Texas DWC Announces May Enforcement Actions

Austin, TX (WorkersCompensation.com) - Commissioner of Workers' Compensation Rod Bordelon recently announced final disciplinary actions taken by the Texas Department of Insurance, Division of Workers' Compensation (TDI-DWC).

The final actions include orders related to violations of the Texas Labor Code and rules promulgated by the Commissioner of Workers' Compensation. Violations cited in orders naming insurers included failure to timely pay a medical bill and failure to timely pay income benefits to an injured employee. Violations cited in orders naming health care providers included failure to timely file and/or accurately complete TDI-DWC forms, reports or records.

American Home Assurance Company of New York, NY
Order Number: DWC-12-0076
Date of Order: 5/14/2012
Order Final In: May
Action Taken: Fined $4,200
Violation: Failed to timely reimburse injured employee for travel expenses; Failed to pay death benefits at correct rate

AOC Senior Home Health Corporation of Howe
Order Number: DWC-12-0080
Date of Order: 5/18/2012
Order Final In: May
Action Taken: Fined $500
Violation: Failed to timely comply with a TDI-DWC order to provide workers compensation coverage status

August, Brian James M.D. of El Paso
Order Number: DWC-12-0084
Date of Order: 5/21/2012
Order Final In: May
Action Taken: Removed from Designated Doctor List
Violation: Failed to comply with order or decision of Commissioner or TDI-DWC; Failed to timely file and/or accurately complete TDI-DWC forms, reports or records

Axiom Home Health Inc. of San Antonio
Order Number: DWC-12-0082
Date of Order: 5/18/2012
Order Final In: May
Action Taken: Fined $1,000
Violation: Failed to timely comply with a TDI-DWC order to provide workers compensation coverage status

Chimanji, Mahanprakash D., M.D. of Dallas
Order Number: DWC-12-0078
Date of Order: 5/16/2012
Order Final In: May
Action Taken: Must complete Designated Doctor course and course certification examination within 180 days
Violation: Failed to properly perform and/or document an adequate Designated Doctor examination

El Paso Orthopaedic Surgery Group of El Paso
Order Number: DWC-12-0090
Date of Order: 5/30/2012
Order Final In: May
Action Taken: Fined $1,000
Violation: Improperly billed an injured employee for workers' compensation medical services provided

Fields Fast Foods F.L.P. of Rosenberg
Order Number: DWC-12-0075
Date of Order: 5/14/2012
Order Final In: May
Action Taken: Fined $1,500
Violation: Failed to timely comply with a TDI-DWC order to provide workers compensation coverage status

Fries Restaurant Management L.L.C. Burger King of Dallas
Order Number: DWC-12-0091
Date of Order: 5/30/2012
Order Final In: May
Action Taken: Fined $1,000
Violation: Failed to timely comply with a TDI-DWC order to provide workers compensation coverage status

Irving Laboratories PA of Dallas
Order Number: DWC-12-0085
Date of Order: 5/22/2012
Order Final In: May
Action Taken: Fined $500
Violation: Improperly billed an injured employee for workers' compensation medical services provided

La Bianca, Inc. of Ennis
Order Number: DWC-12-0088
Date of Order: 5/24/2012
Order Final In: May
Action Taken: Fined $500
Violation: Failed to timely comply with a TDI-DWC order to provide workers compensation coverage status

LM Insurance Corporation of Boston, MA
Order Number: DWC-12-0083
Date of Order: 5/21/2012
Order Final In: May
Action Taken: Fined $62,500
Violation: Failed to timely pay income benefits to injured employee; Failed to notify injured employee and TDI-DWC of actions taken on a claim

McShane, Ricky Michael D.O. of Deer Park
Order Number: DWC-12-0089
Date of Order: 5/30/2012
Order Final In: May
Action Taken: Removed from Designated Doctor List
Violation: Failed to comply with order or decision of Commissioner or TDI-DWC; Failed to timely file and/or accurately complete TDI-DWC forms, reports or records

Nickep Enterprises of Dallas
Order Number: DWC-12-0077
Date of Order: 5/14/2012
Order Final In: May
Action Taken: Fined $1,000
Violation: Failed to timely comply with a TDI-DWC order to provide workers compensation coverage status

Patel, Manish V., M.D. of Austin
Order Number: DWC-12-0092
Date of Order: 5/30/2012
Order Final In: May
Action Taken: Fined $5,000
Violation: Failed to comply with order or decision of Commissioner or TDI-DWC

Quest Diagnostics Inc. of Madison, NJ
Order Number: DWC-12-0074
Date of Order: 5/14/2012
Order Final In: May
Action Taken: Fined $3,000
Violation: Improperly billed an injured employee for workers' compensation medical services provided

Richards, Barna Allen M.D. of Arlington
Order Number: DWC-12-0073
Date of Order: 5/14/2012
Order Final In: May
Action Taken: Must attend approved educational course or event related to medical practice in Texas workers' compensation system
Violation: Failed to appropriately certify maximum medical improvement; Failed to properly determine injured employee's impairment rating; Failed to perform additional testing or refer an employee to other health care providers when necessary

The Netherlands Insurance Company of Boston, MA
Order Number: DWC-12-0079
Date of Order: 5/18/2012
Order Final In: May
Action Taken: Fined $8,000
Violation: Failed to timely pay income benefits to injured employee; Failed to accurately submit medical bill and payment data

Trudy's Texas Star, Inc. of Austin
Order Number: DWC-12-0086
Date of Order: 5/22/2012
Order Final In: May
Action Taken: Fined $1,500
Violation: Failed to timely provide information requested by TDI-DWC; Failed to timely file non-covered employer's report of occupational injury or illness

Ultra Medical Cleaning of Stafford
Order Number: DWC-12-0081
Date of Order: 5/18/2012
Order Final In: May
Action Taken: Fined $1,000
Violation: Failed to timely comply with a TDI-DWC order to provide workers compensation coverage status

Williams Fried Chicken, Inc. of Dallas
Order Number: DWC-12-0094
Date of Order: 5/31/2012
Order Final In: May
Action Taken: Fined $500
Violation: Failed to timely comply with a TDI-DWC order to provide workers compensation coverage status

Zegarelli, Louis D., D.O. of Dallas
Order Number: DWC-12-0093
Date of Order: 5/31/2012
Order Final In: May
Action Taken: Must attend University of California at SanDiego PACE course in clinician-patient communications within 180 days
Violation: Provided long-term care and pain management without any resulting improvement or return to work

Zurich American Insurance Company of Schaumburg, IL
Order Number: DWC-12-0087
Date of Order: 5/24/2012
Order Final In: May
Action Taken: Fined $35,000
Violation: Failed to timely pay income benefits to injured employee; Failed to notify TDI-DWC and injured employee of actions taken on a claim

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