Texas Workers Compensation Reform

December 7th, 2005 by Julie Ferguson

After our recent post on Missouri, one of our regular readers asked for a summary of reform provisions in the Texas law enacted in June. Here’s what we came up with – we invite Texas readers to add any comments and clarifications – we’d welcome the input!

  • TWCC was eliminated; workers compensation is now managed by the TX Department of Insurance through the Division of Workers Compensation (DWC). The intent is to streamline & reduce bureaucracy.
  • Office of Injured Employee Counsel (OIEC) is formed to advocate for and help injured workers.
  • Employers can designate a medical provider network (MPN) which employees will be required to use for workers compensation medical care. This is optional, employers can choose a network or not. This is a major new provision, rather complex, and still in the works since rules were to be adopted by Dec. 1, 2005. Essentially, networks will designate treating doctors, and injured workers must choose a treating doctor from the network list. For several years, the number of docs in the system had been decreasing, and the hopes are that these changes will help attract more quality MDs back into the system, and afford employers more control; the employee still has choice, but for those employers with certified networks, the employee must choose a doctor in the network. (However, they can redirect for a second visit).
  • Employee benefits will increase after 10/1/06 (according to AON, by about 15%) and the waiting period for payment of Temporary Income Benefits is reduced from 4 to 2 weeks.
  • Exclusive remedy is bolstered to encompass some claims that were previously denied, such as horseplay. While these were meant to exclude employees who were at fault, the end result was that denied employees were free to sue for damages.
  • A fee schedule for prescription drugs has been added.
  • The Supplemental Income Benefits eligibility has been tightened in terms of work-search requirements
  • The Hazardous Employer Program will be eliminated. This was a program that identified employers with injury rates substantially higher than those anticipated for their industries. Once identified as Hazardous, these employers were mandated to hire a consultant approved by the Division.

Texas Department of Insurance page on the new law
Key provisions and frequently asked questions about the new law broken into separate sections for employees, for employers, for health care providers, and for insurers; also, House Bill 7 Frequently Asked Questions for Employers and Insurance Carriers.
Changes in Texas Workers� Compensation (pdf)
An excellent summary and analysis of the changes by AON, September 2005.
Texas Enacts Workers� Compensation Reform Featuring MPNs, Administrative Reforms
A brief summary of the reform by Sedgwick June 3, 2005.
Texas Workers� Compensation 2005 Reform (HB7) Overview (pdf)
A brief summary of the changes in the law by St Paul Travelers.
Texas Reforms Its Workers’ Compensation System
Summary of the new law by law firm Littler Mendelson.
The complete text of the law
The text shows additions and deletions from the prior law.