UPDATE ON WORKERS’ COMPENSATION CHANGES

Presented by:

THE LAW OFFICE OF RICKY D. GREEN, PLLC9600 Escarpment Blvd, Ste 745-52

Austin, Texas 78749(512) 280-0055 Phone

(866) 853-9407 Toll Free(512) 280-0071 Fax

www.rickydgreen.com

OVERVIEW OF 2009 LEGISLATIVE CHANGES

In the 81st Legislative session (2009), the Legislature proposed several controversial bills, but passed very few of them.

The Legislature expects the major changes from the 2005 session, most notably House Bill 7, to continue to penetrate the system to effect positive changes.

THE OMBUDSMAN BILL – EFFECTIVE SEPTEMBER 1, 2009

The public counsel (ombudsmen) can refuse to provide or can terminate services to any claimant who is abusive or violent, requests assistance in claiming benefits not allowed by law, or commits or threatens to commit a criminal act in pursuing workers’ compensation benefits.

Ombudsmen may now appear before the State Office of Administrative Hearings or appear in an enforcement action by the Division, in addition to appearing before the Division.

THE OMBUDSMAN BILL – EFFECTIVE SEPTEMBER 1, 2009

Ombudsmen can not access information that is an attorney-client communication or work-product privilege, and can not access any other information to which the injured employee is not entitled.

The Office of Injured Employee Counsel rather than the Division must approve the injured employee’s rights and responsibilities.

SAFETY AND APPROPRIATENESS OF RETURN-TO-WORK –

EFFECTIVE SEPTEMBER 1, 2009

SAFETY AND APPROPRIATENESS OF RETURN-TO-WORK –

EFFECTIVE SEPTEMBER 1, 2009

• The employee’s functions and job responsibilities form will have area for:

1. the employer’s name, address and contact information for an employer representative who has knowledge of the employee’s job;

2. the scope of the injured employee’s job, including information of specific tasks, duties or activities the employee was required to perform; and,

3. an area for additional comments regarding the employee’s job or other jobs the employee may be able to do.

RETURN-TO-WORK COORDINATION SERVICES –

EFFECTIVE NOW

The insurance carrier must provide the employer with return-to-work coordination services on an ongoing basis.

The insurance carrier must evaluate potential lost time cases to determine if “skilled case management” is needed.

Employers with 2 to 50 employees may be eligible for reimbursement from the State of Texas if they make workplace modifications; reimbursement may not exceed $5,000.

UTILIZATION AND PREAUTHORIZATION FOR WORKERS’ COMPENSATION NETWORKS –

EFFECTIVE SEPTEMBER 1, 2009

TIME TO FILE A PETITION FOR TIME TO FILE A PETITION FOR JUDICIAL REVIEW – EFFECTIVE JUDICIAL REVIEW – EFFECTIVE

SEPTEMBER 1, 2009SEPTEMBER 1, 2009

Either party can file Either party can file for judicial review no for judicial review no

later than 45 days later than 45 days after the date the after the date the Division mails the Division mails the

appeals panel appeals panel decision.decision.

DEATH BENEFITS – EFFECTIVE SEPTEMBER 1, 2009

REGULATION OF PAIN MANAGEMENT CLINICS – EFFECTIVE SEPTEMBER 1, 2010

REGULATION OF PAIN MANAGEMENT CLINICS –

EFFECTIVE SEPTEMBER 1, 2010 A doctor who owns or maintains a clinic

must apply for a license. The owner or operator of a clinic must

have an unrestricted, valid license to dispense medications, and has not been convicted of or pled guilty to a felony or a misdemeanor involving the distribution of illegal prescription drugs or controlled substances.

The owner or operator must be on-site at least 33% of the time when the clinic is open, and must review at least 33% of the patient files.

FREESTANDING EMERGENCY MEDICAL CARE FACILITIES –

EFFECTIVE SEPTEMBER 1, 2009

FREESTANDING EMERGENCY MEDICAL CARE FACILITIES – EFFECTIVE

SEPTEMBER 1, 2009

• An Executive Commissioner will adopt rules to, at a minimum, monitor:

(1) the construction and design of the facility, including plumbing, heating, lighting, ventilation, and other   design standards;

(2) the number, qualifications, and organization of the professional staff and other personnel;

(3) the administration of the facility; (4) the equipment; (5) the sanitary and hygienic conditions within the facility and

its surroundings; (6) the requirements for the contents, maintenance, and

release of medical records; (7) the minimal level of care and standards for denial of care; (8) the provision of laboratory and radiological services; (9) the distribution and administration of drugs and controlled

substances.

FREESTANDING EMERGENCY MEDICAL CARE FACILITIES – EFFECTIVE

SEPTEMBER 1, 2009

(10) a quality assurance program for patient care;               

(11) disclosure of the name and social security number of the sole proprietor, if the facility is a sole proprietor, the name and social security number of each   general partner who is an individual, if the facility is a   partnership, the name and social security number of any individual who has an ownership interest of more than 25 percent in   the corporation, if the facility is a corporation, and the name and license numbers of any   physicians licensed by the Texas Medical Board who have a financial   interest in the facility or any entity which has an ownership   interest in the facility;               

(12) transfer protocols for patients requiring advanced medical care at a hospital; and,                

(13) any other aspect of the operation of a facility that the executive commissioner considers necessary to protect the facility's patients and the public.

PROVISIONAL LICENSE TO PRACTICE IN CERTAIN AREAS – EFFECTIVE JANUARY 1, 2010

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HAVE A GREAT DAYTHE LAW OFFICE OF RICKY D. GREEN, PLLC