Texas Workers’ Compensation

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Medical CCH Decisions

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Non-Network
August 13, 2019
DECISION AND ORDER This case is decided pursuant to the Texas Workers’ Compensation Act and the Rules of the Texas Department of Insurance, Division of Workers’ Compensation.  For the reasons discussed herein, the Administrative Law Judge determines that the preponderance of the evidence is not contrary to the decision of the Independent Review Organization that a repeat intrathecal pump trial is not health care reasonably required for the compensable injury of (Date of Injury). STATEMENT...

Non-Network
July 16, 2019
DECISION AND ORDER This case is decided pursuant to Chapter 410 of the Texas Workers’ Compensation Act and the Rules of the Texas Department of Insurance, Division of Workers’ Compensation (DWC). For the reasons discussed herein, the Administrative Law Judge (ALJ) determines that: Claimant is not entitled to trigger point injections, 3 or more muscles, left flank battery site for the compensable injury of (Date of Injury). STATEMENT OF THE CASE On July 15, 2019,...

Non-Network
July 3, 2019
DECISION AND ORDER This case is decided pursuant to Chapter 410 of the Texas Workers’ Compensation Act and Rules of the Division of Workers’ Compensation adopted thereunder. For the reasons discussed herein, the Administrative Law Judge (ALJ) determines that: Claimant is not entitled to the requested left ankle arthroscopy. ISSUES A contested case hearing (CCH) was held on June 10, 2019, to decide the following disputed issue: Is the preponderance of the evidence contrary to...

Non-Network
May 17, 2019
DECISION AND ORDER This case is decided pursuant to Chapter 410 of the Texas Workers’ Compensation Act and the Rules of the Texas Department of Insurance, Division of Workers’ Compensation (DWC). For the reasons discussed herein, the Administrative Law Judge (ALJ) determines that: Petitioner/Claimant is not entitled to twenty hours of a work conditioning program for the compensation injury of (Date of Injury). STATEMENT OF THE CASE On May 13, 2019, Warren E. Hancock, Jr.,...

Non-Network
March 6, 2019
DECISION AND ORDER This case is decided pursuant to Chapter 410 of the Texas Workers’ Compensation Act and the Rules of the Texas Department of Insurance, Division of Workers’ Compensation. For the reasons discussed herein, the Administrative Law Judge determines that Claimant is not entitled to a transforaminal lumbar epidural steroid injection at bilateral L4-L5 with epidurography for the (Date of Injury) compensable injury. STATEMENT OF THE CASE On March 5, 2019, Ana Thornton, a...

Non-Network
February 27, 2019
DECISION AND ORDER This case is decided pursuant to Chapter 410 of the Texas Workers’ Compensation Act and the Rules of the Texas Department of Insurance, Division of Workers’ Compensation. For the reasons discussed herein, the Administrative Law Judge determines that Claimant is not entitled to Functional Capacity Evaluation x 12 units for the compensable injury of (Date of Injury). STATEMENT OF THE CASE On February 20, 2019, Teresa G. Hartley, a Division Administrative Law...

Non-Network
February 27, 2019
DECISION AND ORDER This case is decided pursuant to Chapter 410 of the Texas Workers’ Compensation Act and the Rules of the Texas Department of Insurance, Division of Workers’ Compensation (DWC). For the reasons discussed herein, the Administrative Law Judge (ALJ) determines that: Claimant is entitled to Botox injections (x 2) for the compensable injury of (Date of Injury). Claimant is not entitled to occipital nerve block injections (x 12) for the compensable injury of...

Non-Network
January 28, 2019
DECISION AND ORDER This case is decided pursuant to the Texas Workers’ Compensation Act and the Rules of the Texas Department of Insurance, Division of Workers’ Compensation.  For the reasons discussed herein, the Administrative Law Judge determines that Claimant is not entitled a lumbar left hemilaminectomy L3-L4. STATEMENT OF THE CASE   A contested case hearing was held on January 23, 2019, to decide the following disputed issue: Is the preponderance of the evidence contrary...

Non-Network
January 15, 2019
DECISION AND ORDER This case is decided pursuant to Chapter 410 of the Texas Workers’ Compensation Act and the Rules of the Texas Department of Insurance, Division of Workers’ Compensation. For the reasons discussed herein, the Administrative Law Judge determines that Claimant is not entitled to physical therapy (2 times per week for 6 weeks) for the left wrist for the (Date of Injury) compensable injury. STATEMENT OF THE CASE On January 14, 2019, Ana...

Non-Network
December 11, 2018
DECISION AND ORDER This case is decided pursuant to Chapter 410 of the Texas Workers’ Compensation Act and Rules of the Division of Workers’ Compensation adopted thereunder. For the reasons discussed herein, the Administrative Law Judge determines that NDC – 552890651 NORCO 10/325 MG TID #90 is not health care reasonably required for the compensable injury of (Date of Injury). STATEMENT OF THE CASE A contested case hearing was held on December 4, 2018 to...

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