1-1 By: Giddings (Senate Sponsor - West) H.B. No. 2512
1-2 (In the Senate - Received from the House April 22, 1999;
1-3 April 26, 1999, read first time and referred to Committee on
1-4 Economic Development; May 13, 1999, reported favorably by the
1-5 following vote: Yeas 4, Nays 0; May 13, 1999, sent to printer.)
1-6 A BILL TO BE ENTITLED
1-7 AN ACT
1-8 relating to interlocutory orders and decisions used in adjudication
1-9 of disputes regarding workers' compensation benefits and to
1-10 reimbursement from the subsequent injury fund for overpayments of
1-11 benefits made under those interlocutory orders or decisions.
1-12 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-13 SECTION 1. Section 402.073(b), Labor Code, is amended to
1-14 read as follows:
1-15 (b) In a case in which a hearing is conducted by the State
1-16 Office of Administrative Hearings under Section 411.049, 413.031,
1-17 413.055, or 415.034, the administrative law judge who conducts the
1-18 hearing for the State Office of Administrative Hearings shall enter
1-19 the final decision in the case after completion of the hearing.
1-20 SECTION 2. Section 410.032, Labor Code, is amended to read
1-21 as follows:
1-22 Sec. 410.032. PAYMENT OF BENEFITS UNDER INTERLOCUTORY
1-23 ORDER[; REIMBURSEMENT]. [(a)] If a benefit review officer
1-24 recommends that benefits be paid or not paid, the benefit review
1-25 officer may issue an interlocutory order for the payment of all or
1-26 part of medical benefits or income benefits. The order may address
1-27 accrued benefits, future benefits, or both accrued benefits and
1-28 future benefits [to pay or not pay the benefits].
1-29 [(b) The subsequent injury fund shall reimburse an insurance
1-30 carrier for any overpayments of benefits made under an order
1-31 entered under this section if that order is reversed or modified at
1-32 a contested case hearing or at arbitration. The commission shall
1-33 adopt rules to provide for a periodic reimbursement schedule,
1-34 providing for reimbursement at least annually.]
1-35 SECTION 3. Section 410.168, Labor Code, is amended to read
1-36 as follows:
1-37 Sec. 410.168. DECISION. (a) The hearing officer shall
1-38 issue a written decision that includes:
1-39 (1) findings of fact and conclusions of law;
1-40 (2) a determination of whether benefits are due; and
1-41 (3) an award of benefits due.
1-42 (b) The decision may address accrued benefits, future
1-43 benefits, or both accrued benefits and future benefits.
1-44 (c) The hearing officer may enter an interlocutory order for
1-45 the payment of all or part of medical benefits or income benefits.
1-46 The order may address accrued benefits, future benefits, or both
1-47 accrued benefits and future benefits. The order is binding during
1-48 the pendency of an appeal to the appeals panel.
1-49 (d) On a form that the commission by rule prescribes, the
1-50 hearing officer shall issue a separate written decision regarding
1-51 attorney's fees and any matter related to attorney's fees. The
1-52 decision regarding attorney's fees and the form may not be made
1-53 known to a jury in a judicial review of an award, including an
1-54 appeal.
1-55 (e) [(c)] The commission by rule shall prescribe the times
1-56 within which the hearing officer must file the decisions with the
1-57 division.
1-58 (f) [(d)] The division shall send a copy of the decision to
1-59 each party.
1-60 SECTION 4. Section 410.205, Labor Code, is amended to read
1-61 as follows:
1-62 Sec. 410.205. EFFECT OF DECISION[; REIMBURSEMENT FOR
1-63 OVERPAYMENT]. (a) A decision of an appeals panel regarding
1-64 benefits is final in the absence of a timely appeal for judicial
2-1 review.
2-2 (b) The decision of the appeals panel regarding benefits is
2-3 binding during the pendency of an appeal under Subchapter F or G.
2-4 [(c) If the court of last resort in the case finally
2-5 modifies or reverses an appeals panel decision awarding benefits,
2-6 the insurance carrier who has paid benefits as required by this
2-7 section may recover reimbursement of any benefit overpayments from
2-8 the subsequent injury fund.]
2-9 SECTION 5. Subchapter E, Chapter 410, Labor Code, is amended
2-10 by adding Section 410.209 to read as follows:
2-11 Sec. 410.209. REIMBURSEMENT FOR OVERPAYMENT. The subsequent
2-12 injury fund shall reimburse an insurance carrier for any
2-13 overpayments of benefits made under an interlocutory order or
2-14 decision if that order or decision is reversed or modified by final
2-15 arbitration, order, or decision of the commission or a court. The
2-16 commission shall adopt rules to provide for a periodic
2-17 reimbursement schedule, providing for reimbursement at least
2-18 annually.
2-19 SECTION 6. Subchapter E, Chapter 413, Labor Code, is
2-20 amended by adding Section 413.055 to read as follows:
2-21 Sec. 413.055. INTERLOCUTORY ORDERS; REIMBURSEMENT. (a) The
2-22 executive director, as provided by commission rule, may enter an
2-23 interlocutory order for the payment of all or part of medical
2-24 benefits. The order may address accrued benefits, future benefits,
2-25 or both accrued benefits and future benefits.
2-26 (b) The subsequent injury fund shall reimburse an insurance
2-27 carrier for any overpayments of benefits made under an order
2-28 entered under Subsection (a) if the order is reversed or modified
2-29 by final arbitration, order, or decision of the commission or a
2-30 court. The commission shall adopt rules to provide for a periodic
2-31 reimbursement schedule, providing for reimbursement at least
2-32 annually.
2-33 (c) A party that disputes an order entered under Subsection
2-34 (a) is entitled to a hearing. The hearing shall be conducted by
2-35 the State Office of Administrative Hearings in the manner provided
2-36 for a contested case under Chapter 2001, Government Code. The
2-37 order is binding during the pendency of the appeal.
2-38 SECTION 7. This Act takes effect September 1, 1999, and
2-39 applies only to an interlocutory order or decision regarding a
2-40 claim for workers' compensation benefits that is issued on or after
2-41 that date. An interlocutory order or decision issued before that
2-42 date is governed by the law in effect on the date that the
2-43 interlocutory order or decision was issued, and the former law is
2-44 continued in effect for that purpose.
2-45 SECTION 8. The importance of this legislation and the
2-46 crowded condition of the calendars in both houses create an
2-47 emergency and an imperative public necessity that the
2-48 constitutional rule requiring bills to be read on three several
2-49 days in each house be suspended, and this rule is hereby suspended.
2-50 * * * * *