Course 1: Subrogation: The Ugly Duckling of Claims Adjustment (1.5 credit hours)
An overview of principles, rules/regulations and applicable cases regarding subrogation claims, how the possibility of subrogation relates to loss adjustment in workers’ compensation claims in the state of Texas, and how subrogation impacts settlement of third-party claim.
Course 2: Problems Related to Identifying the Correct Employer (1.5 credit hours)
An overview of principles, rules/regulations and applicable cases regarding identification of the correct employer in workers’ compensation claims involving more than one employer and how this issue relates to loss adjustment in workers’ compensation claims in the state of Texas.
Course 3: Extraterritorial Coverage Issues (1.0 credit hour)
An overview of principles, rules/regulations and applicable cases regarding extraterritorial coverage and out of state injuries and how these issues relate to loss adjustment in workers’ compensation claims in the state of Texas.
Course 4: Sufficiency of Controversion (1.5 credit hours)
An overview of principles, rules/regulations and applicable cases as they pertain to drafting a sufficient controversion via TWCC-21 (Carriers’ “Payment of Compensation or Notice of Refused or Disputed Claim”) and how sufficient and insufficient controversions relate to loss adjustment in workers’ compensation claims in the state of Texas.
Course 5: The Benefits Scheme (2.0 credit hours)
An overview of principles, rules/regulations and applicable cases as they pertain to the benefits scheme under the Texas Workers’ Compensation Act. The course examines Temporary Income Benefits (“TIBs”), Impairment Income Benefits (“IIBs”), Supplemental Income Benefits (“SIBs”), Death Benefits and Lifetime Income Benefits (“LIBs”). Pertinent deadlines and penalties are stressed, as well as issues regarding entitlement and suspension.
Course 6: Issues Regarding Recoupment and Salary Continuation (2.0 credit hours)
An overview of principles, rules/regulations and applicable cases as they pertain to the recoupment of benefits and the effect of salary continuation under the Texas Workers’ Compensation Act. The course examines various scenarios for recoupment of benefits against Temporary Income Benefits (“TIBs”), Impairment Income Benefits (“IIBs”), Supplemental Income Benefits (“SIBs”), Death Benefits and Lifetime Income Benefits (“LIBs”). Pertinent deadlines and penalties are stressed, as well as issues regarding entitlement and suspension. The course also examines the effects of salary continuation on TIBs.
Course 7: Identifying Exceptions and Defenses Under TWCA (1.5 credit hours)
An overview of principles, rules/regulations and applicable cases as they pertain to various defenses and exceptions to liability under the Texas Workers’ Compensation Act. The course examines various defenses such as the Good Samaritan, Access, Personal Comfort and Convenience and Sole Cause doctrines, as well as the Intoxication and Social, Recreational or Athletic exceptions.
Course 8: Identifying Occupational Diseases and Repetitive Trauma Injuries (2.0 credit hours)
An overview of principles, rules/regulations and applicable cases and law as they pertain to identifying occupational diseases and repetitive trauma injuries under the Texas Workers’ Compensation Act. The course also provides the licensee with the analytical skills needed in recognizing what constitutes an injury with regard to occupational diseases, communicable diseases, ordinary diseases of life and repetitive trauma injuries.
Course 9: Defending the Adjusting Occupational Disease and Repetitive Trauma Injury Claims (2.0 credit hours)
An overview of principles, rules/regulations and applicable cases as they pertain to defending and adjusting occupational disease and repetitive trauma injury claims under the Texas Workers’ Compensation Act. The course will enable the licensee to appraise notice issues and coverage issues with clearer understanding, and provide them with the analytical skills needed to evaluate claims when launching an investigation, as well as the skills needed in crafting a sufficient controversion of occupational disease and repetitive trauma injury claims.
Course 10: Troubleshooting in Contribution and SIBs Cases (3.0 credit hours)
An overview of concepts, rules/regulations and applicable cases relating to Supplemental Income Benefits (“SIBs”) and contribution issues under the Texas Workers’ Compensation Act and “new” Texas workers’ compensation law.
Course 11: MMI, Impairment and the 90-Day Rule (1.5 credit hours)
An overview of principles, rules/regulations and applicable cases and statutes regarding maximum medical improvement (“MMI”) and impairment rating (“IR”) issues and how these issues relate to loss adjustment in workers’ compensation claims in the state of Texas. The course also covers the application of TWCC Rule 130.5(e) (the “90 Day Rule”) and its exceptions under the Texas Workers’ Compensation Act.
