SIBs Work-Search Requirements Return; Second CoVID-19 Data Call Imminent
Two CoVID-19 related regulatory developments loom on the horizon at the end of October 2020. The SIBs work search compliance standards, which have been suspended since March 27, 2020, may be returning November 1, 2020. In addition, responses to the second CoVID-19 Data Call are due October 30, 2020.
SIBs Work Search Requirements
On March 27, 2020, Governor Greg Abbott approved the Division’s request to suspend work search compliance standards for supplemental income benefits under Labor Code § 408.1415(a) and Rule 130.102(d). Commissioner’s Bulletin # B-0012-20. The effect of this suspension was that SIBs claimants were entitled to receive monthly benefits without looking for work as required by the statute and rule.
Making a compliant search for employment is a federal requirement to receive unemployment benefits. Compliance with that work search requirement is one way to qualify for SIBs. The Commissioner’s suspension of the rule effectively required carriers to pay TIBs to claimants who were not looking for work.
This week, the Texas Workforce Commission announced that it will reinstate work search requirements for unemployment benefit entitlement on November 1, 2020. We anticipate the Commissioner of Workers’ Compensation will rescind the agency’s suspension of SIBs work search compliance standards under § 408.1415(a) and Rule 130.102(d) on November 1st or shortly thereafter.
CoVID-19 Data Call
On June 2, 2020, the Texas Division of Workers’ Compensation issued a mandatory data call for certain information related to CoVID-19 injuries reported to selected insurance carriers on or after December 1, 2019. The action, which was announced in Commissioner’s Bulletin No. B-0029-20 follows the agency’s request for public comment from system stakeholders to help shape the parameters of the data call.
The Workers’ Compensation Research and Evaluation Group is compiling the results on behalf of DWC. The data call is designed to provide DWC with immediate access to information necessary to determine the impact of CoVID-19 injuries on the Texas workers’ compensation system. The Division plans three separate data call submissions. Submissions for the first data call were completed August 17, 2020.
Upcoming CoVID-19 Data Call Submission Deadlines
| What to Submit | Deadline For Submission to DWC |
| COVID-19 exposures and injuries reported to the insurance carrier from December 1, 2019, through September 30, 2020, and payments made on those injuries as of September 30, 2020. | October 30, 2020 |
| COVID-19 exposures and injuries reported to the insurance carrier from December 1, 2019, through December 31, 2020, and payments made on those injuries as of December 31, 2020. | January 29, 2021 |
The Division has directed all selected insurance carriers and insurance carrier groups to provide summary data using the CoVID-19 data call reporting forms and instructions. Each selected insurance carrier or group is required to provide one data submission per insurance carrier or group.
For the second data call, insurance carriers and groups must submit the requested data to DWC through the insurance carrier Austin representative’s Secure File Transfer Protocol box no later than 5 p.m., Central time on October 30, 2020. If FO&L serves as your Austin Representative, please coordinate your planned data submission with our office through Heather Terrones at hta@fol.com.
Carriers’ second data call submission is a cumulative data submission. It should include all CoVID-19 exposures and injuries reported and payments made on these injuries from December 1, 2019, through September 30, 2020.
Insurance carriers should maintain injury level data for the injuries reported in this data call and may be asked to submit that data to DWC in the future.
The Division has published a list of 66 carriers that it indicates will be participants in the data call. These carriers include four state workers’ compensation systems, 17 Texas cities who self-insure, 12 self-insured Texas counties, 6 Texas hospital districts who self-insure, 6 intergovernmental risk pools, 2 certified self-insured employers, and 19 commercial insurance carriers or carrier groups.
Reminder on CoVID-19 Coding
In the past, Division staff has voiced concerns that they are not seeing the reporting of as many CoVID-19 claims as has been anticipated. Under Rule 120.2 (a) an employer must notify its carrier of each death or occupational disease it receives notice of, as well as any injury that results in more than one day’s absence from work. The employer must do so within eight days of receipt of this notice. Carriers must then electronically file specific information from the original Employer’s First Report of Injury not later than the seventh day after receipt of such a required report where there is lost time from work or an occupational disease. Rule 124.2(c) (1) (A).
It is also important to remember that DWC issued the following coding guidance in a memo March 27, 2020. DWC expects carriers to use the International Association of Industrial Accident Boards and Commissions codes for EDI claims reports: “cause of injury” code 83 -Pandemic and “nature of injury” code 83 – CoVID-19 on April, 2020. We recommend that you remind those persons within your organization who are responsible for injury coding of this obligation. If the coding has been omitted on claims reported on or after April 1, 2020, we recommend going back and amending your reporting to include the proper coding.
If you have any questions regarding this data call, please contact Bobby Stokes or James Sheffield.
FOLIO
