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.
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If you have questions
about the Division’s new EDI data collection agent and the billing registration
process, you’re not alone. Insurance carriers have so many questions that the
Division is hosting a Zoom call to address them. The call comes in the wake of
the Division’s announcement that it is changing the process by which insurance
carriers must report claim data through electronic data interchange
(EDI).
Currently, carriers are required to report EDI claim data using an antiquated
standard – to be precise, International Association of Industrial
Accident Boards and Commissions (IAIABC) Release 1.0. But beginning July 26,
2023, the Division will be requiring carriers to use the current standard,
IAIABC Release 3.1.4. This and other requirements are set out in new Division
rules 124.100 - 124.108.
As part of the conversion, the Division designated a private contractor,
Verisk, as its data collection agent for claim EDI release 3.1 data. Verisk
will bill insurance carriers, other than governmental entities, for the cost of
data collection. Accordingly, insurance carriers were required to register
their billing contact information with Verisk by June 13, 2022.
Also, as part of the conversion, each insurance carrier will be required to
designate one person as its claim EDI compliance coordinator and provide that
person’s contact information to the Division. Carriers can report this
information to the Division on new Form EDI-03.
Bonus cocktail party trivia:
According to its website, the IAIABC was founded in 1914 and is an association
of workers’ compensation jurisdictional agencies from around the world, as well
as private organizations involved in the delivery of workers’ compensation
benefits and services. It works to identify best practices, develop and
implement standards, and provide education and information sharing.
Copyright 2022, Stone Loughlin & Swanson, LLP
Speaking of appeals,
we continue to await the decision of the appeals court in our legal challenge
to the Division’s Supplemental Income Benefits rule.
Readers may recall that our firm, on behalf of an interested insurance carrier,
filed suit challenging the validity of the SIBs rule on the basis that it
impermissibly allows claimants to collect SIBs even if they do not document
their work search with job applications as required by the Texas Workers’
Compensation Act. Travis County district judge Maya Guerra Gamble agreed with
the carrier that the rule is invalid, and she enjoined the Division from
applying it. But the Division appealed to the Third Court of Appeals and,
because the Division is part of a state agency, the judgment is stayed during
the appeal.
The parties filed legal briefs in the court of appeals, and on August 30, 2021
the court announced that it did not need to hear oral argument and the
case was “ready for disposition on the briefs.” That was 10 months ago. By
comparison, in the recent case of Dobbs
v. Jackson Women’s Health Organization, in which the Supreme Court
of the United States ruled that the Constitution does not guarantee the right
to an abortion, the court issued its decision 8 months and 11 days after
briefing was complete. And one could
conclude that the issues in that case are more complicated than the issues in
our SIBs case.
By the way, SLS partner Jane Stone will be discussing the SIBs case at the
upcoming Texas Bar CLE Advanced Workers’ Compensation seminar in August, by
which time the court might have issued a decision.
Copyright 2022, Stone Loughlin & Swanson, LLP
The Texas Department
of Insurance, Division of Workers’ Compensation has posted job openings for
three Appeals Panel judges. This, apparently, is in response to three recent
departures – we’ve learned that Rafael Quintanilla, Gary Kilgore, and Tom Knapp
have retired. We’re envious, and we wish them well.
Speaking of envy, the Division’s job posting describes some sweet fringe benefits. They
include the following:
• Telecommuting
• 96 hours of accrued vacation a year
• 96 hours of accrued sick leave a year
• 20+ holidays every year
Copyright 2022, Stone Loughlin & Swanson, LLP
Don't do this:
Or this:
Copyright 2022, Stone Loughlin & Swanson, LLP
Those of you who listen to podcasts when you walk, run, or simply want to avoid
any conversation with the unwashed masses on Southwest Airlines should check
out Feedspot’s revised list of the 30
Best Workers’ Compensation Podcasts. Rounding out Feedspot’s top
three are:
1. Comp
+ Coffee
Described by Feedspot as a podcast from Payscale that talks through the art and
science of compensation management. Two episodes per quarter. Average length 38
minutes.
2. Third
Fridays
Described by Feedspot as a podcast from Lois LLC in which attorneys discuss
workers’ compensation issues, share their opinions, and engage in colorful
conversations. One episode per month. Average length 37 minutes.
3. Adjusted
Described by Feedspot as a podcast in which Claire Muselman and Greg Hamlin
take a deep dive with industry leaders who are changing the landscape of
workers' compensation to offer a new perspective on insurance. Two episodes per
month. Average length 36 minutes.
Copyright 2022, Stone Loughlin & Swanson, LLP
Kids’ Chance of Texas
has awarded 30 scholarships so far this year to kids who had a parent killed or
catastrophically injured at work. There are more waiting to apply, so the group
is hard at work raising money to make sure each one can be helped. You or your
company can impact this effort directly by buying a sponsorship for the
upcoming KCTX Golf Tournament on October 28.
SLS is sponsoring again this year because this effort is near and dear to us.
Go to www.Kidschanceoftexas.org for details, or send
a check made out to Kids’ Chance of Texas to the attention of Jane Stone at SLS
and she will make sure you get signed up . . . golf is included, depending on
the level of sponsorship.
Copyright 2022, Stone Loughlin & Swanson, LLP
New research suggests that many people suffer neurological symptoms long after
contracting COVID-19.
According to Neuroscience News,
researchers at the University of California San Diego School of Medicine are
conducting a longitudinal study to track neurological symptoms in COVID-19
“long-haulers.” The first round of results, published June 15 in Annals of Clinical and Translational
Neurology, found that the majority of participants still had some
neurological symptoms after six months.
56 persons with neurological symptoms following a COVID-19 infection were
recruited to the study. Baseline measurements were taken a few months
after their initial infection and repeated three and six months later. When
participants returned for their six-month follow-up, only one-third reported
complete resolution of symptoms. The other two-thirds reported persistent
neurological symptoms, though most had diminished in severity. The most
prevalent symptoms at six-months were memory impairment and decreased
concentration.
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
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
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