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Simplifying the Work of Workers' Compensation



Texas Workers' Compensation Information

  • Home
  • States
  • Workers' Compensation Information


  • State Telephone Numbers
  • State Forms
  • State Rules & Statutes

Please Note: for Claims assistance or questions about coverage and exemptions You will need to call one of the numbers listed below.

Also be aware that the Workers' Compensation Assistance Offices in different states may go by different names such as "Industrial Accidents".
These are the only numbers that we are aware of and have available for Texas Workers' Compensation.


Texas Workers' Compensation Telephone Directory


DWC - Austin - Central Office Toll Free: 800-252-7031

DWC - Abilene - Field Office - Toll Free: 800-252-7031

DWC - Amarillo - Field Office - Toll Free: 800-252-7031

DWC - Austin - Field Office - Toll Free: 800-252-7031

DWC - Beaumont - Hearings only Office - Toll Free: 800-252-7031

DWC - Bryan - Field Office - Toll Free: 800-252-7031

DWC - Corpus Christi - Field Office - Toll Free: 800-252-7031

DWC - Dallas - Field Office - Toll Free: 800-252-7031

DWC - Denton - Field Office - Toll Free: 800-252-7031

DWC - El Paso - Field Office - Toll Free: 800-252-7031

DWC - Euless - Field Office - Toll Free : 800-252-7031

DWC - Houston EAST- Field Office - Toll Free: 800-252-7031

DWC - Houston WEST - Field Office - Toll Free: 800-252-7031

DWC - Laredo - Field Office - Toll Free: 800-252-7031

DWC - Lubbock - Field Office - Toll Free: 800-252-7031

DWC - Lufkin - Field Office: 936-639-6406

DWC - San Angelo - Field Office - Toll Free: 800-252-7031

DWC - San Antonio - Field Office - Toll Free: 800-252-7031

DWC - Tyler - Field Office - Toll Free: 800-252-7031

Safety Violations Hotline - Toll Free: 800-452-9595

DWC - Waco - Field Office - Toll Free: 800-252-7031

DWC - Weslaco - Field Office - Toll Free: 800-252-7031

Hearings - Main Line: 512-804-4010

DWC-Midland/Odessa-Field Office - Toll Free: 800-252-7031

Safety Training - Phone & Email Address: 512-804-4610

Claims and Customer Services - Toll Free: 800-252-7031, #1

Workplace Safety - Toll Free & Email: 800-252-7031, #2

Self Insurance Regulation: 512-804-4775

Fraud: 844-FRAUD99

Fraud - Phone Number (hotline) & Email Address: 844-373-8399

DWC Workplace Safety - Toll Free: 800-687-7080

Managed Care Quality Assurance - Toll Free: 866-554-4926

Open Records Request - Fax, Email Address & Mailing Address: 512-490-1021

Vocational Rehabilitation - Phone & Email Address: 512-936-6400

Medical Fee Dispute Resolution: 800-252-7031 opt3

DWC Media Relations: 512-804-4208

Dispute Resolution - Ombudsman: 866-393-6432 x441

Workplace Safety from WC Carrier Information: 800-687-7080

DWC Chief Clerk of Proceedings/Hearings: 512-804-4020

Workers' Compensation Commission: 512-804-4103

Appeals Panel: 512-804-4033

Appeals Panel - Second Number: 512-804-4020

Compliance & Investigations : 512-804-4733

Hearings: 512-804-4015

Hearings Director: 512-804-4085

TXCOMP: 888-489-2667

Report Suspected WC Fraud: 512-804-4710

Accident Prevention Services: 800-252-7031 opt 2

Comp Connection for Health Care Providers: 800-252-7031 opt3

DWC Fraud Mailing Address & Phone Number: 512-804-4720

Health & Safety: 512-804-4870

Commissioner of Workers' Compensation Cassie Brown: 512-804-4400

Legal Services: 512-804-4040

Obtaining an Attorney: 800-252-9690

Office of Injured Employee Counsel: 866-393-6432x44186

Bureau of Labor Statistics (BLS) of Fatal Occupational Injuries: 512-804-4640

OIEC (Office of Injured Employee Counsel): 512-804-4170

OIEC (Office of Injured Employee Counsel) - First Responder Liaison: 512-804-4173

