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AN ACT
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relating to certain claims for benefits, compensation, or |
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assistance by certain public safety employees and survivors of |
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certain public safety employees. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. The heading to Subchapter B, Chapter 607, |
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Government Code, is amended to read as follows: |
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SUBCHAPTER B. DISEASES OR ILLNESSES SUFFERED BY DETENTION |
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OFFICERS, CUSTODIAL OFFICERS, FIREFIGHTERS, PEACE OFFICERS, AND |
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EMERGENCY MEDICAL TECHNICIANS |
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SECTION 2. Section 607.051, Government Code, is amended by |
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amending Subdivision (1) and adding Subdivisions (1-a) and (1-b) to |
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read as follows: |
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(1) "Custodial officer" means a person who is employed |
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by the Board of Pardons and Paroles or the Texas Department of |
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Criminal Justice as a parole officer or caseworker or who is |
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employed by the correctional institutions division of the Texas |
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Department of Criminal Justice and certified by the department as |
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having a normal job assignment that requires frequent or infrequent |
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regularly planned contact with, and in close proximity to, inmates |
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or defendants of the correctional institutions division without the |
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protection of bars, doors, security screens, or similar devices and |
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includes assignments normally involving supervision or the |
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potential for supervision of inmates in inmate housing areas, |
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educational or recreational facilities, industrial shops, |
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kitchens, laundries, medical areas, agricultural shops or fields, |
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or in other areas on or away from property of the department. |
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(1-a) "Detention officer" means an individual |
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employed by a state agency or political subdivision of the state to |
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ensure the safekeeping of prisoners and the security of a |
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municipal, county, or state penal institution in this state. |
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(1-b) "Disability" means partial or total disability. |
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SECTION 3. Sections 607.052(a), (b), (e), and (g), |
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Government Code, are amended to read as follows: |
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(a) Notwithstanding any other law, this subchapter applies |
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only to a detention officer, custodial officer, firefighter, peace |
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officer, or emergency medical technician who: |
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(1) on becoming employed or during employment as a |
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detention officer, custodial officer, firefighter, peace officer, |
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or emergency medical technician, received a physical examination |
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that failed to reveal evidence of the illness or disease for which |
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benefits or compensation are sought using a presumption established |
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by this subchapter; |
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(2) is employed for five or more years as a |
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firefighter, peace officer, or emergency medical technician, |
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except for the presumption under Section 607.0545; and |
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(3) seeks benefits or compensation for a disease or |
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illness covered by this subchapter that is discovered during |
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employment as a detention officer, custodial officer, firefighter, |
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peace officer, or emergency medical technician. |
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(b) A presumption under this subchapter does not apply: |
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(1) to a determination of a survivor's eligibility for |
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benefits under Chapter 615; |
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(2) in a cause of action brought in a state or federal |
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court except for judicial review of a proceeding in which there has |
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been a grant or denial of employment-related benefits or |
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compensation; |
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(3) to a determination regarding benefits or |
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compensation under a life or disability insurance policy purchased |
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by or on behalf of the detention officer, custodial officer, |
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firefighter, peace officer, or emergency medical technician that |
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provides coverage in addition to any benefits or compensation |
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required by law; or |
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(4) if the disease or illness for which benefits or |
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compensation is sought is known to be caused by the use of tobacco |
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and: |
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(A) the firefighter, peace officer, or emergency |
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medical technician is or has been a user of tobacco; or |
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(B) the firefighter's, peace officer's, or |
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emergency medical technician's spouse has, during the marriage, |
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been a user of tobacco that is consumed through smoking. |
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(e) A detention officer, custodial officer, firefighter, |
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peace officer, or emergency medical technician who uses a |
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presumption established under this subchapter is entitled only to |
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the benefits or compensation to which the detention officer, |
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custodial officer, firefighter, peace officer, or emergency |
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medical technician would otherwise be entitled to receive at the |
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time the claim for benefits or compensation is filed. |
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(g) This subchapter applies to a detention officer, |
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custodial officer, firefighter, peace officer, or emergency |
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medical technician who provides services as an employee of an |
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entity created by an interlocal agreement. |
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SECTION 4. Section 607.054, Government Code, is amended to |
