C.S.H.B. 2198 78(R)    BILL ANALYSIS


C.S.H.B. 2198
By: Solomons
Business & Industry
Committee Report (Substituted)



BACKGROUND AND PURPOSE 

The Texas Workers' Compensation Commission (commission), in 2000, amended
their rules by adopting a 90-day  deadline to dispute maximum medical
improvement (MMI) and the resulting impairment rating (IR). On April 12,
2001 the Third District Court of Appeals opined that the commission did
not have statutory authority to adopt a rule to place a deadline on
disputing MMI or IR. This decision repealed all deadlines to dispute these
ratings. The commission and some insurance carriers have started having
disputes of ratings that are several years old. 

C.S.H.B. 2198 would establish a 90-day deadline to dispute MMI or an IR
unless there has been a substantial change of condition, mis-diagnosis or
physician error.  



RULEMAKING AUTHORITY

It is the committee's opinion that rulemaking authority is expressly
granted to the Texas Workers' Compensation Commission in SECTION 1(e)(2)
(Section 408.123, Labor Code) of this bill. 

ANALYSIS

C.S.H.B. 2198 would establish a 90-day deadline to dispute MMI or an IR
unless there is compelling medical evidence showing a physician error in
applying the American Medical Association Guidelines for MMI and/or in
calculating the impairment rating; a mis-diagnosis or non-diagnosis;
improper or inadequate treatment which would render the MMI or IR invalid;
or other compelling circumstances determined by commission rule. The
90-day deadline also be applicable to statutory MMI and any resulting IR.  
 
If an MMI or IR is disputed within the 90-day deadline and is modified or
overturned any subsequent Mmi or IR would have to be disputed within
90-days as well or become final.  



EFFECTIVE DATE

This bill would be effective immediately if it receives a two-thirds vote
of the Legislature or on September 1, 2003 for all MMI and IR assigned on
or after the effective date. 



COMPARISON OF ORIGINAL TO SUBSTITUTE

C.S.H.B. 2198 differs from the original in that the filed version of H.B.
2198 allowed the commission to adopt a rule establishing a deadline to
dispute an MMI or IR assignment, whereas C.S.H.B. 2198 establishes the
90-day rule in statute and allows for the reconsideration of an MMI or IR
assignment after the 90-day rule for physician error, improper/inadequate
treatment or other compelling circumstances determined by commission rule.
C.S.H.B. 2198 also clarifies that the 90day rule also applies to statutory
MMI (and any subsequent IR) and any new MMI and/or IR that results from a
dispute.