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- § 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.
- § 126.5 Entitlement and Procedure for Requesting Required Medical Examinations
- § 126.8 Commission Approved Doctor List.
- § 126.9 Choice of Treating Doctor and Liability for Payment.
- § 126.6 Required Medical Examination
- § 126.7 Designated Doctor Examinations: Requests and General Procedures
- § 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
- § 128.4 Average Weekly Wage Calculation for Part-Time Employees.
- § 128.5 Average Weekly Wage Calculation for Seasonal Employees.
- § 128 CHAPTER 128. BENEFITS -- CALCULATION OF AVERAGE WEEKLY WAGE
- § 128.6 Average Weekly Wage Adjustment for Certain Employees Who Are Also Minors, Apprentices,
- § 128.7 Average Weekly Wage for School District Employees
- § 129.1 Definitions for Temporary Income Benefits. The following terms shall have the following meanings unless the context clearly indicates otherwise:
- § 129.2 Entitlement to Temporary Income Benefits.
- § 129.3 Amount of Temporary Income Benefits.
- § 129.4 Adjustment of Temporary Income Benefit Amount.
- § 129.11 Agreement for Monthly Payment of Temporary Income Benefits.
- § 129 CHAPTER 129. INCOME BENEFITS -- TEMPORARY INCOME BENEFITS
- § 129.5 Work Status Reports.
- § 129.6 Bona Fide Offers of Employment.
- § 129.7 Non-Reimbursable Employer Payments.
- § 130.3 Certification of Maximum Medical Improvement and Evaluation of Permanent Impairment by A Doctor Other Than The Treating Doctor
- § 130.4 Presumption that Maximum Medical Improvement (MMI) has been Reached and Resolution when MMI has not been Certified
- § 130.10 Commission Review of Employment Status during the Impairment Income Benefits Period.
- § 130.11 Agreement for Monthly Payment of Impairment Income Benefits.
- § 130.100 Applicability.
- § 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.
- § 130.106 Permanent Loss of Entitlement to Supplemental Income Benefits.
- § 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.
- § 130 CHAPTER 130. IMPAIRMENT AND SUPPLEMENTAL INCOME BENEFITS
- § 130.1 Certification of Maximum Medical Improvement and Evaluation of Permanent Impairment
- § 130.12 Finality of the First Certification of Maximum Medical Improvement and/or First Assignment of Impairment Rating.
- § 130.2 Certification of Maximum Medical Improvement and Evaluation of Permanent Impairment by the Treating Doctor
- § 130.5 Impairment Income Benefits
- § 130.110 Return to Work Disputes During Supplemental Income Benefits; Designated Doctor
- § 130.7 Acceleration of Impairment Income Benefits.
- § 130.8 Initiating Payment of Impairment 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.
- § 131 CHAPTER 131. BENEFITS -- LIFETIME INCOME BENEFITS
- § 130.6 Designated Doctor Examinations for Maximum Medical Improvement and/or Impairment Ratings.
- § 132.1 Calculation of Death Benefits.
- § 132.2 Determination of Facts of Dependent Status.
- § 132.3 Eligibility of Spouse To Receive Death Benefits.
- § 132.4 Eligibility of a Child To Receive Death Benefits.
- § 132.5 Eligibility of a Grandchild To Receive Death Benefits.
- § 132.10 Payment of Death Benefits to the Subsequent Injury Fund.
- § 132.11 Distribution of Death Benefits.
- § 132.12 Redistribution of Death Benefits.
- § 132.13 Burial Benefits.
- § 132.14 Autopsy.
- § 132.15 Definitions.
- § 132.16 Change in Payment Periods; Purchase of Annuity for Death Benefits.
- § 132 CHAPTER 132. DEATH BENEFITS -- DEATH & BURIAL BENEFITS
- § 132.17 Denial, Dispute, and Payment of Death Benefits.
- § 132.6 Eligibility of Other Surviving Dependents To Receive Death Benefits.
- § 132.7 Duration of Death Benefits for Eligible Spouse.
- § 132.8 Duration of Death Benefits for an Eligible Child.
- § 132.9 Duration of Death Benefits for an Eligible Grandchild and any Other Eligible Dependents.
- § 133 CHAPTER 133. GENERAL MEDICAL PROVISIONS
- § 133.206 Spinal Surgery Second Opinion Process.
- § 133.1 Applicability of Medical Billing and Processing.
- § 133.3 Communication Between Health Care Providers and Insurance Carriers.
- § 133.20 Medical Bill Submission by Health Care Provider.
- § 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.
- § 133.306 Interlocutory Orders for Medical Benefits.
- § 133.309 Alternate Medical Necessity Dispute Resolution by Case Review Doctor.
- § 133.104 Consultant Medical Reports
- § 133.105 Physical or Occupational Therapy Report.