OIEC (Office of Injured Employee Counsel) - Legal & Staff Services Manager: 512-804-4194

OIEC (Office of Injured Employee Counsel) - General Counsel: 512-804-4185

OIEC (Office of Injured Employee Counsel) - Assistant General Counsel: 512-804-4170

OIEC (Office of Injured Employee Counsel) - Field Operations Director: 512-804-4170

Chief Clerk of Proceedings (Appeal): 512-804-4021

Department of Insurance (State): 512-676-6000

Department of Insurance (State) - Mailing Address & Toll Free Number: 800-578-4677

Department of Insurance (State) - Chief Deputy Commissioner Doug Slape: 512-676-6023

Insurance (State) Fraud: 512-676-6925

OSHA - Austin Area Ofc. - Federal OSHA covers private Employers/Employees in TX : 512-374-0271

Forms & Publications


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Some "Revision Dates" may be displayed as part of the Description.

NOTICE: Beginning December 6, 2018, revised DWC Form-032, Request for Designated Doctor Examination and DWC Form-068, Designated Doctor Examination Data Report must be used to comply with new rules to 28 Texas Administrative Code Chapter 127, regarding Designated Doctor Procedures and Requirements.

On March 1, 2018, Texas workers' compensation insurance carriers must use the new and revised plain language notices. The Texas Department of Insurance, Division of Workers' Compensation (TDI-DWC) recently revised plain language notices PLN-1, PLN-2, and PLN-4 through PLN-12; and created new notices PLN-3a, PLN3b, and PLN-3c.

Insurance carriers may not use older versions of the plain language notices on or after March 1, 2018. TDI-DWC will remove all previous versions from its website.

