HBA-ATS H.B. 2513 76(R)    BILL ANALYSIS


Office of House Bill AnalysisH.B. 2513
By: Ritter
Business & Industry
3/11/1999
Introduced



BACKGROUND AND PURPOSE 

This bill addresses several issues related to the treatment of injured
employees and their return to work. 

Currently, an insurance carrier may provide vocational rehabilitation
services to an injured worker through a private or carrier-sponsored
vocational case managers.  The law does not regulate private or
carrier-sponsored vocational rehabilitation case managers who participate
in an injured worker's case.  H.B. 2513 authorizes the Texas Workers'
Compensation Commission (commission) to require that private providers of
rehabilitation services maintain certain credentials and qualifications in
order to participate in workers' compensation insurance claims. 

Currently, when injured employees apply for supplemental income benefits,
the commission refers them to the Texas Rehabilitation Commission (TRC) if
the worker could benefit from vocational rehabilitation services.  However,
because of TRC's limited resources, many injured workers have reported that
TRC was unable to assist them.  Although these workers have been identified
as likely candidates for vocational rehabilitation, the commission is not
required to notify the insurance carrier of the injured worker's need in
the event that the carrier would be willing to provide vocational
rehabilitation services.  H.B. 2513 requires the commission to notify an
insurance carrier of the need for vocational rehabilitation or training
services in the event that the carrier chooses to provide services through
a private provider of vocational rehabilitation services. 

Current law requires the commission to periodically review the medical care
provided to injured employees whose claims have exceeded "lost-time
guidelines."  These guidelines were intended to help identify workers who
were not making progress in returning to work or workers who needed
additional attention or assistance.  Although the commission has gathered a
great deal of information as a basis for these guidelines, a draft proposal
has not yet been presented to the commission for consideration because of
some confusion as to what the term "lost-time guidelines" really means.
H.B. 2513 replaces lost-time or other appropriate guidelines with
guidelines for expected or average return to work time frame as the
guidelines that are used to determine whether the medical care provided to
an injured employee exceeded the recovery time expected. 

The commission routinely provides outreach assistance to employers seeking
health and safety information.  This outreach comes in many forms,
including booklets, videos, training sessions and on-site assessments.
Information to assist employers in creating written return-to-work or
modified duty programs has never been part of the commission's outreach
efforts.  Several research studies, including some conducted by the
Research and Oversight Council on Workers' Compensation, have shown that
employers have a great influence on whether injured employees are able to
successfully return to work after an injury.  Workers are more likely to
return to work if their employers have a modified duty or job retraining
program or other return-to-work program in place. An effective
return-to-work program minimizes lost time and lowers medical and indemnity
costs, which result in lower premiums.  H.B. 2513 requires the commission,
by January 1, 2000, to implement a program to encourage employers and
treating doctors to discuss the availability of modified duty to encourage
safe and timely return-to-work for injured employees.  This bill also
requires the commission, through its health and safety information and
medical review outreach programs, to provide information to employers
regarding effective return-to-work programs. 


 Before an injured worker is able to return to work in either a full or
modified duty capacity, a functional capacity exam is typically performed
to determine the ability of the injured worker to perform the physical
aspects of the job.  Without good communication between the employer and
the injured worker's treating doctor, it is difficult for an employer with
a progressive return-to-work program to initiate this exam and provide a
modified duty assignment for the injured worker.  H.B. 2513 authorizes the
commission to require a treating or examining doctor to perform an
evaluation and report on the injured employee's functional capacity upon
the request of the employer, insurance carrier, or the commission. 
       
RULEMAKING AUTHORITY

It is the opinion of the Office of House Bill Analysis that rulemaking
authority is expressly delegated to the Texas Workers' Compensation
Commission in SECTION 1 (Section 409.012, Labor Code) and SECTION 3
(Section 413.018, Labor Code) of this bill. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Section 409.012, Labor Code, by adding Subsection (e),
to authorize the Texas Workers' Compensation Commission (commission) to
require that private providers of rehabilitation services maintain certain
credentials and qualifications in order to participate in workers'
compensation insurance claims.  Authorizes the commission to adopt rules to
implement this section. 

SECTION 2.  Amends Section 408.150, Labor Code, as follows:

(a) Adds a provision requiring the commission to notify an insurance
carrier of the need for vocational rehabilitation or training services in
the event that the carrier chooses to provide services through a private
provider of vocational rehabilitation services under Section 409.012
(Vocational Rehabilitation Information) of this title. 

(b) Adds references to the Texas Rehabilitation Commission and a private
provider to provides that an employee who refuses services or refuses to
cooperate with services by the Texas Rehabilitation Commission or a private
provider under this section loses entitlement to supplemental income
benefits.  Makes a nonsubstantive change. 

SECTION 3.  Amends Section 413.018, Labor Code, as follows:

(a) Replaces lost-time or other appropriate guidelines with guidelines for
expected or average return to work time frame as the guidelines that are
used to determine whether the medical care provided to an injured employee
exceeded the recovery time expected. 

(c) Adds this subsection to require the commission, by January 1, 2000, to
implement a program to encourage employers and treating doctors to discuss
the availability of modified duty to encourage safe and more timely
return-to-work for injured employees.  Authorizes the commission to require
a treating or examining doctor to perform an evaluation and report on the
injured employee's functional capacity upon the request of the employer,
insurance carrier, or the commission.  Defines a "functional capacity
evaluation" for purposes of this section. 

(d) Adds this subsection to require the commission, through its health and
safety information and medical review outreach programs, to provide
information to employers regarding effective return-to-work programs.
Provides that nothing in this section requires an employer to provide
modified duty or for the employee to accept a modified duty assignment;
however, an employee may lose eligibility for income benefits if the
commission determines that the employer made a bona fide job offer under
Section 408.103(e) (Amount of Temporary Income Benefits) and that offer was
not accepted by the employee. 


(e) Adds this subsection to authorize the commission to adopt rules and
reporting forms to implement this section. 
 
SECTION 4.  Effective date: September 1, 1999.

SECTION 5.  Emergency clause.