In addition to its impact on Texans and their property, Hurricane Harvey has also had an impact on infrastructure and benefits programs, like workers’ compensation.
Gov. Greg Abbott’s disaster proclamation directs that all necessary measures, both public and private, as authorized under Section 418.017 of the Texas Government Code, be implemented to meet that threat. To meet the governor’s directive, the Texas Department of Insurance (TDI) has issued Bulletin # B-0020-17 for all insurance companies writing workers’ compensation and employers’ liability insurance in Texas, their agents and representatives, and anyone “participating” in the workers’ compensation system.
For the duration of the governor’s disaster proclamation, in regard to any claims involving workers’ compensation claimants residing in a county included in the latest proclamation, insurance carriers must provide or continue to do the following:
Process and deliver benefit checks and necessary medical care, services, and supplies, including physical therapy, pharmaceutical benefits, and medical equipment;
Waive penalties and restrictions related to necessary emergency and non-emergency health care provided out-of-network;
Cover payments for necessary emergency and non-emergency health care services obtained out-of-network;
Extend deadlines for medical examinations;
Authorize payment to pharmacies for up to a 90-day supply of any prescription medication, subject to the remaining number of days authorized by the prescribing provider, for individuals regardless of the date upon which the prescription had most recently been filled; and
Expedite change-of-address processing.
Deadlines on hold for participants
For system participants who reside in the counties listed in the proclamation, the Texas workers’ compensation deadlines for the following procedures are on hold through the duration of the disaster:
Workers’ compensation claim notification and filing deadlines;
Medical billing deadlines;
Medical and income benefit payment deadlines;
Electronic data reporting deadlines; and
Medical and income benefit dispute deadlines.
The Department of Workers’ Compensation (DWC) is also concerned about protecting the first responders who are helping with rescue and recovery efforts. According to the DWC, Section 504.055 of the Texas Labor Code states that both DWC and political subdivisions shall accelerate and give first priority to an injured first responder’s claim for workers’ compensation medical benefits if that first responder sustains a serious bodily injury in the course and scope of employment. For any first responder hurt on the job, the Office of Injured Employee Counsel has a designated First Responder Liaison, Yolanda Garcia, who can be reached at 512-804-4173 or FirstResponderHelp@oiec.texas.gov.
If you have access to a telephone and need help or more information, the DWC directs you to these key contact numbers:
To reschedule a benefit review conference or a contested case hearing, call DWC’s local field office or, if the office is not available, 1-800-252-7031.
For questions related to workers’ compensation health care networks, call 866-554-4926 or 512-676-6400, Option # 7 or contact firstname.lastname@example.org.
For other questions related to the disaster, call the Workers’ Compensation Injured Employee Hotline at 1-800-252–7031.
BY ROSALIE L. DONLON, PROPERTYCASUALTY360.COM