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

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On July 2, the DWC announced a revised DWC Form-052 “Supplemental Income Benefits (SIBs) Application,” which went into effect on June 20 and became immediately available on the TDI website.  

A great many changes on the new form are immediately noticeable.  Gone is the requirement from the old DWC Form-052 to supply the treating doctor’s name and phone number, the name of the injured worker’s prior employer, and the claimant’s county of residence. New items include the adjuster’s fax number, the claimant’s email address, and a section to specify whether the application is for the first quarter of SIBs or a subsequent one.  

The work status chart has been streamlined, while the grid pertaining to wages earned during the qualifying period allows for more information (pay period dates and whether wages were earned weekly, biweekly, or monthly). Also new: the adjuster may now check a box pertinent to the reason for a quarter’s denial from a list provided, or include a written explanation otherwise.  Formerly, a written explanation was required.  

The certification that accompanies a claimant’s signature has been modified to attest that the applicant has either been searching for work or is completely unable to work, but the warning that an administrative or criminal penalty can follow from intentionally providing false information to obtain benefits has been excised.  

Most notably, the weekly work search log has been modified substantially. The applicant is no longer asked to supply the method by which a work opportunity was sought (in person, phone, fax, mail, email/web), nor is he/she asked to indicate what was submitted to the potential employer (cover letter, application, or resume). The form now asks only if a job was offered, not whether it was accepted or if the employer was “not hiring.”  The column for recording the day of the work search now reads “Date you applied” rather than merely “date,” aligning with the requirement that job applications must be included with the submission of the DWC Form-052.  
 

Copyright 2024, Stone Loughlin & Swanson, LLP

Coming and Going, Part II


Another month, another round of new hires and exits at the Division of Workers’ Compensation.

We recently reported on the departure of the Deputy Commissioner of Appeals, who oversees the Division’s Appeals Panel. We are pleased to report that the position has been filled by former Ft. Worth Administrative Law Judge Kara Squier, who has been a Division employee for more than a decade. We congratulate her on the promotion!

Pam Delgado, the Administrative Law Judge in Corpus Christi, retired on July 12. The Division has posted her position but has yet to fill it. No word yet on what life post-DWC might have in store for Judge Delgado, but whatever it may be, we thank her for her service and wish her the best.

As one vacancy opens, another closes. Kathryn Labowitz, recently of Bailey & Galyen, is the newest Administrative Law Judge in Dallas. Ms. Labowitz graduated from the University of Texas at Arlington with a BA in political science before obtaining her JD from Baylor Law School in 2003. In the interim, her practice took her into the fields of family law, personal injury, probates, and toxic tort litigation. We are excited to see what her experience will bring to the DWC.  

Mariana Kuznetsov, formerly a Proceedings Resolution Officer, has been promoted to Benefit Review Officer. She began presiding over BRCs in July. Our congratulations to her!
 

Copyright 2024, Stone Loughlin & Swanson, LLP  

A Judgment Disorder


“He who represents himself has a fool for a client.” That morsel of legal wisdom, well-known among those in the profession, is generally attributed, perhaps apocryphally, to Abraham Lincoln. Well, if the gentleman from Springfield ever did say it, no one bothered to tell Phyllis Lee.  

Ms. Lee, was a Grand Prairie ISD employee. Without legal counsel, she filed a petition for judicial review of a Decision and Order and Appeals Panel affirmance that her injury does not extend to or include “adjudgment disorder” (whatever that is) along with “depressed mood, psychological factors adversely affecting medical conditions, or major depression.” She further accused the School District of “due process violations, fraud, and conspiracies” committed against her.  

The school district scored a victory at the trial court level, where Ms. Lee’s suit was dismissed summarily for not having been filed within the thirty days allotted under the Administrative Procedure Act (APA). But the Austin Court of Appeals sided with the still-unrepresented Ms. Lee, reversing the decision and remanding the case back to the trial court. The Court of Appeals confirmed that Ms. Lee’s deadline to file her petition was forty-five days under Texas Labor Code Section 410.252, which is the statute that applies to all Appeals Panel decisions, and not thirty days per Section 2001.176 of the APA.  

