Texas Workers' Compensation Rules

Table of Contents

Primary Item (H2)Sub Item 1 (H3)Sub Item 2 (H4)
Sub Item 3 (H5)
Sub Item 4 (H6)

Texas Administrative Code

Title 28. Insurance

Part 2. Texas Department of Insurance, Division of Workers' Compensation

Old Law Rules

(Injury dates prior to January 1, 1991.)

Chapter 41. Practice and Procedure

Subchapter A. Communications

§ 41.1. Name Change § 41.5. Compliance and Suspension of Rules § 41.8. Contents of Rule-Making Petitions § 41.10. Definitions § 41.15. Social Security Number § 41.20. Adjuster Identification § 41.25. Attorney Identification § 41.27. Employer's Identification § 41.30. Self-Insureds § 41.35. Designation of Insurance Carriers' Austin Representative § 41.40. General Policy Concerning Communications § 41.45. Communication to Claimants § 41.55. Communication to Employers § 41.60. Communication to Insurance Carriers § 41.65. Communication to Health Care Provider § 41.70. Filing of Instruments § 41.75. Timely Filing § 41.80. Filing Subsequent to Final Order or Award § 41.85. Translation of Documents § 41.90. Responsibility of Translators § 41.95. Wage Information

Subchapter B. Access to Board Records

[Repealed]

Chapter 42. Medical Benefits

Subchapter A. General Medical Provisions

§ 42.5. Applicability and Scope of Rules § 42.10. Acceptance of Rules and Guidelines § 42.15. Definitions § 42.20. Who May Treat § 42.25. Prohibited Practices § 42.28. Confirmation of Coverage § 42.30. Written Communications § 42.33. Health Care Providers’ Reporting Requirements § 42.35. Required Reports: First Report § 42.40. Required Reports: Subsequent Reports § 42.55. Required Reports: Change of Status Reports § 42.60. Required Reports: Special Reports § 42.65. Changing Treating Doctors § 42.75. Excess Recovery from Third Party Actions § 42.78. Reports To Be Filed by the Carrier § 42.80. Assignment of Medical Benefits § 42.85. Voluntary Arbitration § 42.90. Demand for Surgical Operation § 42.95. Scars and Deformities

Subchapter B. Medical Cost Evaluation

§ 42.101. Purpose § 42.105. Medical Fee Guideline § 42.115. Pharmaceutical Fee Guideline § 42.135. Liability for Covered Health Care § 42.137. Utilization Review § 42.140. Amount of Payment § 42.145. Billing § 42.155. Carrier Review of Bills § 42.160. Carrier Desk Audit of Bills § 42.165. Carrier On-Site Audit of Hospital Bills § 42.175. Miscellaneous Covered Services

Subchapter D. Dispute Resolution

§ 42.305. Requesting Dispute Review and Resolution § 42.307. Procedure for Requesting Dispute Review § 42.308. Procedure for Responding to a Request for Dispute Review § 42.309. Payment for the Review § 42.310. Board Review and Resolution § 42.315. Appeal

Chapter 43. Insurance Coverage

§ 43.5. Notice That Employer Has Become Subscriber § 43.10. Termination of Coverage

Chapter 45. Employer’s Report of Injury or Disease

§ 45.5. Forms § 45.10. Employer’s Report of Injury and Disease § 45.13. Wage Statement § 45.20. Board Request for Additional Information § 45.25. Employer’s Supplemental Report of Injury § 45.30. Sanctions

Chapter 47. Employee Notice of Injury or Death and Claim for Benefits

§ 47.5. Information Constituting Claim § 47.10. Signature of Claimant § 47.15. Employer Advances Compensation § 47.20. Beneficiaries Filing Claim

Chapter 49. Procedures for Formal Hearings by the Board

Subchapter A. Formal Hearings

§ 49.5. Schedule of Hearings § 49.10. Timely Acceptance of Evidence § 49.15. Formal Statement of Position § 49.20. Request for Cancellation § 49.25. Delay or Postponement of Hearing § 49.30. Filing of Medical Bills § 49.35. Filing of Medical Reports and Records § 49.40. Carrier Attendance § 49.45. Contents of Formal Statement of Position § 49.50. Sanctions

