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At a Glance:
Title:
453-02-1772-m6
Date:
June 28, 2002

453-02-1772-m6

June 28, 2002

DOCKET NO. 453-02-1772.M6

PROPOSAL FOR DECISION

The Staff for the Medical Review Division of the Texas Workers' Compensation Commission (the Staff/Commission) recommended that Nilon Tallant, M.D. (Petitioner) be denied approval for reinstatement to the Commission's approved doctor list (the ADL). The Staff alleges that Petitioner treated workers= compensation patients (injured workers) prior to being reinstated by the Commission to the ADL, proving his unwillingness to comply with the Commission order deleting him from the ADL. Dr. Tallant admits he treated injured workers prior to being reinstated on the ADL, but claims it was unintentional. Dr. Tallant requested a hearing. The Administrative Law Judge (ALJ) concludes Dr. Tallant unintentionally violated the Commission order, and should now be reinstated on the ADL and recommends the Commission so order.

I. NOTICE, JURISDICTION, AND PROCEDURAL HISTORY

As there were no contested issues of notice or jurisdiction, those issues will not be discussed except in the Findings of Fact and Conclusions of Law set forth below.

The hearing in this matter convened April 4, 2002, before State Office of Administrative Hearings (SOAH) ALJ Catherine C. Egan. Timothy P. Riley, Commission attorney, appeared on behalf of Staff. Jim Duvall, attorney, appeared on behalf of Dr. Tallant. After receipt of the parties' briefs and written closing arguments on April 29, 2001, the ALJ closed the record the following day.

II. BACKGROUND

Dr. Tallant, who is a seventy-one-year-old man, began practicing medicine in 1957. The first few years he served on active duty with the Air Force. In 1978 he joined the Air Force Reserves (Reserves), and developed a specialty in occupational medicine as the flight surgeon at Kelly Air Force Base in San Antonio. He retired from the Reserves as a Colonel in 1993.

In 1985, while in the Reserves, Dr. Tallant opened a family practice in San Marcos, Texas. Because of the work he was doing in the Reserves, Dr. Tallant's practice evolved into occupational medicine treating injured workers.[1] In 1993, when Section 408.022 of the Tex. Labor Code Ann. ( the Act) created the ADL, Dr. Tallant was automatically placed on it, as were other doctors licensed to practice medicine in Texas.

Dr. Tallant treated patients without incident for 30 years. In 1995, Dr. Tallant was charged with having an improper relationship with a 17-year-old girl. Dr. Tallant entered into an Agreed Order on August 17, 1996, with the Texas State Board of Medical Examiners (Medical Board) which included the revocation of his medical license (C5259) effective January 1, 1997. It is undisputed that the revocation of Dr. Tallant's medical license had nothing to do with the quality of care he provided in his medical practice. Dr. Tallant complied with the Medical Board's order and worked to have his medical license reinstated.

Almost three years later, the Commission notified Dr. Tallant that it was removing him from the ADL because he was no longer licensed. The May 16, 2000 Commission order states:

Upon the effective date of this order the aforementioned doctor listed in this order, except in an emergency, shall not provide medical treatment to an "employee" with a "compensable injury," as the terms are defined in Tex.Lab. Code, '' 401.011(10) and 401.012. On and after the effective date of this Order, the doctor listed in this Order is required to inform any injured employee seeking treatment under the Texas Workers= Compensation Act of the deletion from the ADL and that the injured employee may not, except in an emergency, receive treatment from the aforementioned doctor.[2]

Dr. Tallant explained that because the Medical Board had already revoked his medical license, he accepted the Commission's determination. However, he called the Staff to find out what he needed to do to get back on the ADL if the Medical Board reinstated his medical license. From his conversation with the Staff, Dr. Tallant understood all he needed to do to be put back on the ADL was to file proof that his medical license was reinstated and submit a completed application.

