GEC H.B. 3216 75(R) BILL ANALYSIS BUSINESS & INDUSTRY H.B. 3216 By: Stiles 3-28-97 Committee Report (Amended) BACKGROUND In 1989, legislation was passed implementing major reform in the worker's compensation system. One goal of the reform was to make administrative proceedings simpler, more objective, and less argumentative. This reform has dramatically reduced the number of claimants represented by attorneys during contested administrative proceedings; however insurance companies have continued to be represented by counsel when appearing before the commission for such proceedings. Currently, insurance carriers are represented by attorneys at benefit review conferences 51% of the time, with workers only being represented 33% of the time. The numbers for contested case hearings and appeals panel decisions are even more divergent. Insurance carriers use attorneys 88% and 91% of the time at contested case hearings and appeals panel decisions, respectively, versus 42% and 41%, respectively, for workers (Texas Worker's Compensation Commission System Data Report, March 4, 1997). Chapter 410, Labor Code, governs the adjudication of disputes before the Commission. Section 410.202 requires a party wishing to appeal the decision of the hearing officer to file a written request within 15 days and serve notice on the other party. The respondent must then file a written response to the appeals panel within 15 days of being served and provide a copy to the other party. These petitions must clearly and concisely rebut or support the decision of the hearing officer. PURPOSE This bill responds to the concern that an unequal playing field exists during contested administrative proceedings before the Workers' Compensation Commission by prohibiting insurance carriers from being represented by counsel in administrative proceedings unless the claimant is represented by counsel. RULEMAKING AUTHORITY This bill provides rulemaking authority to the Texas Worker's Compensation Commission to adopt rules necessary to implement and enforce the changes mandated by this legislation. SECTION BY SECTION ANALYSIS SECTION 1. Amends Section 410.006, Labor Code. Section 410.006. Amends title of section. (b) Allows a claimant to use the services of an attorney or another individual if the individual does not receive a fee to file an appeal request or a response to an appeal request under Section 410.202. (c) Allows an insurance carrier to be represented by an attorney or adjuster at any proceeding at which a claimant is represented by an attorney; prohibits an insurance carrier from being represented by an attorney in a proceeding before the commission unless the claimant is represented by an attorney. (d) Requires the commission to adopt rules necessary to implement and enforce this section. SECTION 2. Effective date: September 1, 1997; applies to worker's compensation proceedings regarding claims filed with the commission on or after that date; former law is continued in effect for claims filed before September 1, 1997. SECTION 3. Emergency clause. EXPLANATION OF AMENDMENTS Committee Amendment #1 amends Section 410.006, Labor Code, by stating that an insurance carrier may not be represented by an attorney in a proceeding before the Workers' Compensation Commission in which a claimant is a party if that claimant is not represented by an attorney. Committee Amendment #2 amends SECTION 2. This amendment states that an insurance carrier may be represented in any proceeding before the commission by a person who was dually licensed or registered as an adjuster and an attorney on January 1, 1997, and who appears before the commission in the capacity of an adjuster and maintains the adjuster's license or registration in good standing.