TXMF-TXSG-J1                                                                                             24 March 2008

 

 

MEMORANDUM FOR ALL TEXAS STATE GUARD COMMANDERS AND MEMBERS

 

SUBJECT: TXSG Policy Memorandum for Reporting Claims Under State Worker's Compensation

 

1.  The purpose of this memorandum is to establish the command policy for reporting any injury involving members of the Texas State Guard who are serving in a duty status for the Texas Military Forces.  This policy applies to all members of the TXSG.  This is the initial policy memorandum for this command interest matter.

 

2.  Effective the above date, duty status includes any TXSG member who is activated for state active duty by a TXMF-directed deployment order and/or a HQ TXSG approved unit training as documented by a signed unit training schedule.  The member's attendance must have been entered into a command-certified duty reporting document at the beginning of such duty.

 

3.  Proper and timely reporting procedures are a required for TXSG members to access Worker's Compensation benefits under Texas Law.  Upon sustaining any injury, the member must immediately notify their immediate commander of the nature of the injury, date and time of the injury, and the relevant circumstances.  The member must then fill out an Employee's Report of Injury (Form SORM-29) and an Authorization for Release of Information (form SORM-16) and insure they are received by the State Office of Risk Management NLT 5 calendar days after the accident is reported to his/her "front line supervisor".  Additionally, any witnesses to the accident must fill out a Witness Statement (form SORM-74).  These forms can be downloaded at http://www.sorm.state.tx.us/Claims_Coordinator_Handbook/form.php. 

 

4.  The member's immediate commander will notify the J1, TXSG at (512) 782-5101 of the incident and all pertinent data within 24 hours of being notified of the accident.  The commander must also complete an Employers First Report of Injury (form DWC-IS) which must be sent electronically to the State Office of Risk Management within 5 days of being notified by the employee of the accident (with a copy forwarded to HQS, TXSG, ATTN: J1).  This form can be filled out on-line at http://www.sorm.state.tx.us/Claims_Coordinator_Handbook/form.php.  Additionally, the member's commander must perform a Line of Duty Investigation to gather all pertinent information pertaining to the injured member within 72 hours of notification of an accident.  The LOD will be forwarded through the chain of command to the J1 for review and action. 

 

5.  The injured employee has one year to submit a Claim for Compensation (form DWC-41) with the Texas Department of Insurance Division of Worker's Compensation.  Final determination of “course and scope” of coverage as well as benefits, if any, will be made by the State Office of Risk Management.

 

 

 

6.  An accident must be reported within 30 days of its occurrence; failure to do so will automatically invalidate any employee's worker's compensation rights.  Assistance or information concerning Worker's Compensation can be obtained at the Texas Department of Insurance Division of Worker's Compensation Help-Line at (800) 252-7031.

 

7.  Questions about this policy should be directed to HQ, TXSG (ATTN: JFTX-TXSG- J1). 

FOR THE ADJUTANT GENERAL

                                                                                               

 

                                                                        CHRISTOPHER J. POWERS

                                                                        Major General, Texas State Guard

                                                                        Commanding