454-06-0843-p1
DECISION AND ORDER Highmark Casualty 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, under the specific facts of this case, that […]
454-07-2298-p1
DECISION AND ORDER I. INTRODUCTION Transportation Insurance Company (Carrier) requested a hearing to contest a medical interlocutory order issued by the Texas Department of Insurance, Division of Workers’ Compensation (Division) regarding medical services for ____ (Claimant), a ______. Richard Wilson, M.D., prescribed certain medications for Claimant, and Carrier denied the medical necessity of such medications […]
454-07-0892-p1
DECISION AND ORDER Continental Casualty Company (Carrier) challenges a Medical Interlocutory Order issued by the Texas Department of Insurance, Division of Workers’ Compensation (the Division), requiring Carrier to reimburse for medications provided by Co-Respondent Ronald Washington, M.D., to Claimant ____. This decision finds in favor of the Division and Dr. Washington. I. PROCEDURAL HISTORY, NOTICE, […]
454-07-1789-p1
DECISION AND ORDER Winn Dixie Louisiana, Inc. (Carrier) challenges a medical interlocutory order (MIO) issued by the Texas Department of Insurance, Division of Workers’ Compensation (Division), requiring Carrier to pay for acupuncture and spinal manipulation treatments over a ninety-day period. This decision concludes that Carrier established that the acupuncture and spinal manipulation treatments were not […]
454-06-2157-p1
DECISION AND ORDER Albertsons, Inc.(Carrier) challenges a medical interlocutory order (MIO) issued by the Texas Department of Insurance, Division of Workers’ Compensation (Division) on April 3,2006, requiring it to pay for certain medications and office visits over a 90-day period for ___ (Claimant). Carrier did not establish that the medications and office visits were medically […]
454-07-1464-p1-etal
DECISION AND ORDER Service Lloyds Insurance Company (Carrier) challenges two medical interlocutory orders (MIOs) issued by the Texas Department of Insurance, Division of Workers’ Compensation (Division), requiring it to pay for certain office visits and medications over two sequential ninety-day periods. The cases were consolidated based on the parties’ representation that the requested health care […]
454-06-2586-p1
DECISION AND ORDER I. INTRODUCTION Lumbermens Mutual Casualty 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 or pay Bill Weldon, D.O., for providing medical services to J. B. (Claimant). Stephen R. Fowler, M.D., performed a prospective review medical examination […]
454-06-0899-p1
DECISION AND ORDER Harris County (Carrier), a self-insured government entity, contested a medical interlocutory order (MIO) issued by the Texas Department of Insurance, Division of Workers’ Compensation (Division). The MIO required Carrier to pay for certain medications found to be medically necessary for the last three months of 2005 to treat a claimant’s ___ hip […]
454-06-1941-p1
DECISION AND ORDER Lumbermens Mutual Casualty 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 one office visit per month and three prescriptions (Hydrocodone, Flexeril, and Zoloft) over a three-month period. This decision concludes that the treatment is medically […]
454-07-1289-p1
DECISION AND ORDER Farmington Casualty Company (Farmington) requested a hearing to contest a Medical Interlocutory Order (MIO) issued by the Texas Department of Insurance, Division of Workers’ Compensation (Division), requiring payment for prescription drugs and one office visit per month for three months that were found to be medically necessary in a Prospective Review Medical […]