Other changes in the Texas workers’ comp process have been made lately that employers ought to know about too. Remember, in our last important blog entry, we discussed the new form and process used by the Workers’ Comp Division of the Texas Department of Insurance. The new form and system were specific to how meetings with physicians were handled, including making sure that all requests for a physician visit are now sent to one central office in the capital of Austin.
As I might need to remind you, workers’ comp injuries are a little bit different than the situation when an employee gets sick or hurt off the job. When that happens, they can use their health care insurance and basically visit whatever doctor they want, depending of course if they have a PPO, HMO, or some form of consumer directed health care. In the case of workers’ comp, they need to see specific doctors in the workers’ comp provider network for their employer, or they must submit a form to request to see doctors outside of this network.
Whew! Reviews of old material can be tough, but it is always necessary. We know how much employers have on their plates. Plus you can never tell when we have a newbie around this blog, digging into all of the information here for the first time.
Back to the other rules changes to the workers’ comp labor laws in the state of Texas. The state legislature also passed a House Bill 7, which the Commissioner of Workers’ Comp, Albert Betts, is set to make sure get implemented in this new year. The new HB 7 has created a new system for the certification of the Workers’ Comp Health Care Networks that we talked about above by the Texas Department of Insurance. That way, when employers buy workers’ comp insurance, they can pick the network of providers they want.
A new labor law involving workers’ comp has been passed in the Texas legislature, the Labor Code 408.0041 under the House Bill 7 and the 28 Texas Administrative Code 128. Got all that? Good, see you in the next blog entry.
Just kidding. Of course I will tell you what the Labor Code 408.0041 under the House Bill 7 and the 28 Texas Administrative Code 128 is all about. Why all those numbers anyway, Texas legislature? Can’t one number for a law suffice. (Sheesh, I guess I am a little bit testy today. Insurance renewal issues, friends. Any employer who has dealt with them personally feels my pain.)
Nevertheless, this new law that we keep mentioning (the Labor Code 408.0041 under the House Bill 7 and the 28 Texas Administrative Code 128) deals with how a designated doctor examination can be requested through the Texas workers’ comp system. In response to this new law, the Texas Department of Insurance’s Division of Workers’ Comp had to completely revise the form that is used by employers in this process. So, employers, the message of the day in Texas is: Make sure you know about and have this new form for your employees who happen to get hurt on the job.
The new form could actually be important because it is intended to make the job easier for everyone involved, by streamlining and simplifying the doctor request process. It does this by centralizing all of the designating doctor scheduling to one central office in Austin, instead of having the forms sent to multiple field offices across the state.
Still, if you are attached to the old form, or just have a lot of them left, you can continue to use them until March 31, 2007. After April 1, however, be sure to use the new DWC Form 32 (as it is known).
The state of Texas has similar procedures that we’ve seen in other states when it comes to reporting workplace related injuries and illness. In the Longhorn state, home of the open range and the oil field, the Cowboys and the Mavericks, employers must make sure that all of their employees know to report their injuries as soon as they happen, or as close to thereabouts as possible.
Then it is up to the employer. The responsibility is handed off from the employee to the employer like a football being handed off from Troy Aikman to Emmitt Smith. In the human resource and workers’ comp world though, it is not a matter of getting a few yards or a first down. It is a matter of making sure that you stick with the letter of the law, so that workers’ comp claims always proceed smoothly and that your employee gets the medical care and disability comp that they are entitled to, nothing more.
This responsibility begins with you as having to file the Employer’s First Report of Injury or Illness form, also called the DWC-1 form. This form is different than say other forms you may be knowledgeable about in the workers’ comp arena. The Employer’s First Report of Injury or Illness form must be filed by you the employer within eight days of when you employee first stopped going to work because of the disability from their work related injury or illness. This Employer’s First Report of Injury or Illness form is obviously different than the Workers’ Compensation Information sheet forms that you may have in your human resource office.
Those Workers’ Comp Information sheet forms are more an educational material than anything else. Whereas the Employer’s First Report of Injury or Illness form is a practical form that alerts your insurance carrier for workers’ comp coverage of a pending case, the Workers’ Comp Information sheet form lets employees know how the workers’ comp system works in Texas, in general, and in your organization specifically.
One of the particularities of the Texas workers’ comp system is that the state considers employers who have workers’ comp to be called “subscribers.” But of course you aren’t subscribers to a magazine or to a club. You are instead “subscribing” to a service that affords you employees medical care and compensation for lost wages in case they get hurt or sick at work and are disabled because of their injuries or illness.
As a subscriber to the workers’ comp system in Texas, you have to let your employees know about your status. As with Tennessee and some of the other states that we’ve looked at here in this blog in the last couple of days, Texas requires employers to put up a workers’ comp poster at their works sites. These posters let your employees know that one, you have workers’ comp coverage for them.
But it also is to inform your workers about exactly who your workers’ comp insurance company is, information they need to know about the state of Texas workers’ comp officials, and numbers so they can report an injury if one happens to the workers’ comp insurance company, as well as a number in case your employees want to prevent a possible injury by reporting unsafe workplace environment or policies at your work site. You have to have this workers’ comp posting in your personnel office in the very least, as well as in another location in your work sites where employees are liable to easily and often see it.
When you first hire somebody into your company, you are also required to give them a written notice that they are covered under your Texas workers’ comp approved plan. Believe it or not, new employees can refuse to be a part of your workers’ comp program. Also, if you ever change workers’ comp insurance companies, or have your program lapse and then switch workers’ comp carriers, you must also let all of your employees know about the change in some written memo or letter.
I found that in Texas, the Workers’ Compensation Law is governed by the Texas Workers’ Compensation Commission. The Commission oversees certain work-related communicable diseases and eligibility for workers as well as their compensation benefits.
When it comes to exposure to a disease, the Texas Workers’ Compensation Commission has very strict guidelines. Under the tenants of the law, law enforcement officers, fire fighters, emergency medical service employees, paramedics and correctional officers must qualify in order to receive workers’ compensation benefits.
An employee who claims a possible work-related exposure to a reportable disease, including an HIV infection, must be tested for the disease not later than the 10th day after the exposure. Additionally, he must provide the employer with documentation of the test and a sworn affidavit of the date and circumstances of the exposure. The test result must indicate that absence of the disease and an employee is not required to pay for the disease.
In the event that an employee does have a reportable disease, the employee and employer are required to report the disease to the Texas Department of Health. Exposure criteria and testing protocol must conform to the Texas Department of Health requirements.
Employers who have more than 4 employees are legally bound to have Workers’ Compensation Insurance. The Workers’ Compensation Insurance is intended to help pay for workers who lose their jobs or are restricted from working due to illness, job-related injury, disability or disfigurement. A worker can receive workers compensation for a set period of weeks, during which time he or she will receive a percentage of the total salary prior to leaving work.
Also, it is important to note that if an employee needs medical care, the employer’s insurance is responsible for paying the cost of the doctor’s visit in addition to any physical therapy or alternative medical needs.