HBA-ATS H.B. 1826 76(R)    BILL ANALYSIS


Office of House Bill AnalysisH.B. 1826
By: Hochberg
Business & Industry
3/10/1999
Introduced



BACKGROUND AND PURPOSE 

Under the Texas Workers' Compensation Act (Act), an employee injured at
work may be entitled to receive lifetime medical coverage, temporary
benefits replacing a substantial part of lost wages during convalescence,
impairment benefits, and long-term wage replacement if the employee
suffers moderately severe impairments.  For permanent injuries, income
benefits are allocated using the following two-step formula.  First,
impairment benefits are awarded in direct proportion to the extent of
impairment, without regard to the actual wage loss.  Second, supplemental
income benefits are awarded based on wage loss, if the extent of impairment
equals or exceeds 15 percent.  To keep receiving supplemental benefits, an
injured employee must file a statement quarterly with the employee's
insurance carrier specifying that the employee has earned less than 80
percent of the employee's average weekly wage as a direct result of the
employee's impairment, and that the employee has in good faith sought
employment commensurate with the employee's ability to work. 
Failure to file a statement relieves the insurance carrier of liability for
supplemental income benefits for the period during which a statement is not
filed. 

In addition to the requirements found in the Labor Code, some insurance
carriers require an injured employee to undergo a medical examination each
time the employee files the statement, even when the employee's condition
is not likely to have improved since the last examination.  H.B. 1826
authorizes an injured employee who has received supplemental income
benefits for two years to file a statement annually, rather than quarterly,
if the injured employee's condition has not improved during the last year
of the two-year period.  This bill also prohibits an insurance carrier from
requiring an employee who has received benefits for two years to submit to
a medical examination more than annually if the injured employee's
condition has not improved during the preceding year. 

RULEMAKING AUTHORITY

It is the opinion of the Office of House Bill Analysis that this bill does
not expressly delegate any additional rulemaking authority to a state
officer, department, agency, or institution. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Section 408.143, Labor Code, to provide an exception to
the general rule that an injured employee must file a statement quarterly
with the employee's insurance carrier after the Texas Workers' Compensation
Commission (commission) initially awards supplemental income benefits
(benefits).  The exception authorizes an employee, on or after the second
anniversary of the date the commission initially awards benefits, to file
an annual report if the employee has shown no improvement during the
one-year period preceding the date of the report.  Makes  conforming
changes. 

SECTION 2.  Amends Subchapter H, Chapter 408, Labor Code, by adding Section
408.151, as follows: 

Sec. 408.151.  MEDICAL EXAMINATIONS FOR SUPPLEMENTAL INCOME BENEFITS.  (a)
Prohibits an insurance carrier,  on or after the second anniversary of the
date the commission initially awards benefits, from requiring an employee
who is receiving benefits to submit to a medical examination more than
annually if the injured employee's condition has not improved during the
preceding year. 
 
(b) Provides that this section does not apply to a medical examination
required by the commission under Section 408.004 (Required Medical
Examinations; Administrative Violation). 

SECTION 3.  Effective date: September 1, 1999.
            Makes application of this Act prospective.

SECTION 4.  Emergency clause.