Bill Text: TX SB22 | 2021-2022 | 87th Legislature | Enrolled

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Bill Title: Relating to certain claims for benefits, compensation, or assistance by certain public safety employees and survivors of certain public safety employees.

Sponsorship: Bipartisan Bill

Status: (Passed) 2021-06-14 - Effective immediately [SB22 Detail]

Download: Texas-2021-SB22-Enrolled.html

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S.B. No. 22

AN ACT
relating to certain claims for benefits, compensation, or
assistance by certain public safety employees and survivors of
certain public safety employees.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. The heading to Subchapter B, Chapter 607,
Government Code, is amended to read as follows:
SUBCHAPTER B. DISEASES OR ILLNESSES SUFFERED BY DETENTION
OFFICERS, CUSTODIAL OFFICERS, FIREFIGHTERS, PEACE OFFICERS, AND
EMERGENCY MEDICAL TECHNICIANS
SECTION 2. Section 607.051, Government Code, is amended by
amending Subdivision (1) and adding Subdivisions (1-a) and (1-b) to
read as follows:
(1) "Custodial officer" means a person who is employed
by the Board of Pardons and Paroles or the Texas Department of
Criminal Justice as a parole officer or caseworker or who is
employed by the correctional institutions division of the Texas
Department of Criminal Justice and certified by the department as
having a normal job assignment that requires frequent or infrequent
regularly planned contact with, and in close proximity to, inmates
or defendants of the correctional institutions division without the
protection of bars, doors, security screens, or similar devices and
includes assignments normally involving supervision or the
potential for supervision of inmates in inmate housing areas,
educational or recreational facilities, industrial shops,
kitchens, laundries, medical areas, agricultural shops or fields,
or in other areas on or away from property of the department.
(1-a) "Detention officer" means an individual
employed by a state agency or political subdivision of the state to
ensure the safekeeping of prisoners and the security of a
municipal, county, or state penal institution in this state.
(1-b) "Disability" means partial or total disability.
SECTION 3. Sections 607.052(a), (b), (e), and (g),
Government Code, are amended to read as follows:
(a) Notwithstanding any other law, this subchapter applies
only to a detention officer, custodial officer, firefighter, peace
officer, or emergency medical technician who:
(1) on becoming employed or during employment as a
detention officer, custodial officer, firefighter, peace officer,
or emergency medical technician, received a physical examination
that failed to reveal evidence of the illness or disease for which
benefits or compensation are sought using a presumption established
by this subchapter;
(2) is employed for five or more years as a
firefighter, peace officer, or emergency medical technician,
except for the presumption under Section 607.0545; and
(3) seeks benefits or compensation for a disease or
illness covered by this subchapter that is discovered during
employment as a detention officer, custodial officer, firefighter,
peace officer, or emergency medical technician.
(b) A presumption under this subchapter does not apply:
(1) to a determination of a survivor's eligibility for
benefits under Chapter 615;
(2) in a cause of action brought in a state or federal
court except for judicial review of a proceeding in which there has
been a grant or denial of employment-related benefits or
compensation;
(3) to a determination regarding benefits or
compensation under a life or disability insurance policy purchased
by or on behalf of the detention officer, custodial officer,
firefighter, peace officer, or emergency medical technician that
provides coverage in addition to any benefits or compensation
required by law; or
(4) if the disease or illness for which benefits or
compensation is sought is known to be caused by the use of tobacco
and:
(A) the firefighter, peace officer, or emergency
medical technician is or has been a user of tobacco; or
(B) the firefighter's, peace officer's, or
emergency medical technician's spouse has, during the marriage,
been a user of tobacco that is consumed through smoking.
(e) A detention officer, custodial officer, firefighter,
peace officer, or emergency medical technician who uses a
presumption established under this subchapter is entitled only to
the benefits or compensation to which the detention officer,
custodial officer, firefighter, peace officer, or emergency
medical technician would otherwise be entitled to receive at the
time the claim for benefits or compensation is filed.
(g) This subchapter applies to a detention officer,
custodial officer, firefighter, peace officer, or emergency
medical technician who provides services as an employee of an
entity created by an interlocal agreement.
SECTION 4. Section 607.054, Government Code, is amended to
read as follows:
Sec. 607.054. TUBERCULOSIS OR OTHER RESPIRATORY ILLNESS.
(a) A firefighter, peace officer, or emergency medical technician
who suffers from tuberculosis, or any other disease or illness of
the lungs or respiratory tract that has a statistically positive
correlation with service as a firefighter, peace officer, or
emergency medical technician, that results in death or total or
partial disability is presumed to have contracted the disease or
illness during the course and scope of employment as a firefighter,
peace officer, or emergency medical technician.
(b) This section does not apply to a claim that a
firefighter, peace officer, or emergency medical technician
suffers from severe acute respiratory syndrome coronavirus 2
(SARS-CoV-2) or coronavirus disease 2019 (COVID-19).
SECTION 5. Subchapter B, Chapter 607, Government Code, is
amended by adding Section 607.0545 to read as follows:
Sec. 607.0545. SEVERE ACUTE RESPIRATORY SYNDROME
CORONAVIRUS 2 (SARS-CoV-2) OR CORONAVIRUS DISEASE 2019 (COVID-19).
(a) A detention officer, custodial officer, firefighter, peace