Subchapter B. Special Formal and Other Investigative Hearings

§ 49.105. Procedures § 49.110. Commencement of Hearings § 49.115. Notice § 49.120. Special Statutory Notice § 49.125. Notice of Special Formal Hearing § 49.130. Personal Appearance Hearings in Austin § 49.131. Withdrawal of Attorney § 49.135. Use of Court Reporters § 49.140. Continuance § 49.145. Recess § 49.150. Complaint Specifications § 49.155. Documentary Evidence § 49.160. Filing of Formal Statement of Position § 49.165. Subpoenas and Subpoenas Duces Tecum

Chapter 51. Award of the Board

§ 51.10. Joint Payment of Award § 51.15. Periodic Installments § 51.20. Lump Sum Payment § 51.25. Request for Review § 51.30. Review of Award § 51.50. Payments of Attorney’s Fees § 51.65. Attorney Fees

Chapter 53. Carrier’s Report of Initiation and Suspension of Compensation Payments

§ 53.5. Payment of Benefits Without Prejudice § 53.10. Written Notice of Injury Defined § 53.15. Board Notice to Carrier of Injury § 53.20. Notice of Initiation of Compensation; Mode of Payment of Compensation § 53.22. Application To Change the Benefits Payment Period § 53.25. Contents of Statement of Controversion or Statement of Position § 53.30. Filing of Wage Statement § 53.35. Notice of Suspension of Compensation § 53.40. Transmittal Letters § 53.45. Maximum Payment to Minor § 53.48. Payment of Partial Benefits for General Injuries § 53.50. Resumption of Compensation § 53.55. Payment for Amputation § 53.60. Application for Suspension of Compensation § 53.63. Suspension of Weekly Compensation § 53.64. Nonpayment of Compensation Based on Another Carrier’s Liability § 53.65. Certification Procedure

Chapter 55. Lump Sum Payments

§ 55.3. Request for Advance Payment of Compensation § 55.5. Lump Sum Payments § 55.10. Settlements Final When Approved § 55.15. Compromise Settlement Agreements § 55.20. Execution of Compromise Settlement Agreement § 55.25. Loss of an Eye § 55.30. Hearing Impairment § 55.35. Stipulation of Medical Payments § 55.40. Attorney’s Signature § 55.45. Percent of Medical Impairment § 55.50. Attorneys Fees and Expenses § 55.55. Compromise Settlement Agreement To Set Aside Award § 55.60. Consent Withdrawn § 55.65. Withdrawal of Consent by Death § 55.75. Tender Payment Time Period § 55.80. Waiving of Approval Appearance

Chapter 56. Structured Compromise Settlement Agreements

§ 56.5. Definitions § 56.10. Form § 56.15. Execution § 56.20. Personal Appearance by Claimant § 56.25. Medical Benefits § 56.30. Consent of Parties–Withdrawal § 56.35. Attorney’s Signature § 56.40. Attorney’s Fees and Expenses § 56.45. Tender Payment Time Period § 56.50. Final When Approved § 56.55. Annuity Company § 56.60. Payments Guaranteed § 56.65. Cost of the Annuity § 56.70. Structured Settlement Agreement To Set Aside Award

Chapter 57. Request for Case Folders and Certifications of Actions of the Board -

[Repealed]

Chapter 59. Notices of Intention to Appeal

§ 59.5. Filing of Notice § 59.10. Receipt of Notice

Chapter 61. Prehearing Conferences

§ 61.5. Request for Prehearing Conference § 61.7. Request of Prehearing Conference § 61.15. Setting under Texas Civil Statutes, Article 8306, 18a § 61.20. Setting on Hardship § 61.25. Setting at Carrier’s Request § 61.30. Filing of Medical Information § 61.35. Exchange of Medical Information § 61.40. Additional Medical § 61.45. Charges for Reports § 61.50. Representatives Must Be Qualified § 61.55. Supply of Forms § 61.60. Attendance at Conference § 61.65. Request for Cancellation of Prehearing Conference § 61.70. Maintain Setting § 61.75. Failure To Appear § 61.80. Participation at Conference § 61.85. Carrier Self-Audit of Prehearing Conference § 61.90. Conduct at Prehearing Conference § 61.95. Consular Officers

Chapter 63. Promptness of First Payment

§ 63.5. Quarterly Report § 63.10. Sanctions for Late Payment

Chapter 64. Representing Claimants Before the Board

§ 64.25. Discharged Attorney § 64.30. Adverse Representation in Claims for Death Benefits

