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.
The National Workers' Compensation Defense Network (NWCDN) is hosting an excellent conference in Atlanta on October 18 and 19. It is by invitation only, so if you are interested in attending, please contact Jane Stone atjstone@slsaustin.com.
Another attorney pled guilty to conspiracy to commit health care fraud, admitting to a scheme under which he received more than $26 million from the US Department of Labor Office of Workers’ Compensation Program. Dallas attorney, Tshombe “Shaun” Anderson, admitted that he and four family members ran a durable medical equipment billing scheme involving patient information taken from Union Treatment Centers. Anderson had previously worked for Union Treatment Centers as an attorney. The scheme involved duplicate billing for unwanted durable medical equipment that was not medically necessary, using outdated medical information. Anderson faces sentencing on 11/19/17, and faces up to 10 years in prison and restitution. In addition, $8.4 million was seized from 25 bank accounts associated with him, his firm and his family, as well as two houses, several luxury cars and almost $700,000 in cash seized from his home and that of his sister. It appears that the powers that be are starting to take workers’ compensation fraud seriously!
DWC has lost two more long-time Hearing Officers. Carol Fougerat is leaving the San Antonio Field Office and Patrice Squirewell-Jean is leaving the Houston East Field Office. These two ladies have been Hearing Officers for many years. Their retirement follows a continuing pattern of attrition of experienced Hearing Officers at the DWC.
On 8/1/17, DWC announced changes to the form DWC-45 to allow system participants to request to proceed directly to a contested case hearing. The DWC explained that parties are not required to participate in a BRC when the DWC determines that mediation would not prove effective to resolve the dispute or that the overall policy of the Workers’ Compensation Act would be advanced by proceeding directly to a contested case hearing. The stated goal of this change is to “focus BRC time and resources on disputes in which participation is thought to be the most productive. The revised form can be found athttp://www.tdi.texas.gov/forms/form20numeric.html.
On 8/18/17, DWC posted changes to the Designated Doctor Rules and asked system participants for informal comments. The stated reason for the changes is to “simplify certain DD processes, retain and recruit doctors to continue to ensure the most optimally qualified doctor is selected for an examination, provide transparency, and allow for better monitoring of designated doctors.
The DWC Designated Doctor List (DDL) has undergone significant demographic changes since Rule 127 was adopted in September of 2012. Specifically, there are half as many doctors on the DDL and there has been a dramatic decrease in the number of medical doctors on the DDL, while the number of chiropractors has steadily increased. Of the 540 total doctors on the DDL, 167 of them are medical doctors and 352 are chiropractors. When Rule 127 was adopted, there were 1247 doctors on the DDL, 929 of whom were medical doctors and 203 were chiropractors.
In an effort to keep designated doctors in the program, and ostensibly to lure more medical doctors back to the fold, the DWC is proposing changes to the selection and qualification criteria that would allow more examinations per appointment and more specialization (in other words, more exams for medical doctors and doctors of osteopathy) for more complex injuries, which have been further defined by the proposed rules. The current selection process “penalizes” the more specialized doctors by moving them to the bottom of the appointment list when appointed to complex cases.
Of interest is the fact that the DWC has not addressed any increase in the fee schedule to take into account changes in the complexity of the system, the Designated Doctor rules and the kinds of examinations designated doctors are appointed to address.
The informal comment period closes on 9/1/17, but the rules will be posted for formal comment.
On August 29, 2017, Commissioner Brannan issued a bulletin, which can be read in its entirety at the following:http://www.tdi.texas.gov/bulletins/2017/b-0020-17.html. The bulletin refers to the Governor’s disaster proclamation and directs that, for the duration of that proclamation, Carriers must provide or continue to provide: (1) processing and delivery of benefits checks and medical care, services, supplies and equipment; (2) waiver of penalties and restrictions related to necessary and non-emergency health care provided out of network; (3) coverage of payment for necessary emergency and non-emergency health care services obtained out of network; (4) extended deadlines for medical examinations; authorization of payment to pharmacies for up to a 90 day supply of prescription medications (subject to the number of days authorized by the provider) regardless of the date on which the prescription had most recently been filed; and (5) expedited change of address processing.
In addition to the direction to carriers, the bulletin informs system participants of a tolling of deadlines for participants who reside in the counties listed in the Governor’s disaster proclamation. For the duration of the proclamation, deadlines are tolled for: (1) workers’ compensation claim notification and filing deadlines; (2) medical billing deadlines; (3) medical and income benefits payment deadlines; (4) electronic data reporting deadlines; and, (5) medical and income benefit dispute deadlines.
The DWC also reminded political subdivisions that first responders are on the front lines of the disaster and DWC and those subdivisions shall accelerate and give first priority to an injured first responder’s claim for workers’ compensation medical benefits if that first responder sustains a serious bodily injury in the course and scope of employment. OIEC has designated a First Responder Liaison, Yolanda Garcia, who can be reached at 512-804-4173 orFirstResponderHelp@oiec.texas.gov.
Governor Abbott issued a disaster proclamation on 8/23/17, certifying that Hurricane Harvey posed a threat of imminent disaster, including severe flooding, storm surge and damaging winds for the following counties: Aransas, Atascosa, Austin, Bastrop, Bee, Bexar, Brazoria, Brazos, Burleson, Caldwell, Calhoun, Cameron, Chambers, Colorado, Comal, DeWitt, Fayette, Fort Bend, Galveston, Goliad, Gonzales, Grimes, Guadalupe, Hardin, Harris, Jackson, Jasper, Jefferson, Jim Wells, Karnes, Kerr, Kleberg, Lavaca, Lee, Leon, Liberty, Live Oak, Madison, Matagorda, Montgomery, Newton, Nueces, Polk, Refugio, San Jacinto, San Patricio, Tyler, Victoria, Walker, Waller, Washington, Wharton, Willacy and Wilson counties. On 8/28/17, the Governor added Angelina, Orange, Sabine and Trinity counties to the proclamation.
Last week Hurricane Harvey was predicted to cause significant damage to South Texas. What we know now is that no one was prepared for the catastrophic devastation Harvey would leave in its wake. It will, no doubt, be several months before we know the full extent of the damage. We at SLS send our thoughts and prayers to our friends and colleagues impacted by the hurricane.
To speed healing and improve return to work times, the Division has proposed a rule requiring that every claimant be given a magnetic copper bracelet and compression wraps infused with magnets and copper. The chiropractic lobby is strongly in support of the proposal stating that the “science” is sound. On a somewhat related note, if you’d like to purchase a magnetic copper bracelet, James Loughlin will sell you one for 4 easy payments of $24.95.
Jacqueline Harrison, a Hearing Officer in the Houston West Field Office, has moved on from the Division. No word yet on whether she’s left the world of workers’ compensation.