Texas Insurance Regulators Outline New Workers’ Comp Laws

August 29, 2019

The Texas Department of Insurance has issued a bulletin providing summaries of selected bills enacted by the 86th Legislature that affect workers’ compensation and may be relevant to individuals and entities regulated by the Texas Department of Insurance, Division of Workers’ Compensation (DWC).

TDI-DWC is only providing summary information in this bulletin regarding particular provisions of the bills that may apply to the regulation of workers’ compensation. Participants are advised to refer to the actual bills for the complete content of the legislation.

Listed below are the bills outlined by the department along with the effective dates of the legislation.

House Bill 29: Physical Therapy Practice Without a Referral

Allows certain physical therapists to treat patients without a referral for up to either 10 or 15 consecutive business days, depending on the physical therapists’ qualifications. A physical therapist may treat a patient for up to 10 consecutive business days without a referral if the therapist has a doctoral degree in physical therapy or has been licensed for at least one year and completed at least 30 hours of continuing competence activities in the area of differential diagnosis. Therapists must also be covered by professional liability insurance. A physical therapist with a doctoral degree who has also completed a residency or fellowship may treat for up to 15 consecutive business days.

Note: Physical therapists are not included under the definitions of doctor or treating doctor in Labor Code §401.011. Labor Code §408.021(c) provides that workers’ compensation health care must be approved or recommended by an employee’s treating doctor. Texas Insurance Code §1305.103 also states that a certified workers’ compensation health care network’s treating doctor must provide health care to the injured employee and make referrals to other network or approved out-of-network health care providers. Treatment by a physical therapist in the workers’ compensation system must be approved by the employee’s treating doctor.

Effective Sept. 1, 2019.

House Bill 387: Advanced Practice Registered Nurse Report Submission

Allows a treating doctor to delegate to an advanced practice registered nurse the authority to complete and sign a DWC Form-073, Work Status Report regarding an injured employee’s ability to return to work.

Effective Sept. 1, 2019.

House Bill 1665: Obsolete Reporting Requirement

Eliminates the requirement for hiring contractors to file DWC Form-84, Exception to Application of Joint Agreement to Affirm Independent Relationship for Certain Building and Construction Workers with DWC. This form will continue to be sent to the hiring contractor’s insurance carrier and will be available to DWC, if requested.

Effective for new notifications on or after May 23, 2019.

House Bill 2143: Post-Traumatic Stress Disorder Eligibility for First Responders

Clarifies that post-traumatic stress disorder (PTSD) is a compensable injury for first responders if the disorder was caused by one or more events in the course and scope of employment, rather than a single event. Sets the date of injury for PTSD as the date the first responder knew or should have known that the disorder may be related to their employment.

Effective for new injuries that occur on or after Sept. 1, 2019.

House Bill 2503: First Responder Death Benefits

Expands eligibility of spouses who may receive death benefits for life, regardless of remarriage, to spouses of peace officers as described in Texas Code of Criminal Procedures Article 2.12 and intrastate fire mutual aid system team members or regional incident management team members.

Effective for remarriages occurring on or after Sept. 1, 2019.

Senate Bill 619: Sunset Advisory Commission Scheduling Bill

Reschedules the DWC and the Office of Injured Employee Counsel (OIEC) review by the Sunset Advisory Commission from 2021 to 2023.

Effective June 10, 2019.

Senate Bill 935: Federal Military Treatment Facilities

Clarifies that medical care provided in a federal military treatment facility (FMTF) is exempt from certain workers’ compensation-specific statutory requirements. Requires insurance carriers to pay the amount charged by these facilities under federal law. Requires the commissioner to adopt rules regarding the billing and payment for medical care provided to injured employees and the resolution of medical disputes in situations where the injured employee has been balance billed. Rules must be adopted by December 1, 2019.

Effective for health care services provided by an FMTF on or after Jan, 1, 2020.

Senate Bill 1336: Obsolete Rate Relativities Requirements

Eliminates TDI’s statutory obligation to develop workers’ compensation classification relativities. Insurance companies may continue to use the loss costs filed by the National Council on Compensation Insurance or the insurance company’s own independent, company-specific relativities filed by TDI to set insurance rates.

Effective Sept. 1, 2019.

Senate Bill 1582: Peace Officer Presumptions

Extends the statutory presumption that certain occupational diseases are work-related to a peace officer as described in Texas Code of Criminal Procedures Article 2.12. Those presumptions include smallpox or other diseases that can be immunized, tuberculosis or other respiratory diseases, and heart attacks and strokes. The bill also entitles peace officers to preventative immunization for any disease that they may be exposed at work.

Effective Sept. 1, 2019.

Senate Bill 2551: Firefighter and Emergency Medical Technician Cancer Presumption

Replaces the presumption standard for cancer claims from a cancer known to be associated with firefighting or exposure to heat, smoke, radiation, or a known or suspected carcinogen as determined by the International Agency for Research on Cancer, with a list of 11 cancers. Those cancers are cancers that originate at the stomach, colon, rectum, skin, prostate, testis, or brain; non-Hodgkin’s lymphoma; multiple myeloma; malignant melanoma; and renal cell carcinoma.

In addition, SB 2551:

  • Exempts insurance carriers from the 15-day pay or dispute requirement in Texas Labor Code §409.021(a) if certain conditions are met.
  • Provides that the presumption for any of the occupational diseases described in Government Code Chapter 607 may be rebutted through a showing by a preponderance of the evidence that a risk factor or cause not associated with the firefighter or emergency medical technician’s work was a substantial factor in bringing about the disease, without which the disease would not have occurred.
    Adds factors that DWC must consider when determining whether to assess administrative penalties under Labor Code 409.021(a-3).
  • Clarifies and confirms that political subdivisions do not have sovereign immunity from compliance, enforcement actions, and administrative penalties under Chapter 415 and adds liability for claimant’s attorney fees under Labor Code §408.221.
  • Allows a political subdivision to create an account for the payment of lifetime income benefits or death benefits.
  • Requires the commissioner to adopt rules as required by or necessary to implement this legislation not later than Jan. 1, 2020.

Effective for new claims filed on or after June 10, 2019.

Source: TDI-DWC

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