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read as follows: |
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Sec. 607.054. TUBERCULOSIS OR OTHER RESPIRATORY ILLNESS. |
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(a) A firefighter, peace officer, or emergency medical technician |
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who suffers from tuberculosis, or any other disease or illness of |
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the lungs or respiratory tract that has a statistically positive |
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correlation with service as a firefighter, peace officer, or |
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emergency medical technician, that results in death or total or |
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partial disability is presumed to have contracted the disease or |
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illness during the course and scope of employment as a firefighter, |
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peace officer, or emergency medical technician. |
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(b) This section does not apply to a claim that a |
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firefighter, peace officer, or emergency medical technician |
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suffers from severe acute respiratory syndrome coronavirus 2 |
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(SARS-CoV-2) or coronavirus disease 2019 (COVID-19). |
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SECTION 5. Subchapter B, Chapter 607, Government Code, is |
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amended by adding Section 607.0545 to read as follows: |
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Sec. 607.0545. SEVERE ACUTE RESPIRATORY SYNDROME |
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CORONAVIRUS 2 (SARS-CoV-2) OR CORONAVIRUS DISEASE 2019 (COVID-19). |
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(a) A detention officer, custodial officer, firefighter, peace |
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officer, or emergency medical technician who suffers from severe |
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acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or |
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coronavirus disease 2019 (COVID-19) that results in death or total |
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or partial disability is presumed to have contracted the virus or |
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disease during the course and scope of employment as a detention |
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officer, custodial officer, firefighter, peace officer, or |
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emergency medical technician if the detention officer, custodial |
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officer, firefighter, peace officer, or emergency medical |
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technician: |
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(1) is employed in the area designated in a disaster |
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declaration by the governor under Section 418.014 or another law |
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and the disaster is related to severe acute respiratory syndrome |
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coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19); |
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and |
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(2) contracts the disease during the disaster declared |
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by the governor described by Subdivision (1). |
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(b) The presumption under this section applies only to a |
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person who: |
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(1) is employed as a detention officer, custodial |
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officer, firefighter, peace officer, or emergency medical |
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technician on a full-time basis; |
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(2) is diagnosed with severe acute respiratory |
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syndrome coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 |
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(COVID-19): |
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(A) using a test authorized, approved, or |
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licensed by the United States Food and Drug Administration; or |
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(B) if the person is deceased: |
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(i) using a test described by Paragraph |
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(A); or |
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(ii) by another means, including by a |
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physician; and |
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(3) was last on duty: |
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(A) not more than 15 days before the date the |
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person is diagnosed with severe acute respiratory syndrome |
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coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19) |
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using a test described by Subdivision (2)(A); or |
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(B) if the person is deceased, not more than 15 |
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days before the date the person: |
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(i) was diagnosed with severe acute |
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respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus |
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disease 2019 (COVID-19) using a test described by Subdivision |
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(2)(A); |
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(ii) began to show symptoms of severe acute |
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respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus |
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disease 2019 (COVID-19) as determined by a licensed physician; |
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(iii) was hospitalized for symptoms related |
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to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or |
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coronavirus disease 2019 (COVID-19); or |
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(iv) died if severe acute respiratory |
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syndrome coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 |
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(COVID-19) was a contributing factor in the person's death. |
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(c) This section does not affect the right of a detention |
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officer, custodial officer, firefighter, peace officer, or |
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emergency medical technician to provide proof, without the use of |
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the presumption under this section, that an injury or illness |
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occurred during the course and scope of employment. |
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(d) Sections 409.009 and 409.0091, Labor Code, do not apply |
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to a claim for compensation determined to be compensable or |
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accepted by an insurance carrier as compensable using the |
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presumption under this section. Notwithstanding this subsection, |
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an injured employee may request reimbursement for health care paid |
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by the employee as provided by Section 409.0092, Labor Code. |
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(e) This section expires September 1, 2023. |
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SECTION 6. Section 607.057, Government Code, is amended to |
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read as follows: |
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Sec. 607.057. EFFECT OF PRESUMPTION. Except as provided by |
