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

Effects of Inflation Continue to be Seen in New State Average Weekly Wage/Maximum and Minimum Weekly Benefits



The Division has announced the State AWW and maximum/minimum weekly benefits for the period from October 1, 2023 through September 30, 2024 and it should come as no surprise that the effects of inflation continue to impact the SAWW and weekly benefits.

For the period from October 1, 2023 through September 30, 2024, the new SAWW and weekly benefits were increased approximately 5.6% as follows:
 

State Average Weekly Wage:                        From $1,111.55 to $1,173.81
Maximum Temporary Income Benefits:         From $1,112.00 to $1,174.00
Minimum Temporary Income Benefits:          From $167.00 to $176.00
Maximum Impairment Income Benefits:        From $778.00 to $822.00
Minimum Impairment Income Benefits:         From $167.00 to $176.00
Maximum Supplemental Income Benefits:    From $778.00 to $822.00
Maximum Lifetime Income Benefits:             From $1,112.00 to $1,174.00
Minimum Lifetime Income Benefits:              From $167.00 to $176.00
Maximum Death Benefits:                             From $1,112.00 to $1,174.00


To access the SAWW and maximum/minimum weekly benefits for Fiscal years 1991 through 2024, click here.

Copyright 2023, Stone Loughlin & Swanson, LLP 


There is still time to help us help the kids by becoming a participant or sponsor and joining us for fun and camaraderie at The Lakes at Castle Hills on October 23 for the Fourth Annual Kids’ Chance Texas Golf Tournament!! All proceeds will fund Kids’ Chance of Texas scholarships. Do not delay, spots are limited and filling quickly.

As we remind readers on a regular basis, Stone, Loughlin & Swanson is a Founding Sponsor and long-time supporter of Kids’ Chance of Texas, an organization whose mission is to create and support scholarship programs to provide educational opportunities for children in Texas who have had a parent catastrophically or fatally injured while in the course and scope of his or her employment. As participants in the Texas Workers’ Compensation system, we are particularly aware of the devastating toll such an injury takes on a family and, especially, the children. 

For more information and to register as a player and/or sponsor, click here.
 

Copyright 2023, Stone Loughlin & Swanson, LLP 

Who Ya' Gonna Call?

 



Disclaimer: This is not an actual flow chart and is not intended to accurately represent real persons or events.

 

Copyright 2023, Stone Loughlin & Swanson, LLP 

WTH is an OARFI?


When we dusted off our rule book to look at the rules in the aforementioned chapters of the Administrative Code, we discovered all kinds of little treasures. For example, many acronyms that we use every day in the system, such as AWW, BRC, MMI, etc., are actually codified in DWC Rule 102.7. Others, such as BRO, DD, LOC, POD, etc. are not included. 

This past month saw some new acronyms enter the system, resulting in a new form and some new additions to DWC staff hierarchy.  

You might recall that the new DD request form (DWC032) implemented on 6/5/23 does not include a box for the Carrier to identify the accepted condition and thus, the DD determines the compensable injury during the exam. In the April edition of The Compendium, our own Erika Copeland predicted that the change to the DWC032 would create more problems with informal resolution. Kudos to Erika and her foresight, because the new OARFI (“Request for Information”) appears to be the first attempt at righting the ship. The OARFI lists multiple conditions and requests that the Carrier check whether it “Accepts” or “Disputes” the condition. It also asks the parties to identify any additional injuries that they believe should be considered when assessing MMI or the impairment rating. The parties are asked to send the information to a named “Benefit Review Officer” within three business days, and notice is given that the information is for “mediation purposes only.” The Carrier is told that the answers are not binding and that they can change their mind but inaccurate answers will likely cause additional exams and delays in the dispute resolution process. Likewise, to date there doesn’t appear to be any penalty associated with not returning the form.

The “Benefit Review Officer” named on the form is actually known as a “BRO-1” (which begs the question – is the BRO that presides over the BRC now known as “Big Bro”?). The BRO-1 has been charged with looking at issues before a BRC and requesting information of the parties so a Presiding Officer’s Directive (POD) can be sent to the DD.

Meanwhile, we have been informed that if you need to request the status of LOC requests or responses, DD reports, or RME reports, you need to contact the Proceeding Resolution Officer or “PRO.” If you are seeking information about scheduling, resets, requests for dates, motions, subpoenas, agreements, or interpreter requests, you need to contact the Docketer.

Unfortunately, we do not have the key to knowing who actually handles the docketing for each field office nor are we able to keep up with the frequent changes in PRO assignments. Our wish list for next month includes periodic information updates from the DWC regarding these changes. Until then, here is our (non)helpful chart of how this works on a daily basis.