- § 133.106 Fair and Reasonable Fees for Required Reports and Records
- § 133.300 Insurance Carrier Receipt of Medical Bills from Health Care Providers
- § 133.301 Retrospective Review of Medical Bills.
- § 133.302 Preparation for an Onsite Audit
- § 133.303 Onsite Audits
- § 133.304 Medical Payments and Denials.
- § 133.401 Orders for Production of Documents.
- § 133.402 Delivery of Order; Compliance.
- § 133.403 Noncompliance; Enforcement.
- § 133.200 Insurance Carrier Receipt of Medical Bills from Health Care Providers
- § 133.100 Required Medical Reports.
- § 133.10 Required Billing Forms/Formats.
- § 133.305 Medical Dispute Resolution - General
- § 133.307 Medical Dispute Resolution of Fee Disputes.
- § 133.308 Medical Dispute Resolution by Independent Review Organizations.
- § 133.2 Definitions.
- § 133.4 Written Notification to Health Care Providers of Contractual Agreements for Informal and Voluntary Networks.
- § 134.302 Dental Fee Guideline.
- § 134.401 Acute Care Inpatient Hospital Fee Guideline.
- § 134.1000 Mental Health Treatment Guideline.
- § 134.303 2005 Dental Fee Guideline
- § 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.
- § 134.201 Medical Fee Guideline for Medical Treatments and Services Provided Under the Texas Workers' Compensation Act.
- § 134.202 Medical Fee Guideline.
- § 134.302 Dental Fee Guideline.
- § 134.303 2005 Dental Fee Guideline
- § 134.401 Acute Care Inpatient Hospital Fee Guideline.
- § 134.500 Definitions.
- § 133.500 Electronic Formats for Electronic Medical Bill Processing.
- § 133.501 Electronic Medical Bill Processing.
- § 134.5 Treating Doctor Attendance at Medical Examination under a Medical Examination Order.
- § 134.402 Ambulatory Surgical Center Fee Guideline
- § 134.403 Hospital Facility Fee Guideline - Outpatient.
- § 134.404 Hospital Facility Fee Guideline - Inpatient.
- § 134.1 Medical Reimbursement.
- § 133.5 Informal Network and Voluntary Network Reporting Requirements to the Division.
- § 134.501 Initial Pharmaceutical Coverage.
- § 134.502 Pharmaceutical Services.
- § 134.503 Reimbursement Methodology.
- § 134.504 Pharmaceutical Expenses Incurred by the Injured Employee.
- § 134.506 Outpatient Drug Formulary.
- § 134.600 Preauthorization, Concurrent Review, and Voluntary Certification of Health Care.
- § 134.802 Insurance Carrier Medical Electronic Data Interchange to the Division.
- § 134.900 Medical Benefit Review and Audit.
- § 134.6 Travel Expenses Incurred by the Injured Employee.
- § 134.800 Required Billing Forms and Information
- § 134.801 Submitting Medical Bills for Payment.
- § 134.803 Calculating Interest for Late Payment on Medical Bills and Refunds.
- § 136 CHAPTER 136. BENEFITS--VOCATIONAL REHABILITATION
- § 136.2 Registry of Private Providers of Vocational Rehabilitation Services.
- § 136.1 Review of Employer Report of Injury.
- § 137.42 Definitions.
- § 137.43 Return-to-Work Account Administrator.
- § 137.44 Return-to-Work Account for Small Employers.
- § 137.45 Employer Eligibility for Reimbursement from the Return-to-Work Account.
- § 137.46 Application for Reimbursement from the Return-to-Work Account.
- § 137.47 Criteria for Evaluation of Applications.
- § 137.48 Return-to-Work Account Administrator Determinations.
- § 137 CHAPTER 137: DISABILITY MANAGEMENT
- § 137.100 Treatment Guidelines
- § 137.1 Disability Management Concept
- § 137.10 Return to Work Guidelines
- § 137.41 Purpose.
- § 137.49 Optional Preauthorization Plan.
- § 140 CHAPTER 140. DISPUTE RESOLUTION--GENERAL PROVISIONS
- § 140.2 Special Accommodations.
- § 140.3 Expedited Proceedings
- § 140.5 Correction of Clerical Error.
- § 140.1 Definitions.
- § 140.4 Conduct and Decorum.
- § 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 Filing and Exchanging Pertinent Information.
- § 142 CHAPTER 142. DISPUTE RESOLUTION--BENEFIT CONTESTED CASE HEARING
- § 142.1 Application of the Administrative Procedure Act.
- § 142.2 Authority of the Hearing Officer.
- § 142.3 Ex Parte Communications.
- § 142.4 Delivery of Copies to All Parties
- § 142.5 Sequence of Proceedings to Resolve Benefit Disputes.