Chapter 65. Unethical or Fraudulent Claims Practices

§ 65.5. Practicing before the Board § 65.10. Actions by Carrier, Claimant's Attorney, and/or Agent § 65.15. Filing of Violation Report

Chapter 67. Allegations of Fraud

§ 67.5. Referral to Attorney General

Chapter 69. Medical Examination Orders

§ 69.5. Application of Chapter § 69.10. Definitions § 69.15. Carrier May Apply for Order from Board § 69.20. Application § 69.25. Bases for Denial § 69.30. Appeal § 69.33. Claimant's Medical Records § 69.35. Claimant's Expenses § 69.40. Attendance of Claimant's Health Care Provider § 69.45. Unreasonable Delay § 69.50. Reports of Examinations § 69.55. Failure to Attend Examination

Chapter 89. Crime Victims Compensation Act -

[Repealed]

New Law Rules

(Injury dates on or after January 1, 1991.)

Chapter 102. Practices and Procedures—General Provisions

§ 102.2. Application of Chapter § 102.3. Computation of Time § 102.4. General Rules for Non-Division Communications § 102.5. General Rules for Written Communications to and from the Division § 102.7. Abbreviations § 102.8. Information Requested on Written Communications to the Division § 102.9. Submission of Information Requested by the Commission § 102.10. Interest, General § 102.11. Electronic Formats for Electronic Claim Data Request and Report

Chapter 103. Agency Administration -

[Repealed]

Subchapter A. Employee Training and Education Program -

[Repealed]

Subchapter B. Agency Contracts -

[Repealed]

Subchapter C. Resolution of Contract Claims -

[Repealed]

Subchapter D. Facilities and Property Management -

[Repealed]

Chapter 104. General Provisions—Rule-Making

§ 104.1. Contents of Rulemaking Petitions

Chapter 108. Fees -

[Repealed]

Chapter 109. Workers’ Compensation Coverage for State Employees

§ 109.1. State Agencies: General Provisions

Chapter 110. Required Notices of Coverage

Subchapter A. Carrier Notices

§ 110.1. Insurance Carrier Requirements for Notifying the Division of Insurance Coverage § 110.7. Self-Insured Political Subdivision Requirements for Notifying the Division of Election to Provide Medical Benefits

Subchapter B. Employer Notices

§ 110.101. Covered and Non-Covered Employer Notices to Employees § 110.103. Employer Requirements for Notifying the Division of Non-Coverage § 110.105. Employer Requirements for Notifying the Division of Termination of Coverage § 110.108. Employer Notice Regarding Work-Related Exposure to Communicable Disease/HIV: Posting Requirements; Payment for Tests § 110.110. Reporting Requirements for Building or Construction Projects for Governmental Entities

Chapter 112. Scope of Liability for Compensation

§ 112.101. Agreement Regarding Workers' Compensation Insurance Coverage Between General Contractors and Subcontractors § 112.102. Agreements Between Motor Carriers and Owner Operators

§ 112.200. Definition of Residential Structures § 112.201. Agreement to Establish Employer-Employee Relationship for Certain Building and Construction Workers § 112.202. Joint Agreement to Affirm Independent Relationship for Certain Building and Construction Workers § 112.203. Exception to Application of Agreement to Affirm Independent Relationship for Certain Building and Construction Workers

§ 112.301. Labor Agent's Notification of Coverage

§ 112.401. Election of Coverage by Certain Professional Athletes § 112.402. Determination of Equivalent Benefits for Professional Athletes

Chapter 114. Self-Insurance

§ 114.1. Purpose § 114.2. Definitions § 114.3. Application Form and Financial Information Requirements § 114.4. Security Deposit Requirements § 114.5. Excess Insurance Requirements § 114.6. Safety Program Requirements § 114.7. Certification Process § 114.8. Refusal to Certify an Employer § 114.9. Required Safety Program Inspections § 114.10. Claims Contractor Requirements § 114.11. Audit Program § 114.12. Required Reporting § 114.13. Required Notices to the Division § 114.14. Impaired Employer § 114.15. Revocation or Suspension of Certificate of Authority to Self-Insure § 114.16. Withdrawal from Self-Insurance

