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At a Glance:
Title:
09196
Date:
July 15, 2009
Status:
Concurrent Medical Necessity

09196

July 15, 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 July 15, 2009 to decide the following disputed issue:

Is the preponderance of the evidence contrary to the decision of the Independent Review Organization (IRO) that the Claimant is not entitled to cervical epidural steroid injections with fluoroscopy for the compensable injury of _________?

PARTIES PRESENT

Petitioner/Claimant appeared by telephone and was assisted by LM, ombudsman. Respondent/Carrier appeared by telephone and was represented by JL, attorney.

AGREEMENT

The parties reached an agreement. The agreement resolves only those issues to be decided at this hearing. The agreement does not resolve all issues with regard to this claim and is not a settlement.

In this decision, this Agreement section includes findings of fact and the Decision section constitutes the conclusions of law.

The Hearing Officer found:

A.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 1.

The parties stipulated as follows:

  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 of the Texas Department of Insurance, Division of Workers’ Compensation.
  3. The Claimant sustained a compensable injury on _________ while in the course and scope of her employment with (Employer).

The parties agreed as follows:

that the preponderance of the evidence is not contrary to the decision of the IRO that the proposed cervical epidural steroid injections with fluoroscopy are not reasonable and necessary.

DECISION

Per the parties' agreement, the preponderance of the evidence is not contrary to the decision of the IRO that the proposed cervical epidural steroid injections with fluoroscopy are not reasonable and necessary.

ORDER

The Carrier is not liable for the benefits at issue in this hearing. The Claimant remains entitled to medical benefits for the compensable injury in accordance with Section 408.021.

The true corporate name of the insurance carrier is AMERICAN HOME ASSURANCE CO., and the name and address of its registered agent for service of process is

CORPORATION SERVICE CO.

701 BRAZOS, STE. 1050

AUSTIN, TX 78701

Signed this 15th day of July, 2009.

Patrice Fleming-Squirewell
Hearing Officer

End of Document
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