On June 20, 2001, the Medical Board reinstated Dr. Tallant's medical license. The next day he returned to his medical practice at Occupational Health Services. He called the Commission's Doctor Regulation & Enforcement Team (DRET) asking to be reinstated on the ADL. In response, a DRET employee, Randy Russell, sent Dr. Tallant by facsimile transmission (fax), an "Application For Approved Doctor List," and provided the following written instructions:

The Commission has received your request to be reinstated on the Commission's Approved Doctor's List. In order to process your request it is necessary that you complete an Approved Doctor's Application and submit it along with documentation of corrective action to support your request for reinstatement.[3]

Dr. Tallant understood from his conversation with DRET that if he filed with the Commission the completed application and proof that the Medical Board had reinstated his medical license he would be "ready to go again."[4] Neither the application, nor the instructions on the cover sheet, advised Dr. Tallant not to treat injured workers until he received notification from the Commission that he was on the ADL. Neither notified Dr. Tallant that the Commission had a web page listing doctors on the ADL so he could confirm that he reinstated on the list. On June 25, 2001,[5] Dr. Tallant began treating injured workers. On June 28, 2001, he filed his application to be reinstated on the ADL with the Commission.

Although DRET knew Dr. Tallant was treating injured workers as early as the fall of 2001, it was not until the Staff's letter dated January 23, 2002, (the denial letter)[6] that Staff notified Dr. Tallant he was not on the ADL. The Staff also notified Dr. Tallant that it was recommending against reinstatement because he had treated injured workers (in non-emergency situations) in the year 2000 in violation of the Commission's order. On January 28, 2002, Dr. Tallant requested a hearing on the recommendation. The following day he stopped treating injured workers.

Dr. Tallant collected his records and proved to the Staff's satisfaction that he had not treated any patients in 2000 as alleged the denial letter. But because he admitted treating injured workers after his medical license was reinstated on June 20, 2001, the Staff recommended against his reinstatement for treating injured workers during the period he was not on the ADL.

III. LEGAL STANDARDS

Section 408.022 of the Texas Labor Code requires that "except in an emergency, the commission shall require an employee to receive medical treatment from a doctor chosen from a list of doctors approved by the commission." As of January 1, 1993, all doctors licensed in Texas were automatically placed on the Commission's ADL. The doctors remain on the list unless deleted by the Commission. Pursuant to the mandate in ' 408.023 of the Act to establish criteria for deletion, the Commission adopted the rule at 28 Tex. Admin. Code (TAC) ' 126.8(d), which lists the reasons for deletion, including:

(1) sanctions imposed by the commission against the doctor for violations of the Act, commission rules, or commission orders;

(7) other activities which warrant deletion.

Deletion from the list renders the doctor ineligible to treat workers' compensation patients. 28 TAC ' 126.8(f). The Commission's mandate also required adoption of procedures for reinstatement to the list. Reinstatement requires an application for reinstatement and a Medical Review Division (MRD) finding that the doctor: (1) has all the appropriate unrestricted licenses to practice medicine; (2) has overcome the conditions which resulted in deletion; and (3) is entitled to reinstatement. 28 TAC ' 126.8(g).[7] If MRD determines that "the doctor has not met the requirements for reinstatement, or for other reason should not be reinstated," it must notify the doctor by certified mail and advise the doctor that it intends to recommend to the Commissioners that the doctor not be reinstated to the ADL.

The Staff has the burden of proving by a preponderance of the evidence that the grounds for denial of reinstatement are justified. 28 TAC ' 148.21(h) and (i).

IV. Should Dr. Tallant be Reinstated to the List?

A. Staff's Evidence

Staff claimed Dr. Tallant should not be reinstated to the ADL, because if he were on the ADL, the Commission would delete him from the ADL pursuant to 28 TAC ' 126.8(d)(1) for violating the Commission order. Irma Chavez, manager of DRET[8], recalled speaking with Dr. Tallant three times. The first time was on June 29, 2001. Ms. Chavez testified that she told Dr. Tallant that when the Commission removes a doctor from the ADL, the doctor has to "reapply with us again and fill out the application."[9] Dr. Tallant said he had already done that, so she advised him to look on the Commission's web page to see if the Commission listed him on the ADL. She also recalled telling him that he would be notified by certified mail when he was reinstated on the ADL.