Chapter 116. General Provisions—Subsequent Injury Fund

§ 116.11. Request for Reimbursement from the Subsequent Injury Fund § 116.12. Subsequent Injury Fund Payment/Reimbursement Schedule

Chapter 120. Compensation Procedure—Employers

§ 120.1. Employer's Record of Injuries § 120.2. Employer's First Report of Injury and Notice of Injured Employee Rights and Responsibilities § 120.3. Employer's Supplemental Report of Injury § 120.4. Employer's Wage Statement

Chapter 122. Compensation Procedure—Claimants

Subchapter A. Claims Procedure for Injured Employees

§ 122.1. Notice to Employer of Injury or Occupational Disease § 122.2. Injured Employee's Claim for Compensation § 122.3. Exposure to Communicable Diseases: Reporting and Testing Requirements for Emergency Responders § 122.4. State Employees Exposed to Human Immunodeficiency Virus (HIV): Reporting and Testing Requirements § 122.5. Employee's Multiple Employment Wage Statement

Subchapter B. Claims Procedure for Beneficiaries of Injured Employees

§ 122.100. Claim for Death Benefits

Chapter 124. Insurance Carriers: Notices, Payments, and Reporting

Subchapter A. Insurance Carriers: Required Notices and Modes of Payment

§ 124.1. Notice of Injury § 124.2. Insurance Carrier Reporting and Notification Requirements § 124.3. Investigation of an Injury and Notice of Denial or Dispute § 124.5. Mode of Payment Made by Insurance Carriers § 124.6. Electronic Transfer Payments Made Through an Access Card § 124.7. Initial Payment of Temporary Income Benefits

Subchapter B. Insurance Carrier Claim Electronic Data Interchange Reporting to the Division

§ 124.100. Applicability § 124.101. Purpose § 124.102. Definitions § 124.103. Reporting Standards § 124.104. Reporting Requirements § 124.105. Records Required to be Reported § 124.106. Records Excluded from Reporting § 124.107. State Specific Requirements § 124.108. Insurance Carrier EDI Compliance Coordinator and Trading Partners

Chapter 126. General Provisions Applicable to All Benefits

§ 126.1. Definitions Applicable to All Benefits § 126.2. Payment of Benefits to Minors § 126.3. Payment of Benefits to Legally Incompetent Persons § 126.4. Advance of Benefits Based on Financial Hardship § 126.5. Entitlement and Procedure for Requesting Required Medical Examinations § 126.6. Required Medical Examination § 126.8. Commission Approved Doctor List § 126.9. Choice of Treating Doctor and Liability for Payment § 126.11. Extension of the Date of Maximum Medical Improvement for Spinal Surgery § 126.12. Payment of Interest on Accrued but Unpaid Income Benefits § 126.13. Employer Initiation of Benefits and Reimbursement § 126.14. Treating Doctor Examination to Define the Compensable Injury § 126.15. Procedures for Resolution of Underpayments of Income Benefits § 126.16. Procedures for Recouping Overpayments of Income Benefits § 126.17. Guidelines for Examination by a Treating Doctor or Referral Doctor After a Designated Doctor Examination to Address Issues Other than Certification of Maximum Medical Improvement and the Evaluation of Permanent Impairment

Chapter 127. Designated Doctor Procedures and Requirements

Subchapter A. Claims Procedure for Injured Employees

§ 127.1. Requesting Designated Doctor Examinations § 127.5. Scheduling Designated Doctor Appointments § 127.10. General Procedures for Designated Doctor Examinations § 127.15. Undue Influence on a Designated Doctor § 127.20. Requesting a Letter of Clarification Regarding Designated Doctor Reports § 127.25. Failure to Attend a Designated Doctor Examination

Subchapter B. Designated Doctor Certification, Recertification, and Qualifications

§ 127.100. Designated Doctor Certification § 127.120. Exception to Certification as a Designated Doctor for Out-of-State Doctors § 127.130. Qualification Standards for Designated Doctor Examinations § 127.140. Disqualifying Associations

Subchapter C. Designated Doctor Duties and Responsibilities

§ 127.200. Duties of a Designated Doctor § 127.210. Designated Doctor Administrative Violations § 127.220. Designated Doctor Reports

