Your FREE and easy resource for all things Texas workers' compensation
At a Glance:
Title:
10018-m6r
Date:
September 1, 2009

10018-m6r

September 1, 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 August 31, 2009, to decide the following disputed issues:

  1. Is the preponderance of the evidence contrary to the decision of the Independent Review Organization (IRO) that the claimant is entitled to an initial trial of 10 sessions of a chronic pain management program?
  2. Is the preponderance of the evidence contrary to the decision of the Independent Review Organization (IRO) that the claimant is not entitled to continued chronic pain management x 10 sessions?

PARTIES PRESENT

The petitioner/carrier appeared by telephone and was represented by LW, attorney. The claimant appeared by telephone and was represented by KW, attorney, by telephone. The respondent/provider appeared by telephone and was represented by RL, attorney.

AGREEMENT

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

In this decision, the Agreement section constitutes the Findings of Fact and the Decision section constitutes the Conclusions of Law. This agreement was made orally on the record.

The parties agreed to the following:

  1. Venue is proper in the (City) Field Office of the Workers’ Compensation Division of the Texas Department of Insurance.
  2. On _________, the claimant was the employee of (Self-Insured), a Self-Insured Employer.
  3. On _________, the claimant sustained a compensable injury to her lumbar spine.
  4. The IRO determined in a report dated June 17, 2009 that the claimant is entitled to an initial trial of 10 sessions of a chronic pain management program.
  5. The IRO determined in a report dated August 18, 2009 that the claimant is not entitled to continued chronic pain management x 10 sessions following the initial 10 sessions.
  6. The claimant is entitled to the initial 10 sessions of a chronic pain management program which were the subject of the June 17, 2009 IRO decision.
  7. The claimant is entitled to two of the 10 additional sessions of chronic pain management which were the subject of the August 18, 2009 IRO decision, for a total of 12 sessions.
  8. The claimant is not entitled to the last eight of the 10 additional sessions of chronic pain management which were the subject of the August 18, 2009 IRO decision.
  9. Carrier delivered to Claimant a single document stating the true corporate name of Carrier, and name and street address of Carrier's registered agent which was admitted into evidence as Hearing Officer's Exhibit Number 2.

DECISION

The Workers’ Compensation Division of the Texas Department of Insurance has jurisdiction to hear this case. Venue is proper in the (City) Field Office. The claimant is entitled to a total of 12 sessions of a chronic pain management program out of the 20 sessions requested by the claimant.

ORDER

The carrier is liable for 12 of the 20 sessions of a chronic pain management program at issue in this hearing. The 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:

CSC

(STREET ADDRESS)

(CITY), TX (ZIP CODE)

Signed this 1st day of September, 2009.

William M. Routon, II
Hearing Officer

End of Document
Top