By: Springer S.B. No. 2471
 
 
 
   
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to certain claims for benefits, compensation, or
  assistance by certain public safety employees and survivors of
  certain public safety employees.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  The heading to Subchapter B, Chapter 607,
  Government Code, is amended to read as follows:
  SUBCHAPTER B.  DISEASES OR ILLNESSES SUFFERED BY DETENTION
  OFFICERS, CUSTODIAL OFFICERS, FIREFIGHTERS, PEACE OFFICERS, AND
  EMERGENCY MEDICAL TECHNICIANS
         SECTION 2.  Section 607.051, Government Code, is amended by
  amending Subdivision (1) and adding Subdivisions (1-a) and (1-b) to
  read as follows:
               (1)  "Custodial officer" means a person who is employed
  by the Board of Pardons and Paroles or the Texas Department of
  Criminal Justice as a parole officer or caseworker or who is
  employed by the correctional institutions division of the Texas
  Department of Criminal Justice and certified by the department as
  having a normal job assignment that requires frequent or infrequent
  regularly planned contact with, and in close proximity to, inmates
  or defendants of the correctional institutions division without the
  protection of bars, doors, security screens, or similar devices and
  includes assignments normally involving supervision or the
  potential for supervision of inmates in inmate housing areas,
  educational or recreational facilities, industrial shops,
  kitchens, laundries, medical areas, agricultural shops or fields,
  or in other areas on or away from property of the department.
               (1-a)  "Detention officer" means an individual
  employed by a state agency or political subdivision of the state to
  ensure the safekeeping of prisoners and the security of a
  municipal, county, or state penal institution in this state.
               (1-b)  Disability" means partial or total disability.
         SECTION 3.  Sections 607.052(a), (b), (e), and (g),
  Government Code, are amended to read as follows:
         (a)  Notwithstanding any other law, this subchapter applies
  only to a detention officer, custodial officer, firefighter, peace
  officer, or emergency medical technician who:
               (1)  on becoming employed or during employment as a
  detention officer, custodial officer, firefighter, peace officer,
  or emergency medical technician, received a physical examination
  that failed to reveal evidence of the illness or disease for which
  benefits or compensation are sought using a presumption established
  by this subchapter;
               (2)  is employed for five or more years as a
  firefighter, peace officer, or emergency medical technician,
  except for the presumption under Section 607.0545; and
               (3)  seeks benefits or compensation for a disease or
  illness covered by this subchapter that is discovered during
  employment as a detention officer, custodial officer, firefighter,
  peace officer, or emergency medical technician.
         (b)  A presumption under this subchapter does not apply:
               (1)  to a determination of a survivor's eligibility for
  benefits under Chapter 615;
               (2)  in a cause of action brought in a state or federal
  court except for judicial review of a proceeding in which there has
  been a grant or denial of employment-related benefits or
  compensation;
               (3)  to a determination regarding benefits or
  compensation under a life or disability insurance policy purchased
  by or on behalf of the detention officer, custodial officer,
  firefighter, peace officer, or emergency medical technician that
  provides coverage in addition to any benefits or compensation
  required by law; or
               (4)  if the disease or illness for which benefits or
  compensation is sought is known to be caused by the use of tobacco
  and:
                     (A)  the firefighter, peace officer, or emergency
  medical technician is or has been a user of tobacco; or
                     (B)  the firefighter's, peace officer's, or
  emergency medical technician's spouse has, during the marriage,
  been a user of tobacco that is consumed through smoking.
         (e)  A detention officer, custodial officer, firefighter,
  peace officer, or emergency medical technician who uses a
  presumption established under this subchapter is entitled only to
  the benefits or compensation to which the detention officer,
  custodial officer, firefighter, peace officer, or emergency
  medical technician would otherwise be entitled to receive at the
  time the claim for benefits or compensation is filed.
         (g)  This subchapter applies to a detention officer,
  custodial officer, firefighter, peace officer, or emergency
  medical technician who provides services as an employee of an
  entity created by an interlocal agreement.
         SECTION 4.  Section 607.054, Government Code, is amended to
  read as follows:
         Sec. 607.054.  TUBERCULOSIS OR OTHER RESPIRATORY ILLNESS.
  (a)  A firefighter, peace officer, or emergency medical technician
  who suffers from tuberculosis, or any other disease or illness of
  the lungs or respiratory tract that has a statistically positive
  correlation with service as a firefighter, peace officer, or
  emergency medical technician, that results in death or total or
  partial disability is presumed to have contracted the disease or
  illness during the course and scope of employment as a firefighter,
  peace officer, or emergency medical technician.
         (b)  This section does not apply to a claim that a
  firefighter, peace officer, or emergency medical technician
  suffers from severe acute respiratory syndrome coronavirus 2
  (SARS-CoV-2) or coronavirus disease 2019 (COVID-19).
         SECTION 5.  Subchapter B, Chapter 607, Government Code, is
  amended by adding Section 607.0545 to read as follows:
         Sec. 607.0545.  SEVERE ACUTE RESPIRATORY SYNDROME
  CORONAVIRUS 2 (SARS-CoV-2) OR CORONAVIRUS DISEASE 2019 (COVID-19).  
