85R13066 KKR-F
By: Perry S.B. No. 1876
A BILL TO BE ENTITLED
AN ACT
relating to disputes regarding the compensability of an injury by
certain doctors under the Texas Workers' Compensation Act.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 409.021, Labor Code, is amended by
adding Subsection (b-1) and amending Subsection (c) to read as
follows:
(b-1) On request by an insurance carrier and at the
insurance carrier's expense, an injured employee's treating doctor
may provide to the insurance carrier notice of all medical
conditions the doctor considers related to the employee's
compensable injury and how the mechanism of the injury caused each
condition. The commissioner shall adopt rules necessary to
implement this subsection, including rules regarding the interval
an insurance carrier must wait after receipt of a notice before the
insurance carrier may request a second or subsequent notice
regarding an injured employee.
(c) If an insurance carrier does not contest the
compensability of an injury on or before the 60th day after the date
on which the insurance carrier is notified of the injury, including
by receipt of a notice under Subsection (b-1), the insurance
carrier waives its right to contest compensability. The initiation
of payments by an insurance carrier does not affect the right of the
insurance carrier to continue to investigate or deny the
compensability of an injury during the 60-day period.
SECTION 2. Section 409.022(a), Labor Code, is amended to
read as follows:
(a) An insurance carrier's notice of refusal to pay benefits
under Section 409.021 must:
(1) specify the grounds for the refusal;
(2) describe the evidence the insurance carrier
reviewed in making the determination; and
(3) describe how the evidence substantiates that the
insurance carrier's refusal to pay benefits is reasonable.
SECTION 3. Section 408.0042, Labor Code, is repealed.
SECTION 4. As soon as practicable after the effective date
of this Act, the commissioner of workers' compensation shall adopt
rules necessary to implement Sections 409.021 and 409.022, Labor
Code, as amended by this Act.
SECTION 5. The change in law made by this Act applies only
to a claim for workers' compensation benefits based on a
compensable injury that occurs on or after the effective date of
this Act. A claim based on a compensable injury that occurs before
that date is governed by the law as it existed on the date the
compensable injury occurred, and the former law is continued in
effect for that purpose.
SECTION 6. This Act takes effect September 1, 2017.