TITLE 28.INSURANCE

Part 2. TEXAS WORKERS' COMPENSATION COMMISSION

Chapter 102. PRACTICE AND PROCEDURES--GENERAL PROVISIONS

28 TAC §102.10

The Texas Workers' Compensation Commission (the commission) adopts new §102.10 (Interest, General) without changes to the text as published in the September 15, 2000, issue of the Texas Register (25 TexReg 9180).

As required by the Texas Government Code §2001.033(1), the commission's reasoned justification for this rule is set out in this order which includes the preamble, which in turn includes the rule. This preamble contains a summary of the factual basis of the rule, a summary of comments received from interested parties, names of those groups and associations who commented and whether they were for or against adoption of the rule, and the reasons why the commission disagrees with some of the comments and proposals.

This rule remains unchanged from the proposal as published in the Texas Register after taking into consideration public comment received in writing and at a public hearing held on August 31, 2000, described in the summary of comments and responses section of this preamble.

The new rule is adopted to clarify the application of simple interest on accrued but unpaid benefits except where compounded interest is specifically provided for by statute or rule.

New §102.10 is added to clarify the method to be used when calculating interest required on workers' compensation benefits under the Texas Workers' Compensation Act (the Act). (The new rule does not address other references to interest in the Act and recognizes that there are laws outside the Act, which may affect the payment of interest.) The fact that there is a specific statutory provision for compound interest in some parts of the Act and commission rules (for instance, for payments to the subsequent injury fund, see Texas Labor Code §403.007(b) and 28 T.A.C. §132.10(f)), and not in others, indicates the legislature intended to require compound interest only where specifically provided. The interpretation of simple interest whenever the term interest appears with respect to interest due on workers' compensation benefits, is consistent with Johnson & Higgins of Texas v. Kenneco Energy, 962 S.W.2d 507, 533 (Tex. 1998), which called for uniformity in the law holding that prejudgment interest is to be computed as simple interest .

Commission Advisory 93-07 (Interest/Discount Rates Applicable to Commission Orders for Income Benefits) addressed interest on accrued income or death benefits and may have been misinterpreted by some to say that compound interest was to be applied to all commission orders. Subsequent Appeals Panel decisions have clarified that compound interest is limited to commuted death benefits paid to the Subsequent Injury Fund. It is understood that the possibility exists that this advisory may have been misconstrued to read that the application of compounded interest was to be applied to all benefits. However, the paragraph which addresses the application of compounded interest directly followed and addressed commuted death benefits paid to the Subsequent Injury Fund referred to in the preceding paragraph, and is limited to that situation. This limited application of the third paragraph of the advisory has further been supported by commission Appeals Panel decisions. The purpose of this rule is for clarification of the statute and commission rules.

By simple interest the proposal refers to interest computed for each interest period on the same amount of principle each period, regardless of any interest accrued in the past.

One comment suggesting changes to proposed §102.10 was received from an individual. A summary of the comment and commission's response is as follows:

COMMENT: Commentor suggested that when the law does not specify the type of interest to be paid, then the presiding officer at the Benefit Review Conference or Contested Case Hearing should make the decision. The commentor felt this would provide a deterrent when carriers deny claims without justification. Commenter also felt that the simple interest provision in the rule as proposed provides minimal consequences for denying benefits to injured employees.

RESPONSE: The Commission disagrees. The intent of this rule is to provide a uniform interpretation to the term interest . The award of interest is to compensate for the loss of use of money which should have been paid. Although the requirement to pay interest may act as a deterrent to withholding money which is owed, that is not its primary purpose. Administrative penalties may be imposed as a result of violation of the Act or commission rules. These penalties are structured to deter and punish violations. The commission's interpretation of the Act is that it requires use of simple interest on payment of interest due on workers' compensation benefits, unless the Act explicitly provides for compounded interest. The rule as proposed follows that legislative intent; the commentor's suggestion would be contrary to that legislative intent.

