PartnerSource injury benefit plans afford medical coverage for those injuries and for conditions that directly and solely result from the course and scope of employment -- with a few exceptions. Consistent among the few exceptions are criteria that, if satisfied, indicate the work activity, although not the direct and sole cause of the injury, is to a reasonable degree of medical probability a major contributing cause. Hernias are one such exception.
A federal district court recently dismissed a case against Texas-based Tyson Foods, Inc., alleging exposure and contraction of COVID-19 by several employees at its Carthage, Texas, plant. The plaintiffs alleged that Tyson directed employees to return to work following stay-at-home orders and failed to provide personal protective equipment to its employees and implement social-distancing guidelines, which caused employees to contract COVID-19.
Podcast & Webinars
June 2021 webinar
July 2020 webinar
May 2020 podcast on Legal Talk Network
May 2020 webinar
February 2020 Sedgwick Institute podcast
August 2016 podcast
Have you experienced a situation where an employee injury is so unique that it’s challenging to determine how the injury benefit plan applies in that specific set of facts? For more than 30 years, PartnerSource has designed custom plans for clients and consulted on claim decisions when plan questions arise. Despite the level of detail included in these custom plans, it’s impossible for every claim scenario to be contemplated, creating gray areas that need to be interpreted by the plan fiduciary. This can seem like a daunting task, magnified by the understanding that the injured employee is impacted by the decision. However, PartnerSource has demonstrated that by approaching any seemingly gray area with a few key things in mind, employers can feel confident the plan is being applied appropriately and fairly.
She combined two unique interests in a career that helps injured workers. A self-described "type A" personality, she throws caution to the wind when she pursues some favorite hobbies. Having worked with PartnerSource before she ever worked for the company, this claims manager has the distinction of being the only PartnerSource employee to have won a very special award. Meet Sara Greene.
The Employee Benefits Security Administration (EBSA) division within the Department of Labor (DOL) recently completed a review of several Texas injury benefit plans, including plan documents PartnerSource had drafted over the years. This fall, PartnerSource and all programs reviewed received a no action letter with guidance on how to administer the injury reporting provisions in a manner more consistent with EBSA’s interpretation of a long-standing claim regulation. Here’s what we have learned.
Two industry professionals were recently awarded for their outstanding dedication to employees’ health and well-being. Diane Holliday, RN, BSN, COHN-S, director of operations with OccMD; and Melissa Smith, senior claims examiner with Sedgwick; were each honored for their compassionate commitment to injured workers as winners of the Compassionate Service Awards at the 2021 PartnerSource Employers’ Conference held September 30.
She’s analytical and amiable, and hails from Michigan. Most people know her as an expert on the Texas Option and how it helps businesses take better care of their injured employees – but most don’t know she comes from a family of sports fanatics. Meet Julie Lambeth.
In addition to helping clients stay in compliance with Texas injury benefit program and ERISA requirements, PartnerSource also keeps a watchful eye for any claims that could potentially have negligence liability exposure. It’s yet another benefit of utilizing PartnerSource’s claim consulting services.
Most PartnerSource plans contain generous plan benefits conditioned on an injured worker following the terms of the plan, including reporting the injury or seeking treatment within defined timeframes. But sometimes circumstances exist that the injured worker could not foresee or were beyond their control. Or some benefits may exist for which the injured worker simply doesn’t know to ask. A plan document should allow exceptions for unusual circumstances; and, as fiduciaries, plan administrators should lend a hand, asking questions to enable injured workers to access all available plan benefits.
By Amanda Thompson, J.D., senior vice president, PartnerSource
If you’ve discussed key opinions with anyone seeking to uphold arbitration in Texas in recent years, you’ve likely heard the word "Kmart" followed by a guttural groan. That same groan grew louder with the word "Aerotek." But thanks to the Texas Supreme Court, we are no longer groaning. In a recent decision favorable to employers that utilize electronic arbitration agreements (and, really, to all businesses that conduct electronic transactions in Texas), the Texas Supreme Court reversed the Dallas Court of Appeals decision in Aerotek.