officer, or emergency medical technician who suffers from severe
acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or
coronavirus disease 2019 (COVID-19) that results in death or total
or partial disability is presumed to have contracted the virus or
disease during the course and scope of employment as a detention
officer, custodial officer, firefighter, peace officer, or
emergency medical technician if the detention officer, custodial
officer, firefighter, peace officer, or emergency medical
technician:
(1) is employed in the area designated in a disaster
declaration by the governor under Section 418.014 or another law
and the disaster is related to severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19);
and
(2) contracts the disease during the disaster declared
by the governor described by Subdivision (1).
(b) The presumption under this section applies only to a
person who:
(1) is employed as a detention officer, custodial
officer, firefighter, peace officer, or emergency medical
technician on a full-time basis;
(2) is diagnosed with severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019
(COVID-19):
(A) using a test authorized, approved, or
licensed by the United States Food and Drug Administration; or
(B) if the person is deceased:
(i) using a test described by Paragraph
(A); or
(ii) by another means, including by a
physician; and
(3) was last on duty:
(A) not more than 15 days before the date the
person is diagnosed with severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19)
using a test described by Subdivision (2)(A); or
(B) if the person is deceased, not more than 15
days before the date the person:
(i) was diagnosed with severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus
disease 2019 (COVID-19) using a test described by Subdivision
(2)(A);
(ii) began to show symptoms of severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus
disease 2019 (COVID-19) as determined by a licensed physician;
(iii) was hospitalized for symptoms related
to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or
coronavirus disease 2019 (COVID-19); or
(iv) died if severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019
(COVID-19) was a contributing factor in the person's death.
(c) This section does not affect the right of a detention
officer, custodial officer, firefighter, peace officer, or
emergency medical technician to provide proof, without the use of
the presumption under this section, that an injury or illness
occurred during the course and scope of employment.
(d) Sections 409.009 and 409.0091, Labor Code, do not apply
to a claim for compensation determined to be compensable or
accepted by an insurance carrier as compensable using the
presumption under this section. Notwithstanding this subsection,
an injured employee may request reimbursement for health care paid
by the employee as provided by Section 409.0092, Labor Code.
(e) This section expires September 1, 2023.
SECTION 6. Section 607.057, Government Code, is amended to
read as follows:
Sec. 607.057. EFFECT OF PRESUMPTION. Except as provided by
Section 607.052(b), a presumption established under this
subchapter applies to a determination of whether a detention
officer's, custodial officer's, firefighter's, peace officer's, or
emergency medical technician's disability or death resulted from a
disease or illness contracted in the course and scope of employment
for purposes of benefits or compensation provided under another
employee benefit, law, or plan, including a pension plan.
SECTION 7. Section 607.058, Government Code, is amended to
read as follows:
Sec. 607.058. PRESUMPTION REBUTTABLE. (a) A presumption
under Section 607.053, 607.054, 607.0545, 607.055, or 607.056 may
be rebutted through a showing by a preponderance of the evidence
that a risk factor, accident, hazard, or other cause not associated
with the individual's service as a detention officer, custodial
officer, firefighter, peace officer, or emergency medical
technician was a substantial factor in bringing about the
individual's disease or illness, without which the disease or
illness would not have occurred.
(b) A rebuttal offered under this section must include a
statement by the person offering the rebuttal that describes, in
detail, the evidence that the person reviewed before making the
determination that a cause not associated with the individual's
service as a detention officer, custodial officer, firefighter,
peace officer, or emergency medical technician was a substantial
factor in bringing about the individual's disease or illness,
without which the disease or illness would not have occurred.
(c) In addressing an argument based on a rebuttal offered
under this section, an administrative law judge shall make findings
of fact and conclusions of law that consider whether a qualified
expert, relying on evidence-based medicine, stated the opinion
that, based on reasonable medical probability, an identified risk
factor, accident, hazard, or other cause not associated with the
individual's service as a detention officer, custodial officer,
firefighter, peace officer, or emergency medical technician was a
substantial factor in bringing about the individual's disease or
illness, without which the disease or illness would not have
occurred.
(d) A rebuttal offered under this section to a presumption
under Section 607.0545 may not be based solely on evidence relating
to the risk of exposure to severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19)
of a person with whom a detention officer, custodial officer,
firefighter, peace officer, or emergency medical technician
resides. This subsection expires September 1, 2023.
SECTION 8. Subchapter A, Chapter 409, Labor Code, is
amended by adding Section 409.0092 to read as follows:
Sec. 409.0092. HEALTH CARE REIMBURSEMENT PROCEDURES FOR
CERTAIN INJURED EMPLOYEES. (a) An injured employee who is subject
to Section 607.0545, Government Code, and whose claim for benefits
is determined to be compensable by an insurance carrier or the
division, may request reimbursement for health care paid by the