Several weeks later, Ms. Chavez testified, Dr. Tallant called again and asked her several questions. She remembered him telling her, "I just want to be a good doctor,"[10] and that he was not overbilling or unbundling. She recommended to Dr. Tallant that he speak with his attorney. According to Ms. Chavez, Dr. Tallant was very pleasant.

Ms. Chavez heard from Dr. Tallant one other time, after he received the Staff's letter denying his reinstatement to the ADL. Again, she told him to speak with his attorney and to follow the order on how to appeal. Dr. Tallant admitted to her that he was treating patients and stated he was trying to do the right thing, and trying to do "good doctoring."[11]

When Dr. Tallant's application arrived, Ms. Chavez explained, two different people on her staff worked on it: Randy Russell and Michael Torres. By July 11, 2001, DRET received a portion of Medical Board's order reinstating Dr. Tallant's medical license. Ms. Chavez asked for a copy of the entire order, which she received on July 18, 2001. DRET also ran a SAS report[12] to learn if Dr. Tallant had billed for services provided to injured workers while off the ADL. DRET received all of the required information by the end of July 2001, to refer the matter to the Doctor Deletion Team (DDT) for consideration. Unfortunately, the Commission experienced changes in the individuals serving as the Director and Executive Director during this period causing delays in processing applications for reinstatement. As a result, Dr. Tallant's application was not considered until the October 2001 DDT meeting. While not a voting member, Ms. Chavez participated in the DDT meetings. Ms. Chavez could not remember if the DDT met in August or September 2001.

During the October 29, 2001, DDT meeting, they discussed Dr. Tallant's application, then tabled it. During the November 30, 2001, DDT meeting, Ms. Chavez reported to DDT that DRET had received an anonymous tip that Dr. Tallant was treating injured workers while not on the ADL. The team asked for an updated SAS report to detect if Dr. Tallant had billed for the treatment of injured workers. According to Ms. Chavez, the SAS computer system had not worked properly from July 2001 to April 2002, and DRET's initial investigation did not show that Dr. Tallant had billed for services provided to injured workers.

Under cross examination, Ms. Chavez admitted that she had spoken with a thousand doctors during this time. She agreed that documenting her conversations with these doctors was important. Nonetheless, only one note exists documenting her conversation with Dr. Tallant. This scant note reads:

29th

Dr. Tallant

Sent form to be approved

for reinstatement[13]

The note does not show wht month she wrote it or to whom she was speaking. Moreover, the note does not embrace the portion of her alleged conversation with Dr. Tallant regarding her cautionary statements to him. While Ms. Chavez testified initially that Dr. Tallant used the phrase Agood doctoring during her second conversation with him, under cross-examination, she stated that it happened during her June 29, 2001, conversation with him. Ms. Chavez also admitted that Randy Russell faxed the application to Dr. Tallant, and she had no idea whether he spoke with Dr. Tallant because DRET did not require its staff to log in telephone calls.

Ms. Chavez acknowledged that the cover sheet faxed by DRET to Dr. Tallant did not tell him to refrain from treating injured workers until the Commission notified him that he was reinstated on the ADL. Likewise, Ms. Chavez could not explain why she failed to advise the DDT that Dr. Tallant was treating injured workers, as she claims he admitted to her in their first and second conversation. Instead, she testified she waited until DRET received an anonymous tip that Dr. Tallant was treating injured workers without being on the ADL to advise DDT of this violation. Even then, the Staff did not send Dr. Tallant a letter telling to stop treating injured workers because he was not on the ADL. The first time Dr. Tallant received any written response regarding his application was when the Staff sent him the denial letter dated January 23, 2002.

Dr. Tallant's evidence

Dr. Tallant asserts that he unintentionally violated the Commission's order, believing he was added to the ADL after he filed his application and proof that his medical license was reinstated. When the ADL was enacted, he and all other Texas doctors were automatically included on the list. Logically, Dr. Tallant opined, it was reasonable for him to believe that once the reason for his removal from the ADL was corrected (his medical license restored), the Commission would automatically reinstate him on the ADL. He believed that the Staff confirmed that his reinstatement was automatic during their discussions before he submitted his application.