A wise person once said, "The only GOOD claim is a closed claim." Successful Texas work injury programs take this wisdom even further to say, "The only GOOD claim is the one that never occurs!" In this case study illustrating how PartnerSource can help clients understand patterns and causes of work injuries and help devise a plan to mitigate future losses.
In case you missed this PartnerSource webinar, Remote Worker Injuries: Coverage Analysis, Risk Minimization, and Employer Responsibilities led by Julie M. Lambeth, J.D., executive vice president of PartnerSource, and Janet A. Hendrick, J.D., shareholder of Phillips Murrah, click here to listen as they discuss work from home as a reasonable accommodation, key remote work considerations, policies and best practices.
PartnerSource is participating in the Let’s Roll Toilet Paper Challenge, an initiative to help Metrocrest Services supply toilet paper for those in need. Please help us reach our goal of 500 rolls! Learn how you can help and some fun facts about toilet paper!
The 87th Texas Legislature began on January 12 and concluded May 31, 2021. Several bills impacting employers utilizing the Texas Option were on the table. PartnerSource President Jennifer Hurless explains how these bills were resolved and will impact the industry including the newly signed law offering COVID liability protections to businesses in Texas.
With increased vaccination access--coupled with the recent CDC exemptions for fully vaccinated persons--many employers are now very open to eliminating or reducing workplace mask requirements and other COVID-19 workplace accommodations. To help employers with this task, the new EEOC guidance answers some key questions.
She’s originally from halfway around the globe, but she’s as Texan as they come. For this team player, organization is the key to her success and her drive comes from her desire to help her client, their injured employers, and her fellow teammates. Meet Melek Kaplan.
Are injuries sustained while an employee is working from home covered under the employer’s occupational injury benefit plan? The answer is grounded in consistent claim investigations and consistent interpretation of plan definitions, and it just may surprise you.
For PartnerSource clients, most Texas work injury programs only see 1.5% of all work-related injury claims receive an attorney letter asserting negligence liability – and only 0.4% of work-related injury claims resulting in an actual lawsuit or arbitration demand. However, how you handle these claims can make or break your program. For that reason, it is critical that employers and TPAs have a basic understanding of negligence liability exposure for Texas work injury programs – and how that exposure differs from general liability exposure applicable to customers.
Are injuries sustained while an employee is working from home covered under the employer’s occupational injury benefit plan? The answer is grounded in consistent claim investigations and consistent interpretation of plan definitions, and it just may surprise you.
Born and raised in Junction City, Kansas, working remotely is something this account manager did long before the pandemic. She puts her educational skills to good use when helping clients select insurance, and she loves to connect through sports. Meet Kathy Glessner.
Industry Update: PartnerSource President Jennifer Hurless on Topics Important to the Texas Option
The Texas legislative agenda, DOL’s assessment of injury reporting, trends in injury benefit plan design, claims resolution and an important Texas Supreme Court case: Hear from Jennifer Hurless about current topics important to the Texas injury benefits industry.
From colleagues in this industry, we often hear the question, "How could I have handled this claim differently to reach a better end result for the injured worker?" With more than 25 years of experience, PartnerSource has proven that putting the injured worker first is the simple solution to the claims equation. The design of any injury benefit plan should revolve around the needs of an injured worker. To accomplish this, PartnerSource steps into the shoes of the injured worker, considering how their needs can be met before that person is ever injured on the job.
Since announcing my retirement from PartnerSource at the end of March, I’ve been reflecting on what has been a wild and wonderful ride. As I enjoy memories from decades in this business and think critically about what has led me to this next chapter, I see four themes that may also help you strive to be your best.
At the annual PartnerSource Employers’ Conference, clients have the opportunity to meet potential new vendor partners that share their commitment to better medical outcomes, improved benefits for injured workers and cost savings for employers. One employer’s challenge was solved recently by collaborating with one of these trusted vendors who were able to provide a creative outcome that benefited everyone involved.
It’s very likely that hers will be the first face you see if you come to the PartnerSource offices. She’s an engaging people person with her feet firmly planted on the ground, and a competitive streak she uses to push herself to be her best. Find out more about claims manager Valerie Harding.
