A Summary of HB 7

Sunday, June 5, 2005 | 0

The following is an edited reproduction of the Texas Workers' Compensation Commission synposis of House Bill 7, the reform measure signed into law the week of June 1 by Gov. Rick Perry, and effective as of September 1, 2005.

Major provisions of the bill include the creation of a division of workers' compensation at the Texas Department of Insurance (TDI) to assume the responsibilities of the Texas Workers' Compensation Commission (TWCC). The new TDI division will be overseen by a commissioner to be appointed by the governor.

In addition, HB 7 contains many provisions that will enable improvements to the administration of workers' compensation system. The new law:

*Allows insurance carriers to create health care networks for the treatment of workers' compensation injuries;

*Retains the benefit dispute resolution process that includes BRCs, CCHs and Appeals Panel review (with adjustments to address the Sunset recommendations -- most of which we have implemented or are well underway);

*Maintains the IRO process, but eliminates the appeal of medical disputes to SOAH;

*Increases the enforcement options available to Compliance and Practices, such as eliminating the requirement to prove "willful and intentional" intent and providing increased penalty authority;

*Creates the Office of Injured Employee Counsel to represent the interests of injured workers and provides access to legal resources for the ombudsmen;

*Continues the Approved Doctor List until Sept. 1, 2007;

*Authorizes the workers' compensation division to adopt any edition of the AMA Guides;

*Increases the state average weekly wage that serves as the foundation for maximum benefit levels;

*Reduces the retroactive period for the payment of the first week of income benefits. The time period becomes two weeks, down from four;

*Continues to require carriers to pay claimant attorney fees if carrier appeals to court and loses (removed Sept, 1, 2005, sunset date).

More information about the implementation of HB 7 and changes in governance for the workers' compensation system will be posted on the TWCC website at http://www.twcc.state.tx.us under "What's New" in the near future. Also, a "Frequently Asked Questions" page about the transition is planned.