454-06-1284-c1
DECISION AND ORDER I. INTRODUCTION Staff of Texas Department of Insurance, Division of Workers’ Compensation (Staff/Division), Respondent, alleged that Justin C. Benedict, D.C., Petitioner, violated Tex. Labor Code Ann. § 415.003 and 28 Tex. Admin. Code (TAC) § 134.801 by submitting medical bills for aquatic therapy services that he did not provide. Dr. Benedict was […]
453-05-7061-c1
DECISION AND ORDER I. INTRODUCTION On June 2, 2005, the staff of the Texas Department of Insurance, Division of Workers’ Compensation (Division) issued notices of violation to the _______ (the City), notifying it of various violations of Commission rules relating to the preauthorization for medical services provided to injured workers. On June 21, 2005, the […]
453-05-2167-c1
DECISION AND ORDER Fidelity and Guaranty Insurance Company (Petitioner) contests the assessment of an administrative penalty against it by the Texas Workers’ Compensation Commission (Respondent or Commission).[1] The Commission asserts that Petitioner failed to timely process and take final action on a properly completed medical bill within 45 days of receipt of the bill in […]
453-05-2812-c1
DECISION AND ORDER ___ (Petitioner) contests a Notice of Administrative Violation issued by the Texas Workers’ Compensation Commission (TWCC or Commission). The Notice charged him with knowingly or intentionally concealing a material fact for the purpose of obtaining workers’ compensation benefits, in violation of the Texas Workers’ Compensation Act (Act), Tex. Lab. Code415.008(a). Specifically, the […]
453-05-0898-c1
DECISION AND ORDER The _______ (the City), which is self-insured, contests the assessment of an administrative penalty against it by the Texas Workers’ Compensation Commission (the Commission). The Commission asserts that the City’s report of inaccurate data to the Commission through the Electronic Data Interchange (EDI) for temporary income benefit (TIB) initial payment dates in […]
453-05-2157-c1
DECISION AND ORDER G. Kenneth Marshall M.D., (Petitioner), challenged the Findings and Decision of the Texas Workers’ Compensation Commission (Commission) assessing a penalty of $113.00 due to Petitioner’s failure to file a Work Status Report[1] after a patient experienced a change in work status, and Petitioner’s failure to file a copy of the Work Status […]
453-04-3808-c1
DECISION AND ORDER The Texas Workers’ Compensation Commission (Commission) seeks an administrative penalty against ___ (Respondent) based on the allegation that he had failed to notify his workers’ compensation carrier, Zurich American Insurance Company (Zurich), that he had returned to work, earning income and continuing to collect Supplemental Income Benefits (SIBs). Though duly notified of […]
453-04-0405-c1
DECISION AND ORDER _____ (Petitioner) contests the Notice of Administrative Violation and Order to Respond of the Texas Workers’ Compensation Commission (Commission), charging her with committing an administrative violation, pursuant to § 415.032 of the Texas Workers’ Compensation Act (Act). The Commission charges that _____ knowingly or intentionally concealed a material fact for the purpose […]
453-03-2327-c1
DECISION AND ORDER The Texas Workers’ Compensation Commission (TWCC or Commission) brings this compliance action against Dr. Wright H. Singleton (Petitioner) for failing to timely file reports of medical evaluations (TWCC-69s) for the month of December 2001. The Commission seeks $1,310.00 in administrative penalties and findings of administrative violations in fourteen matters, in accordance with […]
453-02-2992-c1
DECISION AND ORDER _______________contests the Notice of Administrative Violation(s) and Order to Respond of Texas Workers’ Compensation Commission (Commission), charging him with committing one or more administrative violation(s) pursuant to §415.032 of the Texas Workers’ Compensation Act (Act). The Commission charges that __________knowingly or intentionally concealed a material fact for the purpose of obtaining workers’ […]