we sustain appellants’ second and third issues.

Conclusion

We reverse and remand the trial court’s judgment for proceedings consistent 

with this opinion.

Jim Sharp

Justice 

Panel consists of Justices Jennings, Sharp, and Brown.