Chapter 128. Benefits—Calculation of Average Weekly Wage

§ 128.1. Average Weekly Wage: General Provisions § 128.2. Carrier Presumption of Employee's Average Weekly Wage § 128.3. Average Weekly Wage Calculation for Full-Time Employees, and for Temporary Income Benefits for All Employees § 128.4. Average Weekly Wage Calculation for Part-Time Employees § 128.5. Average Weekly Wage Calculation for Seasonal Employees § 128.6. Average Weekly Wage Adjustment for Certain Employees Who Are Also Minors, Apprentices, Trainees, or Students § 128.7. Average Weekly Wage for School District Employees

Chapter 129. Income Benefits—Temporary Income Benefits

§ 129.1. Definitions for Temporary Income Benefits § 129.2. Entitlement to Temporary Income Benefits § 129.3. Amount of Temporary Income Benefits § 129.4. Adjustment of Temporary Income Benefit Amount § 129.5. Work Status Reports § 129.6. Bona Fide Offers of Employment § 129.7. Non-Reimbursable Employer Payments § 129.11. Agreement for Monthly Payment of Temporary Income Benefits

Chapter 130. Impairment and Supplemental Income Benefits

Subchapter A. Impairment Income Benefits

§ 130.1. Certification of Maximum Medical Improvement and Evaluation of Permanent Impairment § 130.2. Certification of Maximum Medical Improvement and Evaluation of Permanent Impairment by the Treating Doctor § 130.4. Presumption that Maximum Medical Improvement (MMI) Has Been Reached and Resolution when MMI Has Not Been Certified § 130.7. Acceleration of Impairment Income Benefits § 130.8. Initiating Payment of Impairment Income Benefits § 130.11. Agreement for Monthly Payment of Impairment Income Benefits § 130.12. Finality of the First Certification of Maximum Medical Improvement and/or First Assignment of Impairment Rating

Subchapter B. Supplemental Income Benefits

§ 130.101. Definitions § 130.102. Eligibility for Supplemental Income Benefits; Amount § 130.103. Determination of Entitlement or Non-Entitlement for the First Quarter § 130.104. Determination of Entitlement or Non-Entitlement for Subsequent Quarters § 130.105. Failure to Timely File Application for Supplemental Income Benefits; Subsequent Quarters § 130.107. Payment of Supplemental Income Benefits § 130.108. Contesting Entitlement or Amount of Supplemental Income Benefits; Attorney Fees § 130.109. Reinstatement of Entitlement if Discharged with Intent to Deprive of Supplemental Income Benefits

Chapter 131. Benefits—Lifetime Income Benefits

§ 131.1. Initiation of Lifetime Income Benefits; Notice of Denial § 131.2. Calculation of Lifetime Income Benefits § 131.3. Carrier's Petition for Payment of Benefits by the Subsequent Injury Fund § 131.4. Change in Payment Period; Purchase of Annuity for Lifetime Income Benefits

Chapter 132. Death Benefits—Death and Burial Benefits

Chapter 133. General Medical Provisions

Subchapter A. General Rules for Medical Billing and Processing

§ 133.1. Applicability of Medical Billing and Processing § 133.2. Definitions § 133.3. Communication Between Health Care Providers and Insurance Carriers § 133.4. Written Notification to Health Care Providers of Contractual Agreements for Informal and Voluntary Networks § 133.5. Informal Network and Voluntary Network Reporting Requirements to the Division

Subchapter B. Health Care Provider Billing Procedures

§ 133.10. Required Billing Forms/Formats § 133.20. Medical Bill Submission by Health Care Provider § 133.30. Telemedicine and Telehealth Services

Subchapter C. Medical Bill Processing/Audit by Insurance Carrier

§ 133.200. Insurance Carrier Receipt of Medical Bills from Health Care Providers § 133.210. Medical Documentation § 133.230. Insurance Carrier Audit of a Medical Bill § 133.240. Medical Payments and Denials § 133.250. Reconsideration for Payment of Medical Bills § 133.260. Refunds § 133.270. Injured Employee Reimbursement for Health Care Paid § 133.280. Employer Reimbursement for Health Care Paid

Subchapter D. Dispute of Medical Bills

§ 133.305. MDR—General § 133.306. Interlocutory Orders for Medical Benefits § 133.307. MDR of Fee Disputes § 133.308. MDR of Medical Necessity Disputes § 133.309. Alternate Medical Necessity Dispute Resolution by Case Review Doctor