(dwc1) Employer's First Report of Injury or Illness 10/05
(dwc1s) Employer's First Report of Injury or Illness 10/05
(dwc2) Employer's Report for Reimbursement of Voluntary Payment 2/17
(dwc3) Employer's Wage Statement 10/05
(dwc3s) Employer's Wage Statement (Spanish) 10/05
(dwc3me) Employer's Multiple Employment Wage Statement 4/16
(dwc3mes) Employer's Multiple Employment Wage Statement (Spanish) 4/16
(dwc3sd) Employer's Wage Statement for School Districts 10/05
(dwc3sds) Employer's Wage Statement for School Districts (Spanish) 10/05
(dwc4) Employer's Contest of Compensability Interim 11/08
(dwc5) Employer's Notice of No Coverage or Termination of Coverage 2/18
(dwc5s) Employer's Notice of No Coverage or Termination of Coverage (Spanish) 2/18
(dwc6) Supplemental Report of Injury 10/05
(dwc7) Employer's Report of Non-covered Employee's Occupational Injury or Disease 2/22
(dwc8) Application for Reimbursement from the Return-to-Work Account for Small Employers 4/10
(dwc20a) Correction/Revision/Endorsement to Existing Policy 10/05
(dwc20si) Self-Insured Governmental Entity Coverage Information 08/12
(dwc22) Required Medical Examination Notice or Request for Order 7/11
(dwc22s) Required Medical Examination Notice or Request for Order (Spanish) 7/11
(dwc24) Benefit Dispute Agreement 11/17
(dwc24s) Benefit Dispute Agreement (Spanish) 11/17
(dwc25) Benefit Dispute Settlement 11/17
(dwc25s) Benefit Dispute Settlement (Spanish) 11/17
(dwc26 2015) Request for Reimbursement of Payment Made by Health Care Insurer 01/15
(dwc27) Designation of Insurance Carrier's Austin Representative 03/22
(dwc29) Request for Standard Detailed Data Reports 3/22
(dwc31) Application for Division Approval of Change in the Payment Period and/or Purchase of an Annuity for Death Benefits 2/17
(dwc31s) Application for Division Approval of Change in the Payment Period and/or Purchase of an Annuity for Death Benefits (Spanish) 2/17
(dwc32) Request for Designated Doctor Examination 10/18
(dwc32s) Request for Designated Doctor Examination (Spanish) 10/18
(dwc33) Request To Reduce Income Benefits Due to Contribution 5/22
(dwc35) Application for Division Approval of the Purchase of an Annuity for Lifetime Income Benefits 2/17
(dwc41) Employee's Notice of Injury or Occupational Disease and Claim for Compensation 3/07
(dwc41s) Employee's Notice of Injury or Occupational Disease and Claim for Compensation (Spanish) 3/07
(dwc42) Claim for Workers'Compensation Death Benefits 3/16
(dwc42s) Claim for Workers' Compensation Death Benefits (Spanish) 3/16
(dwc44) Election to Engage in Arbitration 6/12
(dwc44s) Election to Engage in Arbitration - (Spanish) 6/12
(dwc45) Request to Schedule, Reschedule, or Cancel a Benefit Review Conference (BRC) 7/21
(dwc45s) Request to Schedule, Reschedule, or Cancel a Benefit Review Conference (BRC) (Spanish) 7/21
(dwc45a) Request for Medical Contested Case or SOAH Hearing 9/07
(dwc45as) Request for Medical Contested Case or SOAH Hearing (Spanish) 10/07
(dwc45m) Request to Schedule, Reschedule, or Cancel a Benefit Review Conference to Appeal a Medical Fee Dispute Decision (BRC-MFD) 7/21
(dwc45ms) Request to Schedule, Reschedule, or Cancel a Benefit Review Conference to Appeal a Medical Fee Dispute Decision (BRC-MFD)(For disputes filed on or after June 1, 2012) (Spanish) 7/21
(dwc46) Employee's Request for Acceleration of Impairment Income Benefits 2/17
(dwc46s) Employee's Request for Acceleration of Impairment Income Benefits (Spanish) 2/17
(dwc47) Employee's Request for Advance of Benefits 2/17
(dwc47s) Employee's Request for Advance of Benefits (Spanish) 2/17
(dwc48) Request to Get Reimbursed for Travel Costs 7/21
(dwc48s) Request to Get Reimbursed for Travel Costs(Spanish) 7/21
(dwc49) Request to Schedule a Medical Contested Case Hearing (MCCH) 11/17
(dwc49s) Request to Schedule a Medical Contested Case Hearing (MCCH) (Spanish) 11/17
(dwc51) Employee's Election for Commuted (Lump Sum) Impairment Income Benefits 2/17
(dwc51s) Employee's Election for Commuted (Lump Sum) Impairment Income Benefits (Spanish) 2/17
(dwc52) Application for Supplemental Income Benefits 2/17
(dwc52s) Application for Supplemental Income Benefits (Spanish) 2/17
(dwc53) Employee's Request to Change Treating Doctors 3/12
(dwc53s) Employee's Request to Change Treating Doctors (Spanish) 3/12
(dwc54) Notice to Employee: Intention to Request Division Permission to Adjust Benefits 2/17
(dwc54s) Notice to Employee: Intention to Request Division Permission to Adjust Benefits (Spanish) 2/17
