Texas Benefit Review Conference Exchanges

On October 1, 2010, the new rules for BRC exchanges take effect. We recommend that you develop work flow processes to assure that you meet the time sensitive deadlines. You also need to train whomever is going to perform the evidence exchange on what information is considered “pertinent”...

Texas: Potential Violations for Failure to Timely Exchange Evidence Prior to a Benefit Review Conference

The new BRC rules for exchange of evidence went into effect on October 1, 2010. As provided in Advisory 10-27, dated September 24, 2010, Downs Stanford provided information concerning the new schedule of required exchanges of relevant documents preceding a Benefit Review Conference. As reported in the...

Texas: Performance Based Oversight Committee Update

By Stuart D. Colburn, Esq., Shareholder, Downs Stanford The Division of Workers’ Compensation (DWC) is holding stakeholder meetings regarding Performance Based Oversight (PBO). The Division is seeking stakeholder input to add additional measures. Currently, the Division measures carriers on...

Texas: Performance Based Oversight Committee Update

By Stuart D. Colburn, Esq., Shareholder, Downs Stanford The Division of Workers’ Compensation (DWC) is holding stakeholder meetings regarding Performance Based Oversight (PBO). The Division is seeking stakeholder input to add additional measures. Currently, the Division measures carriers on four...

Texas: SORM v Rodriguez 08-10-00278

By Stuart D. Colburn, Esq., Shareholder, Downs Stanford This case addresses when a DWC-69 is required after a change in an impairment rating (IR) due to a mathematical error. State Office of Risk Mgmt. v. Rodriguez , 2011 Tex. App. LEXIS 6839 (Tex. App. El Paso Aug. 26, 2011) . The Appeals Panel...

Texas: SORM v Rodriguez 08-10-00278

By Stuart D. Colburn, Esq., Shareholder, Downs Stanford This case addresses when a DWC-69 is required after a change in an impairment rating (IR) due to a mathematical error. State Office of Risk Mgmt. v. Rodriguez , 2011 Tex. App. LEXIS 6839 (Tex. App. El Paso Aug. 26, 2011) . The Appeals Panel...

Texas Case Management

By Stuart D. Colburn, Esq., Shareholder, Downs Stanford The preamble to New Rule 137.5 is causing a controversy and perhaps a significant increase in costs to employers and carriers. Tex. Lab. Code Sec. 413.021(a) , states: "The insurance carrier shall evaluate a compensable injury in which...

Texas Case Management

By Stuart D. Colburn, Esq., Shareholder, Downs Stanford The preamble to New Rule 137.5 is causing a controversy and perhaps a significant increase in costs to employers and carriers. Tex. Lab. Code Sec. 413.021(a) , states: "The insurance carrier shall evaluate a compensable injury in which...

Texas Performance Based Oversight (11/2/2011)

The Division is evaluating the current criteria Performance Based Oversight (PBO) committee meetings and seeking additional measures. The Division is also accepting input on the weights given to the various measures, a re-assessment opportunity, procedure to challenge or provide additional evidence regarding...

Texas: TPCIGNA v Brooks 03-10-00428

By Stuart D. Colburn, Esq., Shareholder, Downs Stanford This case concerns application of the TX Supreme Court's decision in Leordeanu v. American Protection Ins. Co., 330 S.W.3d 239 (Tex 2010) . The claimant in Tex. Prop. & Cas. Ins. Guar. Ass'n v. Brooks, 2011 Tex. App. LEXIS...

Texas: Performance Based Oversight (12/23/11 Update)

Beginning January 1, 2012, the Division of Workers’ Compensation (DWC) will begin its six month collection of data to assess insurance carriers for Performance Based Oversight (PBO). The PBO period will last until June 30, 2011. The PBO measures are as follows: Timely Initial Payment of Benefits...