Texas Regulations 137.49
From Wcc
§ 137.49 Optional Preauthorization Plan.
| (a) An eligible employer who participates in the return-to-work pilot program for small employers may apply to the Division for a guaranteed reimbursement of eligible expenses from the return-to work account prior to making workplace modifications or other changes designed to accommodate an injured employee's return to work.
(b) To apply for a guaranteed reimbursement of eligible expenses, an eligible employer must submit to the Division a properly completed Preauthorization Proposal Plan (DWC Form -- 008). An eligible employer must provide all information required by this form including: (1) a description of the workplace modifications and other changes that the employer proposes to make to accommodate the injured employee's return to work; (2) the estimated costs in making those proposed modifications and changes; and (3) a copy of the Division's "Work Status Report" from the injured employee's examining doctor that specifies the injured employee's physical restrictions or limitations which necessitates the provision of a workplace modification in order for the employee to return to work in a modified or alternative duty capacity. (c) An incomplete proposal plan may be denied or returned to the employer for additional information. (d) The Preauthorization Proposal Plan form (DWC Form -- 008) shall be available on the Division's website (http://www.tdi.state.tx.us/wc/index.html) and at the Division's central office. Upon request, the Division shall provide a Preauthorization Proposal Plan form to an employer. (e) The administrator shall review each submitted proposal plan in accordance with § 137.48 of this title (relating to Return-to-Work Account Administrator Determinations). After review, the administrator may approve or deny the proposal plan in whole or in part or request additional information. The administrator shall promptly notify the employer in writing of the approval or denial of the proposal plan. (f) Upon receipt of Division approval of the proposal plan, the employer may begin all approved modifications and changes set out in the approved proposal plan. Upon completion of the approved modifications and changes, the employer may obtain reimbursement from the return-to-work account by submitting to the Division a properly completed Application for Reimbursement under § 137.46 of this title (relating to Application for Reimbursement from the Return-to-Work Account) that contains the information under § 137.47 of this title (relating to Criteria for Evaluation of Applications). (g) Upon receipt of the information described in subsection (f) of this section and subject to § 137.44 of this title (relating to Return-to-Work Account for Small Employers), the Division shall reimburse the employer the costs incurred by the employer in making the approved modifications and changes unless the Division determines that the modifications and changes differ materially from the employer's proposal. The provision of this § 137.349 adopted to be effective February 7, 2008, 33 TexReg 930 |