So, this time, anyway, it seems Lee got the better of Lincoln.  

Copyright 2024, Stone Loughlin & Swanson, LLP

One Big Trucking Fraud


Frances Hall, the widow of San Antonio-based trucking mogul Bill Hall, Jr., was sentenced to ten years deferred adjudication and ordered to pay $150,000.00 in restitution for her role in a workers’ compensation fraud on July 10 by the 147th District Court in Austin pursuant to a plea agreement entered the prior May.  She is also ordered to undergo unspecified “treatment,” per the probation department’s recommendation.  

Mrs. Hall co-founded Bill Hall Jr. Trucking with her husband. The Division’s fraud unit found that Mrs. Hall underreported payroll information and concealed payroll reports to her workers’ compensation insurance carrier between 2006 and 2016, which allowed her to avoid paying approximately $9 million in work comp premiums. 

Mrs. Hall was convicted in September 2016 of felony murder in the death of her husband, but received only a two-year prison sentence. She has since been released.

Copyright 2024, Stone Loughlin & Swanson, LLP

CGI (Computer-Generated Impairment)


On July 15, the DWC revealed its proposed revision to Texas Administrative Code §133.30, “Telemedicine, Telehealth, and Teledentistry Services.” The change would permit treating doctors (not Designated Doctors or Required Medical Examiners) to perform MMI evaluations remotely via telemedicine. The certifying doctor would only be permitted to determine if MMI has been attained and, if so, to provide a determination of no permanent impairment. The rule change specifies that “The term (telemedicine services) does not include an examination to assign an impairment rating” under Rule 130.1.  

The new “telecertification” Rule references Rule 130.2, subsection (a)(2), which currently allows a treating doctor to provide an MMI certification without scheduling an examination, so long as the injured employer has been released from treatment without the expectation of further treatment and is not receiving Temporary Income Benefits.  

Thoughts on the rule draft can be submitted to RuleComments@tdi.texas.gov by 5:00 p.m. on August 12, 2024.  


Copyright 2024, Stone Loughlin & Swanson, LLP

Giving Credit Where Credit Is Due


Vindication for the Appeals Panel!  The Court of Appeals in Amarillo determined this month that an insurance carrier may take credit for previously paid Indemnity Income Benefits (IIBs) and Supplemental Income Benefits (SIBs) by redesignating them as Lifetime Income Benefits (LIBs) if either were paid prior to the LIBs accrual date.  Lubbock County v. Reyna, No. 07-23-00380-CV, 2024 WL 2925337.

The injured worker sustained a traumatic brain injury entitling him to Lifetime Income Benefits. However, Claimant had already received approximately four and a half years of IIBs and SIBs after the LIBs accrual date.  He won a summary judgment decision at the district court level, where he asserted his right to collect LIBs during the same time frame he previously received IIBs and SIBs.  Lubbock County’s summary judgment motion, asserting that such double recoveries are prohibited as a matter of law, was denied.

The Court of Appeals reversed the trial court in holding that an injured worker may recover only one form of income benefits for a single compensable injury at any given time.  Referencing the Appeals Panel’s decision in the case that both IIBs and SIBs could properly be redesignated as LIBs, the Court of Appeals concurred.  To permit receipt of multiple forms of income benefits for the same period would potentially allow an injured worker to recover more than his or her average weekly wage in indemnity benefits, something the Texas Labor Code forbids.

Instructions to the insurance carrier on the PLN-7 form (“Notice of Change of Indemnity Benefit Type”) have been changed to advise that the form is to be used when an injured worker gains entitlement to LIBs following payment of a previous income benefit type.  

Copyright 2024, Stone Loughlin & Swanson, LLP

An Item of Slightly Greater Interest


The DWC announced on June 21 that interest on benefits owed under the Texas Labor Code will now be at the rate of 8.57%, up infinitesimally from the prior rate of 8.55%.  The new rate went into effect on July 1, 2024.  So, if you spent your Canada Day watching Letterkenny with a six-pack of Molson instead of obsessively checking interest rates on past due workers’ compensation benefits, now you know.

