The State Office of Risk Management provides risk management and insurance services to Texas state agencies, and also provides workers’ compensation benefits to injured state employees. The agency consists of three divisions – Legal Services, Strategic Programs, and Internal Operations.
Strategic Programs Division
The Strategic Programs Division is comprised of five departments, including Communications and Development, Claims Operations, Risk Management, and Document Processing.
The Risk Management Department provides Risk Management, Insurance, and Continuity of Operations Planning services to client agencies. SORM’s Risk Managers assist state agencies in establishing and maintaining risk management programs to protect state employees, state assets, and the public served; they also support the insurance, COOP, and workers’ compensation programs. SORM’s Insurance Managers develop and administer insurance programs to transfer the financial risk of the state, and provide consultative insurance services to our clients. In coordination with the Office of Homeland Security, Texas Division of Emergency Management, and Department of Information Resources, SORM’s Continuity Planner assists agencies with the implementation of the Continuity of Operations Planning (COOP).
Claims Operations performs initial file investigations of each reported injury and determines compensability. Claims examiners handle all aspects of claims as required by law and policy.
Document Processing is responsible for the initial setup and data entry of injury claims received, as well as the maintenance of all inactive claim files.
Communications is responsible for outreach, media, and business communications. The Communications department focuses on internal and external training, client and vendor relations, website services, video production, marketing, and business correspondence.
Legal Services Division
The Legal Services Division is comprised of three departments: Litigation, Fraud and Recovery, and Compliance and Practices.
The Litigation Department is responsible for presenting and directing SORM’s defenses during various administrative dispute resolution processes. Litigation also monitors and assists the Tort Litigation Division of the Office of the Attorney General when it represents the agency in administrative and judicial proceedings.
The Fraud and Recovery department focuses on subrogation, medical recovery, and fraud investigation. This Section is responsible for the recovery of workers’ compensation benefits, medical costs, and other expenses paid on behalf of state employees injured in the course and scope of employment due to the negligence of a third party. Medical recovery focuses on recovering monies from health care providers due to billing errors and coordinates with our two investigators in identifying fraudulent practices by injured workers and/or providers. They coordinate with various district attorneys across the State to recover these funds.
The Compliance and Practices department focuses on the review and updating of existing policies and procedures. The department also provides quality assurance by auditing claims for compliance with all statutory and policy requirements, tracking overpayments both statutory and errors. In addition, the department manages contracts, customer complaint/ethics, and open records functions. They also provide legal and policy assistance for agency-wide issues, as well as decisions that affect covered state agencies. They track relevant legislation and respond to Legislative inquiries, and work with executive management to comment and educate on proposed rules and legislation.
Internal Operations Division
The Internal Operations Division consists of three departments, including, Accounting, Human Resources, and Information Resources.
Accounting processes and issues approved workers’ compensation medical and indemnity payments to claimants and medical providers, including the cancellation, re-issue, and correction of warrants. This division also administers the assessment program which allocates the amounts to participating state agencies for the costs of operating the agency, including processing workers’ compensation claims. Fund Accounting provides all accounting and budget functions for the agency in coordination with the Office of Attorney General (OAG) Accounting and Budget Divisions.
Human Resources serves as a liaison between SORM and the full OAG HR division and the SORM Legal Services Division, and is responsible for personnel action and leave accounting
Information Resources maintains RMIS, CMS and other systems and interfaces; monitor and provide data; and oversee and respond to security issues. The support staff conducts all agency hardware and software maintenance; monitor software licensing; maintain user access; maintain passwords; and interface with OAG IT.