454-07-3261-p1
DECISION AND ORDER Service Lloyds Insurance Company (Carrier) challenges a medical interlocutory order (MIO) issued by the Texas Department of Insurance, Division of Workers’ Compensation (Division), requiring it to pay for certain office visits and medications provided over a ninety-day period to an injured worker (Claimant). The Administrative Law Judge (ALJ) finds that Carrier did […]
454-07-0976-p1
DECISION AND ORDER I. INTRODUCTION Sentry Insurance, A Mutual Company (Carrier) challenges a medical interlocutory order (MIO) issued by the Texas Department of Insurance’s Division of Workers’ Compensation (DWC) requiring Carrier to reimburse Alvaro Garcia, M.D., for providing medical services to _______. (Claimant). William Wayne Hairston, D. O., performed a prospective review medical examination (PRME) […]
454-07-0889-p1
DECISION AND ORDER _________ (self-insurer, referred to as Carrier) challenges a medical interlocutory order (MIO) issued by the Texas Department of Insurance, Division of Workers’ Compensation (Division), requiring Carrier to pay for two epidural steroid injections (injections) in a 90-day period to be performed in a doctor’s office. This decision concludes that both injections were […]
454-06-1794-p1
DECISION AND ORDER I. INTRODUCTION Lumbermen’s Mutual Casualty Company (Carrier) requested a hearing to contest a medical interlocutory order (MIO) issued by the Texas Department of Insurance, Division of Workers’ Compensation (Division). The MIO ordered the Carrier to reimburse the Claimant for medical services and a prescription for pain reliever. The medical services and prescription […]
454-05-0705-p1
DECISION AND ORDER ______ (self-insurer, referred to as Carrier) challenges a medical interlocutory order (MIO) issued by the Texas Workers’ Compensation Commission, now the Texas Department of Insurance, Division of Workers’ Compensation (Division), requiring Carrier to pay for an orthopaedic specialist, a pain management specialist, and three medications (Ambien, Neurontin, and Hydrocodone) over a three-month […]
454-06-0898-p1
DECISION AND ORDER National Fire Insurance Company (Carrier) challenges a medical interlocutory order (MIO) issued by the Texas Department of Insurance, Division of Workers’ Compensation (Division), requiring it to pay for certain office visits and medications provided over a ninety-day period. The Administrative Law Judge (ALJ) concludes that Carrier did not persuasively show that the […]
454-06-0702-p1
DECISION AND ORDER ________ (Carrier) challenges a medical interlocutory order (MIO) issued by the Texas Department of Insurance, Division of Workers’ Compensation (Division) requiring Carrier to pay A. L. Shaw, M.D. (Provider) for providing medical services to an injured worker (Claimant). Carl Simpson, M.D., performed a prospective review medical examination (PRME) of Claimant and determined […]
454-07-0952-p1
DECISION AND ORDER I. INTRODUCTION Lumbermen’s Mutual Casualty Company (Carrier) requested a hearing to contest a medical interlocutory order issued by the Texas Department of Insurance, Division of Workers’ Compensation (Division) regarding an office visit and prescriptions for two drugs provided in October 2006 by Michael J. Pendleton, M.D., to a workers’ compensation claimant (Claimant). […]
454-07-2300-p1
DECISION AND ORDER American Motorists Insurance Company (Carrier) requested a hearing to contest a medical interlocutory order (MIO)[1] issued by the Division of Workers’ Compensation of the Texas Department of Insurance (Division). The MIO required the Carrier to pay for three office visits to Julian Lowell Haro, M.D., to monitor medication, and for the medications […]
454-06-0778-p1
DECISION AND ORDER Gray Insurance Company (Carrier) challenges a medical interlocutory order (MIO) issued by the Texas Department of Insurance, Division of Workers’ Compensation (Division), requiring Carrier to reimburse Jairo A. Puentes, M.D. (Dr. Puentes) for providing medical services to an injured worker (Claimant). Thomas M. Raymond, M.D., performed a prospective review medical examination (PRME) […]