Subchapter G. Electronic Medical Billing, Reimbursement, and Documentation

§ 133.500. Electronic Formats for Electronic Medical Bill Processing § 133.501. Electronic Medical Bill Processing § 133.502. Electronic Medical Billing Supplemental Data Requirements

Chapter 134. Benefits—Guidelines for Medical Services, Charges, and Payments

Subchapter A. Medical Reimbursement Policies

§ 134.1. Medical Reimbursement § 134.2. Incentive Payments for Workers' Compensation Underserved Areas

Subchapter B. Miscellaneous Reimbursement

§ 134.100. Reimbursement of Treating Doctor for Attendance at Required Medical Examination § 134.110. Reimbursement of Injured Employee for Travel Expenses Incurred § 134.120. Reimbursement for Medical Documentation § 134.130. Interest for Late Payment on Medical Bills and Refunds § 134.150. Reimbursement of Services Provided by a Federal Military Treatment Facility § 134.155. Federal Military Treatment Facility Disputes

Subchapter C. Medical Fee Guidelines

§ 134.201. Medical Fee Guideline for Medical Treatments and Services Provided Under the Texas Workers' Compensation Act § 134.203. Medical Fee Guideline for Professional Services § 134.204. Medical Fee Guideline for Workers' Compensation Specific Services § 134.209. Applicability § 134.210. Medical Fee Guideline for Workers' Compensation Specific Services § 134.215. Home Health Services § 134.220. Case Management Services § 134.225. Functional Capacity Evaluations § 134.230. Return to Work Rehabilitation Programs § 134.235. Return to Work/Evaluation of Medical Care § 134.239. Billing for Work Status Reports § 134.240. Designated Doctor Examinations § 134.250. Maximum Medical Improvement Evaluations and Impairment Rating Examinations § 134.303. 2005 Dental Fee Guideline

Subchapter E. Health Facility Fees

§ 134.402. Ambulatory Surgical Center Fee Guideline § 134.403. Hospital Facility Fee Guideline—Outpatient § 134.404. Hospital Facility Fee Guideline—Inpatient

Subchapter F. Pharmaceutical Benefits

§ 134.500. Definitions § 134.501. Initial Pharmaceutical Coverage § 134.502. Pharmaceutical Services § 134.503. Pharmacy Fee Guideline § 134.504. Pharmaceutical Expenses Incurred by the Injured Employee § 134.506. Outpatient Open Formulary for Claims with Dates of Injury Prior to September 1, 2011 § 134.510. Transition to the Use of the Closed Formulary for Claims with Dates of Injury Prior to September 1, 2011 § 134.520. Outpatient Closed Formulary for Dates of Injury on or After September 1, 2011 § 134.530. Requirements for Use of the Closed Formulary for Claims Not Subject to Certified Networks § 134.540. Requirements for Use of the Closed Formulary for Claims Subject to Certified Networks § 134.550. Medical Interlocutory Order

Subchapter G. Prospective and Concurrent Review of Health Care

§ 134.600. Preauthorization, Concurrent Utilization Review, and Voluntary Certification of Health Care

Subchapter I. Medical Bill Reporting

§ 134.800. Applicability § 134.801. Purpose § 134.802. Definitions § 134.803. Reporting Standards § 134.804. Reporting Requirements § 134.805. Records Required to be Reported § 134.806. Records Excluded from Reporting § 134.807. State Specific Requirements § 134.808. Insurance Carrier Edi Compliance Coordinator and Trading Partners

Subchapter J. Reviews and Audits

§ 134.900. Medical Benefit Review and Audit

Chapter 136. Benefits—Vocational Rehabilitation

§ 136.1. Review of Employer Report of Injury

Chapter 137. Disability Management

Subchapter A. General Provisions

§ 137.1. Disability Management Concept § 137.5. Case Manager Certification

Subchapter B. Return to Work

§ 137.10. Return to Work Guidelines § 137.41. Purpose § 137.42. Definitions § 137.43. Return-to-Work Reimbursement Program Administrator § 137.44. Return-to-Work Reimbursement Program for Employers § 137.45. Employer Eligibility for Disbursements from the Return-to-Work Reimbursement Program § 137.46. Application for Funds from the Return-to-Work Reimbursement Program § 137.47. Criteria for Return-to-Work Reimbursement Program Applications § 137.48. Return-to-Work Reimbursement Program Administrator Determinations § 137.49. Optional Preauthorization Plan § 137.50. Optional Advance of Funds Plan § 137.51. Monitoring and Enforcement

