After a successful pilot project, the Texas Division of Workers’ Compensation rolled out a statewide program in October 2016 that has helped speed up the resolution of some disputes.
The program splits up related claim issues so that a hearing officer can decide the most far-reaching issue first. This can clear the way for secondary issues to be resolved sooner. In the pilot program, the approach helped speed resolution of many workers’ compensation disputes.
“We’re always looking for ways to stay on the cutting edge of workers’ compensation, and this process is a great example of finding a way to improve efficiency in the system,” said Workers’ Compensation Commissioner Ryan Brannan. “From what we’ve seen in the pilot project and in the statewide roll-out, the two-step approach to deciding some of the most complex issues in a dispute is a good option for system participants in many cases.”
When an injured employee has a dispute about a claim, it often involves three issues: extent of the injury, the date that the employee reached maximum medical improvement and the impairment rating for the injury.
According to Deputy Commissioner for Hearings Kerry Sullivan, even though extent of injury is a “threshold issue” that can affect the other issues, it’s often addressed at the same time as the other issues in the dispute process.
“It can be challenging to come into a hearing and know there are so many alternatives for the hearing officer to address,” Sullivan said.
Parties in a dispute may base their arguments about impairment ratings and dates of maximum medical improvement on what they think the extent of injury should be. If the hearing officer decides a different extent of injury, then parties will often have to request more time to adjust those recommendations.
The new two-step program is voluntary, and the existing system is still used in many cases. The option to participate is presented by the presiding officer at the initial benefit review conference for cases that may benefit from the approach. The two-step approach is used only if both parties agree to it.
“The presiding officer usually knows going into the dispute whether a decision on extent of injury will move things along,” Sullivan said. “Deciding the extent of injury issue first can lead to a better outcome, a more efficient hearing, and more agreements. We’re pleased it’s been working out so well.”
The two-step program started at DWC’s Weslaco office in May 2015 and soon was expanded to Dallas. It’s now available at all 20 offices statewide.
Further information on the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
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