On July 22 and 23, 2008 Governor Rick Perry issued proclamations declaring a disaster due to the effects of Tropical Storm Dolly, certifying that Tropical Storm Dolly poses a threat of imminent disaster to Aransas, Bexar, Brooks, Calhoun, Cameron, Hidalgo, Jim Wells, Kenedy, Kleberg, Nueces, Refugio, San Patricio, Starr, Victoria and Willacy counties beginning July 22, 2008, and directing that all necessary measures both public and private as authorized under §418.017 of the Texas Government Code be implemented to meet that threat. The proclamation also states that, as provided in §418.016 of the Texas Government Code, all rules and regulations that may inhibit or prevent prompt response to this threat are suspended for the duration of the incident.
Tropical Storm Dolly made landfall as a Category II hurricane resulting in devastation and the relocation of hurricane victims and other personal hardships sustained by system participant residents of Aransas, Bexar, Brooks, Calhoun, Cameron , Hidalgo , Jim Wells, Kenedy, Kleberg, Nueces , Refugio, San Patricio, Starr , Victoria and Willacy counties. The Texas Department of Insurance ("Department"), Division of Workers' Compensation ("Division") expects insurance carriers to provide all injured employees impacted by the hurricane with methods for reporting a change of address and to use all available means to provide to injured employees prompt and immediate relief, including but not limited to processing and delivery of benefit checks and necessary medical care, services, and supplies, including physical therapy, pharmacy, or medical equipment.
It is also the opinion of the Department and the Division that all insurance carriers should waive penalties and restrictions on injured employees and health care providers when the injured employee is subject to a workers' compensation health care network certified under Texas Insurance Code §1305 and obtains necessary emergency and non-emergency health care out-of-network as a result of the disaster. The waiver should be afforded through the duration of the Governor's disaster proclamation. Further, the Department and the Division determines that insurance carriers should not deny payment for necessary emergency and non-emergency health care services that are obtained out-of-network as a result of the threat of imminent disaster through the duration of the Governor's disaster proclamation.
Under these disaster circumstances for system participant residents of Aransas, Bexar, Brooks, Calhoun, Cameron, Hidalgo, Jim Wells, Kenedy, Kleberg, Nueces, Refugio, San Patricio, Starr, Victoria and Willacy counties, and regardless of where those residents may be currently located, the Texas workers' compensation deadlines for the following procedures should be extended as necessary, through the duration of the Governor's disaster proclamation: workers' compensation claim notification and filing deadlines, medical billing deadlines, and medical and income benefit dispute deadlines. In addition, and when necessary under the circumstances of the disaster, deadlines for medical examinations should be extended for reasonable periods of time. Also, the preauthorization approval requirements are waived for the duration of the Governor's disaster proclamation for circumstances where the injured employee or that employee's health care provider cannot reasonably communicate with the appropriate insurance carrier as required.
Additionally, please refer to the following Bulletin Numbers signed by Mike Geeslin, Commissioner of Insurance:
- B-0037-08 Suspension of Premium Payments
- B-0038-08 Medical Equipment Supplies
- B-0039-08 Adjuster
- B-0042-08 Prescription Medication Bulletin
- B-0043-08 Rating or Underwriting
To reschedule a Benefit Review conference or a Contested Case Hearing, please contact the Division's local field office or, for calls outside of the area code for that office, call the toll free telephone number (800) 252-7031. Questions related to Workers' Compensation Health Care Networks may be directed to (866) 554-4926 or 512-322-4266 or wcnet@tdi.state.tx.us.
All other questions regarding this bulletin may be directed to the Workers' Compensation Injured Employee Hotline at the toll free telephone number (800) 252 - 7031; or, if calling from the Austin area 512-933-1899.
Albert Betts Mike Geeslin
Commissioner of Workers' Compensation Commissioner of Insurance
Texas Department of Insurance Texas Department of Insurance