Texas Division of Insurance promotes 2 Steps to resolve worker’s comp disputes

(Austin, TX – Insurance News and Markets) – A pilot program has launched through the Texas Division of Workers’ Compensation that is designed to simplify and speed up the resolution of some workers’ compensation disputes. The program started last year and splits related claim issues. This allows a hearing officer to decide the most far-reaching issue first. This can clear the way for secondary issues to be resolved sooner. So far, about half of the disputes accepted for the program have had a hearing, and a third of those have resulted in full agreement to resolve the dispute.

“The division has a number of tools in its toolkit to manage claims disputes,” said Workers’ Compensation Commissioner Ryan Brannan. “The two-step approach to deciding some of the most complex issues in a dispute can be a good option for system participants in certain 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.

“It can be very challenging to come into a hearing and know there are so many alternatives for the hearing officer to address,” said Kerry Sullivan, Deputy Commissioner for Hearings

Parties in a dispute may base their recommendations for 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, parties often request more time to adjust those recommendations.

The program is voluntary. 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 two-step program started at the division’s Weslaco office in May 2015 and soon was expanded to Dallas. It’s now available at all 20 offices statewide.

Source: Texas Department of Insurance.