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Section 607.052(b), a presumption established under this |
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subchapter applies to a determination of whether a detention |
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officer's, custodial officer's, firefighter's, peace officer's, or |
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emergency medical technician's disability or death resulted from a |
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disease or illness contracted in the course and scope of employment |
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for purposes of benefits or compensation provided under another |
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employee benefit, law, or plan, including a pension plan. |
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SECTION 7. Section 607.058, Government Code, is amended to |
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read as follows: |
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Sec. 607.058. PRESUMPTION REBUTTABLE. (a) A presumption |
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under Section 607.053, 607.054, 607.0545, 607.055, or 607.056 may |
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be rebutted through a showing by a preponderance of the evidence |
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that a risk factor, accident, hazard, or other cause not associated |
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with the individual's service as a detention officer, custodial |
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officer, firefighter, peace officer, or emergency medical |
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technician was a substantial factor in bringing about the |
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individual's disease or illness, without which the disease or |
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illness would not have occurred. |
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(b) A rebuttal offered under this section must include a |
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statement by the person offering the rebuttal that describes, in |
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detail, the evidence that the person reviewed before making the |
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determination that a cause not associated with the individual's |
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service as a detention officer, custodial officer, firefighter, |
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peace officer, or emergency medical technician was a substantial |
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factor in bringing about the individual's disease or illness, |
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without which the disease or illness would not have occurred. |
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(c) In addressing an argument based on a rebuttal offered |
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under this section, an administrative law judge shall make findings |
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of fact and conclusions of law that consider whether a qualified |
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expert, relying on evidence-based medicine, stated the opinion |
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that, based on reasonable medical probability, an identified risk |
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factor, accident, hazard, or other cause not associated with the |
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individual's service as a detention officer, custodial officer, |
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firefighter, peace officer, or emergency medical technician was a |
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substantial factor in bringing about the individual's disease or |
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illness, without which the disease or illness would not have |
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occurred. |
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(d) A rebuttal offered under this section to a presumption |
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under Section 607.0545 may not be based solely on evidence relating |
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to the risk of exposure to severe acute respiratory syndrome |
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coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19) |
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of a person with whom a detention officer, custodial officer, |
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firefighter, peace officer, or emergency medical technician |
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resides. This subsection expires September 1, 2023. |
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SECTION 8. Subchapter A, Chapter 409, Labor Code, is |
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amended by adding Section 409.0092 to read as follows: |
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Sec. 409.0092. HEALTH CARE REIMBURSEMENT PROCEDURES FOR |
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CERTAIN INJURED EMPLOYEES. (a) An injured employee who is subject |
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to Section 607.0545, Government Code, and whose claim for benefits |
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is determined to be compensable by an insurance carrier or the |
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division, may request reimbursement for health care paid by the |
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employee, including copayments and partial payments, by submitting |
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to the carrier a legible written request and documentation showing |
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the amounts paid to the health care provider. |
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(b) Not later than the 45th day after the date an injured |
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employee submits a request for reimbursement for health care to an |
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insurance carrier under Subsection (a), the carrier shall provide |
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reimbursement or deny the request. |
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(c) If an insurance carrier denies an injured employee's |
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request for reimbursement for health care, the employee may seek |
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medical dispute resolution as provided by Chapter 413 and division |
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rules. Notwithstanding any other law, an employee's request for |
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medical dispute resolution is considered timely if the employee |
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submits the request not later than the 120th day after the date the |
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carrier denies the employee's request for reimbursement. |
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(d) This section expires September 1, 2023. |
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SECTION 9. Section 409.022(d), Labor Code, is amended to |
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read as follows: |
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(d) In this subsection, the terms "custodial officer," |
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"detention officer," "emergency medical technician," |
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"firefighter," and "peace officer" have the meanings assigned by |
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Section 607.051, Government Code. In addition to the other |
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requirements of this section, if an insurance carrier's notice of |
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refusal to pay benefits under Section 409.021 is sent in response to |
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a claim for compensation resulting from a custodial officer's, a |
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detention officer's, an emergency medical technician's, a |
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firefighter's, or a peace officer's disability or death for which a |
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presumption is claimed to be applicable under Subchapter B, Chapter |