Dr. Tallant denied speaking with Ms. Chavez, or anyone with the Commission, from the filing date of his application, June 28, 2001, until he received the denial letter on January 28, 2002. In the denial letter, the Staff accused him of treating injured workers in 2000, informed him that he was not on the ADL, and alleged he violated the Commission order by treating injured workers. Dr. Tallant spoke with Ms. Chavez after he received the denial letter and she told him to speak with Mr. Riley (Staff's counsel), which he did. Dr. Tallant told his employees that he could not treat injured workers until he was on the ADL and together he and his employees signed and sent a letter to Mr. Riley attesting to their desire to return to work serving injured workers.[14] According to Dr. Tallant, he did not know the Commission had a web page, did not know he could look at the ADL on this web page, and did not know he needed to wait until the Staff notified him in writing that the Commission had reinstated him on the ADL before treating injured workers. Had he known these things, Dr. Tallant maintains, he would not have treated injured workers.

While Dr. Tallant conceded he violated the Commission's order, he argued he did not do it intentionally or through indifference, but because he misunderstood what it took to be reinstated on the ADL and believed filing the request for reinstatement was sufficient. However, Dr. Tallant began treating injured workers three days before filing his application with the Commission. In some instances, another doctor in his office may have treated the injured worker, but not all. Dr. Tallant's explained that he was anxious to return to his practice after an absence of almost four years.

The Staff questioned whether Dr. Tallant stopped treating injured patients immediately after receiving the denial letter on January 28, 2002. Dr. Tallant apparently signed the TWCC Form 53 (Employee's Request to Change Treating Doctors) for an injured worker on January 28, 2002, although it was dated January 25, 2002. However, nothing in the record suggested Dr. Tallant treated this injured worker after January 28, 2002.

Dr. Tallant did treat an injured worker on January 29, 2002 after receiving the denial letter. While he did not identify this injured worker as requiring emergency care in response to Staff's discovery request, Dr. Tallant testified he should have. According to Dr. Tallant, (injured worker). is a diabetic who was suffering with a puncture wound. Dr. Tallant treated the wound and referred (injured worker) to the Health Department for a tetanus booster. Because the injured worker was a diabetic, Dr. Tallant opined, treating the puncture wound aggressively was necessary. He has not treated any injured worker since.

C. Reinstatement Recommended

Being included on the Commission's ADL is a revocable privilege conveyed with a Texas medical license. To keep the privilege, the provider must follow the Act and the Commission's rules and orders. Fundamental to remaining on the ADL is having an appropriate medical license. Once Dr. Tallant's medical license was revoked, the Commission properly deleted him from the ADL under 28 TAC ' 126.8(d)(4). The question is whether the Commission should now reinstate him on the ADL.

The Commission rules dictate that to be reinstated on the ADL the doctor must apply for reinstatement. Then the MRD must determine three things. First, it must determine if the doctor has the required license to practice. Dr. Tallant currently holds a medical license. Second, it must determine if the doctor has overcome the condition that resulted in his deletion from the ADL. As Dr. Tallant's revocation from the ADL was based solely on the revocation of his medical license, once his medical license was reinstated, he met this criterion. Third, it must determine if Dr. Tallant should be reinstated. This third requirement is in dispute.

The Staff's sole witness was Ms. Chavez. Ms. Chavez's recollection of her conversations with Dr. Tallant was confusing at best. She asserted throughout her testimony that she usually keeps notes of her conversations with doctors, but she produced only one scant note regarding Dr. Tallant. Ms. Chavez attested that she could remember the dates and contents of her conversations with Dr. Tallant, but she could not remember whether the DDT met in August and September 2001Cmeetings she attends.