PartnerSource Client Update: DOL Announces Rolling Terminations of COVID-19 ERISA Deadline Extensions
On February 26, 2021, the Department of Labor ("DOL") updated guidance that it previously issued on May 4, 2020 with respect to the COVID-19 pandemic, extending certain reporting and notice deadlines for employee benefit plans. Here is what you need to know about the changes.
Last month, my colleague Kelly Norwood reviewed the keys to playing a good defense, an important part to a successful Texas injury benefit program. I will review ways in which a great offense will allow you to achieve the best possible outcomes for your injury benefit program while providing excellent benefits for the participants.
In 2020, the Centers for Medicare & Medicaid Services ("CMS") proposed rules for calculating and imposing civil monetary penalties when a group health plan ("GHP") or non-group health plan ("NGHP") fails to comply with Section 111 Medicare reporting requirements. CMS technically has until 2023 to issue a Final Rule for CMS penalty enforcement – however, the recent release of a new Medicare Reporting User Guide may signal that CMS will issue this Final Rule sooner rather than later.
Five Questions with: Amber Cervin
She’s been on the PartnerSource team for 10 years and is now stepping into a new role to combine her love of communication with her knack for strategy and design. This sportswoman relishes her time in the outdoors and is excited to welcome a new addition to her family. Find out more about Amber Cervin.
Playing Good, Clean Defense in 2021: A Look at Your Plan's Coordination of Benefits Provisions
Let’s begin 2021 by studying your work-injury program’s legal and conceptual basis for “defending” the integrity of an occupational injury benefit plan while also protecting the viability and intent of federal benefit programs.
Modification of an Arbitration Award: The Trial Court’s Limited Authority
In Ortiz v. Builders First Source – S. Tex. LP, 2020 WL 7711294, *__ (Tex. App. – Houston [14th Dist.] Dec. 29, 2020, no pet.), the Court of Appeals for the 14th District of Texas denied Ortiz’s request to add pre-judgment interest and costs to his favorable arbitration award.
Five Questions with: Nan Dillon
She will don a Batman mask for a PartnerSource video, cheer on soccer teams in the freezing cold, and bring a smile or laugh to anyone she meets. Her fun, outgoing spirit is just part of the warm, driven individual that is vice president of Partnership Services at PartnerSource. Get to know Nan Dillon.
Working From Home during COVID-19: Reasoned Guidance for Texas Injury Benefit Plans
November 23, 2021
By Staci Cassidy , J.D., senior vice president of PartnerSource
COVID-19 has made working remotely a necessity in many industries. For example, many employers have issued computers to at-home workers, but have likely exercised little-to-no control over the employee’s at-home work environment. Does this recent uptick in the number of employees working from home expand the circumstances under which an injury may be considered “work-related” and eligible for occupational injury benefits?
Five Questions with: Alisa Garland
November 19, 2020
An insatiable curiosity drives Alisa Garland, information services manager, to dig deeply into the data to find out how and why people get hurt on the job. This dynamic professional is energized by her deep commitment to helping injured workers, taking care of her family, and finding the spiciest peppers on the planet. Find out more about Alisa Garland.
PartnerSource Honors Jeffrey Strege with Greenshield Award
Professional recognized for highest level of achievement in delivering better medical outcomes & economic development through alternatives to workers’ compensation
DALLAS, Texas (Oct. 28, 2020) – PartnerSource, the leading source for responsible alternatives to traditional workers’ compensation in Texas, recently honored with the Greenshield Award Jeffrey Strege, formerly senior director of risk management for Sysco Foods and now senior director of risk management with Academy Sports + Outdoors. The Greenshield Award is given to an outstanding professional who is committed to helping deliver better medical outcomes and economic development through responsible alternatives to workers’ compensation. Learn more about Jeffrey Strege.
