Texas Workers' Compensation

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§ 152.2. Attorney Fees: Representation of Claimants

(a) An attorney who represents a claimant shall notify the commission in writing within 10 days of undertaking representation, and shall provide a copy of the contract of employment if requested by the commission.

(b) For purposes of computing the maximum amount of a fee that may be fixed and approved for a claimant’s attorney, “claimant’s recovery” shall not include:

(1) the amount of benefits paid to the claimant prior to hiring the attorney;

(2) benefits initiated or offered by an insurance carrier when the initiation or offer is based upon documentation in a claimant’s file, and has not been the subject of a dispute with the carrier;

(3) any undisputed portion of impairment benefits paid or offered to the claimant based upon an impairment rating that is assessed by the carrier, under the Texas Workers’ Compensation Act (the Act), § 4.26(f);

(4) the value of medical and hospital benefits provided to the claimant; or

(5) lifetime income or death benefits when the carrier admits liability on all issues involved, and when the maximum benefit is tendered in writing by a carrier, no later than the date on which the carrier is required to contest the claim.

(c) An attorney shall not represent multiple legal beneficiaries on a claim for death benefits if it is reasonably foreseeable that a judgment favorable to one legal beneficiary would impact unfavorably on another legal beneficiary.

(d) The total amount that the commission approves for the attorney’s time and expenses constitute the fee, and shall not exceed 25% of the claimant’s recovery, except as provided in the Act, § 4.28(l)(2), and § 152.1(f) of this title (relating to Attorney Fees: General Provisions).

The provisions of this § 152.2 adopted to be effective February 22, 1991, 16 TexReg 774.

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At a Glance:

Title:

§ 152.2. Attorney Fees: Representation of Claimants

Title:

Title 28. Insurance

Status:

Current

Usage:

New Law Rule

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