Ms. Chavez's unsupported testimony did not convince the ALJ that she told Dr. Tallant prior to January 28, 2002, that he could not treat injured workers until he received notice from the Commission that he was reinstated on the ADL. It is difficult to believe she could remember the date and details of one out of a thousand different conversations with doctors without some written documentation. Unfortunately, DRET did not keep records of these calls, nor did Ms. Chavez document her telephone calls with Dr. Tallant except for the cryptic note mentioned above. In addition, to accept Ms. Chavez's recollection of her conversations with Dr. Tallant, the ALJ would have to believe that Ms. Chavez knew Dr. Tallant was treating injured patients while deleted from the ADL, yet did nothing until she received the anonymous tip in October or November 2001 telling her what she already knewCthat Dr. Tallant was treating injured workers prior to being reinstated on the ADL. If this happened, it appears to be dereliction of duty by Ms. Chavez. Due to the lack of documentation, and her failure to follow through either directly with Dr. Tallant, or internally with DDT, when Dr. Tallant told her he was treating injured workers, the ALJ found Ms. Chavez's testimony to be less than credible.

Dr. Tallant='s explanation for why he began treating injured workers was credible. His belief, based on prior experience, that he would be automatically placed on the ADL, his interpretation of the instructions (or lack of) that he received from Staff coupled with the Staff's inordinate delay in responding to his application, and his exuberance at being able to practice medicine collectively resulted in his unintentional violation of the Commissioner order.

Dr. Tallant's history with the Commission has always been good. He has provided excellent, compassionate care to the injured workers. He has properly reported, documented, and billed for the services he provided to injured workers. Until this incident, Dr. Tallant has abided by the Commission's rules. Many injured workers and companies have come to trust and depend on him for his medical expertise as demonstrated by the many letters submitted on his behalf to the Medical Board. To prevent him from being reinstated on the Commission's ADL at this time would be an extreme sanction for this unintentional infraction.

Because this is an "all or nothing" situation, the ALJ struggled to formulated an appropriate recommendation in this case. While Dr. Tallant clearly violated the Commission order, it is equally clear he did so unintentionally. In his eagerness to return to his medical practice, Dr. Tallant made assumptions based on his experience with the Commission and his interpretation of what the Staff told him prior to filing his reinstatement application. From June 2001 to January 2002, he treated injured workers believing, mistakenly, that he would be automatically added to the ADL upon filing his application with his reinstated medical license.

However, some sanction is appropriate. Dr. Tallant was responsible for knowing and complying with the content of the Commission order and rules. Having failed to make sure he was reinstated on the ADL before treating injured workers, however unintentional, justified Staff's initial recommendation that Dr. Tallant not be reinstated. However, since January 28, 2002, Dr. Tallant has refrained from treating injured workers, demonstrating his willingness to comply with the Commission's rules and the Commission order. Therefore, the ALJ finds that Dr. Tallant has been sanctioned sufficiently for his unintentional violation of the Commission order and recommends that Dr. Tallant be reinstated on the Commission's approved doctor list.

V. PROPOSED FINDINGS OF FACT

  1. In 1993, Nilon Tallant, M.D. was automatically placed on the Texas Worker's Compensation Commission's (Commission) approved doctors list (ADL), allowing him to treat workers' compensation patients.
  2. Dr. Tallant was licensed to practice medicine in 1957 and practice without incident until 1995.
  3. On August 17, 1996, the Texas State Board of Medical Examiners (the Board) entered an Agreed Order, revoking Dr. Tallant's medical license (C5259), effective on January 1, 1997.
  4. The revocation of Dr. Tallant's medical license was unrelated to the quality of his medical care or his treatment of workers= compensation patients.
  5. On May 16, 2000, the Commission entered an order deleting Dr. Tallant from the ADL because he did not have a medical license (the Commission order).
  6. The Commission order provided that:

Upon the effective date of this order the aforementioned doctor listed in this order, except in an emergency, shall not provide medical treatment to an "employee" with a "compensable injury," as the terms are defined in Tex. Lab. Code,'' 401.011(10) and 401.012. On and after the effective date of this Order, the doctor listed in this Order is required to inform any injured employee seeking treatment under the Texas Workers= Compensation Act of the deletion from the ADL and that the injured employee may not, except in an emergency, receive treatment from the aforementioned doctor.