(dwc55) Request to Adjust Average Weekly Wage for Seasonal Employee 2/17
(dwc55s) Request to Adjust Average Weekly Wage for Seasonal Employee (Spanish) 2/17
(dwc56) Carrier's Request for Seasonal Wage Information from Texas Work Force Commission Records 2/17
(dwc57) Request for Extension of Maximum Medical Improvement Date for Spinal Surgery 2/17
(dwc57s) Request for Extension of Maximum Medical Improvement Date for Spinal Surgery (Spanish) 2/17
(dwc58) Request for Interlocutory Order 9/07
(dwc60) Medical Fee Dispute Resolution Request 2/21
(dwc60s) Medical Fee Dispute Resolution Request (For disputes filed on or after June 1, 2012) (Spanish) 2/21
(dwc64) Medical Interlocutory Order Request 8/11
(dwc66) Statement of Pharmacy Services Services 12/11
Designated Doctor Certification Application * For use on or after 9/1/2016 * 8/16
Designated Doctor Examination Data Report- For use on or after 12/6/2018 10/18
(dwc69) DWC069 Report of Medical Evaluation 1/15
Instructions for Completing the ADA J515 Dental Claim Form 10/05
(dwc72) Medical Quality Review Panel Application (for use on or after January 1, 2013) 1/13
(dwc73) Work Status Report 9/19
(dwc73s) Work Status Report- Spanish 9/19
(dwc74) Description of Injured Employee's Employment 9/09
(dwc81) Agreement Between General Contractor and Sub-Contractor to Provide Workers' Compensation Insurance 10/21
(dwc81s) Agreement Between General Contractor and Sub-Contractor to Provide Workers' Compensation Insurance (Spanish) 10/21
(dwc82) Agreement for Motor Carriers and Owner Operators 2/22
(dwc82sp) Agreement between motor carrier and owner operator to provide workers' compensation insurance-Spanish 2/22
(dwc83) Agreement for Certain Building and Construction Workers 10/21
(dwc83s) Agreement for Certain Building and Construction Workers 10/21
(dwc84) Exception to Application of Joint Agreement for Certain Building and Construction Workers 10/21
(dwc84s) Exception to Application of Joint Agreement for Certain Building and Construction Workers (Spanish) 10/21
(dwc85) Agreement between General Contractor and Subcontractor to Establish Independent Relationship 10/21
(dwc85s) Agreement between General Contractor and Subcontractor to Establish Independent Relationship (Spanish) 10/21
(dwc95) SIF Reimbursement Request Form - Overturned Order or Designated Doctor Opinion 1/21
(dwc96) SIF Reimbursement Request Form – Refund of Death Benefits 1/21
(dwc97) SIF Reimbursement Request Form – Multiple Employment 1/21
(dwc98) SIF Reimbursement Request Form – Pharmaceutical 1/21
(dwc101) Program Review Report 11/21
(dwc102) Accident Prevention Plan Cover Sheet 11/21
(dwc104) Employer Request for DWC Safety Consultation 11/21
(dwc105) Accident Prevention Services Worksheet 11/21
(dwc109) Accident Prevention Services Annual Report 11/21
(dwc120) Designation of Administrative Services Company Administrator 3/22
(dwc121) Claim Administration Contact Information 3/20
(dwc150) Notice of Representation 12/16
(dwc150a) Notice of Withdrawal of Representation 11/17
(dwc150as) Notice of Withdrawal of Representation (Spanish) 11/17
(dwc150s) Notice of Representation (Spanish) 12/16
(dwc151) Attorney Application for Web Access 12/16
(dwc152) Application for Attorney's Fees 11/17
(dwc153) Request for Copies of Confidential Claimant Information 2/21
(dwc153s) Request for Copies of Confidential Claimant Information (Spanish) 2/21
(dwc154) Workers' Compensation Complaint Form 3/16
(dwc154s) Workers' Compensation Complaint Form(Spanish) 3/16
(dwc156) Prospective Employment Authorization and Certification 8/21
(dwc156s) Prospective Employment Authorization and Certification (Spanish) 8/21
(dwc205) Locations of Employers' Business 11/10
(dwc205s) Locations of Employers' Business (Spanish) 11/10
(dwc210) Surety Bond for Certified Self-Insurance Liabilities 1/06
(dwc215) Surety Bond Amount Rider 1/06
(dwc216) Surety Bond Name Change Rider 1/06
(dwc223) Documentary Irrevocable Standby Letter of Credit 1/07
(dwc224) Documentary Irrevocable Standby Letter of Credit ("Confirmation") 1/07
(dwc225) Self-Insurers Agreement to Post Documentary Irrevocable Standby Letter of Credit 1/07
(dwc226) Parental Guaranty 1/07
(dwc227) Parental Guaranty for Less than Wholly Owned Subsidiary 1/07
(dwc228) Power of Attorney 1/07
(dwc230suretybond) Surety Bond for Assumed Certified Self-Insurance Liabilities 3/14
(newempnotice) New Employee Notice (covered and non-covered employers shall notify their employees of coverage status, in writing, 7/12
