OIEC Quarterly Review, Number 10, April-June 2008 Page: 4
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Rule Updates
Texas Department of Insurance, Division of Workers' Compensation (DWC)
Proposed Rule Update
OIEC recently made comments to DWC's Subclaim and Enforcement Rules. OIEC staff
continues to participate in workers' compensation rulemaking initiatives as part of OIEC's
mission to advocate on behalf of injured employees as a class.
Adoption of Office of Injured Employee Counsel Rule 276.11
Rule 276.11, Access to Injured Employee Medical Records, was adopted by Public Counsel Norman Darwin on June 10,
2008. Rule 276.11 allows an Ombudsman to request an injured employee's medical documentation from a health care
provider in order to assist the employee in the administrative dispute resolution process. The documentation shall be
received within five days of the request and health care providers may be reimbursed for the copy costs from the
insurance carrier. OIEC believes that having access to an injured employee's medical documentation is critical to fulfill
the agency's mission to assist, educate, and advocate on behalf of the injured employees of Texas.
As a result of resources the agency received during the 80 Texas Legislature, Regular Session, 2007, 276.2 and 276.10
will be amended in the near future. Amendments to both sections are necessary to more closely align the rules with the
agency's enabling statute, Chapter 404 of the Texas Labor Code.
Agency Program Area News
Customer Service Department
The Customer Service Department is now fully staffed and all Customer Service Representatives (CSRs) are working
with injured employees by telephone and in person. The construction of the call center in the Fort Worth Field Office
has been completed and it is also fully staffed. The call center CSRs will assist the injured employees in the Fort Worth
field office area as well as answer the statewide toll free line 1-866-EZE-OIEC (1-866-393-6432).
The Customer Service Department began an initial contact outreach program in May 2008. The CSRs contact injured
employees who have filed claims within the last 30 to 60 days and explain the services that OIEC provides. The CSRs
follow up by sending OIEC brochures, DWC forms, and other requested written materials to the injured employees. It
is our hope that providing information and assistance to injured employees early in their claims process will help them
maneuver through the workers' compensation system with fewer complications and disputes.
Ombudsman Program
"Injured Employee Services" is now the "Ombudsman Program." This change is being made to:
- Clarify the role of the Ombudsman Program;
- More closely align OIEC with the language in its enabling statute (Chapter 404 of the Labor Code;
specifically Subchapter D and Section 404.151); and
- Ensure the Ombudsman Program's heritage and fantastic reputation continues.
OIEC will be changing its brochures, publications, and the OIEC website in the near future to reflect this change.
The Ombudsman Program consists of Ombudsmen, Ombudsman Associates and Ombudsman Assistants. Most
Ombudsman Associates transferred from DWC in September 2007 and have continued their intensive Ombudsman
training program. A requirement of this position is to obtain and maintain a Workers' Compensation Insurance
Adjuster's License. All Ombudsman Associates who entered the program last fall have successfully completed their
adjuster's license training and testing. They are on track to become full Ombudsmen by September 1, 2008. This will
increase the number of Ombudsmen OIEC has to assist injured employees and will further enhance OIEC's early
intervention efforts.
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Texas. Office of Injured Employee Counsel. OIEC Quarterly Review, Number 10, April-June 2008, periodical, April 2008; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth575955/m1/4/: accessed April 24, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.