Texas Will Change Workers’ Comp Disability Management Requirements

June 13, 2007

The Texas Department of Insurance announced that a workers’ compensation rule to require treatment planning for injured employees (28 Texas Administrative Code ยง137.300) will be repealed. This rule was adopted along with other disability management rules in December 2006. The effective date for treatment planning was postponed until Sept. 1, 2007, however, as the agency attempted to address ongoing concerns from system participants.

A repeal of the treatment planning rule will be submitted to the Texas Register. Since the rule has not become effective, system participants will not be required to meet the rule’s requirements.

“System participants support the concept of treatment planning, but many also agree that implementation will require significant business and administrative process changes,” Commissioner of Workers’ Compensation Albert Betts said. “We were concerned that participants would not be able to initiate treatment planning without some lapses in care for injured employees.”

Dr. Howard Smith, Medical Advisor for TDI’s Division of Workers’ Compensation, said TDI plans to work with health care providers and insurance carriers on a treatment planning pilot program.

“This treatment planning pilot will allow us to identify opportunities for improved communication and efficient delivery of appropriate medical care,” Smith said.

Since publication of the adopted disability management rules, system participants expressed the need for additional time to establish processes to appropriately address required treatment planning. Participants also argued for additional time to communicate and develop treatment planning parameters that are mutually acceptable to health care providers and insurance carriers.

Disability management rules requiring the use of workers’ compensation treatment guidelines and return-to-work guidelines became effective May 1, 2007, and will remain in effect.

Source: TDI

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