Articles By Bob Gorsky CHANGES TO TEXAS WORKERS’ COMPENSATION LAW Effective September 1, 2005, the Texas Workers’ Compensation System underwent some significant changes. The Texas Workers’ Compensation Commission no longer exists and the Division of Workers’ Compensation (“DWC”), under the Texas Department of Insurance, will oversee the system. The new system includes mandatory use of health care networks similar to an HMO system. Under the previous system, an injured worker could choose his or her doctor but now, health care networks, certified by the state, must be used when the employee chooses a network plan and the injured employee lives within a network server area. If the employee does not live within a network server area, he or she may choose a doctor, but the doctor will come from a list approved by the DWC. An employee who lives in a network’s service area and who sustained a compensable injury before September 1, 2005 must receive medical treatment through a network provider if the insurance carrier liable for that care elects to use a workers’ compensation network to provide medical benefits to injured employees. If your treating doctor has contracted with your insurance carrier’s network, you may not have to change doctors. According to the Texas Department of Insurance website (see “frequently asked questions for employees”), if your treating doctor is not a part of the insurance carrier’s network, you may have to change to a treating doctor within the network. An injured worker covered under an HMO plan may also use the available HMO plan under certain circumstances. While weekly benefits will rise, the new system seems to be geared towards lowering employer costs with a focus of returning an employee to work. The previous system brought us many problems in choosing a doctor and the approval of medical care. The new system may ease some of those concerns; however, I am fearful that reliance on health care networks will result in the decline of personal medical service and perhaps the quality of service. A moderate increase in weekly benefits (perhaps 15%) is not so much a concern for DPD employees who have wage supplementation and a greater likelihood of accumulated sick time as perhaps some in the private sector. As with any bureaucratic change, we’ll see some things improve but don’t be surprised if some new problems appear on the horizon. For more information on the new workers’ compensation system, go to www.tdi.state.tx.us. _____________________________________________________________ DALLAS APPEALS COURT RULES IN FAVOR OF POLICE AND FIRE EXECUTIVES…. A Dallas Appeals Court has refused to rehear its previous ruling upholding a decision in favor of the police and fire executives who were denied the 5% pay raise in 2002. Unless the case is appealed to the Texas Supreme Court, it will return to the trial court for further proceedings. _____________________________________________________________ BOLTON LOSES LAWSUIT…… A federal judge has dismissed Terrell Bolton’s wrongful termination lawsuit. The judge ruled that Bolton did not have a “property interest” in his job. Ironically, the court cited language in the appeals court decision that went against former Deputy Chief Willie Taylor and former Assistant Chief Robert Jackson. I was surprised at this ruling as I have previously written that I believe Bolton would be successful. I am told that he is going to appeal this ruling. ______________________________________________________________ Bob Gorsky is a partner at the Dallas law firm of Lyon, Gorsky, Haring & Gilbert, L.L.P., 2501 Cedar Springs, Suite 750, Dallas, Texas 75201; (214) 965-0090, website: lyongorsky.com or e-mail Bob at: bgorsky@swbell.net. |