Course 12: Understanding & Preventing Bad Faith Claims (2.0 credit hours) (ethics)
An overview of principles, rules/regulations and applicable cases regarding bad faith claims and how this issue relates to loss adjustment in workers’ compensation claims in the state of Texas. The course will focus on Article 21.21 of the Insurance Code, The Unauthorized Insurers False Advertising Process Act, The Unfair Claim Settlement Practices Act, The Deceptive Trade Practices – Consumer Protection Act, and will draw upon existing applicable case law.
Course 13: Medical Benefits Disputes and Issues Regarding the SOAH Process (2.0 credit hours)
An overview of principles, rules/regulations and applicable cases regarding medical benefits disputes under the Texas Workers’ Compensation Act. This course will provide the licensee with the abilities and skills necessary in managing these disputes as they proceed through the State Office of Administrative Hearings.
Course 14: Automobile Mock Trial and Case Evaluation (3.0 credit hours)
An overview of principles, rules/regulations and applicable cases as they pertain to the trial phase of workers’ compensation law under the Texas Workers’ Compensation Act and the Texas Rules of Civil Procedure. The course examines all phases of the civil suit and pertinent deadlines and strategies are stressed.
Course 15: Dispute Resolution Process – TWCC (2.0 credit hours)
An overview of the dispute resolution process under the Texas Workers’ Compensation Act. The course will impart upon the licensee enhanced understanding of the principles, rules/regulations and applicable cases as they pertain to the dispute resolution process within the Texas Workers’ Compensation Commission. Completion of the course should also provide the licensee with the abilities and skills necessary in managing these disputes as they proceed through the Texas Workers’ Compensation Commission at various levels (i.e., Benefit Review Conference, Benefit Contested Case Hearing).
Course 16: Psychiatric Claims Under TWCA (3.0 credit hours)
An overview of principles, rules/regulations and applicable cases regarding psychological and mental trauma claims and how these issues relate to loss adjustment in workers’ compensation claims in the state of Texas. The course focuses on not only the legal aspects of these claims, but the medical aspects, as well, therefore enhancing the adjuster’s ability to recognize and thoughtfully manage these delicate claims. The provider will draw upon existing applicable statute, case law, medical literature and TWCC Rules. The course will be taught by the provider in collaboration with a medical expert in the field of psychological conditions.
Course 17: A Bi-Partisan Approach to Handling Workers’ Comp Claims (2.5 credit hours)
An overview of principles, rules/regulations and applicable cases necessary for successful claim management and loss adjustment in workers’ compensation claims in the state of Texas. The course focuses on the legal aspects of these claims from both sides of the claim: Carrier and Claimant. The course will enhance the adjuster’s ability to recognize and thoughtfully manage legitimate, as well as fraudulent or malingering claims. The provider will draw upon existing applicable statute, case law, medical literature and TWCC Rules. The course will be taught by the provider in collaboration with a Claimant’s attorney.
Course 18: Understanding & Preventing Bad Faith Claims (3.0 credit hours) (ethics)
An overview of principles, rules/regulations and applicable cases regarding bad faith claims and how this issue relates to loss adjustment in workers’ compensation claims in the state of Texas. The course will focus on Article 21.21 of the Insurance Code, The Unauthorized Insurers False Advertising Process Act, The Unfair Claim Settlement Practices Act, The Deceptive Trade Practices – Consumer Protection Act, and will draw upon existing applicable case law.
Course 19: Spinal Injuries Under the TWCA (2.0 credit hours)
An overview of principles, rules/regulations and applicable cases regarding spinal injury claims and how these issues relate to loss adjustment in workers’ compensation claims in the state of Texas. The course focuses on not only the legal aspects of these claims, but the medical aspects, as well, therefore enhancing the adjuster’s ability to recognize and thoughtfully manage these serious and complicated claims. The provider will draw upon existing applicable statute, case law, medical literature and TWCC Rules. The course will be taught by the provider in collaboration with a medical expert in the field of spinal and orthopaedic injury treatment.
