1-1 AN ACT
1-2 relating to interlocutory orders and decisions used in adjudication
1-3 of disputes regarding workers' compensation benefits and to
1-4 reimbursement from the subsequent injury fund for overpayments of
1-5 benefits made under those interlocutory orders or decisions.
1-6 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-7 SECTION 1. Section 402.073(b), Labor Code, is amended to
1-8 read as follows:
1-9 (b) In a case in which a hearing is conducted by the State
1-10 Office of Administrative Hearings under Section 411.049, 413.031,
1-11 413.055, or 415.034, the administrative law judge who conducts the
1-12 hearing for the State Office of Administrative Hearings shall enter
1-13 the final decision in the case after completion of the hearing.
1-14 SECTION 2. Section 410.032, Labor Code, is amended to read
1-15 as follows:
1-16 Sec. 410.032. PAYMENT OF BENEFITS UNDER INTERLOCUTORY
1-17 ORDER[; REIMBURSEMENT]. [(a)] If a benefit review officer
1-18 recommends that benefits be paid or not paid, the benefit review
1-19 officer may issue an interlocutory order for the payment of all or
1-20 part of medical benefits or income benefits. The order may address
1-21 accrued benefits, future benefits, or both accrued benefits and
1-22 future benefits [to pay or not pay the benefits].
1-23 [(b) The subsequent injury fund shall reimburse an insurance
1-24 carrier for any overpayments of benefits made under an order
2-1 entered under this section if that order is reversed or modified at
2-2 a contested case hearing or at arbitration. The commission shall
2-3 adopt rules to provide for a periodic reimbursement schedule,
2-4 providing for reimbursement at least annually.]
2-5 SECTION 3. Section 410.168, Labor Code, is amended to read
2-6 as follows:
2-7 Sec. 410.168. DECISION. (a) The hearing officer shall
2-8 issue a written decision that includes:
2-9 (1) findings of fact and conclusions of law;
2-10 (2) a determination of whether benefits are due; and
2-11 (3) an award of benefits due.
2-12 (b) The decision may address accrued benefits, future
2-13 benefits, or both accrued benefits and future benefits.
2-14 (c) The hearing officer may enter an interlocutory order for
2-15 the payment of all or part of medical benefits or income benefits.
2-16 The order may address accrued benefits, future benefits, or both
2-17 accrued benefits and future benefits. The order is binding during
2-18 the pendency of an appeal to the appeals panel.
2-19 (d) On a form that the commission by rule prescribes, the
2-20 hearing officer shall issue a separate written decision regarding
2-21 attorney's fees and any matter related to attorney's fees. The
2-22 decision regarding attorney's fees and the form may not be made
2-23 known to a jury in a judicial review of an award, including an
2-24 appeal.
2-25 (e) [(c)] The commission by rule shall prescribe the times
2-26 within which the hearing officer must file the decisions with the
2-27 division.
3-1 (f) [(d)] The division shall send a copy of the decision to
3-2 each party.
3-3 SECTION 4. Section 410.205, Labor Code, is amended to read
3-4 as follows:
3-5 Sec. 410.205. EFFECT OF DECISION[; REIMBURSEMENT FOR
3-6 OVERPAYMENT]. (a) A decision of an appeals panel regarding
3-7 benefits is final in the absence of a timely appeal for judicial
3-8 review.
3-9 (b) The decision of the appeals panel regarding benefits is
3-10 binding during the pendency of an appeal under Subchapter F or G.
3-11 [(c) If the court of last resort in the case finally
3-12 modifies or reverses an appeals panel decision awarding benefits,
3-13 the insurance carrier who has paid benefits as required by this
3-14 section may recover reimbursement of any benefit overpayments from
3-15 the subsequent injury fund.]
3-16 SECTION 5. Subchapter E, Chapter 410, Labor Code, is amended
3-17 by adding Section 410.209 to read as follows:
3-18 Sec. 410.209. REIMBURSEMENT FOR OVERPAYMENT. The subsequent
3-19 injury fund shall reimburse an insurance carrier for any
3-20 overpayments of benefits made under an interlocutory order or
3-21 decision if that order or decision is reversed or modified by final
3-22 arbitration, order, or decision of the commission or a court. The
3-23 commission shall adopt rules to provide for a periodic
3-24 reimbursement schedule, providing for reimbursement at least
3-25 annually.
3-26 SECTION 6. Subchapter E, Chapter 413, Labor Code, is
3-27 amended by adding Section 413.055 to read as follows:
4-1 Sec. 413.055. INTERLOCUTORY ORDERS; REIMBURSEMENT. (a) The
4-2 executive director, as provided by commission rule, may enter an
4-3 interlocutory order for the payment of all or part of medical
4-4 benefits. The order may address accrued benefits, future benefits,
4-5 or both accrued benefits and future benefits.
4-6 (b) The subsequent injury fund shall reimburse an insurance
4-7 carrier for any overpayments of benefits made under an order
4-8 entered under Subsection (a) if the order is reversed or modified
4-9 by final arbitration, order, or decision of the commission or a
4-10 court. The commission shall adopt rules to provide for a periodic
4-11 reimbursement schedule, providing for reimbursement at least
4-12 annually.
4-13 (c) A party that disputes an order entered under Subsection
4-14 (a) is entitled to a hearing. The hearing shall be conducted by
4-15 the State Office of Administrative Hearings in the manner provided
4-16 for a contested case under Chapter 2001, Government Code. The
4-17 order is binding during the pendency of the appeal.
4-18 SECTION 7. This Act takes effect September 1, 1999, and
4-19 applies only to an interlocutory order or decision regarding a
4-20 claim for workers' compensation benefits that is issued on or after
4-21 that date. An interlocutory order or decision issued before that
4-22 date is governed by the law in effect on the date that the
4-23 interlocutory order or decision was issued, and the former law is
4-24 continued in effect for that purpose.
4-25 SECTION 8. The importance of this legislation and the
4-26 crowded condition of the calendars in both houses create an
4-27 emergency and an imperative public necessity that the
5-1 constitutional rule requiring bills to be read on three several
5-2 days in each house be suspended, and this rule is hereby suspended.
_______________________________ _______________________________
President of the Senate Speaker of the House
I certify that H.B. No. 2512 was passed by the House on April
21, 1999, by a non-record vote.
_______________________________
Chief Clerk of the House
I certify that H.B. No. 2512 was passed by the Senate on May
19, 1999, by a viva-voce vote.
_______________________________
Secretary of the Senate
APPROVED: _____________________
Date
_____________________
Governor