(newempnotices) New Employee Notice - (Spanish) 7/12
(notice5) For Employers who do not have coverage 1/13
(notice5s) Notice to Employees Concerning Workers' Compensation in Texas - (Spanish) 1/13
(notice6) Notice to Employees Concerning Workers' Compensation in Texas 1/13
(notice6s) Notice to Employees Concerning Workers' Compensation in Texas - (Spanish) 1/13
(notice07) Notice to Employees Concerning Workers' Compensation in Texas - (Spanish) 1/13
(notice07s) Notice to Employees Concerning Workers' Compensation in Texas - (Spanish) 1/13
(notice8) Required Workers' Compensation Coverage (building or construction projects for governmental entities) 12/15
(notice8s) Required Workers' Compensation Coverage (building or construction projects for governmental entities) (Spanish) 12/15
(notice9) For Work-Related Communicable Diseases 12/15
(notice9s) For Work-Related Communicable Diseases (Spanish) 12/15
(notice10) Notice to Employees Concerning Workers' Compensation in Texas (must be posted for employees to read, for use on or after 1/1/13) 1/13
(notice10s) Notice to Employees Concerning Workers' Compensation in Texas (must be posted for employees to read, for use on or after 1/1/13) (Spanish) 1/13
(pln01) Notice of Denial of Compensability/Liability and Refusal to Pay Benefits 7/21
(pln01s) Notice of Denial of Compensability/Liability and Refusal to Pay Benefits (Spanish) 7/21
(pln02) Notification of First Temporary Income Benefit Payment 7/21
(pln02s) Notification of First Temporary Income Benefit Payment (Spanish) 7/21
(pln03a) Notice of Maximum Medical Improvement and No Permanent Impairment 7/21
(pln03as) Notice of Maximum Medical Improvement and No Permanent Impairment (Spanish) 7/21
(pln03b) Notice of Maximum Medical Improvement and Permanent Impairment 7/21
(pln03bs) Notice of Maximum Medical Improvement and Permanent Impairment (Spanish) 7/21
(pln03c) Notice of Maximum Medical Improvement and Estimated Permanent Impairment 7/21
(pln03cs) Notice of Maximum Medical Improvement and Estimated Permanent Impairment (Spanish) 7/21
(pln04) Notice of Eligibility for Lifetime Income Benefits 7/21
(pln04s) Notice of Eligibility for Lifetime Income Benefits (Spanish) 7/21
(pln05) Notice of First Death Benefit Payment 7/21
(pln05s) Notice of First Death Beenefit Payment (Spanish) 7/21
(pln06) Notification of Employer Full Salary Payment 7/21
(pln06s) Notification of Employer Full Salary Payment (Spanish) 7/21
(pln07) Notice of Change of Indemnity Benefit Payment 7/21
(pln07s) Notification of Change of Indemnity Benefit Payment (Spanish) 7/21
(pln08) Notice of Change in Amount of Indemnity Benefit Payment 7/21
(pln08s) Notification of Change in Amount of Indemnity Benefit Payment - (Spanish) 7/21
(pln09) Notice of Suspension of Indemnity Benefits 7/21
(pln09s) Notification of Suspension of Indemnity Benefit Payment (Spanish) 7/21
(pln10) Notification of Reinstatement of Indemnity Benefit Payment 7/21
(pln10s) Notification of Reinstatement of Indemnity Benefit Payment (Spanish) 7/21
(pln11) Notification of Disputed Issue(s) and Refusal to Pay Benefits 7/21
(pln11s) Notification of Disputed Issue(s) and Refusal to Pay - (Spanish) 7/21
(pln12) Notice of Potential Entitlement to Workers' Compensation Death Benefits 7/21
(pln12s) Notice of Potential Entitlement to Workers' Compensation Death Benefits (Spanish) 7/21
(pln14) Notice of Continuing Investigation 7/21
(pln14s) Notice of Continuing Investigation(Spanish) 7/21
(pln15) Notice of Request to Reprocess a SARS-CoV-2 or COVID-19 Claim Subject to Texas Government Code Section 607.0545 7/21
(pln15sp) Notice of Request to Reprocess a SARS-CoV-2 or COVID-19 Claim Subject to Texas Government Code Section 607.0545-Spanish 7/21
(sample notice) Notice of Underpayment of Income Benefits 12/11
(sample notice s) Notice of Underpayment of Income Benefits (Spanish) 12/11
(samcovid) Sample Request to Reprocess a SARS-CoV-2 or COVID-19 Claim for an Injured Employee Covered under Texas Government Code Section 607.0545 7/21
(samcovid sp) Sample Request to Reprocess a SARS-CoV-2 or COVID-19 Claim for an Injured Employee Covered under Texas Government Code Section 607.0545-Spanish 7/21
(dwc-edi-01) Trading Partner Profile 4/22
(edi002) Insurance Carrier or Trading Partner Medical Electronic Data Interchange (EDI) Profile 4/22
(edi003) Medical EDI Compliance Coordinator and Trading Partner Notification 2/22
(lhl009) Req for review by IRO 5/22
(lhl009s) Req for review by IRO (Spanish) 3/22
  • Texas Rules
  • Texas Statutes