The new rule is adopted pursuant to the Texas Labor Code §402.061 which requires the commission to adopt rules necessary for the implementation and enforcement of the Texas Workers Compensation Act; Texas Labor Code §403.007, which provides for the insurance carrier to commute payments to the subsequent injury fund at the rate established in §401.023, compounded annually; Texas Labor Code §408.064, which directs interest to be paid on income or death benefits pursuant to an order; Texas Labor Code §408.081, which provides that the carrier must pay interest on accrued but unpaid income benefits; Texas Labor Code §408.147, which provides for the contest of an employee's entitlement to supplemental income benefits by an insurance carrier; Texas Labor Code §410.208, which provides for interest on benefits recovered by a judgment; Texas Labor Code §413.019, which directs that interest be paid on late payments, refunds, or overpayments; and Texas Labor Code §415.008, which directs that interest be paid on benefits fraudulently obtained or denied.

The new rule is adopted pursuant to the Texas Labor Code §§402.061, 402.061, 403.007, 401.023, 408.064, 408.081, 408.147, 410.208, 413.019, 415.008.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on February 22, 2001.

TRD-200101091

Susan Cory

General Counsel

Texas Workers' Compensation Commission

Effective date: March 14, 2001

Proposal publication date: September 15, 2000

For further information, please call: (512) 804-4286


Chapter 143. DISPUTE RESOLUTION REVIEW BY THE APPEALS PANEL

28 TAC §143.3, §143.4

The Texas Workers' Compensation Commission (the commission) adopts amendments to §143.3 (relating to Requesting the Appeals Panel to Review the Decision of the Hearing Officer) and §143.4 (relating to Responding to a Request for Review by the Appeals Panel) without changes to the proposed text published in the November 3, 2000, issue of the Texas Register (25 TexReg 10877) and will not be republished.

As required by the Government Code §2001.033(1), the commission's reasoned justification for this rule is set out in this order which includes the preamble, which in turn includes the rule. This preamble contains a summary of the factual basis of the rule, a summary of comments received from interested parties, names of those groups and associations who commented and whether they were for or against adoption of the rule, and the reasons why the commission disagrees with some of the comments and proposals.

Section 143.3(b) and §143.4(b) establish the format for the statement certifying that a copy of the request for the Appeals Panel to review a decision (§143.3) has been served on the other party and the statement certifying that a copy of the response to the request (§143.4) has been served on the appellant.

The format for the certification of service date under §143.3(b) and §143.4(b) has been amended by replacing "19___" with "_____" for use in years on or after January 1, 2000.

One comment proposing further amendments to §143.3 and §143.4 was received from Hermes Sargent Bates, L.L.P. A summary of the comment and commission response follows:

COMMENT: Section 143.3 and §143.4 should be amended to permit, but not require, parties to submit the request for review and the response to the request for review via email and/or fax to the Appeals Panel clerk. This is consistent with Texas Labor Code Annotated §401.021, where the Legislature clearly intends for TWCC to reduce its paper. The date that an emailed or faxed document is received can be actually determined.

RESPONSE: The Commission disagrees. The suggested amendment is outside the scope of this proposed change. Labor Code §401.024 and commission rule 102.5 govern use of electronic transmission for filings with the commission.

The amendment is adopted under the Texas Labor Code §402.061, which authorizes the commission to adopt rules necessary to administer the Act, Texas Labor Code, §410.004, which gives the division of hearings the authority to conduct benefit review conferences, contested case hearings, arbitration, and appeals within the commission related to workers' compensation claims, Texas Labor Code, §410.202, which provides that a party shall file a written request for appeal with the appeals panel and that a respondent shall file a written response with the appeals panel and establishes the time periods for these filings, and Texas Labor Code, §410.204, which provides that the appeals panel shall issue a decision not later than the 30th day after the date on which the written response to the request for appeal is filed.

The amendment is adopted under the Texas Labor Code §§402.061, 410.004, 410.202, and 410.204.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on February 22, 2001.

