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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
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
“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
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
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
• 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?
Copyright 2024, Stone Loughlin & Swanson, LLP