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607, Government Code, the notice must include a statement by the |
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carrier that: |
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(1) explains why the carrier determined a presumption |
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under that subchapter does not apply to the claim for compensation; |
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and |
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(2) describes the evidence that the carrier reviewed |
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in making the determination described by Subdivision (1). |
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SECTION 10. (a) The changes in law made by this Act apply to |
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a claim for benefits pending on or filed on or after the effective |
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date of this Act. A claim for benefits filed before that date is |
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covered by the law in effect on the date the claim was made, and that |
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law is continued in effect for that purpose. |
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(b) Notwithstanding any other law, a person subject to |
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Section 607.0545, Government Code, as added by this Act, who on or |
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after the date the governor declared a disaster under Chapter 418, |
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Government Code, relating to SARS-CoV-2, coronavirus disease 2019 |
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(COVID-19), but before the effective date of this Act, contracted |
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SARS-CoV-2, coronavirus disease 2019 (COVID-19), may file a claim |
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for benefits related to SARS-CoV-2, coronavirus disease 2019 |
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(COVID-19), on or after the effective date of this Act, regardless |
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of whether that claim is otherwise considered untimely and the |
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changes in law made by this Act apply to that claim. A claim |
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authorized under this subsection must be filed not later than six |
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months after the effective date of this Act. |
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(c) Notwithstanding Subsection (a) of this section or |
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Section 409.003, 409.007, 410.169, or 410.205, Labor Code, a person |
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subject to Section 607.0545, Government Code, as added by this Act, |
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who on or after the date the governor declared a disaster under |
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Chapter 418, Government Code, relating to SARS-CoV-2, coronavirus |
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disease 2019 (COVID-19), but before the effective date of this Act, |
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filed a claim for benefits related to SARS-CoV-2, coronavirus |
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disease 2019 (COVID-19), and whose claim was subsequently denied |
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may, on or after the effective date of this Act, request in writing |
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that the insurance carrier reprocess the claim and the changes in |
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law made by this Act shall apply to that claim. A request to |
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reprocess a claim as authorized by this subsection shall be filed |
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not later than one year after the effective date of this Act. |
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(d) Not later than the 60th day after the date an insurance |
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carrier receives a written request to reprocess a claim under |
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Subsection (c) of this section, the insurance carrier shall |
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reprocess the claim and notify the person in writing whether the |
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carrier accepted or denied the claim. If the insurance carrier |
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denies the claim, the notice must include information on the |
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process for disputing the denial. The notice provided by the |
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insurance carrier must use the notice provisions prescribed by the |
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division of workers' compensation of the Texas Department of |
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Insurance under Subsection (e) of this section. |
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(e) As soon as practicable after the effective date of this |
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Act, the division of workers' compensation of the Texas Department |
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of Insurance shall prescribe notice provisions for an insurance |
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carrier to use when providing notice of the insurance carrier's |
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acceptance or denial of a person's claim. The notice provisions |
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must be clear and easily understandable. |
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SECTION 11. This Act takes effect immediately if it |
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receives a vote of two-thirds of all the members elected to each |
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house, as provided by Section 39, Article III, Texas Constitution. |
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If this Act does not receive the vote necessary for immediate |
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effect, this Act takes effect September 1, 2021. |
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______________________________ |
______________________________ |
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President of the Senate |
Speaker of the House |
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I hereby certify that S.B. No. 22 passed the Senate on |
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April 21, 2021, by the following vote: Yeas 31, Nays 0; |
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May 25, 2021, Senate refused to concur in House amendments and |
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requested appointment of Conference Committee; May 27, 2021, House |
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granted request of the Senate; May 30, 2021, Senate adopted |
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Conference Committee Report by the following vote: Yeas 31, |
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Nays 0. |
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______________________________ |
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Secretary of the Senate |
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I hereby certify that S.B. No. 22 passed the House, with |
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amendments, on May 20, 2021, by the following vote: Yeas 139, |
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Nays 6, one present not voting; May 27, 2021, House granted request |
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of the Senate for appointment of Conference Committee; |
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May 30, 2021, House adopted Conference Committee Report by the |
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following vote: Yeas 139, Nays 3, two present not voting. |
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______________________________ |
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Chief Clerk of the House |
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Approved: |
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______________________________ |
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Date |
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______________________________ |
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Governor |