TRD-200101096

Susan Cory

General Counsel

Texas Workers' Compensation Commission

Effective date: March 14, 2001

Proposal publication date: November 3, 2000

For further information, please call: (512) 804-4287


Chapter 144. DISPUTE RESOLUTION

Subchapter A. ARBITRATION

28 TAC §144.3

The Texas Workers' Compensation Commission (the commission) adopts an amendment to §144.3 (relating to Delivery of Copies of Documents), without changes to the proposed text published in the November 3, 2000, issue of the Texas Register (25 TexReg 10879) and will not be republished.

As required by the Government Code §2001.033(1), the commission's reasoned justification for this rule is set out in this order which includes the preamble, which in turn includes the rule. This preamble contains a summary of the factual basis of the rule.

Section 144.3 establishes that a party who sends a document to the commission or the arbitrator and the other parties shall include a statement certifying delivery. The format for the certification of service date under §144.3, has been amended by replacing "19___" with "_____" for use in years on or after January 1, 2000.

No comments were received regarding the proposed amendment.

The amendment is adopted under the Texas Labor Code Annotated §402.061, which authorizes the commission to adopt rules necessary to administer the Act, and Texas Labor Code §410.112, Exchange and Filing of Information; Administrative Violation, which states that a party to the arbitration proceeding must timely file an exchange with the Arbitrator, or be subject to an administrative violation for failure to comply with this subsection.

The amendment is adopted under the Texas Labor Code §402.061 and §410.112.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on February 22, 2001.

TRD-200101097

Susan Cory

General Counsel

Texas Workers' Compensation Commission

Effective date: March 14, 2001

Proposal publication date: November 3, 2000

For further information, please call: (512) 804-4287


Chapter 164. HAZARDOUS EMPLOYER PROGRAM

28 TAC §§164.1-164.4, 164.6-164.12, 164.14-164.16

The Texas Workers' Compensation Commission (the commission) adopts amendments to §§164.1-164.4, 164.6-164.12, and 164.14-164.16, concerning the Extra-Hazardous Employer Program, without changes to the proposed text published in the September 15, 2000 issue of the Texas Register (25 TexReg 9181). The amendments are adopted to implement a change in the name of this commission program contained in Texas Labor Code Chapter 411, Subchapter D.

As required by the Government Code §2001.033(1), the commission's reasoned justification for this rule is set out in this order which includes the preamble, which in turn includes the rule. This preamble contains a summary of the factual basis of the rule.

The 76th Legislature, 1999, in House Bill 2514, amended the Texas Labor Code, Chapter 411, Subchapter D by changing the name of the "Extra-Hazardous Employer Program" to the "Hazardous Employer Program." This change in program name was effective September 1, 1999. Because the change in program name was made by the legislature, in July of 1999 the Texas Register agreed to administratively change the references to the "Extra- Hazardous Employer Program" to the "Hazardous Employer Program" in the commission's rules. Recently, the Texas Register indicated that this change was not made administratively and therefore, it was necessary to incorporate this change of program name into the commission's rules through the formal rulemaking procedures of the Administrative Procedure Act. To incorporate this change into the commission rules which relate to this program, amendments to §§164.1-164.4, 164.6-164.12, and 164.14-164.16 are adopted which change "Extra-Hazardous Employer Program" to "Hazardous Employer Program" and also change references to this program. The adopted amendments make no substantive change to the rules. In addition, the change of "an" to "a" is adopted in appropriate places throughout the rules and correction of the rule title reference in §164.1(b)(8) and §164.2(b)(4) are adopted.

No comments were received regarding these proposed amendments.

The amended rule is adopted pursuant to the Texas Labor Code §402.061 which requires the commission to adopt rules necessary for the implementation and enforcement of the Texas Workers Compensation Act; and the Texas Labor Code §§411.041-411.068, which require the commission to identify hazardous employers and develop, implement and enforce accident prevention programs.

The amended rule is adopted pursuant to the Texas Labor Code §§402, and 411.041-411.068.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on February 22, 2001.

