July 25, 1988 

JIM MATTOX 

ATMRNEY O&NERAL 

Mr. Joseph C. Gagen Opinion No. JM-931 

Chairman 

Texas Industrial Accident Re: Authority of the 

Board Accident Board to 

Industrial 

approve a 

settlement agreement that would 

terminate liability for future 

medical expenses (RQ-1353) 

200 East Riverside 

Austin, Texas 78704 

Dear Mr. Gagen: 

You ask: 

Does the authority of the Industrial 

Accident Board over medical expenses incurred 

after a final award, judgment, or settlement, 

extend to approving compromise settlement 

agreements that would terminate all liability 

for future medical expenses? 

The Industrial Accident Board (the "board") is an administrative body created by statute and possessing only those 

powers conferred on it by statute. mmercial Casualty 

Insurance 

V.T.C.S. artf)'8:;7, § 1.' 

87 'S.W.2d ::81 (Tex. 1935). 

We believe that the determination of the board's 

authority to approve a compromise settlement agreement 

subsequent to a final award of the board or a judgment of a 

court is governed by different statutory provisions than 

those apposite to the determination of the board's authority 

to approve compromise settlement agreements subsequent to an 

original compromise settlement agreement. We will therefore 

treat these two elements of your question separately. 

AUTHORITY OF BOARD TO APPROVE COMPROMISE 

SETTLEMENT AGREEMENT REGARDING FUTURE MEDICAL 

EXPENSES SUBSEQUENT TO FINAL AWARD OF BOARD 

OR JUDGMENT OF COURT. 

Attorney General Opinion JM-361 (1985) dealt with the 

question of whether the board may approve, while a case is 

p. 4672 
Mr. Joseph C. Gagen - Page 2 (JM-931) 

--. 

pending before the board, a compromise settlement agreement 

which terminates liability for future medical expenses, if 

the carrier had admitted liability and the injury was one 

conclusively held to be total and permanent pursuant to 

article 8306, section lla, V.T.C.S. 

Noting that section 12 'of article 8307, V.T.C.S., 

authorized the board to approve a compromise settlement 

agreement ll[w]here the liability of the association or the 

extent of the injury is uncertain," JM-361 concluded that 

where the carrier had admitted liability and where the 

injury was one for which as a matter of law incapacity was 

total and permanent, there was no Wncertaintyl@ as to 

liability or extent of injury within the meaning of section 

12. The opinion ruled that uncertainty as to amounts of 

future medical expenses was not "uncertainty" within the 

meaning of section 12 such that the board would be 

authorized to approve a compromise settlement agreement 

regarding only future medical expenses, where liability and 

extent of injury had been established. 

In our opinion, it follows from the ruling in JM-361 

that the board has no authority to approve a compromise 

settlement agreement that would terminate liability for 

future medical expenses after a final award of the board or 

a judgment of a court, because the proceedings of the board 

or a court in rendering a final award or judgment would 

necessarily have determined "liabilityql and "extent of 

injury" such that there would be no remaining "uncertainty" 

within the meaning of section 12 which would authorize the 

board to approve a compromise settlement agreement regarding 

future medical expenses.. That a final award by the board or 

a judgment of a court1 would have resolved uncertainty as to 

liability or extent of injury is apparent from a reading of 

pertinent parts of section 5 of article 8307: 

fill questions arisins under this law. if 

not settled bv aoreement of the varties 

interested therein and within the vrovisions 

of this law, shall. extent as otherwise 

provided. be determined by the Board. Any 

interested party who is not willing and does 

not consent to abide by the final ruling and 

decision of said Board shall, within twenty 

1. Of course, an award or judgment is not final until 

all appellate remedies have been exhausted. 

p. 4673 
Mr. Joseph C. Gagen - Page 3 (JM-931) 

(20) days after the rendition of said final 

ruling and decision by said Board, file with 

said Board notice that he will not abide by 

said final ruling and decision. And he shall 

within twenty (20) days after giving such 

notice bring suit in the county where the 

injury occurred, or in the county where the 

employee resided at the time the injury 

occurred (or, if such employee is deceased, 

then in the county where the employee resided 

at the time of his death), to set aside said 

final ruling and decision, and said Board 

shall proceed no further toward the 

adjustment of such claim, other than 

hereinafter provided. . . . Whenever such 

rouoht. . * the riohts and liau 

of the narties thereto shall b 

bv the orovisions of this la:. 

determined 

(Emphasis 

added.) 

The liability of the association and the extent of the 

injury are the two key issues to be determined by the board 

or by a court in a worker's compensation case. We find no 

provision of law relieving the board or a court from the 

duty to determine liability and extent of injury in rendering a final award or judgment. Once liability and extent of 

injury are finally determined by the board or by a court, 

there would remain no uncertainty as to the liability or 

extent of injury that would authorize the board under 

section 12 to approve a subsequent compromise settlement 

agreement regarding future medical expenses. 

Moreover, section 5 makes the only specific provision 

for the board's handling of medical expense claims after a 

final award by the board or a judgment of a court. 