employee, including copayments and partial payments, by submitting
to the carrier a legible written request and documentation showing
the amounts paid to the health care provider.
(b) Not later than the 45th day after the date an injured
employee submits a request for reimbursement for health care to an
insurance carrier under Subsection (a), the carrier shall provide
reimbursement or deny the request.
(c) If an insurance carrier denies an injured employee's
request for reimbursement for health care, the employee may seek
medical dispute resolution as provided by Chapter 413 and division
rules. Notwithstanding any other law, an employee's request for
medical dispute resolution is considered timely if the employee
submits the request not later than the 120th day after the date the
carrier denies the employee's request for reimbursement.
(d) This section expires September 1, 2023.
SECTION 9. Section 409.022(d), Labor Code, is amended to
read as follows:
(d) In this subsection, the terms "custodial officer,"
"detention officer," "emergency medical technician,"
"firefighter," and "peace officer" have the meanings assigned by
Section 607.051, Government Code. In addition to the other
requirements of this section, if an insurance carrier's notice of
refusal to pay benefits under Section 409.021 is sent in response to
a claim for compensation resulting from a custodial officer's, a
detention officer's, an emergency medical technician's, a
firefighter's, or a peace officer's disability or death for which a
presumption is claimed to be applicable under Subchapter B, Chapter
607, Government Code, the notice must include a statement by the
carrier that:
(1) explains why the carrier determined a presumption
under that subchapter does not apply to the claim for compensation;
and
(2) describes the evidence that the carrier reviewed
in making the determination described by Subdivision (1).
SECTION 10. (a) The changes in law made by this Act apply to
a claim for benefits pending on or filed on or after the effective
date of this Act. A claim for benefits filed before that date is
covered by the law in effect on the date the claim was made, and that
law is continued in effect for that purpose.
(b) Notwithstanding any other law, a person subject to
Section 607.0545, Government Code, as added by this Act, who on or
after the date the governor declared a disaster under Chapter 418,
Government Code, relating to SARS-CoV-2, coronavirus disease 2019
(COVID-19), but before the effective date of this Act, contracted
SARS-CoV-2, coronavirus disease 2019 (COVID-19), may file a claim
for benefits related to SARS-CoV-2, coronavirus disease 2019
(COVID-19), on or after the effective date of this Act, regardless
of whether that claim is otherwise considered untimely and the
changes in law made by this Act apply to that claim. A claim
authorized under this subsection must be filed not later than six
months after the effective date of this Act.
(c) Notwithstanding Subsection (a) of this section or
Section 409.003, 409.007, 410.169, or 410.205, Labor Code, a person
subject to Section 607.0545, Government Code, as added by this Act,
who on or after the date the governor declared a disaster under
Chapter 418, Government Code, relating to SARS-CoV-2, coronavirus
disease 2019 (COVID-19), but before the effective date of this Act,
filed a claim for benefits related to SARS-CoV-2, coronavirus
disease 2019 (COVID-19), and whose claim was subsequently denied
may, on or after the effective date of this Act, request in writing
that the insurance carrier reprocess the claim and the changes in
law made by this Act shall apply to that claim. A request to
reprocess a claim as authorized by this subsection shall be filed
not later than one year after the effective date of this Act.
(d) Not later than the 60th day after the date an insurance
carrier receives a written request to reprocess a claim under
Subsection (c) of this section, the insurance carrier shall
reprocess the claim and notify the person in writing whether the
carrier accepted or denied the claim. If the insurance carrier
denies the claim, the notice must include information on the
process for disputing the denial. The notice provided by the
insurance carrier must use the notice provisions prescribed by the
division of workers' compensation of the Texas Department of
Insurance under Subsection (e) of this section.
(e) As soon as practicable after the effective date of this
Act, the division of workers' compensation of the Texas Department
of Insurance shall prescribe notice provisions for an insurance
carrier to use when providing notice of the insurance carrier's
acceptance or denial of a person's claim. The notice provisions
must be clear and easily understandable.
SECTION 11. This Act takes effect immediately if it
receives a vote of two-thirds of all the members elected to each
house, as provided by Section 39, Article III, Texas Constitution.
If this Act does not receive the vote necessary for immediate
effect, this Act takes effect September 1, 2021.
______________________________ ______________________________
President of the Senate Speaker of the House
I hereby certify that S.B. No. 22 passed the Senate on
April 21, 2021, by the following vote: Yeas 31, Nays 0;
May 25, 2021, Senate refused to concur in House amendments and
requested appointment of Conference Committee; May 27, 2021, House
granted request of the Senate; May 30, 2021, Senate adopted
Conference Committee Report by the following vote: Yeas 31,
Nays 0.
______________________________
Secretary of the Senate
I hereby certify that S.B. No. 22 passed the House, with
amendments, on May 20, 2021, by the following vote: Yeas 139,
Nays 6, one present not voting; May 27, 2021, House granted request
of the Senate for appointment of Conference Committee;
May 30, 2021, House adopted Conference Committee Report by the
following vote: Yeas 139, Nays 3, two present not voting.
______________________________
Chief Clerk of the House
Approved:
______________________________
Date
______________________________
Governor