Current Rules

Title 28 Insurance - Part 1 - Dept. of Insurance

Chapter 10 Workers' Compensation Health Care Networks

Subchapter A. General Provisions and Definitions


  • 10.1 Purpose and Scope

  • 10.2 Definitions
  • Subchapter B. Certification


  • 10.20 Certification Required

  • 10.21 Certificate Application

  • 10.22 Contents of Application

  • 10.23 Action on Application

  • 10.24 Network Financial Requirements

  • 10.25 Filing Requirements

  • 10.26 Modifications to Service Area

  • 10.27 Modifications to Network Configuration
  • Subchapter C. Contracting


  • 10.40 Management Contracts

  • 10.41 Network-Carrier Contracts

  • 10.42 Network Contracts with Providers
  • Subchapter D. Network Requirements


  • 10.60 Notice of Network Requirements; Employee Information

  • 10.61 Employees Who Live Within the Network Service Area, Employee Access and Insurance Carrier Liability for Health Care

  • 10.62 Dispute Resolution for Employee Requirements Related to In-Network Care

  • 10.63 Plain Language Requirements
  • Subchapter E. Network Operations


  • 10.80 Accessibility and Availability Requirements

  • 10.81 Quality Improvement Program

  • 10.82 Credentialing

  • 10.83 Guidelines and Protocols

  • 10.84 Treating Doctor

  • 10.85 Selection of Treating Doctor; Change of Treating Doctor

  • 10.86 Telephone Access
  • Subchapter F. Utilization Review and Retrospective Review


  • 10.100 Applicability

  • 10.101 General Standards for Utilization Review and Retrospective Review

  • 10.102 Notice of Certain Utilization Review Determinations; Preauthorization and Retrospective Review Requirements

  • 10.103 Reconsideration of Adverse Determination

  • 10.104 Independent Review of Adverse Determination
  • Subchapter G. Complaints


  • 10.120 Complaint System Required

  • 10.121 Complaints; Deadlines for Response and Resolution

  • 10.122 Submitting Complaints to the Department
  • Subchapter H. Examinations


  • 10.200 Fee for Examination of a Certified Workers' Compensation Health Care Network
  • Chapter 12 Independent Review Organizations

    SUBCHAPTER A GENERAL PROVISIONS


  • 12.1 Statutory Basis

  • 12.2 Severability Clause

  • 12.3 Effect of Chapter

  • 12.4 Applicability

  • 12.5 Definitions

  • 12.6 Independent Review of Adverse Determinations of Health Care Provided Under Labor Code Title 5 or Insurance Code Chapter 1305
  • SUBCHAPTER B CERTIFICATE OF REGISTRATION FOR INDEPENDENT REVIEW ORGANIZATIONS