PartnerSource Names 2020 Compassionate Service Award Winners
Winners noted for outstanding dedication to employees’ health and well-being
DALLAS, Texas (October 28, 2020) – PartnerSource, the leading source for responsible alternatives to traditional workers’ compensation in Texas, recently honored two industry professionals with awards for their outstanding commitment and dedication. Nancy Lott, an adjuster with Brinker International; and Jose Martinez, claims manager with Providence Risk and Insurance Services; were each honored for their compassionate commitment to injured workers. Learn more about the winners of the Compassionate Service Awards.
2020 Healthcare Benchmarking for Texas injury benefit programs reflects strong performance for injured workers, employers
October 26, 2020
Relying on the largest claims database for Texas injury benefit programs, PartnerSource has released the 2020 Texas Healthcare Industry Benchmarking Study. Results of the study indicate strong performance for both injured workers and employers.
Five Questions With: Manuel Sosa
October 21, 2020
For Manuel Sosa, a risk analyst with PartnerSource, numbers tell a story that can help people get back to work after an injury. While he loves the science of quantification (he has master’s degrees in both economics and finance!), one thing that he can’t put a number on is his love for this country, his drive to get here, or how much he loves giving back. Find out more about Manuel.
2020 Industry Update for Texas Injury Benefit Programs
October 8, 2020
Bill Minick, Chairman
2020 was an amazing year for Texas injury benefit programs, with:
- New, statistically-credible research showing advantages for injured employees and employers,
- More transparency in goals and processes,
- Successful rollout of an industry-self-regulated “Seal of Approval” for Texas injury benefit programs, called “QCARE”,
- Adapting to COVID-19, and
- Federal regulatory dialogue on prompt reporting of injury claims.
Five Questions with Arlene Markham
August 25, 2020
While she has a passion for critical thinking and analysis, Arlene Markham is someone who also isn’t afraid to follow her intuition, which has guided her through pivotal moments in her life to create an incredible life story. This risk technical analyst for PartnerSource is also deeply dedicated to serving others in both her professional and personal lives. Meet Arlene!
ABD Faux Pas: 5 Missteps to Avoid in Drafting Denial Letters under Texas Injury Benefit Plans
August 24, 2020
Sean Parker, vice president, PartnerSource
As part of PartnerSource’s claim consulting services, we see a broad mix of Adverse Benefit Determinations (ABDs) under Texas injury benefit plans. Recently, we were asked by a new client, “What are some of the common missteps you see when reviewing those letters?” There are several aspects to keep in mind when drafting denial letters under Texas injury benefit plans. Here are the top five:
In the News: PartnerSource Lends Expert View to Industry Magazine
August 19, 2020
Experts from PartnerSource are often called upon to lend their expertise. Recently, an article from Amanda Thompson, J.D., senior vice president of PartnerSource, was featured as an “Expert’s View” by WorkersCompensation.com. Read on for “A Pandemic in Play: Love, Basketball and 10 Tips for Success in Virtual Mediation.”
A Pandemic in Play: Love, Basketball and 10 Tips for Success in Virtual Mediation
July 22, 2020
Amanda Thompson, J.D., Senior Vice President
It has now been exactly four months since my world changed in the midst of this life-changing pandemic. On March 11, 2020, I got the call from my 84-year-old mother, who – in a most dreadful and devastated voice – shared with me important news: She informed me that the NBA had canceled its season.
In the midst of a pandemic, my mother wrestled with the loss of her favorite sport just as I struggled with how mediations of Texas negligence liability claims could be conducted by video conference (or “virtually”). Basketball and virtual mediations? If there’s one thing this pandemic has taught us, it’s to stay on your toes and not waste a second of game play, so lessons from the court translate well into business in a pandemic, too. Here are my tips for achieving success through virtual mediation, inspired by my mother’s favorite sport.
Fifth Circuit Further Addresses Arbitration Exemption for Transportation Workers
July 21, 2020
Julie M. Lambeth, J.D., Executive Vice President
Texas injury benefit programs cannot mandate arbitration of actual benefit disputes under the Employee Retirement Income Security Act (ERISA). However, such programs commonly mandate arbitration of any negligence liability claim by injured employees. The key to this ability on liability claims is the Federal Arbitration Act (FAA), which is of significant importance to nonsubscribers to Texas workers’ compensation. Read more here >>
Five Questions with Dikxi Varughese, Claims Manager
July 19, 2020
Like most parents, Dikxi Varughese has had to get creative to balance the challenges of work and family life in the midst of a pandemic. Find out how her open-minded approach and deep faith guides her in her roles as a mom and wife, and in her job as a claims manager with PartnerSource. Meet Dikxi.
