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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
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
One tap mobile
+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 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
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
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
A joint project sponsored by the Law-Related Education Department of the State
Bar of Texas, the U.S. District Courts of Texas, and Law Focused Education,
Inc. is seeking attorneys to serve as virtual guest speakers to school
classrooms across the state on Constitution Day, September 26, 2022 (observed).
The Zoom program will last approximately one hour, requires minimal preparation
work, and affords attorneys the opportunity to earn pro bono hours while
educating and engaging Texas high school students.
For more information concerning this professional opportunity, attorneys may
register here.
You may also contact kim_schaefer@txnd.uscourts.gov or keend@friscoisd.org
with questions.
Copyright 2022, Stone Loughlin & Swanson, LLP
DWC adopted the Texas
claim Electronic Data Interchange release 3.1.4 on March 9, 2022 and, as a
result, DWC’s designated data collection agent, Verisk, will begin billing
insurance carriers for one-time set-up costs and claim data collection activities
for the first year of EDI 3.1.4. Carriers will be billed half of their one-time
costs immediately after registration.
All insurance carriers or carrier groups must register their billing contact
information with Verisk by June 13, 2022. To register, go to https://txdwcedi.info/ and select “Billing
Registration” from the menu.
Questions concerning registration may be submitted by email to: txdwcbillingquestions@verisk.com
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
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
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