  1. When Dr. Tallant received the Commission's order, he called the Commission Staff asking what he needed to do to be reinstated on the ADL when his medical license was restored.
  2. From his conversation with the Commission Staff, Dr. Tallant understood that he needed to file an application with the Commission to be reinstated on the ADL, attaching proof that the Medical Board had reinstated his medical license, and he would automatically be reinstated.
  3. The Medical Board reinstated Dr. Tallant's medical license on June 20, 2001.
  4. After his medical license was reinstated, Dr. Tallant immediately returned to his medical practice at Occupational Health Services and began treating patients.
  5. Within the week, Dr. Tallant called the Commission's Doctor Regulation & Enforcement Team (DRET) and asked to be reinstated on the ADL.
  6. DRET was the division responsible for processing the applications submitted by doctors for reinstatement on the ADL.
  7. DRET sent Dr. Tallant a copy of an "Application for Approved Doctor List" by facsimile transmission with the following instructions:

The Commission has received your request to be reinstated on the Commission's Approved Doctor's List. In order to process your request it is necessary that you complete an Approved Doctor's Application and submit it along with documentation of corrective action to support your request for reinstatement.

  1. DRET did not advise Dr. Tallant that he was not to treat injured workers until the Commission notified him that he was reinstated on the ADL.
  2. DRET did not advise Dr. Tallant that the Commission had a web page where he could confirm whether the Commission had reinstated him on the ADL.
  3. On June 28, 2001, Dr. Tallant filed a completed application with a copy of his reinstated medical license with the Commission.
  4. By the end of July 2001, DRET had collected all the information it needed to submit Dr. Tallant's application to the Commission's Doctor Deletion Team (DDT) for consideration.
  5. In the fall of 2001, DRET received an anonymous tip that Dr. Tallant was treating injured workers although he was not on the ADL.
  6. DRET did not tell Dr. Tallant about this allegation or advise him to quit treating injured workers because he was not on the ADL.
  7. The DDT did not consider Dr. Tallant's application for reinstatement until October 29, 2001, because of internal changes within the Commission unrelated to Dr. Tallant's application. At that time, the DDT chose to defer consideration of Dr. Tallant's application until its next meeting.
  8. On November 30, 2001, DDT again considered Dr. Tallant's application. DRET advised DDT that it had received an anonymous tip that Dr. Tallant was treating injured workers without being listed on the ADL.
  9. In a letter dated January 23, 2002, (the denial letter) the Staff notified Dr. Tallant that it recommended against his reinstatement on the ADL because he had treated injured workers (in non-emergency situations) in the year 2000 in violation of the Commission order.
  10. Dr. Tallant received the denial letter on January 28, 2002.
  11. The only time Irma Chavez, the DRET's manager, spoke with Dr. Tallant about his application was after he received the January 23, 2002, denial letter.
  12. On January 28, 2002, Dr. Tallant filed a request for a hearing.
  13. Notice of the hearing was sent to both parties on February 13, 2002.
  14. The notice of the hearing contained a statement of the time, place, and nature of the hearing; a statement of the legal authority and jurisdiction under which the hearing was to be held; a reference to the particular sections of the statutes and rules involved; and a short, plain statement of the matters asserted.
  15. By agreement of the parties, the hearing was rescheduled to April 4, 2002, as ordered by the Administrative Law Judge (ALJ) on March 11, 2002.
  16. On March 21, 2002, Staff issued the Commission's Statement of Matters Asserted, arguing that Dr. Tallant's application for reinstatement on the ADL should be denied based on 28 TAC '126.8(g) and (h) because Dr. Tallant treated injured workers in violation of the Commission Order cited above. Staff further argued that had Dr. Tallant been on the ADL, his failure to comply with the Commission Order would have been grounds for deletion under 28 TAC '126.8(d)(7).
  17. The hearing convened April 4, 2002, before State Office of Administrative Hearings (SOAH) Administrative Law Judge (ALJ) Catherine C. Egan. Timothy P. Riley, Commission attorney, appeared on behalf of Staff. Jim Duvall, attorney, appeared on behalf of Dr. Tallant. The final briefs and written closing arguments were received on April 29, 2001, and the record closed the following day.
  18. Dr. Tallant did not treat any patients until his medical license was reinstated on June 20, 2001.
  19. Dr. Tallant began treating injured workers on June 25, 2001, three days before he submitted his application with the Commission.
  20. Dr. Tallant unintentionally violation the Commission order by treating injured workers between June 28, 2001, and January 28, 2002, in non-emergency situations, because he mistakenly believed that the Commission would automatically reinstate him on the ADL upon receipt of his application for reinstatement and a copy of his reinstated medical license.
  21. Dr. Tallant had a responsibility to know and comply with the Commission order, and should not have treated injured workers until he was reinstated to the ADL.
  22. With one exception, Dr. Tallant has not treated injured workers since he received the denial letter on January 28, 2001.
  23. On January 29, 2002, Dr. Tallant provided emergency treatment to an injured worker (Gilbert P.), a diabetic suffering with a puncture wound.
  24. Dr. Tallant has the appropriate unrestricted license to practice medicine.
  25. The condition that caused his removal from the ADL was Dr. Tallant's loss of his medical license.
  26. Dr. Tallant has overcome the condition which resulted in his deletion from the ADL.
  27. The denial of Dr. Tallant's application is not necessary to protect the public, workers= compensation carriers, or the integrity of the workers= compensation system.
  28. Five months exclusion from the ADL is an appropriate sanction for Dr. Tallant's inadvertent violation of the Commission order.
  29. At this time, there is no reason for the Commission to continue to deny Dr. Tallant's reinstatement to the ADL.