4 things we’ve learned about COVID-19 & Texas Injury Benefit Programs
June 23, 2020
By Bill Minick, Chairman
Employers in and out of Texas workers’ comp handle COVID-19 injury claims similarly, and may have related liability exposures. But the pace of innovation and performance continues much faster in the Texas injury benefit program environment, led by companies that employ unsung heroes we finally recognize. Read more.
Podcast on the “QCARE Designation: What it Means for Texas Injury Benefit Programs”
June 16, 2020
This “Workers’ Comp Matters” podcast is hosted by Alan Pierce, one of the most respected and accomplished workers’ compensation claimant attorneys in the U.S. Alan visits with Bill Minick, chairman of PartnerSource, about why Texas laws differ from the rest of the country and how the newly-developed QCARE designation is an important marker of responsibility for Texas injury benefit programs. Click here to listen to this insightful conversation.
Five Questions with Amber Labry
June 15, 2020
As executive support for Jennifer Hurless, PartnerSource president, Amber Labry provides that extra hand that keeps things moving smoothly. Her creativity and passion for the mission of PartnerSource also make her a great addition to the marketing team, where she uses her design and organization skills to help others understand how PartnerSource can benefit their employees and their business. Meet Amber.
Form 5500 Filing Requirements During the Pandemic
June 10, 2020
Like most, your Texas Injury Benefit Plan may define the "plan year" as January 1 through December 31. If this is the case, your Form 5500 will be due on July 31, 2020 (the filing deadline is seven months after the end of the plan year). While the U.S. Government has extended some deadlines related to Employee Benefit Plans due to the COVID-19 national emergency, this does not apply to Form 5500 filing deadlines. Learn more here.
DOL EXTENDS ERISA CLAIM FILING DEADLINES
May 10, 2020
The U.S. Department of Labor has just issued a new rule that extends certain timeframes for Texas injury benefit and other ERISA plan participants in response to the COVID-19 pandemic. The rule became effective on April 30, 2020. We provide this initial guidance in good faith, using the information available to us at this time. We recommend all Texas injury benefit plan employer sponsors, service providers and insurers immediately and thoughtfully consider. Read more>>
Texas Supreme Court Changes Injury Litigation Rules for COVID-19
On April 27, 2020, the Texas Supreme Court issued its Twelfth Emergency Order regarding the COVID-19 State of Disaster. Of significance to personal injury and employment litigation, this Order does the following ...
FACTOR THIS: EXPOSING PREDATORY PRACTICES OF MEDICAL FACTORING COMPANIES AND RELATED INJURY LITIGATION
May 7, 2020
By Julie Lambeth, JD, PartnerSource Executive Vice President
We have all seen the attorney television advertisements touting large awards for their clients. They claim to fight the insurance companies to obtain the compensation their clients deserve for injuries sustained in an accident. This begs the question of how personal injury claims are being valued. Read full article>>
Five Questions With: Jason Thurmond
May 4, 2020
Jason Thurmond’s career went from construction and flooring to working with clients on their Texas injury benefit plans. While that may seem like an unlikely jump to some, for Jason it was pursuing a passion for taking care of people.
FAQ on COVID-19 under Texas injury benefit programs
May 1, 2020
On March 16, PartnerSource provided a client update on COVID-19 and Texas Injury Benefit Programs. Learn more about our second installment of COVID-19 guidance. Read more>>
Texas Nonsubscriber Insurance Market Insights
After more than a decade of hyper-competition that has driven soft (low premium) pricing from innovative insurers, the market for Texas injury benefit programs has experienced significant change in the past year. Read more>
Five Questions With Gabe Saenz
Gabe Saenz, senior team coordinator, celebrates his two-year anniversary with PartnerSource in April. Before joining PartnerSource, Saenz spent 10 years working in the legal profession. He spends a few minutes telling us about his work, his creativity, and a motto in which he finds great inspiration. Meet Gabe.