Subchapter C. Treatment Guidelines

§ 137.100. Treatment Guidelines

Chapter 140. Dispute Resolution—General Provisions

§ 140.1. Definitions § 140.2. Special Accommodations § 140.3. Expedited Proceedings § 140.4. Conduct and Decorum § 140.5. Correction of Clerical Error § 140.6. Subclaimant Status: Establishment, Rights, and Procedures § 140.7. Health Care Insurer Reimbursement Under Labor Code § 409.0091 § 140.8.Procedures for Health Care Insurers to Pursue Reimbursement of Medical Benefits Under Labor Code §409.0091.§ 140.9. Requests by Parties

Chapter 141. Dispute Resolution—Benefit Review Conference

§ 141.1. Requesting and Setting a Benefit Review Conference § 141.2. Canceling or Rescheduling a Benefit Review Conference § 141.3. Failure to Attend a Benefit Review Conference § 141.4. Sending and Exchanging Pertinent Information § 141.5. Description of the Benefit Review Conference § 141.7. Division Actions After a Benefit Review Conference

Chapter 142. Dispute Resolution—Benefit Contested Case Hearing

§ 142.1. Application of the Administrative Procedure Act § 142.2. Authority of the Administrative Law Judge § 142.3. Ex Parte Communications § 142.4. Delivery of Copies to All Parties § 142.5. Sequence of Proceedings to Resolve Benefit Disputes § 142.6. Setting a Benefit Contested Case Hearing § 142.7. Statement of Disputes § 142.8. Summary Procedures § 142.9. Stipulations, Agreements, and Settlements § 142.10. Continuance § 142.11. Failure to Attend a Benefit Contested Case Hearing § 142.12. Subpoena § 142.13. Discovery § 142.14. Permission to Use Court Reporter § 142.16. Decision § 142.17. Transcript or Duplicate of the Hearing Audiotape § 142.18. Special Provisions for Cases on Remand from the Appeals Panel § 142.19. Form Interrogatories § 142.20. Interlocutory Orders

Chapter 143. Dispute Resolution Review by the Appeals Panel

§ 143.1. Definitions § 143.2. Description of the Appeal Proceeding § 143.3. Requesting the Appeals Panel to Review the Decision of the Administrative Law Judge § 143.4. Responding to a Request for Review by the Appeals Panel § 143.5. Decision of the Appeals Panel

Chapter 144. Dispute Resolution

Subchapter A. Arbitration

§ 144.1. Authority and Duties of Arbitrators § 144.2. Ex Parte Communications § 144.3. Delivery of Copies of Documents § 144.4. Election to Engage in Arbitration § 144.5. Statement of Disputes § 144.6. Assignment of Arbitrator § 144.7. Setting the Arbitration Proceeding § 144.8. Expediting Procedures § 144.9. Exchange of Evidence and Proposed Resolution § 144.10. Stipulations, Agreements, and Settlements § 144.11. Continuance § 144.12. Failure to Attend Arbitration § 144.13. Rights of Parties § 144.14. Usual Order of Proceedings § 144.15. Award of the Arbitrator § 144.16. Requesting a Copy of the Record

Chapter 147. Dispute Resolution—Agreements, Settlements, Commutations

§ 147.1. Definitions § 147.2. Form § 147.3. Execution § 147.4. Filing Agreements with the Commission; Effective Dates § 147.5. Filing Settlements with the Commission; Effective Dates § 147.6. Settlement Conference § 147.7. Effect on Previously Entered Decisions and Orders § 147.8. Withdrawal from Settlement § 147.9. Requirements for Agreements and Settlements § 147.10. Commutation of Impairment Income Benefits § 147.11. Notification of Commission of Proposed Judgments and Settlements

