State News : Texas

NWCDN is a network of law firms dedicated to protecting employers in workers’ compensation claims.


NWCDN Members regularly post articles and summary judgements in workers’ compensations law in your state.  


Select a state from the dropdown menu below to scroll through the state specific archives for updates and opinions on various workers’ compensation laws in your state.


Contact information for NWCDN members is also located on the state specific links in the event you have additional questions or your company is seeking a workers’ compensation lawyer in your state.


Texas

STONE LOUGHLIN & SWANSON, LLP

  512-343-1385

We have recently learned that Benefit Review Officers Nora Astorga and Elizabeth Benavides, both assigned to the Houston East Field Office, retired this month. We are sorry to see these knowledgeable and effective BROs leave the Division, however, we extend them our best wishes in whatever new adventures they choose to pursue in the future. 

We have no information concerning replacements for Ms. Astorga and Ms. Benavides. There are currently no job postings on the Division’s website for BRO positions. For now, disputes in the Houston East Field Office which would otherwise be assigned to these BROs are being handled by BROs in other Division field offices. 


Copyright 2022, Stone Loughlin & Swanson, LLP

In response to our firm’s Public Information request, the Division has produced its records of activity by the Appeals Panel during 2021. In this past year, the panel has resolved 2,108 appeals, up 132 cases over the 1,976 appeals resolved in 2020.

Lest you wonder how six judges could possibly handle and resolve so many appeals, let us look a bit closer at the numbers.  

Of those 2,108 appeals resolved, 2,005 became final by operation of law as a result of the Appeals Panel taking no action and allowing the ALJ’s Decision and Order to become the final decision of the Division.

Using a calculator so as not to rely solely on our imperfect math skills, we note that the Appeals Panel wrote decisions in only 103 cases, up significantly from the 60 decisions written in 2020, but still an average of only two decisions per week.  

Of those 103 Appeals Panel Decisions, eight affirmed all issues and 95 reversed and/or remanded issues back to the ALJ. So, in 2021, the odds that the panel would reverse or remand any given Decision and Order were about 4.5%, up from 1.97% the previous year.


Copyright 2022, Stone Loughlin & Swanson, LLP 


 

Well, we don’t know yet. The position has remained unfilled since September, 2021 when Commissioner Cassie Brown left to accept Governor Abbott’s appointment as Commissioner of Insurance, a position that itself had been vacant since September 2020, following Commissioner Kent Sullivan’s resignation to return to the private sector. 

So after nine months, we wonder when a new Commissioner will be appointed to guide the Division into the future…although we must say that the Division seems to be humming along just fine without one.
 

Copyright 2022, Stone Loughlin & Swanson, LLP 

Readers of the Compendium may recall the April 2021 newsletter reporting that, according to Commissioner’s Bulletin #B-0012-21, the Division would relocate its Austin headquarters in the summer of 2022 to the Capitol Complex at 1601 Congress Avenue in Austin. 

On May 2, however, the Division announced that the Austin Field Office would hold hearings on a temporary basis in the Hobby Building at 333 Guadalupe starting on July 18, 2022. 

Two days later, on May 4, DWC rescinded its plans to move temporarily to the Hobby Building and announced that it will continue to hold hearings at the current Metro location through the summer. The move to 1601 Congress Avenue will be announced when the moving date is finalized. 


Copyright 2022, Stone Loughlin & Swanson, LLP 

In a disciplinary order dated May 23, 2022 the Division ordered William R. Francis, Jr., M.D. to pay an administrative penalty of $12,000.00 and attend an Ethics and Boundaries Assessment Services course and workshop. The Division found that Dr. Francis authorized and submitted CMS-1500 billing forms for 6,487 manual  muscle tests (MMT) and functional capacity evaluations (FCE) in which he listed himself as the rendering provider. The Division found, however, that Dr. Francis was neither in the room where the examinations were performed nor did he supervise the technicians performing such examinations.
 

Copyright 2022, Stone Loughlin & Swanson, LLP

The Division intends to amend Texas Administrative Code §132.17 (Rule 132.17) concerning Denial, Dispute, and Payment of Death Benefits. The proposed amendments incorporate updates for plain language and “agency style” and clarify a Carrier’s deadlines to file disputes over eligibility for death benefits. The proposed rule is available here

Comments concerning the proposed rule may be emailed to the Division at RuleComments@tdi.texas.gov

Copyright 2022, Stone Loughlin & Swanson, LLP

You may recall from past issues of the Compendium that we have expressed our concern that the number of designated doctors in the workers’ compensation system continues to decline. In the September 2021 issue we reported that the number of designated doctors in the system had dropped to a total of 272, only 75 of which were physicians.

DWC has announced another presentation concerning proposed changes to the designated doctor program which will allow system participants to discuss the second informal proposal on amendments to 28 Texas Administrative Code Chapter 127 and 28 Texas Administrative Code §180.23. 

The presentation will be held via Zoom on June 7, 2022 from 1:30 to 2:30 p.m. Slides will be posted on the TDI website on the day of the presentation. The informal proposal together with associated documents will be posted on June 1, 2022 on the TDI website.

You may join the Zoom Meeting as follows:
https://TDI-Texas.zoom.us/j/96612443624
Meeting ID: 966 1244 3624
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+19294362866, 96612443624# US (New York)
Dial by your location
+1 929 436 2866 US (New York)
Meeting ID: 966 1244 3624
Find your local number: https://TDI-Texas.zoom.us/u/abfriIPP3u


Copyright 2022, Stone Loughlin & Swanson, LLP

The Division has adopted new DWC Form-033, Request to Reduce Income Benefits Due to Contribution, as of May 18, 2022. The adoption of the form is necessary to allow insurance carriers to reduce the amount of income benefits paid to an injured employee due to a past work-related injury to the same body part or parts. 

Carriers are to use the adopted form on and after June 13, 2022. A copy of the new DWC Form-33 is available here.


Copyright 2022, Stone Loughlin & Swanson, LLP

The Division is accepting public comments on three new proposed forms:

DWC Form-003, Employer’s Wage Statement: The proposed new DWC-003 includes substantially the same information contained in the old form, however, the new form appears much clearer and less complicated for employers to complete.

DWC Form-003ME, Employee’s Multiple Employment Wage Statement: This form provides the injured employee a way to provide wage information for other employers to the Carrier for calculation of the average weekly wage and issue income benefits when the injury affects ability to work.

DWC Form-003SD, Employer’s Wage Statement for School Districts, allows employers a way to report wage information to the Carrier to calculate average weekly wage and issue income benefits for school district employees.    

DWC will consider all substantive comments before adopting the proposed new forms which may be viewed here

Written comments should be submitted on the forms by 5:00 p.m. on June 21, 2022 to: RuleComments@tdi.texas.gov


Copyright 2022, Stone Loughlin & Swanson, LLP

As reported in last month’s Compendium, the deadline for First Responders to request reconsideration, pursuant to Senate Bill 22, of their COVID claims denied between March 13, 2020 and June 14, 2021, is June 14, 2022. A sample Request to Reprocess a denied COVID claim may be found on the Division’s first responder website here.


Copyright 2022, Stone Loughlin & Swanson, LLP