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At a Glance:
Title:
09080
Date:
January 16, 2009
Status:
Concurrent Medical Necessity

09080

January 16, 2009

DECISION AND ORDER

This case is decided pursuant to Chapter 410 of the Texas Workers’ Compensation Act and Rules of the Division of Workers’ Compensation adopted thereunder.

ISSUES

A contested case hearing was held on January 15, 2009, to decide the following disputed issue:

  1. Is the preponderance of the evidence contrary to the decision of the Independent Review Organization (IRO) that urine toxicology screens on March 31, 2008, and June 2, 2008, were reasonably required health care for the compensable injury of __________?

PARTIES PRESENT

Petitioner/Carrier appeared and was represented by TW, attorney. Respondent/Claimant appeared and was assisted by MF, ombudsman.

BACKGROUND INFORMATION

Petitioner/Carrier announced that it had mistakenly appealed the IRO decision that the toxicology screens performed on March 31, 2008, and June 2, 2008, were medically necessary and that it would stipulate that those toxicology screens were reasonably required health care for the compensable injury.

FINDINGS OF FACT

  1. The parties stipulated to the following facts:

A.Venue is proper in the (City) Field Office of the Texas Department of Insurance, Division of Workers’ Compensation.

B.On __________, Claimant sustained a compensable injury while employed by the (Employer).

C.The toxicology screens taken on March 31, 2008, and June 2, 2008, were reasonably required health care for the compensable injury of __________.

  • Carrier delivered to Claimant a single document stating the true corporate name of Carrier, and the name and street address of Carrier’s registered agent, which document was admitted into evidence as Hearing Officer’s Exhibit Number 2.
  • CONCLUSIONS OF LAW

    1. The Texas Department of Insurance, Division of Workers’ Compensation, has jurisdiction to hear this case.
    2. Venue is proper in the (City) Field Office.
    3. The preponderance of the evidence is not contrary to the decision of IRO that toxicology screens performed on March 31, 2008, and June 2, 2008, are reasonably required health care for the compensable injury of __________.

    DECISION

    Claimant is entitled to toxicology screens performed on March 31, 2008, and June 2, 2008.

    ORDER

    Carrier is liable for the benefits at issue in this hearing. Claimant remains entitled to medical benefits for the compensable injury in accordance with §408.021.

    The true corporate name of the insurance carrier is (SELF-INSURED) and the name and address of its registered agent for service of process is

    CITY SECRETARY

    (ADDRESS)

    (CITY), TEXAS (ZIP CODE).

    Signed this 16th day of January, 2009.

    KENNETH A. HUCHTON
    Hearing Officer

    End of Document
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