Notice regarding treatment of work related injuries
Non-Urgent Medical care for work related injuries occurring on, or after, January 1, 2008 must be sought through The Political Subdivision Workers’ Compensation Alliance.
Dear Valued Employees:
House Bill 7, adopted in the 2005 Texas Legislative Session, made substantial changes to the workers’ compensation system. One of the most significant changes pertains to alternative medical benefit options for political subdivisions. The use of medical networks certified by the Division of Workers’ Compensation and direct medical provider contracting were made available to political subdivisions.
HB 7 abolished the Division of Workers’ Compensation Approved Doctors List (ADL) in September 2007. In an effort to provide quality medical treatment to injured workers a partnership was formed by five pools representing political subdivisions. Representatives from Texas Municipal League Intergovernmental Risk Pool, the Texas Association of School Boards Risk Management Fund, Texas Association of Counties Workers’ Compensation Fund, Texas Association Risk Management Fund and the Texas Water Conservation Association Risk Management Fund joined together to form the Political Subdivision Workers’ Compensation Alliance (the Alliance). The Alliance collectively represents over 500,000 public employees statewide.
The Alliance exercised the option to directly contract with doctors. Consultants were hired and the Alliance began direct contracting with medical providers in the summer of 2006. The process of contracting and credentialing physicians continues to date. The Alliance, structured similar to a provider network, has a list of primary and specialty health care providers trained to treat work related injuries and safely return employees to work. Nationally recognized treatment and return to work guidelines will be employed by Alliance physicians.
Effective January 1, 2008, non-urgent medical treatment for work related injuries must be obtained from doctors found on the Alliance web site: www.pswca.org. Urgent care does not require use of Alliance physicians. In case of emergency proceed to the nearest emergency facility.
It is expected that the Alliance will:
- Offer quality health care
- Ease the employee’s physician selection process
- Provide greater access to commonly needed specialists
- Reduce provider billing errors
- Safely return employees to work
Find a Doctor for Work Related Injuries: www.pswca.org
Aldine ISD’s workers’ compensation specialist and risk manager will assist with questions related to medical treatment. TASB Risk Management Fund, the district’s workers’ compensation insurance provider, can also answer questions related to treatment of work related injuries.
- Employees must choose a treating doctor from the Alliance list of doctors designated as primary care physicians.
- TASB will pay the treating doctor and other Alliance providers for health care related to compensable injuries.
- Should an employee elect to use a non-Alliance doctor, the employee may have to pay the medical bills for treatment provided.
- Employees may change treating doctors one time without approval. The third choice requires approval from TASB.
- Making a false or fraudulent workers’ compensation claim is a crime.
We are excited to introduce the Alliance to Aldine ISD employees and anticipate a very successful transition as many of the clinics currently used by injured employees are listed in the Alliance provider directory. Please contact the risk management department with comments and questions.
This information applies to injuries sustained on, or after, January 1, 2008.