Texas 2021 - 87th Regular

Texas Senate Bill SB612 Compare Versions

Only one version of the bill is available at this time.

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1	1	By: Zaffirini S.B. No. 612
2	2
3	3
4	4	A BILL TO BE ENTITLED
5	5	AN ACT
6	6	relating to the eligibility of school district employees for
7	7	workers' compensation benefits for coronavirus disease (COVID-19)
8	8	and payment of those benefits.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Subchapter A, Chapter 408, Labor Code, is
11	11	amended by adding Section 408.009 to read as follows:
12	12	Sec. 408.009. PRESUMPTION OF COMPENSABILITY OF CORONAVIRUS
13	13	DISEASE (COVID-19) FOR SCHOOL EMPLOYEES. (a) In this section,
14	14	"School employee" means a person who receives compensation for
15	15	service performed, other than as an independent contractor, for a
16	16	school district.
17	17	(b) A school employee, who suffers from coronavirus disease
18	18	(COVID-19) on or after February 1, 2020, resulting in disability or
19	19	death, is presumed to have contracted the disease during the course
20	20	and scope of employment as a school employee if the employee:
21	21	(1) interacts with a student or a school district
22	22	employee who is later diagnosed with coronavirus disease; and
23	23	(2) contracts the disease not later than the 14th day
24	24	following the date that the employee interacted or came in contact
25	25	with the student or school district employee diagnosed with the
26	26	disease.
27	27	SECTION 2. Subchapter A, Chapter 408, Labor Code, is
28	28	amended by adding Section 408.010 to read as follows:
29	29	Sec. 408.010. PRESUMPTION REBUTTABLE. (a) A presumption
30	30	under Section 408.009 may be rebutted through a showing by a
31	31	preponderance of the evidence that a risk factor, accident, hazard,
32	32	or other cause not associated with the individual's service as a
33	33	school employee was a substantial factor in bringing about the
34	34	individual's disease or illness, without which the disease or
35	35	illness would not have occurred.
36	36	(b) A rebuttal offered under this section must include a
37	37	statement by the person offering the rebuttal that describes, in
38	38	detail, the evidence that the person reviewed before making the
39	39	determination that a cause not associated with the individual's
40	40	service as a school employee was a substantial factor in bringing
41	41	about the individual's disease or illness, without which the
42	42	disease or illness would not have occurred.
43	43	(c) In addressing an argument based on a rebuttal offered
44	44	under this section, an administrative law judge shall make findings
45	45	of fact and conclusions of law that consider whether a qualified
46	46	expert, relying on evidence-based medicine, stated the opinion
47	47	that, based on reasonable medical probability, an identified risk
48	48	factor, accident, hazard, or other cause not associated with the
49	49	individual's service as a school employee was a substantial factor
50	50	in bringing about the individual's disease or illness, without
51	51	which the disease or illness would not have occurred.
52	52	SECTION 2. Section 409.021(a-3), Labor Code, is amended to
53	53	read as follows:
54	54	(a-3) An insurance carrier is not required to comply with
55	55	Subsection (a) if the claim results from an employee's disability
56	56	or death for which a presumption is claimed to be applicable under
57	57	Section 408.009 of this code or Subchapter B, Chapter 607,
58	58	Government Code, and, not later than the 15th day after the date on
59	59	which the insurance carrier received written notice of the injury,
60	60	the insurance carrier has provided the employee and the division
61	61	with a notice that describes all steps taken by the insurance
62	62	carrier to investigate the injury before the notice was given and
63	63	the evidence the carrier reasonably believes is necessary to
64	64	complete its investigation of the compensability of the injury. The
65	65	commissioner shall adopt rules as necessary to implement this
66	66	subsection.
67	67	SECTION 2. Section 409.022(d), Labor Code, is amended to
68	68	read as follows:
69	69	(d) In this subsection, the terms "emergency medical
70	70	technician," "firefighter," and "peace officer" have the meanings
71	71	assigned by Section 607.051, Government Code. The term "school
72	72	employee" has the meaning assigned by Section 408.009. In addition
73	73	to the other requirements of this section, if an insurance
74	74	carrier's notice of refusal to pay benefits under Section 409.021
75	75	is sent in response to a claim for compensation resulting from an
76	76	emergency medical technician's, a firefighter's, or a peace
77	77	officer's disability or death for which a presumption is claimed to
78	78	be applicable under Subchapter B, Chapter 607, Government Code, or
79	79	from a school employee's disability or death for which a
80	80	presumption is claimed to be applicable under Section 408.009,
81	81	Labor Code, the notice must include a statement by the carrier that:
82	82	(1) explains why the carrier determined a presumption
83	83	under that subchapter does not apply to the claim for compensation;
84	84	and
85	85	(2) describes the evidence that the carrier reviewed
86	86	in making the determination described by Subdivision (1).
87	87	SECTION 3. Section 415.021(c-2), Labor Code, is amended to
88	88	read as follows:
89	89	(c-2) In determining whether to assess an administrative
90	90	penalty involving a claim in which the insurance carrier provided
91	91	notice under Section 409.021(a-3), the commissioner shall consider
92	92	whether:
93	93	(1) the employee cooperated with the insurance
94	94	carrier's investigation of the claim;
95	95	(2) the employee timely authorized access to the
96	96	applicable medical records before the insurance carrier's deadline
97	97	to:
98	98	(A) begin payment of benefits; or
99	99	(B) notify the division and the employee of the
100	100	insurance carrier's refusal to pay benefits; and
101	101	(3) the insurance carrier conducted an investigation
102	102	of the claim, applied the statutory presumptions under Section
103	103	408.009 of this code or Subchapter B, Chapter 607, Government Code,
104	104	and expedited medical benefits under Section 504.055.
105	105	SECTION 4. (a) Except as otherwise provided by this
106	106	section, Section 408.009, Labor Code, as added by this Act, applies
107	107	only to a claim for workers' compensation benefits based on an
108	108	injury that occurs on or after the effective date of this Act. A
109	109	claim based on an injury that occurs before that date is governed by
110	110	the law as it existed on the date the injury occurred, and the
111	111	former law is continued in effect for that purpose.
112	112	(b) Notwithstanding Section 410.169 and 410.205, Labor
113	113	Code, or any other law, a school employee whose COVID-19 injury
114	114	occurred on or after February 1, 2020, but before the effective date
115	115	of this Act, and whose claim was subsequently denied may request in
116	116	writing that the insurance carrier reprocess the claim on or after
117	117	the effective date of this Act, but not later than six months after
118	118	the effective date of this Act, and the changes in law made by this
119	119	Act apply to that claim.
120	120	SECTION 5. This Act takes effect immediately if it receives
121	121	a vote of two-thirds of all the members elected to each house, as
122	122	provided by Section 39, Article III, Texas Constitution. If this
123	123	Act does not receive the vote necessary for immediate effect, this
124	124	Act takes effect September 1, 2021.