453-02-0986-m2
DECISION AND ORDER Petitioner Highlands Insurance Company (Highlands), appeals from the Findings and Decision of the Texas Workers’ Compensation Commission’s Medical Review Division (MRD), which ordered preauthorization for bilateral lumbar facet injections and a lumbar myelogram with CT scan for injured worker ____. Highlands contends that MRD’s decision should be reversed because the medical rationale […]
453-02-0988-m2
DECISION AND ORDER I. Introduction Travelers Indemnity Company of Connecticut (Carrier) has appealed a decision of the Texas Workers Compensation Commission (TWCC) Medical Review Division Officer (MRD). MRD ordered the Carrier to pay the reasonable and necessary costs for outpatient bilateral facet joint injections and bilateral sacroiliac joint injections, first right side, then left (the […]
453-02-0510-m2
DECISION AND ORDER Before me, on December 17, 2001, came on to be heard the above-referenced medical benefit dispute and after hearing the evidence and arguments by the parties the Administrative Law Judge finds as follows: I. FINDINGS OF FACT On May 15, 2001 David Suchowiecky, M.D. requested preauthorization for 30 sessions of chronic pain […]
453-03-0973-m2
DECISION AND ORDER ____ (Claimant) appealed the Findings and Decision of the Texas Workers’ Compensation Commission (Commission) through the Texas Medical Foundation acting as an Independent Review Organization (IRO). The IRO determined that the requested procedure, a cervical discogram at C4-7, was not medically necessary. This decision finds, based on the record in this case, […]
453-02-0305-m2
DECISION AND ORDER Hartford Underwriters Insurance Company (Carrier) appealed the findings of the Texas Workers’ Compensation Commissions Medical Review Division (MRD), which approved Dr. Brad Burden’s (Provider) request for preauthorization for thirty session of chronic pain management. This decision agrees with the MRD and authorizes _________(Claimant) to receive thirty sessions of chronic pain management. I. […]
453-01-3917-m2
DECISION AND ORDER _________, the Petitioner, appealed the decision of the Texas Workers’ Compensation Commission’s Medical Review Division (MRD) to deny preauthorization for an intradiscal electrothermal therapy (IDET) procedure at an ambulatory surgical center. The MRD’s decision found that the IDET was not consistent with the Spine Treatment Guideline of the Texas Workers’ Compensation Commission […]
453-01-3918-m2
DECISION AND ORDERNUNC PRO TUNC[1] Continental Casualty Company (Carrier) appealed the findings of the Texas Workers’ Compensation Medical Review Division (MRD), which had approved __________request for preauthorization for a Queen Serta-flex orthopedic mattress, structured weight loss program to include aquatic therapy, and twelve physical therapy sessions. This decision agrees in part with the MRD and […]
453-01-3693-m2
DECISION AND ORDER I. INTRODUCTION Petitioner, Anthony J. LaMarra, DPM , appeals the Findings and Decision issued by the Medical Review Division (MRD) of the Texas Workers’ Compensation Commission (Commission). Dr. LaMarra seeks preauthorization for left ankle arthroscopy with possible arthrotomy, sinus tarsi decompression, excision of painful hardware, decompression of the saphenous nerve, excision of […]