Course 20: When “It’s Not Fair” is Not Enough (1.0 credit hour)
An overview of principles, rules/regulations and applicable cases necessary for successful claim management and loss adjustment in workers’ compensation claims in the state of Texas. The course focuses on the issue of “good cause” as defined by the Texas Workers’ Compensation Act and the statute. The course will enhance the adjuster’s ability to recognize instances of “good cause,” as it relates to timely reporting of claims and disputes within the workers’ compensation system, thus leading to better management of claims. The provider will draw upon existing applicable statute, case law, medical literature and TWCC Rules.
Course 21: Understanding & Preventing Bad Faith Claims (1.0 credit hour) (ethics)
An overview of principles, rules/regulations and applicable cases regarding bad faith claims and how this issue relates to loss adjustment in workers’ compensation claims in the state of Texas. The course will focus on Article 21.21 of the Insurance Code, The Unauthorized Insurers False Advertising Process Act, The Unfair Claim Settlement Practices Act, The Deceptive Trade Practices – Consumer Protection Act, and will draw upon existing applicable case law.
Course 22: Impairment Ratings and the AMA Guidelines Under the TWCA (2.0 credit hours)
An overview of principles, rules/regulations and applicable cases and law, as well as the AMA Guidelines as they pertain to maximum medical improvement (“MMI”) and impairment rating assignment under the Texas Workers’ Compensation Act. The course will provide the licensee with the knowledge of what an impairment rating is, what the impact of the rating is and how to contest a rating if necessary. The licensee will also be provided knowledge of how impairment rating exams are performed by virtue of discussion and mock examination by a licensed physician/guest speaker.
Course 23: SIBs Under the New Rules (1.5 credit hours)
An overview of concepts, rules/regulations and applicable cases relating to Supplemental Income Benefits under the new and former Rules under the Texas Workers’ Compensation Act and “new” Texas workers’ compensation law.
Course 24: Workers’ Comp Mock Trial (3.0 credit hours)
An overview of principles, rules/regulations and applicable cases as they pertain to the trial phase of workers’ compensation law under the Texas Workers’ Compensation Act and the Texas Rules of Civil Procedure. The course will examine all phases of the civil suit and pertinent deadlines and strategies will be stressed.
Course 25: Workers’ Comp Update 2000 (3.0 credit hours)
An overview of updates in rules/regulations, principals, and cases pertaining to the year 2000.
Course 26: Workers’ Comp Update 2001 (2.0 credit hours)
An overview of updates in rules/regulations, principals, and cases pertaining to the year 2001.
Course 27: Workers’ Comp Subrogation & UM/UIM Coverage (1.5 credit hours)
An overview of the limitations on the ability of a workers’ compensation carrier to assert subrogation claims against Uninsured and Underinsured Motorist Coverage, both inter-company and intra-company. Bad faith implications in the handling of intra-company subrogation and UM/UIM coverage are also covered. The course will enable the licensee to become familiar with identifying the issues presented by attempts to subrogate against UM/UIM coverage and avoid potential bad faith situations.
Course 28: Spinal Injuries Under the TWCA: MD vs. DC (3.0 credit hours)
An overview of principles, rules/regulations and applicable cases regarding spinal injury claims and how these issues relate to loss adjustment in workers’ compensation claims in the state of Texas. The course focuses on not only the legal aspects of these claims, but the medical aspects, as well, therefore enhancing the adjuster’s ability to recognize and thoughtfully manage these serious and complicated claims. The provider will draw upon existing applicable statute, case law, medical literature and TWCC Rules. The course will be taught by the provider in collaboration with two medical experts in the field of spinal and orthopaedic injury treatment
Course 29: Principled Negotiation of Personal Injury Claims (2.0 credit hours)
An overview of the dynamics involved in negotiating personal injury cases, whether in the third party liability or workers’ compensation context. The course focuses on the identification of interests, the planning necessary for successful negotiation, and suggestions on impasse avoidance and navigation in the negotiation of a personal injury claim. The course will enhance the negotiating skills for the participants through discussion and interaction with the speaker.
Course 30: Overview of AWW Calculations and Issues (1.5 credit hours)
An overview of the issues involving Average Weekly Wage (AWW) calculations.
Course 31: Workers’ Compensation Update 2003 (2.0 credit hours)
An overview of the updates in rules/regulations, principals, and cases pertaining to the year 2003.