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When the law leads to unintended consequences

On Behalf of | Feb 7, 2019 | Policy Design And Implementation |

Workers’ compensation is not a mandated benefit in Texas. That is one of a few ways in which our state differs from others. At the same time, some employers, including many local municipalities and political subdivisions do carry some form of coverage. The Texas Municipal League Intergovernmental Risk Pool (TMLIRP) is one such provider.

While one of the missions this organization says it fulfills is protecting those who protect us, such as firefighters, police and other government employees, there can be times when things don’t go as smoothly as anyone would like. Conflicts between desired policy and legal requirements crop up. The work of anticipating issues and striking an effective balance between competing interests can be difficult, but not impossible.

A developing story out of the community of Mission brings this to mind. As one of the central players in the scenario acknowledges, the circumstances have created a situation that is “really awkward” for everyone.

Specifically, there is a city firefighter with kidney cancer. He’s been treated for the condition and been compensated for it by the TMLIRP. But, initially, TMLIRP denied the claim. It paid only after losing two appeals before the Texas Department of Insurance. And now, the insurer is suing the firefighter in the name of the city. No one is very happy with this turn of events.

City leaders in Mission say they back the firefighter’s claim and want TML to drop the suit. But TML says it doesn’t have a choice. It says that Texas law restricts the kinds of cancer for which it can provide compensation and kidney cancer isn’t one of them.

A spokesman for the league says the suit does not reflect any ill will toward the firefighter. He says filing suit is the only avenue available to seek appeal of the decisions by the Department of Insurance. And he says there are about a dozen other similar cases on the same track.

Meanwhile, Mission city leaders plan to write to the TML to ask for a chance to argue for dropping the suit. They say that seems to be the only solution available to them at this point.

How this case will be resolved we do not know. What we do know is that whatever the outcome, it will likely have political and/or financial implications for TML and the members of the Intergovernmental Risk Pool that will need to be addressed.



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