  • 12.101 Certificate of Registration for Independent Review

  • 12.102 IRO Application Form

  • 12.103 Information Required in Original Application for Certificate of Registration

  • 12.104 Review of Original Application

  • 12.105 Revisions During Review Process

  • 12.106 Examinations

  • 12.107 Withdrawal of an Original Application Before Granting a Certificate of Registration and Subsequent Renewal Applications

  • 12.108 Renewal of Certificate of Registration

  • 12.109 Appeal of Denial of Application or Renewal

  • 12.110 Effect of Sale or Transfer of Ownership of an Independent Review Organization
  • SUBCHAPTER C GENERAL STANDARDS OF INDEPENDENT REVIEW


  • 12.201 Independent Review Plan

  • 12.202 Personnel and Credentialing

  • 12.203 Conflicts of Interest Prohibited

  • 12.204 Prohibitions of Certain Activities and Relationships of Independent Review Organizations and Individuals or Entities Associated with Independent Review Organizations

  • 12.205 Independent Review Organization Contact with and Receipt of Information from Health Care Providers and Patients

  • 12.206 Notice of Determinations Made by Independent Review Organizations

  • 12.207 Independent Review Organization Telephone Access

  • 12.208 Confidentiality
  • SUBCHAPTER D ENFORCEMENT OF INDEPENDENT REVIEW STANDARDS


  • 12.301 Complaints, Oversight, and Information

  • 12.302 Administrative Violations

  • 12.303 Surrender of Certificate of Registration
  • SUBCHAPTER E FEES AND PAYMENT


  • 12.401 Fees

  • 12.402 Classification of Specialty

  • 12.403 Fee Amounts

  • 12.404 Payment of Fees

  • 12.405 Failure To Pay Invoice

  • 12.406 Application and Renewal of Certificate of Registration Fees
  • SUBCHAPTER F RANDOM ASSIGNMENT OF INDEPENDENT REVIEW ORGANIZATIONS


  • 12.501 Requests for Independent Review

  • 12.502 Random Assignment
  • Chapter 19 Agents Licensing

    Subchapter A Disciplinary Hearings In Respect Of Insurance Agents


  • 19.1 Purpose

  • 19.2 Effect of Surrendering or Attempting To Surrender Agent's License
  • Subchapter B Medicare Advantage Plans, Medicare Advantage Prescription Drug Plans, And Medicare Part D Plans


  • 19.101 Definitions

  • 19.102 Agent Authority to Market Medicare Advantage Plans, Medicare Advantage Prescription Drug Plans, and Medicare Prescription Drug Plans

  • 19.103 Reporting Requirement
  • Subchapter G Licensing Of Insurance Adjusters


  • RULE 19.601 Fees for Examination

  • RULE 19.602 Types of Adjuster's Licenses

  • RULE 19.603 Interpretations of the Act
  • Subchapter H Licensing Of Public Insurance Adjusters


  • RULE 19.701 Definitions

  • 19.702 Type of Public Insurance Adjuster Licenses

  • 19.703 Temporary Training Certificates

  • RULE 19.704 Public Insurance Adjuster Licensing

  • 19.705 Financial Responsibility Requirement

  • RULE 19.706 Demonstrating Financial Responsibility

  • 19.707 Type of Financial Responsibility

  • RULE 19.708 Public Insurance Adjuster Contracts

  • 19.709 Nonresident Applicants and License Holders

  • RULE 19.710 Nonresidents Required to File Biographical Information

  • RULE 19.711 Fingerprint Requirement

  • 19.712 Advertisement

  • 19.713 Public Insurance Adjuster Code of Ethics
  • Subchapter I Licensing Fees


  • RULE 19.801 General Provisions Regarding Licensing Fees and License Renewal

  • RULE 19.802 Amount of Fees
  • Subchapter J Standards Of Conduct For Licensed Agents


  • 19.901 Definitions Concerning Conduct of Licensed Agents

  • 19.902 One Agent, One License

  • 19.903 Concurrent Eligibility for Managing General Agent's License and Other Licenses

