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ADVISORY 2005-01

SUBJECT: Notice of Modifications to Plain Language Notices

TWCC Rule 124.2 requires the use of Plain Language Notices (PLNs) to provide notice to the injured employee of claim administration actions taken on his/her claim, and in certain instances, to provide the Commission with additional information that is not available via electronic data interchange (EDI).

Based on input received from workers' compensation system participants, the Commission has revised the Plain Language Notices. Each PLN has instructions for its use. The PLNs are designed to match the event triggers identified in Rule 124.2 and replace form TWCC-21, Payment of Compensation or Notice of Refused or Disputed Claim.

While changes were made to all Plain Language Notices, the substantive changes to the Notices are:

  • addition of "NATURE OF INJURY", "PART OF BODY INJURED", "EMPLOYER ADDRESS" and "EMPLOYER CITY, STATE, ZIP" to the claim information section at the top of the forms
  • addition of " date of carrier receipt of notice of injury" to the PLN-1 (Notice of Denial of Compensability/Liability and Refusal to Pay)
  • addition of free text fields to the Notices that did not have free text so that explanatory comments can be provided by the claim administrator
  • modification of instructions for PLN-3 to allow removing unused MMI/IR options and only provide appropriate option when sending to injured worker

The notices should be on insurance carrier/carrier representative company letterhead and must contain the adjuster's contact information. The language contained on the notices is prescribed by the Commission and may not be altered or modified except by the Commission or with Commission permission. As changes to the PLNs are made due to changes in the Workers' Compensation Act, rules, or system participant comment, the amended notices will be made available on the Commission website.

Insurance carriers may start using these notices immediately. Use of these notices will be mandatory effective August 1, 2005. The notices are available for downloading from the Commission's website http://www.tdi.texas.gov/wc/forms/index.html. All previous versions of the Plain Language Notices should be destroyed and no longer used after August 1, 2005.

Signed this 22nd day of February, 2005

Robert L. Shipe, Executive Director

Distribution:
TWCC Staff
Medical Professional Associations
Carrier Representatives
Forms Notification List
Public Information List
TWCC website



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