Copyright 2024, Stone Loughlin & Swanson, LLP

Wage of Enlightenment 


On July 24, 2024, at 2:00 p.m. Central Time, the Division of Workers’ Compensation will offer a free webinar to instruct system participants on the usage and correct completion of the DWC Form-003 Employer’s Wage Statement.  Adjusters, employers, and attorneys are invited to attend and earn an hour of general education credit. Those interested may register here.

The DWC Form-003 is (spoiler alert!) essential for establishing an injured worker’s average weekly wage and, by extension, the rates for income benefits to follow.  No word on the precise topics to be covered in the program, but some suggestions would include:
•    Why is the DWC-003 required?
•    To whom is it then sent?
•    What is considered a non-pecuniary wage?
•    How should wages paid on a biweekly basis be recorded?
•    What if the injury occurred in the middle of the week?
•    Or if the injured worker was not employed for thirteen weeks?
•    Can I get Glenda in H.R. to do this, or do I have to?

Substance Over Forms

 
The DWC has proposed revisions to a slew of forms recently.  Among them:

The DWC Form-001, “Employer’s First Report of Injury or Illness,” has been re-formatted with one noticeable change.  Previously, the employer was asked to provide the “Date Lost Time Began.”  The new version inquires instead after “First day absent from work.”  The same change can now be found in the DWC-002, “Employer’s Report for Reimbursement of Voluntary Payment,” and the DWC-006 “Supplemental Report of Injury.”

The latest alteration to the perpetually revised DWC032 “Request for Designated Doctor Examination” corrects some wording in the extent of injury issue, but more importantly amends the “Other similar issues” (Box 31 G) to incorporate a request for an examination to determine “eligibility to receive lifetime income benefits,” which was not previously specified.  

A new form, the DWC038 “Application for lifetime income benefits,” has been proposed.  The form sets forth a section listing the possible bases for the injured worker’s entitlement to LIBs, including one for a “first responder with a serious bodily injury that makes you permanently unemployable.” 
 

Coming and Going


A great deal of movement within the Division of Workers’ Compensation this month.  San Antonio Administrative Law Judge Gilbert Atkinson has departed to resume his pre-DWC career as an insurance carrier rep.  We wish him nothing but the best, of course.  

Replacing Mr. Atkinson is John Bull, a former municipal court administrative judge in Bexar County for more than two decades. Judge Bull graduated from St. Mary’s University Law School in 1990, where he later became an adjunct professor of trial advocacy. Most recently, Judge Bull spent three years as the Chief Public Defender in Kerrville, Texas.  

The DWC has also hired Raegan Lynn Lambert as a traveling Administrative Law Judge. She graduated from the University of Texas School of Law in 2000 but commenced her career as an Assistant District Attorney in New York.  Thereafter, she served as a Hearing Officer for the New York City Department of Education before returning to Texas to start her own law practice. Judge Lambert has extensive experience with the state, first as an Assistant Attorney General investigating white collar crime, then as Assistant Chief Counsel of General Litigation and Anti-Fraud with the Texas Comptroller of Public Accounts.  

Rebecca Allen, the Docketing Team Lead for the northern and western regions, left the Division at the end of May for a new career in the nursing field.  Her duties have been taken over by Misty Haygood, who now oversees docketing for Benefit Review Conferences and Contested Case Hearings for the entire state. Ms. Allen’s years of tireless service to the DWC and its system participants are surely appreciated.

Jennifer Hopens, the Director of the Appeals Panel since 2017, is also departing after seventeen years with the DWC. She has reportedly taken a position at Child Protective Services, for which we certainly wish her well.  

Finally, Aida Johnson, a Benefit Review Officer in the Fort Worth region, is retiring this summer to spend time with her family and whatever adventures that might bring.  The decision is bittersweet for system participants, who have long appreciated Ms. Johnson’s courtesy, open mindedness, and cheerful spirit, which has been known to calm even the most contentious mediation.  While we are happy for the meaningful time with her family she is about to enjoy, we in the realm of Texas workers’ compensation will miss her immeasurably.
 

Copyright 2024, Stone Loughlin & Swanson, LLP