- § 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.
- § 141.7 Division Actions After a Benefit Review Conference.
- § 141.5 Description of the Benefit Review Conference
- § 141.6 Requesting Interlocutory Orders
- § 142.6 Setting a Benefit Contested Case Hearing.
- § 142.7 Statement of Disputes.
- § 142.8 Summary Procedures.
- § 142.9 Stipulations, Agreements, and Settlements.
- § 143 CHAPTER 143. DISPUTE RESOLUTION--REVIEW BY THE APPEALS PANEL
- § 143.2 Description of the Appeal Proceeding.
- § 143.1 Definitions.
- § 143.3 Requesting the Appeals Panel to Review the Decision of the Hearing Officer.
- § 143.4 Responding to a Request for Review by the Appeals Panel.
- § 144 CHAPTER 144. DISPUTE RESOLUTION REVIEW BY THE APPEALS PANEL
- § 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.
- § 144.10 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.
- § 143.5 Decision of the Appeals Panel.
- § 144.6 Assignment of Arbitrator.
- § 144.7 Setting the Arbitration Proceeding.
- § 144.8 Expediting Procedures.
- § 144.9 Exchange of Evidence and Proposed Resolution.
- § 145 CHAPTER 145. DISPUTE RESOLUTION - HEARINGS UNDER THE ADMINISTRATIV PROCEDURE
- § 145.1 Scope and Applicability.
- § 145.2 Definitions
- § 145.3 Requesting a Hearing.
- § 145.4 Notice of Hearing
- § 145.10 Filing Instruments: Furnishing Copies.
- § 145.11 APTRA Prehearing Conference.
- § 145.12 Request for Alternative Dispute Resolution.
- § 145.13 Discovery and Production of Documents and Things for Inspection, Copying or Photographing.
- § 145.14 Subpoenas; Depositions.
- § 145.15 Ex Parte Communications.
- § 145.16 Conduct and Decorum.
- § 145.17 Hearing Officer's Authority.
- § 145.18 Parties' Rights in Hearings.
- § 145.19 Failure to Appear.
- § 145.20 Recording the Hearing.
- § 145.21 Evidence.
- § 145.22 Reimbursement, Travel Expenses, and Fees for Witnesses and Deponents.
- § 145.23 Decision of the Hearing Officer.
- § 145.24 Special Provisions for Imposing Sanctions Pursuant to Section 2.09(f) of the Act.
- § 145.25 Special Provisions for Administrative Penalties.
- § 145.26 Record of the Hearing.
- § 145.27 Transcript or Duplicate of the Hearing Audiotape.
- § 145.28 Expenses To Be Paid by Petitioner.
- § 145.5 Statement of Matters Asserted.
- § 145.6 Venue
- § 145.7 Appearance and Representation
- § 145.8 Withdrawal of Hearing Request.
- § 145.9 Informal Disposition.
- § 147 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.
- § 147.10 Commutation of Impairment Income Benefits.
- § 147.11 Notification of Commission of Proposed Judgments and Settlements.
- § 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.
- § 148 CHAPTER 148. HEARINGS CONDUCTED BY THE STATE OFFICE OF ADMINISTRATIVE HEARINGS
- § 148.13 Recording the Hearing.
- § 148.1 Definitions.
- § 148.2 Scope and Applicability.
- § 148.3 Requesting a Hearing.
- § 148.4 Correction of Clerical Error in Medical Review Division Decisions or Orders Absent a Request For Hearing.
- § 148.5 Notice of Hearing.
- § 148.10 Hearings Subpoenas to Compel Attendance and Subpoenas Duces Tecum.
- § 148.11 Commissions to Compel Attendance for Deposition.
- § 148.12 Ex Parte Communications.
- § 148.14 Burden of Proof.
- § 148.15 Final Decision by the ALJ.
- § 148.16 Proposal for Decision by the ALJ.
- § 148.17 Special Provisions for Administrative Penalties.
- § 148.18 Record of the Hearing.
- § 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 Commission Enforcement of Orders.
- § 148.24 Special Provisions for Administrative Penalties.
- § 148.25 Record of the Hearing.
- § 148.26 Transcript or Duplicate of the Hearing Audiotape.
- § 148.27 Reimbursement, Travel Expenses, and Fees for Witnesses and Deponents.
- § 148.28 Expenses To Be Paid by Party Seeking Judicial Review.
- § 149 CHAPTER 149. MEMORANDUM OF UNDERSTANDING WITH THE STATE OFFICE OF ADMINISTRATIVE HEARINGS
- § 148.6 Venue.
- § 148.7 Representation.
- § 148.8 Withdrawal of Hearing Request.
- § 148.9 Informal Disposition.
- § 149.1 Definitions.
