See also: Coronavirus resources
Q: What do I do if I think I’ve contracted the coronavirus?
A: Contact your doctor and tell them you think you’ve contracted the coronavirus. They should let you know what to do, and if they need you to come into an office. If you need immediate care, contact a hospital and let them know. They can make sure they’re ready for your arrival and let you know where to go.
Q: I am sick and may not be able to go to my Benefit Review Conference or Contested Case Hearing. What do I do?
A: If you are not able to attend a scheduled Benefit Review Conference or Contested Case Hearing please call us at 512-804-4010.
Q: Does workers’ compensation cover coronavirus-related exposure or illness?
A: Workers’ compensation is an insurance program that pays for medical bills and some lost-time income for employees who have a work-related injury or illness. To qualify, an employer must have workers’ compensation insurance, and an employee must have been injured or contracted an occupational disease as a result of their employment. Whether a workers’ compensation claim is compensable or not is a case by case determination by the insurance carrier. If there is a dispute over a claim and you are not able to resolve the dispute with the insurance carrier, then you may ask for dispute resolution by contacting DWC.
- How to exchange your information and exhibits electronically
- How to participate in your virtual benefit review conference/contested case hearing
Q: I have lost my job due to COVID-19, how do I apply for benefits?
A: The Division of Workers' Compensation regulates the workers' compensation industry which pays benefits to employees who are injured on the job. If you are laid off or lose hours due to the coronavirus, you may be able to file for unemployment benefits. You can apply for those benefits with the Texas Workforce Commission online by using Unemployment Benefits Services or by calling TWC’s Tele-Center at 800-939-6631 from 8 a.m. - 6 p.m., Central Time, Monday through Friday. You should also contact your employer since individual employers have made certain exceptions to their leave and pay policies during this time.
Q: Will 90-day finality for MMI/IR be stopped or disputed if a DWC Form-032 is submitted?
A: Yes. System participants must dispute a first certification of MMI or assigned IR by requesting and setting a Benefit Review Conference or, if a DD has not been appointed, by submitting a DWC Form-032 to request a DD exam.
You fulfill the requirement to dispute a certification of MMI and IR timely if DWC receives your DWC Form-032 within 90 days from the date the first MMI or IR determination was delivered to the injured employee.
Q: What happens to disputes if I’m having trouble getting a DD or RME exam?
A: For disputes that require a DD or RME exam for maximum medical improvement, impairment rating, extent of injury, or other similar issues, and those exams have not yet taken place, the hearings will likely be continued. At this time there should not be many pending dispute hearings that this is impacting. DWC is not yet ordering DD or RME exams for return to work or disability. If you need a designated doctor exam to address a return-to-work or disability issue because my benefits have been affected, contact DWC at DDScheduler@tdi.texas.gov, or 800-252-7031, option 1.
Q: The bulletin authorizes payments to pharmacies up to a 90-day supply for any prescription medication. Does this include refills?
A: If the prescription allows for a 30-day prescription of a medication and three refills, the pharmacy could provide and be reimbursed for one 90-day supply, and the remainder of medication per the prescription could be issued as the final refill.
Q: Can carriers suspend sending correspondence to claimants via mail and send via email instead, if we have claimant’s email address?
A: Yes. Until further notice, insurance carriers may send documents electronically, including with injured employees who have email addresses or fax numbers and agree to receive these documents electronically. DWC encourages parties to use fax or encrypted email.
Q: Will DWC allow the correspondence information to be relayed via phone call with documentation of call content or a recorded call?
A: Nothing prohibits an insurance carrier from relaying information by phone call, but it does not relieve the insurance carrier from also sending the correspondence to the injured employee. Until further notice, insurance carriers may send documents electronically, including with injured employees who have email addresses or fax numbers and agree to receive these documents electronically. DWC encourages parties to use fax or encrypted email.