DECISION AND ORDER GRANTING SUMMARY DISPOSITION

Texas Property and Casualty Insurance Guaranty Association (on behalf of Reliance National Indemnity Company) (Carrier) has filed a motion for summary disposition in this case. Respondents_____. and the Texas Workers’ Compensation Commission have submitted their responses to the motion. After considering the motion and the responses, the Administrative Law Judge (ALJ) finds that summary disposition in favor of Carrier is appropriate.

I. Analysis

The issue in this case is whether house cleaning services are medical benefits or health care within the meaning of the Texas Workers’ Compensation Act (the “Act”). The ALJ concludes, as a matter of law, they are not and respondent ____ is not entitled to be reimbursed for them. In light of this conclusion, summary disposition under 1 Tex. Admin. Code § 155.57 is appropriate.

Section 401.011(31) of the Act defines a medical benefit as “payment for health care. . . .”^[1] The Act defines health care to include “all reasonable and necessary medical aid, medical examinations, medical treatments, medical diagnoses, medical evaluations, and medical services.”^[2] The repeated use of the adjective “medical” (and similar qualifying language) indicates the Legislature’s intention to restrict coverage to services provided by medical professionals, along with devices that are necessarily ancillary to the provision of those services. House cleaning services do not serve a medical purpose, and are not a medical aid, medical examination, medical treatment, medical diagnosis, medical evaluation, or medical service. Therefore, house cleaning services do not meet the definition of health care under the Act. Because house cleaning services do not meet the definition of health care, they do not qualify as a medical benefit for purposes of the Act and Respondent_______. is not entitled to reimbursement for them.

II. Findings of Fact

1. On May 1, 2001, the Medical Review Division of the Texas Workers’ Compensation Commission issued a Medical Dispute Resolution Findings and Decision under MDR Tracking No. M5-01-1457-01.
2. Pursuant to the Findings and Decision, Reliance National Indemnity Company (Reliance) was ordered to reimburse D. A. S. (“Claimant”) $240.20 for house cleaning services provided by “Life Maid Easy” maid service for dates of service from January 2, 2001, to February 26, 2001.
3. Reliance appealed the Findings and Decision of the Medical Review Division.
4. Reliance is an impaired insurer pursuant to Tex. Ins. Code Art. 21.28, et seq.
5. Texas Property and Casualty Insurance Guaranty Association (“TPCIGA”) has assumed handling of this claim.
6. TPCIGA, on behalf of Reliance, filed a Motion for Summary Disposition pursuant to section 155.57 of the SOAH Rules of Practice and Procedure.
7. The basis for the motion for summary disposition was that house cleaning services do not constitute a “medical benefit” or “health care” under the Texas Workers’ Compensation Act.
8. _______ and the Commission filed responses to the motion.
9. In its response, the Commission agreed with the motion for summary disposition, stating that “house cleaning services do not constitute a medical benefit’ or health care’ as contemplated by the Act.”
10. After considering the motion and the responses, the Administrative Law Judge granted the Motion for Summary Disposition.

III. Conclusions of Law

1. The Texas Workers’ Compensation Commission (Commission) has jurisdiction over this matter pursuant to Tex. Lab. Code Ann. § 413.031.
2. The State Office of Administrative Hearings (SOAH) has jurisdiction over this matter pursuant to Tex. Lab. Code Ann. § 413.031(d) and Tex. Gov’t Code Ann. Chapter 2003.
3. Section 401.011(31) of the Texas Workers’ Compensation Act (the “Act”) defines “medical benefit” as “payment for health care reasonably required by the nature of a compensable injury and intended to: (a) cure or relieve the effects naturally resulting from the compensable injury . . . (b) promote recovery, or 8 enhance the ability of the employee to return to or retain employment.” Tex. Lab. Code Ann. § 401.011(31).
4. According to the definition of “medical benefit” set out in Section 401.011(31) of the Act, payable medical benefits must constitute “health care.”
5. Section 401.011(19) of the Act defines “health care” to include “all reasonable and necessary medical aid, medical examinations, medical treatments, medical diagnoses, medical evaluations, and medical services.” Tex. Lab. Code Ann. § 401.011(19).
6. The statute’s repeated use of the adjective “medical” (and similar qualifying language) indicates an intention to restrict coverage to services provided by medical professionals, along with devices that are necessarily ancillary to the provision of those services.
7. House cleaning services do not serve a medical purpose, and are not a medical aid, medical examination, medical treatment, medical diagnosis, medical evaluation, or medical service.
8. House cleaning services do not meet the definition of “health care” under the Act.
9. Because house cleaning services do not meet the definition of “health care,” they do not qualify as a medical benefit for purposes of the Act.
10. Claimant is not entitled to reimbursement for house cleaning services.

IV. Order

Therefore, it is ORDERED that the Carrier’s motion for summary disposition is GRANTED, and Carrier is not required to reimburse Claimant for house cleaning services.

Signed AT AUSTIN, TEXAS the 19^th day of April, 2002.

STATE OFFICE OF ADMINISTRATIVE HEARINGS

CRAIG R. BENNETT
Administrative Law Judge

1. Tex. Lab. Code Ann. § 401.011(31).↑
2. Tex. Lab. Code Ann. § 401.011(19).↑