  (a)  A detention officer, custodial officer, firefighter, peace
  officer, or emergency medical technician who suffers from severe
  acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or
  coronavirus disease 2019 (COVID-19) that results in death or total
  or partial disability is presumed to have contracted the virus or
  disease during the course and scope of employment as a detention
  officer, custodial officer, firefighter, peace officer, or
  emergency medical technician if the detention officer, custodial
  officer, firefighter, peace officer, or emergency medical
  technician:
               (1)  is employed in the area designated in a disaster
  declaration by the governor under Section 418.014 or another law
  and the disaster is related to severe acute respiratory syndrome
  coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19);
  and
               (2)  contracts the disease during the disaster declared
  by the governor described by Subdivision (1).
         (b)  The presumption under this section applies only to a
  person who:
               (1)  is employed as a detention officer, custodial
  officer, firefighter, peace officer, or emergency medical
  technician on a full-time basis;
               (2)  is diagnosed with severe acute respiratory
  syndrome coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019
  (COVID-19):
                     (A)  using a test authorized, approved, or
  licensed by the United States Food and Drug Administration; or
                     (B)  if the person is deceased:
                           (i)  using a test described by Paragraph
  (A); or
                           (ii)  by another means, including by a
  physician; and
               (3)  was last on duty:
                     (A)  not more than 15 days before the date the
  person is diagnosed with severe acute respiratory syndrome
  coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19)
  using a test described by Subdivision (2)(A); or
                     (B)  if the person is deceased, not more than 15
  days before the date the person:
                           (i)  was diagnosed with severe acute
  respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus
  disease 2019 (COVID-19) using a test described by Subdivision
  (2)(A);
                           (ii)  began to show symptoms of severe acute
  respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus
  disease 2019 (COVID-19) as determined by a licensed physician;
                           (iii)  was hospitalized for symptoms related
  to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or
  coronavirus disease 2019 (COVID-19); or
                           (iv)  died if severe acute respiratory
  syndrome coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019
  (COVID-19) was a contributing factor in the person's death.
         (c)  This section does not affect the right of a detention
  officer, custodial officer, firefighter, peace officer, or
  emergency medical technician to provide proof, without the use of
  the presumption under this section, that an injury or illness
  occurred during the course and scope of employment.
         (d)  Sections 409.009 and 409.0091, Labor Code, do not apply
  to a claim for compensation determined to be compensable or
  accepted by an insurance carrier as compensable using the
  presumption under this section. Notwithstanding this subsection,
  an injured employee may request reimbursement for health care paid
  by the employee as provided by Section 409.0092, Labor Code.
         (e)  This section expires September 1, 20232027.
         SECTION 6.  Section 607.057, Government Code, is amended to
  read as follows:
         Sec. 607.057.  EFFECT OF PRESUMPTION. Except as provided by
  Section 607.052(b), a presumption established under this
  subchapter applies to a determination of whether a detention
  officer's, custodial officer's, firefighter's, peace officer's, or
  emergency medical technician's disability or death resulted from a
  disease or illness contracted in the course and scope of employment
  for purposes of benefits or compensation provided under another
  employee benefit, law, or plan, including a pension plan.
         SECTION 7.  Section 607.058, Government Code, is amended to
  read as follows:
         Sec. 607.058.  PRESUMPTION REBUTTABLE.  (a)  A presumption
  under Section 607.053, 607.054, 607.0545, 607.055, or 607.056 may
  be rebutted through a showing by a preponderance of the evidence
  that a risk factor, accident, hazard, or other cause not associated
  with the individual's service as a detention officer, custodial
  officer, firefighter, peace officer, or emergency medical
  technician was a substantial factor in bringing about the
  individual's disease or illness, without which the disease or
  illness would not have occurred.
         (b)  A rebuttal offered under this section must include a
  statement by the person offering the rebuttal that describes, in
  detail, the evidence that the person reviewed before making the
  determination that a cause not associated with the individual's
  service as a detention officer, custodial officer, firefighter,
  peace officer, or emergency medical technician was a substantial
  factor in bringing about the individual's disease or illness,
  without which the disease or illness would not have occurred.
         (c)  In addressing an argument based on a rebuttal offered
  under this section, an administrative law judge shall make findings
  of fact and conclusions of law that consider whether a qualified
  expert, relying on evidence-based medicine, stated the opinion
  that, based on reasonable medical probability, an identified risk
  factor, accident, hazard, or other cause not associated with the
  individual's service as a detention officer, custodial officer,
  firefighter, peace officer, or emergency medical technician was a
  substantial factor in bringing about the individual's disease or
  illness, without which the disease or illness would not have
  occurred.
         (d)  A rebuttal offered under this section to a presumption
  under Section 607.0545 may not be based solely on evidence relating
  to the risk of exposure to severe acute respiratory syndrome
  coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19)
  of a person with whom a detention officer, custodial officer,
  firefighter, peace officer, or emergency medical technician
  resides. This subsection expires September 1, 20232027.