Copyright 2023, Stone Loughlin & Swanson, LLP

Rule Review Time

 

The DWC will be reviewing multiple sections of the Texas Administrative Code (Chapters 102, 104, 109, 110, 112, 114, and 116) to determine whether the rules are still relevant and necessary. The DWC Legal Services team is requesting that system participants send written comments along with proposed alternative language to RuleComments@tdi.texas.gov by 5 p.m. CST on October 3, 2023. 
 

Copyright 2023, Stone Loughlin & Swanson, LLP

Seasonal Employees Simplified


Other proposed form changes include a complete (and long overdue) overhaul of the forms relating to adjusting income benefits for seasonal employees. The DWC intends to retire Form-054 (Notice to Employee: Intention to Request Division Permission to Adjust Benefits) and Form-056 (Seasonal Employee Wage Information from Texas Workforce Commission Records). The proposed new Form-055 will combine the Notice to Employee and Carrier’s Request to Adjust Average Weekly Wage. The DWC invites all who wish to submit comments on the proposed changes to email them to RuleComments@tdi.texas.gov by 5 pm CST on September 18th.

 

Copyright 2023, Stone Loughlin & Swanson, LLP 

Is Change Afoot for SIBs?


Will the Texas Department of Insurance, Division of Workers’ Compensation begin requiring applicants for Supplemental Income Benefits to provide material evidence of job applications they have submitted in their search for work? It sure looks that way. 

In a memo to stakeholders on August 17, General Counsel Kara Mace enclosed proposed changes to the DWC Form-052, Supplemental Income Benefits Application. The proposed revision includes an FAQ page with the following guidance for applicants who are looking for work on their own:
 

Show you were actively looking for a job by attaching job applications or other documents showing you were looking for a job.  


If the Division adopts the proposed version, and if it requires SIBs applicants to actually attach job applications to the Form-052, that would be a welcome change. Currently, Division ALJs typically do not require a SIBs applicant to submit material evidence of job applications they have submitted. Instead, the Division’s position is that an applicant’s assertion, on the Form-052, that he submitted applications is sufficient documentation of such applications.  

Of course, many stakeholders disagree with the Division’s position, and that position is one reason that Accident Fund Insurance Company of America, represented by this Firm, filed an action for declaratory relief in the Travis County district court challenging the validity and applicability of the Division’s SIBs rule. As we have reported previously, the district court held the rule invalid, the Division appealed, and the Austin court of appeals issued a decision on February 28, 2023. Texas Department of Insurance, Division of Workers’ Compensation v. Accident Fund Insurance Company of America, et al. A petition for review is currently pending in the Supreme Court of Texas. 

We will continue to monitor and report on the proposed changes to the Form-052. 


Copyright 2023, Stone Loughlin & Swanson, LLP 

Beat the Heat


Don’t miss this unique chance to golf at The Lakes at Castle Hills on October 23rd! Register today for a rewarding day of golf, while supporting an amazing cause.  Our first full golf team has already signed up! Thank you, Kyle Morris, for putting together a team and showing up again this year! Spots are limited and filling quickly. All proceeds benefit Kids’ Chance of Texas scholarship recipients and provide these students with the opportunity for a strong education and career, despite the most difficult circumstances. Register here. You can also find information at www.kidschanceoftexas.org, and for those of you with modern skills, there is a QR code.  See you on the course!

 

Copyright 2023, Stone Loughlin & Swanson, LLP 

NWCDN in the Windy City


SLS is the Texas selected member of the National Workers’ Compensation Defense Network (NWCDN). This year, the NWCDN conference is set in Chicago October 18th and 19th and we would love to send you an invitation if you are interested in attending.  The conference is free, and there are greatly reduced hotel rates at the Radisson Blu Aqua blocked if you book by September 19th.  Here is a link to the registration materials and the terrific agenda: Program Agenda.  Hope to see you there! 

 

Copyright 2023, Stone Loughlin & Swanson, LLP 

Victory Belongs to the Most Tenacious


Remember when we reported on the SOAH case where the ALJ questioned the DWC’s actions regarding claim investigation and its method of assessing penalties?  We learned that, but for a courageous Third Party Administrator (Abercrombie Simmons & Gillette) who footed the cost of the litigation for its customer, the City of Baytown, the issues the case presented would still be buried at the agency. They say you “can’t fight City Hall” but that saying only goes to those unwilling to do so.

 

Copyright 2023, Stone Loughlin & Swanson, LLP