Workers Compensation

Late Medical Bills Won’t Be a Reason for Workers’ Comp Claims Denials, State Says - 03/26/2020

The Texas Division of Workers’ Compensation says late filings of medical bills will fall under the law’s “catastrophic event” exception due to the COVID-19 pandemic.

Workers’ Comp COVID-19 Claims Require Work-Related Connection, Officials Say - 03/23/2020

As cases of COVID-19 mount in Texas and across the U.S., some patients who test positive for the disease might file a claim under their workers’ compensation insurance if they believe they contracted COVID-19, or the coronavirus that causes the disease, as a result of their work. Under workers compensation, injured workers must prove their infection was work-related, the Texas Division of Workers’ Compensation (DWC) notes. If they don’t, their claim may be denied. And claim denials, of course, mean those workers’ physicians may have trouble getting paid.

Workers' Compensation - 01/30/2020

Practice management tools for workers' compensation.

An Injury to Justice: Workers' Comp Disputes Could Tilt in Insurers' Favor - 01/02/2020

Medicine is working to upend a recent appeals court decision that threatens to give health plans an overwhelming advantage in fee disputes in workers compensation cases.

Charging a Fee to Complete Forms - 10/19/2017

Can practices charge a fee to complete individual disability income claims forms?

Have Your Say in Building Workers’ Comp Audit Process - 10/02/2017

The Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC) wants your help in developing a Designated Doctor Plan-Based Audit to review the quality of reports created by physicians designated to individual workers’ comp cases. The audits also will review whether additional testing and/or referrals ordered by that physician are necessary.

Steering Clear of Trouble - 09/01/2017

Pharmacies that compound topical creams and gels of questionable or nonexistent efficacy and then bill insurance for huge amounts are a growing problem, especially in the Texas workers' compensation program. Sometimes, they convince physicians to play a part in their schemes, offering kickbacks or other inducements in exchange for referrals. It's a nasty business doctors need to know is out there — and strictly avoid.

TDI to Host Workers' Compensation Education Conference - 10/11/2016

Register today for the 2016 Texas Workers' Compensation Education Conference. The Texas Department of Insurance (TDI) Division of Workers' Compensation will host two conferences — Sept. 19–20 in Austin and Oct. 24–25 in Dallas.

Closed Formulary, Part Two - 05/13/2016

Legislation to reduce overuse of pain medications and other addictive and expensive drugs within the workers' compensation program appears to be achieving that goal through stepped implementation of a closed formulary. With phase two of the process set to take effect this September, leaders at the Texas Medical Association and the Texas Department of Insurance Division of Workers' Compensation say physicians should prepare now for what could be the more challenging part of the transition. Under the closed formulary, mandated by the legislature in 2005, physicians must obtain preauthorization from workers' compensation insurance carriers before prescribing roughly 90 different medications. The so-called "N drugs" not in the formulary include mostly opioids, analgesics, muscle relaxants, and antidepressants. Until now, the preapproval process applied only to patients injured on or after Sept. 1, 2011. Starting on Sept. 1 this year, physicians also must obtain N-drug preauthorization for ...

New Claim Form Adopted for Workers' Compensation - 05/13/2016

Texas Commissioner of Workers' Compensation Rod Bordelon adopted rules requiring the use of the newly updated 1500 Health Insurance Claim Form Version 02/12 (CMS-1500).