| 1 | 1 | | 85R13066 KKR-F |
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| 2 | 2 | | By: Perry S.B. No. 1876 |
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| 3 | 3 | | |
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| 4 | 4 | | |
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| 5 | 5 | | A BILL TO BE ENTITLED |
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| 6 | 6 | | AN ACT |
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| 7 | 7 | | relating to disputes regarding the compensability of an injury by |
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| 8 | 8 | | certain doctors under the Texas Workers' Compensation Act. |
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| 9 | 9 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 10 | 10 | | SECTION 1. Section 409.021, Labor Code, is amended by |
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| 11 | 11 | | adding Subsection (b-1) and amending Subsection (c) to read as |
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| 12 | 12 | | follows: |
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| 13 | 13 | | (b-1) On request by an insurance carrier and at the |
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| 14 | 14 | | insurance carrier's expense, an injured employee's treating doctor |
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| 15 | 15 | | may provide to the insurance carrier notice of all medical |
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| 16 | 16 | | conditions the doctor considers related to the employee's |
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| 17 | 17 | | compensable injury and how the mechanism of the injury caused each |
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| 18 | 18 | | condition. The commissioner shall adopt rules necessary to |
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| 19 | 19 | | implement this subsection, including rules regarding the interval |
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| 20 | 20 | | an insurance carrier must wait after receipt of a notice before the |
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| 21 | 21 | | insurance carrier may request a second or subsequent notice |
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| 22 | 22 | | regarding an injured employee. |
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| 23 | 23 | | (c) If an insurance carrier does not contest the |
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| 24 | 24 | | compensability of an injury on or before the 60th day after the date |
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| 25 | 25 | | on which the insurance carrier is notified of the injury, including |
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| 26 | 26 | | by receipt of a notice under Subsection (b-1), the insurance |
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| 27 | 27 | | carrier waives its right to contest compensability. The initiation |
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| 28 | 28 | | of payments by an insurance carrier does not affect the right of the |
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| 29 | 29 | | insurance carrier to continue to investigate or deny the |
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| 30 | 30 | | compensability of an injury during the 60-day period. |
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| 31 | 31 | | SECTION 2. Section 409.022(a), Labor Code, is amended to |
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| 32 | 32 | | read as follows: |
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| 33 | 33 | | (a) An insurance carrier's notice of refusal to pay benefits |
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| 34 | 34 | | under Section 409.021 must: |
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| 35 | 35 | | (1) specify the grounds for the refusal; |
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| 36 | 36 | | (2) describe the evidence the insurance carrier |
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| 37 | 37 | | reviewed in making the determination; and |
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| 38 | 38 | | (3) describe how the evidence substantiates that the |
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| 39 | 39 | | insurance carrier's refusal to pay benefits is reasonable. |
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| 40 | 40 | | SECTION 3. Section 408.0042, Labor Code, is repealed. |
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| 41 | 41 | | SECTION 4. As soon as practicable after the effective date |
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| 42 | 42 | | of this Act, the commissioner of workers' compensation shall adopt |
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| 43 | 43 | | rules necessary to implement Sections 409.021 and 409.022, Labor |
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| 44 | 44 | | Code, as amended by this Act. |
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| 45 | 45 | | SECTION 5. The change in law made by this Act applies only |
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| 46 | 46 | | to a claim for workers' compensation benefits based on a |
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| 47 | 47 | | compensable injury that occurs on or after the effective date of |
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| 48 | 48 | | this Act. A claim based on a compensable injury that occurs before |
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| 49 | 49 | | that date is governed by the law as it existed on the date the |
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| 50 | 50 | | compensable injury occurred, and the former law is continued in |
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| 51 | 51 | | effect for that purpose. |
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| 52 | 52 | | SECTION 6. This Act takes effect September 1, 2017. |
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