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  88R18998 RDS-F
 
  By: Burrows, Tepper, Longoria H.B. No. 2468
 
  Substitute the following for H.B. No. 2468:
 
  By:  Lambert C.S.H.B. No. 2468
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the eligibility of an injured employee for lifetime
  income benefits under the workers' compensation system.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 408.0041, Labor Code, is amended by
  adding Subsection (k-1) to read as follows:
         (k-1)  If the report of a designated doctor indicates that an
  employee receiving lifetime income benefits under Section 408.1615
  is no longer eligible to receive those benefits, the insurance
  carrier may suspend the payment of lifetime income benefits as
  provided by that section.
         SECTION 2.  Section 408.161(a), Labor Code, is amended to
  read as follows:
         (a)  Lifetime income benefits are paid until the death of the
  employee for:
               (1)  total and permanent loss of sight in both eyes;
               (2)  loss of both feet at or above the ankle;
               (3)  loss of both hands at or above the wrist;
               (4)  loss of one foot at or above the ankle and the loss
  of one hand at or above the wrist;
               (5)  an injury to the spine that results in permanent
  and complete paralysis of both arms, both legs, or one arm and one
  leg;
               (6)  a physically traumatic injury to the brain that,
  as determined using evidence-based medicine, results in a permanent
  major neurocognitive disorder:
                     (A)  for which the employee requires occasional
  supervision in the performance of routine daily tasks of self-care;
  and
                     (B)  that renders the employee permanently
  unemployable [resulting in incurable insanity or imbecility]; or
               (7)  third degree burns that cover at least 40 percent
  of the body and require grafting, or third degree burns covering the
  majority of:
                     (A)  [either] both hands;
                     (B)  [or] one hand and one foot; or
                     (C)  one hand or one foot and the face.
         SECTION 3.  Subchapter I, Chapter 408, Labor Code, is
  amended by adding Section 408.1615 to read as follows:
         Sec. 408.1615.  LIFETIME INCOME BENEFITS FOR CERTAIN FIRST
  RESPONDERS. (a)  In this section: 
               (1)  "First responder" means an individual who is:
                     (A)  a peace officer under Article 2.12, Code of
  Criminal Procedure;
                     (B)  certified under Chapter 773, Health and
  Safety Code, as an emergency care attendant, advanced emergency
  medical technician, emergency medical technician-paramedic or a
  licensed paramedic;
                     (C)  a firefighter subject to certification by the
  Texas Commission on Fire Protection under Chapter 419, Government
  Code, whose principal duties are aircraft crash and rescue or fire
  fighting; or
                     (D)  an individual covered under Section 504.012
  who is providing volunteer services as:
                           (i)  a volunteer fire fighter, regardless of
  whether the individual is certified under Chapter 419, Government
  Code; or
                           (ii)  an emergency medical services
  volunteer, as defined by Section 773.003, Health and Safety Code.
               (2)  "Serious bodily injury" has the meaning assigned
  by Section 1.07, Penal Code.
         (b)  This section applies only to an employee who sustains a
  serious bodily injury, other than an injury described by Section
  408.161, in the course and scope of the employee's employment or
  volunteer service as a first responder that renders the employee
  permanently unemployable.
         (c)  Except as otherwise provided by this section, an
  employee to which this section applies is entitled to receive
  lifetime income benefits paid until the employee's death for the
  employee's injury. Sections 408.161(c) and (d) apply to the
  payment of lifetime income benefits under this section.
         (d)  The division shall accelerate any dispute, including a
  contested case hearing or appeal requested by the employee,
  regarding an employee's eligibility for lifetime income benefits
  under this section.  The employee shall provide notice to the
  division that the dispute involves a first responder.
         (e)  An employee receiving lifetime income benefits under
  this section shall annually certify to the insurance carrier, in
  the form and manner prescribed by the division, that the employee
  was not employed in any capacity during the preceding year.
         (f)  Notwithstanding Sections 410.169 and 410.205, an
  insurance carrier may periodically review an employee's
  eligibility for lifetime income benefits under this section, but
  not more than once during any five-year period.
         (g)  An employee is not entitled to lifetime income benefits
  under this section, and an insurance carrier is authorized to
  suspend the payment of lifetime income benefits, during and for a
  period in which the employee fails to certify the employee's
  eligibility under Subsection (e), the employee is employed in any
  capacity, or as provided under Section 408.0041(k-1), unless the
  commissioner determines that there is good cause. The commissioner
  by rule shall ensure that an employee receives reasonable notice of
  the insurance carrier's basis for the suspension and is provided a
  reasonable opportunity to certify the employee's eligibility under
  Subsection (e) or otherwise respond to the notice.
         (h)  The commissioner shall adopt rules necessary to
  implement this section, including rules:
               (1)  prescribing the form and manner for the annual
  certification required by Subsection (e); and
               (2)  establishing procedures for:
                     (A)  the suspension and reinstatement of lifetime
  income benefits under Subsection (g); and
                     (B)  the termination of lifetime income benefits
  under this section on a final determination that an employee is no
  longer eligible for the benefits.
         SECTION 4.  The changes in law made by this Act apply to a
  claim for lifetime income benefits based on a compensable injury
  that occurs on or after the effective date of this Act.  A claim
  based on a compensable injury that occurs before the effective date
  of this Act is governed by the law in effect on the date the
  compensable injury occurred, and the former law is continued in
  effect for that purpose.
         SECTION 5.  This Act takes effect September 1, 2023.