Chapter 148. Hearings Conducted by the State Office of Administrative Hearings

§ 148.1. Definitions § 148.2. Scope and Applicability § 148.3. Requesting a Hearing § 148.4. Correction of Clerical Error § 148.5. Notice of Hearing § 148.6. Venue § 148.7. Representation § 148.8. Withdrawal of Hearing Request § 148.10. Hearings Subpoenas to Compel Attendance and Subpoenas Duces Tecum § 148.11. Commissions to Compel Attendance for Deposition § 148.13. Recording the Hearing § 148.14. Burden of Proof § 148.15. Final Decision by the ALJ § 148.16. Proposal for Decision or Order by the ALJ § 148.17. Special Provisions for Sanctions § 148.19. Transcript or Duplicate of the Hearing Audiotape or Videotape § 148.20. Reimbursement, Travel Expenses, and Fees for Witnesses and Deponents § 148.21. Expenses to be Paid by Party Seeking Judicial Review § 148.22. Failure to Appear or Comply with Order or Decision, Administrative Violation § 148.23. Division Enforcement of Orders § 148.24. Confidentiality of Records

Chapter 149. Memorandum of Understanding with the State Office of Administrative Hearings

[Repealed]

Chapter 150. Representation of Parties Before the Agency—Qualifications for Representatives

§ 150.1. Minimum Standards of Practice for an Attorney § 150.2. Qualification and Authorization of Attorney to Practice Before the Commission § 150.3. Representatives: Written Authorization Required

Chapter 152. Attorney Fees

§ 152.1. Attorney Fees: General Provisions § 152.2. Attorney Fees: Representation of Claimants § 152.3. Approval or Denial of Fee by the Division § 152.4. Guidelines for Legal Services Provided to Claimants and Insurance Carriers § 152.5. Allowable Expenses § 152.6. Attorney Withdrawal

Chapter 156. Representation of Parties Before the Agency—Carrier's Austin Representative

§ 156.1. Carrier's Austin Representative

Chapter 160. Reports of Injury and Occupational Disease—General Provisions

§ 160.1. Applicability § 160.2. Non-Subscribing Employer's Report of Injury § 160.3. Subscribing Employer's Report of Injury

Chapter 165. Rejected Risk: Injury Prevention Services

§ 165.1. Identification and Notification of Certain Policyholders Insured by the Texas Mutual Insurance Company Acting as the Insurer of Last Resort § 165.2. Safety Consultation § 165.3. Formulation and Components of Accident Prevention Plan § 165.4. Request for Safety Consultation from the Division § 165.5. Reimbursement of Division for Services Provided to Rejected Risk Employers § 165.6. Follow-up Inspection of the Policyholder's Premises by the Division § 165.7. Report of Follow-up Inspection

Chapter 166. Accident Prevention Services

§ 166.1. Definitions of Terms § 166.2. Adequacy of Accident Prevention Services § 166.3. Annual Information Submitted by Insurance Companies § 166.5. Inspections of Adequacy of Accident Prevention Facilities and Services

Chapter 167. Emergency Rules

Subchapter A. Covid-19 Emergency Rules

§ 167.1. Physical Medicine and Rehabilitation Services - Telemedicine and Telehealth Billing Procedures

Chapter 180. Monitoring and Enforcement

Subchapter A. General Rules for Enforcement

§ 180.1. Definitions § 180.2. Filing a Complaint § 180.3. Compliance Audits § 180.4. On-Site Visits § 180.5. Access to Workers' Compensation Related Records and Information § 180.8. Notices of Violation; Notices of Hearing; Default Judgments § 180.9. Proposals for Decision § 180.10. Ex Parte Emergency Cease and Desist Orders § 180.19. Incentives

Subchapter B. Medical Benefit Regulation

§ 180.22. Health Care Provider Roles and Responsibilities § 180.23. Division Required Training for Doctors § 180.24. Financial Disclosure § 180.25. Improper Inducements, Influence and Threats § 180.26. Criteria for Imposing, Recommending and Determining Sanctions; Other Remedies § 180.27. Restoration § 180.28. Peer Review Requirements, Reporting, and Sanctions § 180.50. Severability

Subchapter C. Medical Quality Review Panel

§ 180.60. Definitions § 180.62. Medical Quality Review Panel § 180.64. Mqrp Application Process § 180.66. Medical Case Review § 180.68. Medical Quality Review Process § 180.70. Mqrp Training § 180.72. Conflict of Interest § 180.74. Mqrp Notification of Case Status § 180.76. Rights and Responsibilities of Persons Involved in the Medical Quality Review Process § 180.78. Effective Date