Notwithstanding any other provision of 

this law, as amended, no award of the Board, 

and no judgment of the court, having jurisdiction of a claim against the association 

for the cost or expense of items of medical 

aid, hospital services, nursing, chiropractic 

services, medicines or prosthetic appliances 

furnished to an employee under circumstances 

creating a liability therefor on the part of 

the association under the provisions of this 

law, shall include in such award or judgment 

any cost or expense of any such items not 

actually furnished to and received by the 

employee prior to the date of said award or 

p. 4674 
Mr. Joseph C. Gagen - Page 4 (JM-931) 

judgment. The first such final award or 

judgment rendered on such claim shall be res 

judicata of the liability of the association 

for all such cost or expense which could have 

been claimed up to the date of said award or 

judgment and of the issue that the injury of 

said employee is subject to the provisions of 

this law with respect to such items, but 

shall not be res judicata of the obligation 

of the association to furnish or pay for any 

such items after the date of said award or 

nt. After the first such final award 

oment. the Board shall have continuinq 

iurisdiction in the same case to render 

successive awards to determine the liabilitv 

gf the association for the cost or exoense of 

w such items actuallv furnished to and 

received bv said emulov e not more than 

(6) months orior to tze date of each 

six 

such 

successive award, until the association shall 

have fullv discharaed its oblicration under 

this law to furnish all such medical aid, 

hosnital services. nursina. ChirODraCtiC 

. . services. medicines or DrOSthetiC aDDliance 

$0 hich said emulovee mav be entitled: 

provyded, each such successive award of the 

Board shall be subject to a suit to set aside 

said award by a court of competent 

jurisdiction, in the same manner as provided 

in the case of other awards under this law. 

(Emphasis added.) 

The board possesses only those powers conferred on it by 

statute. We have found no provisions authorizing the board 

to approve compromise settlements subsequent to board awards 

or court judgments, or to take other action regarding future 

medical expenses. Section 5 provides a procedure the board 

may utilize for the disposition of claims for medical 

expenses incurred subsequent to a board award or court 

judgment. 

AUTHORITY OF THE BOARD TO APPROVE COMPROMISE 

SETTLEMENT AGREEMENTS REGARDING FUTURE 

MEDICAL EXPENSES SUBSEQUENT TO AN ORIGINAL 

COMPROMISE SETTLEMENT AGREEMENT. 

We note at the outset that we have found no reported 

cases dealing with a compromise settlement agreement made 

subsequent to an original compromise settlement agreement. 

Many courts have stated that once an original compromise 

p. 4675 
Mr. Joseph C. Gagen - Page 5 (JM-931) 

settlement agreement is approved by the board, the agreement 

is binding on the parties until the original settlement 

agreement is lawfully set aside by a court. See. e.cr., 

-.. 

Luersen v. Trawerica Insurance Co, 550 S.W.2d 171 (Tex. 

Civ. App. - Austin 1977, writ ref'd n1r.e.); Pearce v. Texas 

EmoloversJnsurance Association 403 S.W.2d 493 (Tex. Civ. 

APP. - Dallas 1966, writ ref'd' n.r.e.), reh*a denied, 412 

S.W.Zd 647 (Tex. 1967), and the authorities cited therein. 

In this vein, section 12b of article 8307, V.T.C.S., 

now specifically provides that the board "shall have no 

jurisdiction to rescind or set aside any compromise 

settlement agreement approved by the board or any agreed 

judgment approved by the court." Acts 1983, 68th Leg., ch. 

501, section 1. 

Section 12b now also provides a specific procedure for 

the board's resolving disputes as to' medical expenses 

arising pursuant to compromise settlement agreements 

approved by the board or agreed judgments approved by the 

court : 

Whenever in any compromise settlement 

agreement approved by the board or in any 

agreed judgment approved by the court, any 

dispute arises concerning the payment of 

medical, hospital, nursing, chiropractic or 

podiatry services or aids or treatment, or 

for medicines or prosthetic appliances for 

the injured employee as provided in Section 

7, Article 8306, Revised Statutes, 

amended, or as provided in such compromizi 

settlement agreements or agreed judgments, 

all such disputes concerning the payment 

thereof shall be first presented by any party 

to the Industrial Accident Board within six 

months from the time such dispute has arisen 

(except where 'good cause' is shown for any 

delay) for the board's determination. . . . 

It is our opinion that approval of a compromise 

settlement agreement regarding medical expenses subsequent 

to an original approved compromise settlement agreement 

would necessarily have the effect of rescinding or setting 

aside, at least to some extent, the original compromise 

settlement agreement and would thus be barred by section 

12b. Section 12b provides a procedure for the board's 

dealing with questions of medical expenses pursuant to a 

compromise settlement agreement or agreed judgment approved 

by a court. 

p. 4676 
Mr. Joseph C. Gagen - Page 6 (JM-931) 

-. 

SUMMARY 

After a final award of the board, court 

judgment, or compromise settlement agreement 

which has not been lawfully set aside, the 

Industrial Accident Board has no authority to 

approve a compromise settlement agreement to 

terminate liability for future medical 

expenses. 

JIM MATTOX 

Attorney General of Texas 

MARYRELLER 

First Assistant Attorney General 

MU MCCREARY 

Executive Assistant Attorney General 

JUDGE ZOLLIE STBARLBY 

Special Assistant Attorney General 

RICK GILPIN 

Chairman, Opinion Committee 

Prepared by William Walker 

Assistant Attorney General 

p. 4677