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Texas Senate Bill SB2471

Texas 2023 - 88th Regular

Texas Senate Bill SB2471 Compare Versions

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11 By: Springer S.B. No. 2471
22
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44 A BILL TO BE ENTITLED
55 AN ACT
66 relating to certain claims for benefits, compensation, or
77 assistance by certain public safety employees and survivors of
88 certain public safety employees.
99 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1010 SECTION 1. The heading to Subchapter B, Chapter 607,
1111 Government Code, is amended to read as follows:
1212 SUBCHAPTER B. DISEASES OR ILLNESSES SUFFERED BY DETENTION
1313 OFFICERS, CUSTODIAL OFFICERS, FIREFIGHTERS, PEACE OFFICERS, AND
1414 EMERGENCY MEDICAL TECHNICIANS
1515 SECTION 2. Section 607.051, Government Code, is amended by
1616 amending Subdivision (1) and adding Subdivisions (1-a) and (1-b) to
1717 read as follows:
1818 (1) "Custodial officer" means a person who is employed
1919 by the Board of Pardons and Paroles or the Texas Department of
2020 Criminal Justice as a parole officer or caseworker or who is
2121 employed by the correctional institutions division of the Texas
2222 Department of Criminal Justice and certified by the department as
2323 having a normal job assignment that requires frequent or infrequent
2424 regularly planned contact with, and in close proximity to, inmates
2525 or defendants of the correctional institutions division without the
2626 protection of bars, doors, security screens, or similar devices and
2727 includes assignments normally involving supervision or the
2828 potential for supervision of inmates in inmate housing areas,
2929 educational or recreational facilities, industrial shops,
3030 kitchens, laundries, medical areas, agricultural shops or fields,
3131 or in other areas on or away from property of the department.
3232 (1-a) "Detention officer" means an individual
3333 employed by a state agency or political subdivision of the state to
3434 ensure the safekeeping of prisoners and the security of a
3535 municipal, county, or state penal institution in this state.
3636 (1-b) Disability" means partial or total disability.
3737 SECTION 3. Sections 607.052(a), (b), (e), and (g),
3838 Government Code, are amended to read as follows:
3939 (a) Notwithstanding any other law, this subchapter applies
4040 only to a detention officer, custodial officer, firefighter, peace
4141 officer, or emergency medical technician who:
4242 (1) on becoming employed or during employment as a
4343 detention officer, custodial officer, firefighter, peace officer,
4444 or emergency medical technician, received a physical examination
4545 that failed to reveal evidence of the illness or disease for which
4646 benefits or compensation are sought using a presumption established
4747 by this subchapter;
4848 (2) is employed for five or more years as a
4949 firefighter, peace officer, or emergency medical technician,
5050 except for the presumption under Section 607.0545; and
5151 (3) seeks benefits or compensation for a disease or
5252 illness covered by this subchapter that is discovered during
5353 employment as a detention officer, custodial officer, firefighter,
5454 peace officer, or emergency medical technician.
5555 (b) A presumption under this subchapter does not apply:
5656 (1) to a determination of a survivor's eligibility for
5757 benefits under Chapter 615;
5858 (2) in a cause of action brought in a state or federal
5959 court except for judicial review of a proceeding in which there has
6060 been a grant or denial of employment-related benefits or
6161 compensation;
6262 (3) to a determination regarding benefits or
6363 compensation under a life or disability insurance policy purchased
6464 by or on behalf of the detention officer, custodial officer,
6565 firefighter, peace officer, or emergency medical technician that
6666 provides coverage in addition to any benefits or compensation
6767 required by law; or
6868 (4) if the disease or illness for which benefits or
6969 compensation is sought is known to be caused by the use of tobacco
7070 and:
7171 (A) the firefighter, peace officer, or emergency
7272 medical technician is or has been a user of tobacco; or
7373 (B) the firefighter's, peace officer's, or
7474 emergency medical technician's spouse has, during the marriage,
7575 been a user of tobacco that is consumed through smoking.