VI. PROPOSED CONCLUSIONS OF LAW

  1. The Texas Workers' Compensation Commission (Commission) has jurisdiction to decide this matter pursuant to Tex. Labor Code Ann. (the Act) '' 408.023 and 402.073.
  2. The State Office of Administrative Hearings has jurisdiction to hear this case and make findings of fact and conclusions of law pursuant to ' 402.073 of the Act and Tex. Gov=t Code Ann. ch. 2003.
  3. The Texas Workers= Compensation Act '' 408.022 and 408.023 of the Act, includes every doctor licensed to practice in the State of Texas on the Commission's approved doctor list unless the doctor is subsequently deleted. It also authorizes the Commission to establish criteria for deleting a doctor from the list and for reinstating a doctor to the list. Only a doctor on the ADL may treat an injured worker, except in an emergency.
  4. The Staff followed the requirements of 28 Tex. Admin. Code (TAC) ' 126.8 in notifying Dr. Tallant of its intent to recommend the denial of his application for reinstatement on the ADL.
  5. Adequate and timely notice of the hearing was provided in accordance with Tex. Gov=t Code Ann.' 2001.052.
  6. The Staff has the burden of proving Dr. Tallant should not be reinstated on the ADL.
  7. Based on the Findings of Fact, Dr. Tallant should now be reinstated on the Commission's approved doctor list pursuant to ' 408.023 of the Act and 28TAC ' 126.8(g) and (h).

Signed this 28th day of June, 2002.

CATHERINE C. EGAN
Administrative Law Judge
STATE OFFICE OF ADMINISTRATIVE HEARINGS

  1. The term "injured workers" refer to employees receiving medical treatment under the Texas Workers= Compensation Act.
  2. TWCC Ex. 1.
  3. TWCC Ex. 15.
  4. Tr. at 137.
  5. Dr. Tallant stipulated that he treated injured workers from July 1, 2001 to January 28, 2002. Tr. at 7. The Staff does not dispute that the dates of service listed on TWCC Ex. 5 are for medical services provided to injured workers by Dr. Tallant in an emergency situation.
  6. TWCC Ex. 3 (Attachment Ex. G) and Tallant Ex. 5.
  7. The Commission rule reads: A(g) To be reinstated, a doctor deleted from the list must apply for reinstatement in the form and manner prescribed by the commission through the Medical Review Division in Austin. If, in the division's opinion, the doctor has all the appropriate unrestricted licenses to practice at the time of reinstatement, has overcome the conditions which resulted in deletion, and should be reinstated, the division shall recommend that the commissioners reinstate the doctor to the list.
  8. The Doctor Regulation Enforcement Team processed the applications for reinstatement.
  9. Tr. at 41.
  10. Tr. at 42.
  11. Tr. at 43.
  12. Ms. Chavez did not know what the acronym stood for.
  13. Tallant Ex. 1.
  14. TWCC Ex. 20.
End of Document
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