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A BILL TO BE ENTITLED
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AN ACT
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relating to disputes regarding the compensability of an injury by |
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certain doctors under the Texas Workers' Compensation Act. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 409.021, Labor Code, is amended by |
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adding Subsection (b-1) and amending Subsection (c) to read as |
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follows: |
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(b-1) On request by an insurance carrier and at the |
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insurance carrier's expense, an injured employee's treating doctor |
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may provide to the insurance carrier notice of all medical |
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conditions the doctor considers related to the employee's |
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compensable injury and how the mechanism of the injury caused each |
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condition. The commissioner shall adopt rules necessary to |
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implement this subsection, including rules regarding the interval |
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an insurance carrier must wait after receipt of a notice before the |
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insurance carrier may request a second or subsequent notice |
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regarding an injured employee. |
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(c) If an insurance carrier does not contest the |
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compensability of an injury on or before the 60th day after the date |
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on which the insurance carrier is notified of the injury, including |
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by receipt of a notice under Subsection (b-1), the insurance |
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carrier waives its right to contest compensability. The initiation |
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of payments by an insurance carrier does not affect the right of the |
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insurance carrier to continue to investigate or deny the |
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compensability of an injury during the 60-day period. |
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SECTION 2. Section 409.022(a), Labor Code, is amended to |
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read as follows: |
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(a) An insurance carrier's notice of refusal to pay benefits |
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under Section 409.021 must: |
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(1) specify the grounds for the refusal; |
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(2) describe the evidence the insurance carrier |
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reviewed in making the determination; and |
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(3) describe how the evidence substantiates that the |
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insurance carrier's refusal to pay benefits is reasonable. |
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SECTION 3. Section 408.0042, Labor Code, is repealed. |
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SECTION 4. As soon as practicable after the effective date |
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of this Act, the commissioner of workers' compensation shall adopt |
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rules necessary to implement Sections 409.021 and 409.022, Labor |
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Code, as amended by this Act. |
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SECTION 5. The change in law made by this Act applies only |
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to a claim for workers' compensation benefits based on a |
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compensable injury that occurs on or after the effective date of |
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this Act. A claim based on a compensable injury that occurs before |
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that date is governed by the law as it existed on the date the |
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compensable injury occurred, and the former law is continued in |
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effect for that purpose. |
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SECTION 6. This Act takes effect September 1, 2017. |