7676 (e) A detention officer, custodial officer, firefighter,
7777 peace officer, or emergency medical technician who uses a
7878 presumption established under this subchapter is entitled only to
7979 the benefits or compensation to which the detention officer,
8080 custodial officer, firefighter, peace officer, or emergency
8181 medical technician would otherwise be entitled to receive at the
8282 time the claim for benefits or compensation is filed.
8383 (g) This subchapter applies to a detention officer,
8484 custodial officer, firefighter, peace officer, or emergency
8585 medical technician who provides services as an employee of an
8686 entity created by an interlocal agreement.
8787 SECTION 4. Section 607.054, Government Code, is amended to
8888 read as follows:
8989 Sec. 607.054. TUBERCULOSIS OR OTHER RESPIRATORY ILLNESS.
9090 (a) A firefighter, peace officer, or emergency medical technician
9191 who suffers from tuberculosis, or any other disease or illness of
9292 the lungs or respiratory tract that has a statistically positive
9393 correlation with service as a firefighter, peace officer, or
9494 emergency medical technician, that results in death or total or
9595 partial disability is presumed to have contracted the disease or
9696 illness during the course and scope of employment as a firefighter,
9797 peace officer, or emergency medical technician.
9898 (b) This section does not apply to a claim that a
9999 firefighter, peace officer, or emergency medical technician
100100 suffers from severe acute respiratory syndrome coronavirus 2
101101 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19).
102102 SECTION 5. Subchapter B, Chapter 607, Government Code, is
103103 amended by adding Section 607.0545 to read as follows:
104104 Sec. 607.0545. SEVERE ACUTE RESPIRATORY SYNDROME
105105 CORONAVIRUS 2 (SARS-CoV-2) OR CORONAVIRUS DISEASE 2019 (COVID-19).
106106 (a) A detention officer, custodial officer, firefighter, peace
107107 officer, or emergency medical technician who suffers from severe
108108 acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or
109109 coronavirus disease 2019 (COVID-19) that results in death or total
110110 or partial disability is presumed to have contracted the virus or
111111 disease during the course and scope of employment as a detention
112112 officer, custodial officer, firefighter, peace officer, or
113113 emergency medical technician if the detention officer, custodial
114114 officer, firefighter, peace officer, or emergency medical
115115 technician:
116116 (1) is employed in the area designated in a disaster
117117 declaration by the governor under Section 418.014 or another law
118118 and the disaster is related to severe acute respiratory syndrome
119119 coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19);
120120 and
121121 (2) contracts the disease during the disaster declared
122122 by the governor described by Subdivision (1).
123123 (b) The presumption under this section applies only to a
124124 person who:
125125 (1) is employed as a detention officer, custodial
126126 officer, firefighter, peace officer, or emergency medical
127127 technician on a full-time basis;
128128 (2) is diagnosed with severe acute respiratory
129129 syndrome coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019
130130 (COVID-19):
131131 (A) using a test authorized, approved, or
132132 licensed by the United States Food and Drug Administration; or
133133 (B) if the person is deceased:
134134 (i) using a test described by Paragraph
135135 (A); or
136136 (ii) by another means, including by a
137137 physician; and
138138 (3) was last on duty:
139139 (A) not more than 15 days before the date the
140140 person is diagnosed with severe acute respiratory syndrome
141141 coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19)
142142 using a test described by Subdivision (2)(A); or
143143 (B) if the person is deceased, not more than 15
144144 days before the date the person:
145145 (i) was diagnosed with severe acute
146146 respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus
147147 disease 2019 (COVID-19) using a test described by Subdivision
148148 (2)(A);
149149 (ii) began to show symptoms of severe acute
150150 respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus
151151 disease 2019 (COVID-19) as determined by a licensed physician;
152152 (iii) was hospitalized for symptoms related
153153 to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or
154154 coronavirus disease 2019 (COVID-19); or
155155 (iv) died if severe acute respiratory
156156 syndrome coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019
157157 (COVID-19) was a contributing factor in the person's death.
158158 (c) This section does not affect the right of a detention
159159 officer, custodial officer, firefighter, peace officer, or
160160 emergency medical technician to provide proof, without the use of
161161 the presumption under this section, that an injury or illness
162162 occurred during the course and scope of employment.