         SECTION 8.  Subchapter A, Chapter 409, Labor Code, is
  amended by adding Section 409.0092 to read as follows:
         Sec. 409.0092.  HEALTH CARE REIMBURSEMENT PROCEDURES FOR
  CERTAIN INJURED EMPLOYEES. (a)  An injured employee who is subject
  to Section 607.0545, Government Code, and whose claim for benefits
  is determined to be compensable by an insurance carrier or the
  division, may request reimbursement for health care paid by the
  employee, including copayments and partial payments, by submitting
  to the carrier a legible written request and documentation showing
  the amounts paid to the health care provider.
         (b)  Not later than the 45th day after the date an injured
  employee submits a request for reimbursement for health care to an
  insurance carrier under Subsection (a), the carrier shall provide
  reimbursement or deny the request.
         (c)  If an insurance carrier denies an injured employee's
  request for reimbursement for health care, the employee may seek
  medical dispute resolution as provided by Chapter 413 and division
  rules. Notwithstanding any other law, an employee's request for
  medical dispute resolution is considered timely if the employee
  submits the request not later than the 120th day after the date the
  carrier denies the employee's request for reimbursement.
         (d)  This section expires September 1, 20232027.
         SECTION 9.  Section 409.022(d), Labor Code, is amended to
  read as follows:
         (d)  In this subsection, the terms "custodial officer,"
  "detention officer," "emergency medical technician,"
  "firefighter," and "peace officer" have the meanings assigned by
  Section 607.051, Government Code. In addition to the other
  requirements of this section, if an insurance carrier's notice of
  refusal to pay benefits under Section 409.021 is sent in response to
  a claim for compensation resulting from a custodial officer's, a
  detention officer's, an emergency medical technician's, a
  firefighter's, or a peace officer's disability or death for which a
  presumption is claimed to be applicable under Subchapter B, Chapter
  607, Government Code, the notice must include a statement by the
  carrier that:
               (1)  explains why the carrier determined a presumption
  under that subchapter does not apply to the claim for compensation;
  and
               (2)  describes the evidence that the carrier reviewed
  in making the determination described by Subdivision (1).
         SECTION 10.  (a) The changes in law made by this Act apply to
  a claim for benefits pending on or filed on or after the effective
  date of this Act. A claim for benefits filed before that date is
  covered by the law in effect on the date the claim was made, and that
  law is continued in effect for that purpose.
         (b)  Notwithstanding any other law, a person subject to
  Section 607.0545, Government Code, as added by this Act, who on or
  after the date the governor declared a disaster under Chapter 418,
  Government Code, relating to SARS-CoV-2, coronavirus disease 2019
  (COVID-19), but before the effective date of this Act, contracted
  SARS-CoV-2, coronavirus disease 2019 (COVID-19), may file a claim
  for benefits related to SARS-CoV-2, coronavirus disease 2019
  (COVID-19), on or after the effective date of this Act, regardless
  of whether that claim is otherwise considered untimely and the
  changes in law made by this Act apply to that claim. A claim
  authorized under this subsection must be filed not later than six
  months after the effective date of this Act.
         (c)  Notwithstanding Subsection (a) of this section or
  Section 409.003, 409.007, 410.169, or 410.205, Labor Code, a person
  subject to Section 607.0545, Government Code, as added by this Act,
  who on or after the date the governor declared a disaster under
  Chapter 418, Government Code, relating to SARS-CoV-2, coronavirus
  disease 2019 (COVID-19), but before the effective date of this Act,
  filed a claim for benefits related to SARS-CoV-2, coronavirus
  disease 2019 (COVID-19), and whose claim was subsequently denied
  may, on or after the effective date of this Act, request in writing
  that the insurance carrier reprocess the claim and the changes in
  law made by this Act shall apply to that claim. A request to
  reprocess a claim as authorized by this subsection shall be filed
  not later than one year after the effective date of this Act.
         (d)  Not later than the 60th day after the date an insurance
  carrier receives a written request to reprocess a claim under
  Subsection (c) of this section, the insurance carrier shall
  reprocess the claim and notify the person in writing whether the
  carrier accepted or denied the claim. If the insurance carrier
  denies the claim, the notice must include information on the
  process for disputing the denial.  The notice provided by the
  insurance carrier must use the notice provisions prescribed by the
  division of workers' compensation of the Texas Department of
  Insurance under Subsection (e) of this section.
         (e)  As soon as practicable after the effective date of this
  Act, the division of workers' compensation of the Texas Department
  of Insurance shall prescribe notice provisions for an insurance
  carrier to use when providing notice of the insurance carrier's
  acceptance or denial of a person's claim. The notice provisions
  must be clear and easily understandable.
         SECTION 11.  This Act takes effect immediately if it
  receives a vote of two-thirds of all the members elected to each
  house, as provided by Section 39, Article III, Texas Constitution.
  If this Act does not receive the vote necessary for immediate
  effect, this Act takes effect September 1, 2023.