December 7, 2005

Texas Workers Compensation Reform

After our recent post on Missouri, one of our regular readers asked for a summary of reform provisions in the Texas law enacted in June. Here's what we came up with - we invite Texas readers to add any comments and clarifications - we'd welcome the input!

  • TWCC was eliminated; workers compensation is now managed by the TX Department of Insurance through the Division of Workers Compensation (DWC). The intent is to streamline & reduce bureaucracy.
  • Office of Injured Employee Counsel (OIEC) is formed to advocate for and help injured workers.
  • Employers can designate a medical provider network (MPN) which employees will be required to use for workers compensation medical care. This is optional, employers can choose a network or not. This is a major new provision, rather complex, and still in the works since rules were to be adopted by Dec. 1, 2005. Essentially, networks will designate treating doctors, and injured workers must choose a treating doctor from the network list. For several years, the number of docs in the system had been decreasing, and the hopes are that these changes will help attract more quality MDs back into the system, and afford employers more control; the employee still has choice, but for those employers with certified networks, the employee must choose a doctor in the network. (However, they can redirect for a second visit).
  • Employee benefits will increase after 10/1/06 (according to AON, by about 15%) and the waiting period for payment of Temporary Income Benefits is reduced from 4 to 2 weeks.
  • Exclusive remedy is bolstered to encompass some claims that were previously denied, such as horseplay. While these were meant to exclude employees who were at fault, the end result was that denied employees were free to sue for damages.
  • A fee schedule for prescription drugs has been added.
  • The Supplemental Income Benefits eligibility has been tightened in terms of work-search requirements
  • The Hazardous Employer Program will be eliminated. This was a program that identified employers with injury rates substantially higher than those anticipated for their industries. Once identified as Hazardous, these employers were mandated to hire a consultant approved by the Division.

Resources
Texas Department of Insurance page on the new law
Key provisions and frequently asked questions about the new law broken into separate sections for employees, for employers, for health care providers, and for insurers; also, House Bill 7 Frequently Asked Questions for Employers and Insurance Carriers.

Changes in Texas Workers� Compensation (pdf)
An excellent summary and analysis of the changes by AON, September 2005.

Texas Enacts Workers� Compensation Reform Featuring MPNs, Administrative Reforms
A brief summary of the reform by Sedgwick June 3, 2005.

Texas Workers� Compensation 2005 Reform (HB7) Overview (pdf)
A brief summary of the changes in the law by St Paul Travelers.

Texas Reforms Its Workers' Compensation System
Summary of the new law by law firm Littler Mendelson.

The complete text of the law
The text shows additions and deletions from the prior law.

| 2 Comments

2 Comments

Go to the Community of Injured Workers and view this site.
wcbcanada.com
It is now a small world we live in.

hi there,

Was wondering why compensation relies on professionals committing fraud intentional negligence)when advancing a claim and since the exemption does not appear to have been removed under the reformed concept of compensation .. how has the process actually changed?
Our Canadian courts refuse to allow our Constitution be used in the courts for compensation purposes ...something to do with the judges financial interests in the law firms retained to defend the compensation system .. which shulod fall under criminal activity but because it is compensation .. all professionals are exempt from any and or all criminal and civil laws they break. During our federal elections on january 23, 2006 we hosted an information picket in front of the polling stations sharing these and other related issues. Not a single person, police, politiicans, lawyers, that approached us during the picket disagreed with us .. most had no idea compensation breaks so many normal laws or that the professionals are exempt from law for participating in creating litigation rather than provide indemnity benefits. Since our compensation executives travel extensively in the United States sharing ideas and profits .. i would think the information also applicable to injured workers and related associations throughout the U.S.
Does your compensation system classify your injured workers under the anti -terrorism legislation as they do here?
Does your system allow investigators to video your family in the house (bathroom) as they have here and does your compensation ystem provide the government employees with bonuses for the litigation they create when denying claim entitlement?
Would love to hear views from your readers.
Sicnerely,

Ronald B Knox

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This page contains a single entry by Julie Ferguson published on December 7, 2005 7:52 AM.

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