163163 (d) Sections 409.009 and 409.0091, Labor Code, do not apply
164164 to a claim for compensation determined to be compensable or
165165 accepted by an insurance carrier as compensable using the
166166 presumption under this section. Notwithstanding this subsection,
167167 an injured employee may request reimbursement for health care paid
168168 by the employee as provided by Section 409.0092, Labor Code.
169169 (e) This section expires September 1, 20232027.
170170 SECTION 6. Section 607.057, Government Code, is amended to
171171 read as follows:
172172 Sec. 607.057. EFFECT OF PRESUMPTION. Except as provided by
173173 Section 607.052(b), a presumption established under this
174174 subchapter applies to a determination of whether a detention
175175 officer's, custodial officer's, firefighter's, peace officer's, or
176176 emergency medical technician's disability or death resulted from a
177177 disease or illness contracted in the course and scope of employment
178178 for purposes of benefits or compensation provided under another
179179 employee benefit, law, or plan, including a pension plan.
180180 SECTION 7. Section 607.058, Government Code, is amended to
181181 read as follows:
182182 Sec. 607.058. PRESUMPTION REBUTTABLE. (a) A presumption
183183 under Section 607.053, 607.054, 607.0545, 607.055, or 607.056 may
184184 be rebutted through a showing by a preponderance of the evidence
185185 that a risk factor, accident, hazard, or other cause not associated
186186 with the individual's service as a detention officer, custodial
187187 officer, firefighter, peace officer, or emergency medical
188188 technician was a substantial factor in bringing about the
189189 individual's disease or illness, without which the disease or
190190 illness would not have occurred.
191191 (b) A rebuttal offered under this section must include a
192192 statement by the person offering the rebuttal that describes, in
193193 detail, the evidence that the person reviewed before making the
194194 determination that a cause not associated with the individual's
195195 service as a detention officer, custodial officer, firefighter,
196196 peace officer, or emergency medical technician was a substantial
197197 factor in bringing about the individual's disease or illness,
198198 without which the disease or illness would not have occurred.
199199 (c) In addressing an argument based on a rebuttal offered
200200 under this section, an administrative law judge shall make findings
201201 of fact and conclusions of law that consider whether a qualified
202202 expert, relying on evidence-based medicine, stated the opinion
203203 that, based on reasonable medical probability, an identified risk
204204 factor, accident, hazard, or other cause not associated with the
205205 individual's service as a detention officer, custodial officer,
206206 firefighter, peace officer, or emergency medical technician was a
207207 substantial factor in bringing about the individual's disease or
208208 illness, without which the disease or illness would not have
209209 occurred.
210210 (d) A rebuttal offered under this section to a presumption
211211 under Section 607.0545 may not be based solely on evidence relating
212212 to the risk of exposure to severe acute respiratory syndrome
213213 coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19)
214214 of a person with whom a detention officer, custodial officer,
215215 firefighter, peace officer, or emergency medical technician
216216 resides. This subsection expires September 1, 20232027.
217217 SECTION 8. Subchapter A, Chapter 409, Labor Code, is
218218 amended by adding Section 409.0092 to read as follows:
219219 Sec. 409.0092. HEALTH CARE REIMBURSEMENT PROCEDURES FOR
220220 CERTAIN INJURED EMPLOYEES. (a) An injured employee who is subject
221221 to Section 607.0545, Government Code, and whose claim for benefits
222222 is determined to be compensable by an insurance carrier or the
223223 division, may request reimbursement for health care paid by the
224224 employee, including copayments and partial payments, by submitting
225225 to the carrier a legible written request and documentation showing
226226 the amounts paid to the health care provider.
227227 (b) Not later than the 45th day after the date an injured
228228 employee submits a request for reimbursement for health care to an
229229 insurance carrier under Subsection (a), the carrier shall provide
230230 reimbursement or deny the request.
231231 (c) If an insurance carrier denies an injured employee's
232232 request for reimbursement for health care, the employee may seek
233233 medical dispute resolution as provided by Chapter 413 and division
234234 rules. Notwithstanding any other law, an employee's request for
235235 medical dispute resolution is considered timely if the employee
236236 submits the request not later than the 120th day after the date the
237237 carrier denies the employee's request for reimbursement.