- § 149.2 General Statement.
- § 149.3 Referral of Contested Case to SOAH.
- § 149.4 Notice of Hearing.
- § 149.10 Custody of the Hearing Record.
- § 150 CHAPTER 150. REPRESENTATION OF PARTIES BEFORE THE AGENCY – QUALIFICATIONS OF REPRESENTATIVES
- § 150.1 Minimum Standards of Practice for an Attorney.
- § 150.2 Qualification and Authorization of Attorney to Practice Before the Commission.
- § 150.3 ation Required. Representatives: Written Authoriz
- § 149.5 Hearings.
- § 149.6 Confidentiality of Records.
- § 149.7 Action Upon Withdrawal of Decision.
- § 149.8 Final Orders in Accordance with the Act, ��411.049, 413.031, 413.055 and 415.034.
- § 149.9 Proposals for Decision in Accordance with the Act, ��402.072, 407.046, and 408.0231.
- § 152 CHAPTER 152. REPRESENTATION OF PARTIES BEFORE THE AGENCY - ATTORNEY FEES
- § 152.1 Attorney Fees: General Provisions.
- § 152.2 Attorney Fees: Representation of Claimants.
- § 152.3 Approval or Denial of Fee by the Commission.
- § 152.4 Guidelines for Legal Services Provided to Claimants and Carriers.
- § 152.5 Allowable Expenses.
- § 156 CHAPTER 156. REPRESENTATION OF PARTIES BEFORE THE AGENCY—CARRIER'S AUSTIN REPRESENTATIVE
- § 156.1 Carrier's Austin Representative.
- § 160 CHAPTER 160. WORKERS' HEALTH AND SAFETY--GENERAL PROVISIONS
- § 160.2 Non-Subscribing Employer's Report of Injury.
- § 160.3 Subscribing Employer's Report of Injury.
- § 164 CHAPTER 164. HAZARDOUS EMPLOYER PROGRAM
- § 164.1 Criteria for Identifying Hazardous Employers.
- § 164.2 Notice to Hazardous Employers.
- § 164.3 Safety Consultation for Public Employers.
- § 164.5 Follow-up Inspection for Public Employers by the Division.
- § 164.10 Removal from the List of Approved Professional Sources.
- § 164.11 Request for Safety Consultation from the Division.
- § 164.12 Reimbursement of Division for Services Provided to Hazardous Employer.
- § 164.14 Values Assigned for Computation of Hazardous Employer Identification.
- § 164.15 Administrative Reviews and Hearings Regarding Identification as a Hazardous Employer.
- § 164.16 Removal of Private Employers from Hazardous Employer Status.
- § 164.17 Availability of OSHCON Services.
- § 164.18 Severability.
- § 164.4 Formulation of Accident Prevention Plan for Public Employers.
- § 164.6 Report of Follow-up Inspection, Public Employers.
- § 164.7 Removal of Public Employers from Hazardous Employer Status.
- § 164.8 Continuation of Hazardous Employer Status, Public Employers.
- § 164.9 Approval of Professional Sources for Safety Consultations
- § 165 CHAPTER 165. REJECTED RISK: INJURY PREVENTION SERVICES
- § 165.4 Request for Safety Consultation From the Division.
- § 165.1 Identification and Notification of Certain Policyholders Insured by the Texas
- § 165.2 Safety Consultation.
- § 165.3 Formulation and Components of Accident Prevention Plan.
- § 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.
- § 166 CHAPTER 166. WORKERS' HEALTH AND SAFETY - ACCIDENT PREVENTION SERVICES
- § 166.1 Definitions of Terms.
- § 166.2 Initial Writing and Resumption of Writing of Workers' Compensation Insurance.
- § 166.3 Annual Report to the Commission.
- § 166.5 Required Periodic Inspections of Accident Prevention Services and Site of Inspection.
- § 165.7 Report of Follow-Up Inspection.
- § 166.4 Accident Prevention Services.
- § 166.7 Inspection of Accident Prevention Services: Conducting and Reporting.
- § 166.8 Qualification of Field Safety Representatives.
- § 166.9 Approval of Occupational Health and Safety Education Programs.
- § 166.6 Exchange of Information for the Inspection.
- § 169 CHAPTER 169. WORKERS' HEALTH AND SAFETY--DRUG-FREE WORKPLACE PROGRAM
- § 169.1 Notification of Drug Abuse Policy.
- § 169.2 Required Elements of Drug Abuse Policy. An employer adopting a policy for the elimination of drug abuse shall provide each employee with a written copy of the policy, which shall include:
- § 180 CHAPTER 180. MONITORING AND ENFORCEMENT
- § 180.2 Referrals.
- § 180.5 Access to Workers' Compensation Related Records.
- § 180.24 Financial Disclosure.
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