Texas Innovation: Applied to Injury Benefits
One of the many reasons Texas is a unique place for business is the opportunity to choose your own responsible injury benefit program. NTX, a publication of the North Texas Commission, profiled PartnerSource in its most recent issue, which focused on the future for Texas businesses. Read more>
Benchmarking studies reflect strong performance for injured employees, employers
Relying on the largest claims database for Texas injury benefit programs, PartnerSource performs biennial benchmarking studies within the healthcare, manufacturing, retail, trucking & distribution, restaurant, and hospitality industries. Read More>
Top 5 tips on getting injured workers back to work
The likelihood of a long, expensive leave of absence skyrockets if an injured employee is not treated well and the employer is disengaged. Learn 5 tips on getting injured workers back to work.
Five Questions With: Kelly Jones, director of administrative services and TSETA program manager
Kelly wears many hats at PartnerSource, and she keeps processes moving smoothly. What don’t you know about this 15-year veteran? You might be surprised to find out! Get to know Kelly>>
Top 4 Arbitration Practice Tips … At The Front End
July 22, 2019
by Amanda Thompson, PartnerSource Team Leader
There are well-established Texas law that favors agreements between workers and companies to arbitrate negligence liability claims. Learn four tips for arbitration.
Bucking trends in injured worker care for 25 years
June 26, 2019
Almost overnight, companies ramped up outsourcing of human capital processes, including workers’ compensation claims management. In the midst of rapid globalization and rethinking how best to support on-the-job injuries, PartnerSource was formed.
Texas injury benefit plans powered by PartnerSource keep getting better
June 20, 2019
Thirty years ago, senior partners at Dallas’ oldest and largest law firm were telling their young-pup-lawyer, Bill Minick (now PartnerSource Chairman) about how clients could no longer stay in business due to crazy-high workers’ compensation insurance costs.
On-the-job injury is a simple social policy issue, right? Well, not exactly… But it may be more straight-forward than you think.
June 10, 2019
Important topics that require determination and insight do need to be addressed, like injury benefit eligibility and benefit adequacy.
New Tax Laws Benefit Texas Workers in Alternative Plans
April 15, 2019
2018 opt-out taxes are down, so “Tim’s” injury benefits are up when he loses time from work
What about the Workers? Explosive Growth in Gig Economy, Including Lyft and Uber, Brings Worker Benefit Programs to Forefront
March 29, 2019
It’s ‘back to the future,’ as embryonic gig worker benefit programs look like Texas injury benefit plans 30 years ago
There’s no shortage of investment in the growing gig economy. With it comes significant interest in finding out how our modern workplace’s workers will be covered in the event of an injury or illness on the job. Read More>
PartnerSource Names Compassionate Service Award Winners
December 12, 2018
PartnerSource, the leading source for responsible alternatives to traditional workers’ compensation, recently honored two industry professionals with awards for outstanding commitment and dedication...
December 6, 2016
"This new TDI report, coupled with actuarial data on Texas Option performance -- which we have extensive and verifiable results on -- provides clear proof that Texas’ competitive environment encourages innovation and delivers positive results."
Oklahoma Innovative Work Comp Alternative Works, New Survey Says
February 11, 2016
The workers’ compensation alternative that Oklahoma legislators passed in 2013 is working, according to a new client survey conducted by PartnerSource. This is the first time data on the “Oklahoma Option” has been compiled.
Oklahoma Option Supreme Court Litigation and PCI Report on Cost Shifting
June 30, 2016
Option success: “The Oklahoma Option has been very successful in providing more information to workers on their rights and responsibilities, improving disability benefits for injured workers and achieving better medical outcomes. It has also dramatically reduced the number of claim disputes between employers and workers, and reduced costs for employers and taxpayers, which supports creation of new jobs in a struggling Oklahoma economy.”