238238 (d) This section expires September 1, 20232027.
239239 SECTION 9. Section 409.022(d), Labor Code, is amended to
240240 read as follows:
241241 (d) In this subsection, the terms "custodial officer,"
242242 "detention officer," "emergency medical technician,"
243243 "firefighter," and "peace officer" have the meanings assigned by
244244 Section 607.051, Government Code. In addition to the other
245245 requirements of this section, if an insurance carrier's notice of
246246 refusal to pay benefits under Section 409.021 is sent in response to
247247 a claim for compensation resulting from a custodial officer's, a
248248 detention officer's, an emergency medical technician's, a
249249 firefighter's, or a peace officer's disability or death for which a
250250 presumption is claimed to be applicable under Subchapter B, Chapter
251251 607, Government Code, the notice must include a statement by the
252252 carrier that:
253253 (1) explains why the carrier determined a presumption
254254 under that subchapter does not apply to the claim for compensation;
255255 and
256256 (2) describes the evidence that the carrier reviewed
257257 in making the determination described by Subdivision (1).
258258 SECTION 10. (a) The changes in law made by this Act apply to
259259 a claim for benefits pending on or filed on or after the effective
260260 date of this Act. A claim for benefits filed before that date is
261261 covered by the law in effect on the date the claim was made, and that
262262 law is continued in effect for that purpose.
263263 (b) Notwithstanding any other law, a person subject to
264264 Section 607.0545, Government Code, as added by this Act, who on or
265265 after the date the governor declared a disaster under Chapter 418,
266266 Government Code, relating to SARS-CoV-2, coronavirus disease 2019
267267 (COVID-19), but before the effective date of this Act, contracted
268268 SARS-CoV-2, coronavirus disease 2019 (COVID-19), may file a claim
269269 for benefits related to SARS-CoV-2, coronavirus disease 2019
270270 (COVID-19), on or after the effective date of this Act, regardless
271271 of whether that claim is otherwise considered untimely and the
272272 changes in law made by this Act apply to that claim. A claim
273273 authorized under this subsection must be filed not later than six
274274 months after the effective date of this Act.
275275 (c) Notwithstanding Subsection (a) of this section or
276276 Section 409.003, 409.007, 410.169, or 410.205, Labor Code, a person
277277 subject to Section 607.0545, Government Code, as added by this Act,
278278 who on or after the date the governor declared a disaster under
279279 Chapter 418, Government Code, relating to SARS-CoV-2, coronavirus
280280 disease 2019 (COVID-19), but before the effective date of this Act,
281281 filed a claim for benefits related to SARS-CoV-2, coronavirus
282282 disease 2019 (COVID-19), and whose claim was subsequently denied
283283 may, on or after the effective date of this Act, request in writing
284284 that the insurance carrier reprocess the claim and the changes in
285285 law made by this Act shall apply to that claim. A request to
286286 reprocess a claim as authorized by this subsection shall be filed
287287 not later than one year after the effective date of this Act.
288288 (d) Not later than the 60th day after the date an insurance
289289 carrier receives a written request to reprocess a claim under
290290 Subsection (c) of this section, the insurance carrier shall
291291 reprocess the claim and notify the person in writing whether the
292292 carrier accepted or denied the claim. If the insurance carrier
293293 denies the claim, the notice must include information on the
294294 process for disputing the denial. The notice provided by the
295295 insurance carrier must use the notice provisions prescribed by the
296296 division of workers' compensation of the Texas Department of
297297 Insurance under Subsection (e) of this section.
298298 (e) As soon as practicable after the effective date of this
299299 Act, the division of workers' compensation of the Texas Department
300300 of Insurance shall prescribe notice provisions for an insurance
301301 carrier to use when providing notice of the insurance carrier's
302302 acceptance or denial of a person's claim. The notice provisions
303303 must be clear and easily understandable.
304304 SECTION 11. This Act takes effect immediately if it
305305 receives a vote of two-thirds of all the members elected to each
306306 house, as provided by Section 39, Article III, Texas Constitution.
307307 If this Act does not receive the vote necessary for immediate
308308 effect, this Act takes effect September 1, 2023.