TRD-200101095

Susan Cory

General Counsel

Texas Workers' Compensation Commission

Effective date: March 14, 2001

Proposal publication date: September 15, 2000

For further information, please call: (512) 804-4286


Chapter 165. REJECTED RISK: INJURY PREVENTIONS SERVICES

28 TAC §165.1

The Texas Workers' Compensation Commission (the commission) adopts an amendment to §165.1 concerning identification and notification of certain policyholders insured by the Texas Workers' Compensation Insurance Fund (the Fund) without changes to the proposed text published in the September 15, 2000, issue of the Texas Register (25 TexReg 9185). The amendment is adopted to eliminate the requirement for identified employers with corporate offices outside of Texas to provide information concerning their senior officials in Texas to the commission.

As required by the Government Code §2001.033(1), the commission's reasoned justification for this rule is set out in this order which includes the preamble, which in turn includes the rule. This preamble contains a summary of the factual basis of the rule.

Previously, subsection (c) of the rule required a policyholder whose corporate office is outside of Texas, who received a notice from the Fund that injury prevention services were required as a condition of insurance, to provide information concerning its senior official in Texas to the Texas Workers Compensation Insurance Fund and to the Texas Workers Compensation Commission. The requirement to provide that information to the commission is deleted. The commission intends to obtain that information exclusively from the Fund in the future.

No comments were received regarding the proposed amendment.

The amendment is adopted pursuant to the Texas Labor Code §402.061 which requires the commission to adopt rules necessary for the implementation and enforcement of the Texas Workers Compensation Act; Texas Labor Code Chapter 415, which sets out prohibited acts, penalties, and procedures for administrative violations; and the Texas Insurance Code, Article 5.76-3, Section 10, which authorizes the commission to implement accident prevention plans, conduct follow-up inspections, and enforce the plans.

The amendment is adopted pursuant to the Texas Labor Code §402.061, Chapter 415, and the Texas Insurance Code, Article 5.76-3, Section 10.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on February 22, 2001.

TRD-200101093

Susan Cory

General Counsel

Texas Workers' Compensation Commission

Effective date: March 14, 2001

Proposal publication date: September 15, 2000

For further information, please call: (512) 804-4286


Chapter 166. WORKERS' HEALTH & SAFETY--ACCIDENT PREVENTION SERVICES

28 TAC §166.7, §166.8

The Texas Workers' Compensation Commission (the commission) adopts an amendment to §166.7 and §166.8, without changes to the proposed text published in the September 15, 2000 issue of the Texas Register (25 TexReg 9186).

As required by the Government Code §2001.033(1), the commission's reasoned justification for this rule is set out in this order which includes the preamble, which in turn includes the rule. This preamble contains a summary of the factual basis of the rule.

The 76th Legislature, 1999, in House Bill 2514, amended the Texas Labor Code, Chapter 411, Subchapter D by changing the name of the "Extra-Hazardous Employer Program" to the "Hazardous Employer Program." This change in program name was effective September 1, 1999. Because this change in program name was made by the legislature, in July of 1999 the Texas Register agreed to administratively change the references to the "Extra- Hazardous Employer Program" to the "Hazardous Employer Program" in the commission's rules. Recently, the Texas Register indicated that this change was not made administratively and therefore, it is necessary to incorporate this change of program name into the commission's rules through the formal rulemaking procedures of the Administrative Procedure Act. To incorporate this change into the commission rules, which refer to this program, adopted amendments to §166.7 and §166.8 change "Extra-Hazardous Employer Program" to "Hazardous Employer Program" and change references to this program. The adopted amendments make no substantive change to the rules.

No public comments were received.

The new rules are adopted pursuant to the Texas Labor Code §402.061 which requires the commission to adopt rules necessary for the implementation and enforcement of the Texas Workers Compensation Act; the Texas Labor Code §411.041 and §411.068 which require the commission to identify hazardous employers and to develop, implement, and enforce accident prevention programs.

The new rules are adopted pursuant to the Texas Labor Code §§402.061, 411.041 and 411.068.

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on February 22, 2001.

TRD-200101094

Susan Cory

General Counsel

Texas Workers' Compensation Commission

Effective date: March 14, 2001

Proposal publication date: September 15, 2000

For further information, please call: (512) 804-4286