  • 19.904 Joint Advertising by Similarly Licensed Agents

  • 19.905 Referral Business and Insurance Company Appointments

  • 19.906 Last Known Address
  • Subchapter K Continuing Education, Adjuster Prelicensing Education Programs, And Certification Courses


  • 19.1001 General Provisions

  • 19.1002 Definitions

  • 19.1003 Licensee Requirements

  • 19.1004 Licensee Exemption from and Extension of Time for Continuing Education

  • 19.1005 Provider Registration, Instructor, and Speaker Criteria

  • 19.1006 Course Criteria

  • 19.1007 Course Certification Submission Applications, Course Expirations, and Resubmissions

  • 19.1008 Certified Course Advertising, Modification, and Assignment

  • 19.1009 Types of Courses

  • 19.1010 Hours of Credit

  • 19.1011 Requirements for Successful Completion of Continuing Education Courses

  • RULE 19.1012 Forms and Fees

  • RULE 19.1013 Licensee Record Maintenance

  • 19.1014 Provider Compliance Records

  • 19.1015 Failure to Comply

  • 19.1016 Automatic Fines

  • 19.1017 Adjuster Prelicensing Education Course Content and Examination Requirements

  • RULE 19.1018 Adjuster Prelicensing Examination Topics

  • 19.1019 Full-Time Home Office Salaried Employees

  • 19.1020 State and National Insurance Association Credit

  • 19.1021 Flood Insurance Education Course

  • 19.1022 Long-Term Care Partnership Certification Course

  • 19.1023 Long-Term Care Partnership Continuing Education

  • 19.1024 Medicare-Related Product Certification Course

  • 19.1025 Medicare-Related Product Continuing Education

  • 19.1026 Small Employer Health Benefit Plan Specialty Certification Course

  • 19.1027 Small Employer Health Benefit Plan Specialty Continuing Education

  • 19.1028 Annuity Certification Course

  • RULE 19.1029 Annuity Continuing Education

  • 19.1030 Effect of License Expiration, Revocation, or Refusal to Renew on Certification Requirements
  • Subchapter L Selection Of A Testing Services Vendor For Administration Of Licensing Examinations


  • RULE 19.1101 Vendor Selection Process

  • RULE 19.1102 Evaluation

  • RULE 19.1103 Selection of Vendor

  • RULE 19.1104 Objection to Selection Process
  • Subchapter M Licensing And Regulation Of Managing General Agents


  • RULE 19.1201 General Provisions

  • RULE 19.1202 Definitions Concerning Licensing and Regulation of Managing General Agents

  • RULE 19.1203 Adoption by Reference of Forms Relating to Licensing and Regulation of Managing General Agents

  • RULE 19.1204 Contract Provisions

  • 19.1205 Escrow Accounts

  • 19.1206 Errors and Omissions Policies
  • Subchapter N Licensing And Regulation Of Risk Managers


  • RULE 19.1301 Purpose, Scope, and Interpretation of This Subchapter

  • 19.1302 Definitions

  • RULE 19.1303 Forms Adopted by Reference

  • RULE 19.1304 Last Known Address

  • 19.1305 License Requirement

  • RULE 19.1306 Qualifications for Risk Manager's License

  • 19.1307 Exemption

  • RULE 19.1308 Application for License

  • 19.1309 Place of Business

  • RULE 19.1310 Examination

  • 19.1311 Examination and License Fees and Charges

  • 19.1312 License Renewal; Renewal Fee

  • 19.1313 Denial, Suspension, or Revocation of a License

  • 19.1314 Duration of Suspension

  • 19.1315 Reinstatement or Relicensing

  • RULE 19.1316 Nonresident License

  • RULE 19.1317 License by Endorsement

  • 19.1318 Dual Compensation

  • 19.1319 Penalty

  • RULE 19.1320 Distribution of Rules and Attachments
  • Subchapter O Procedures And Requirements For Reinsurance Intermediaries (Brokers And Managers)


  • 19.1401 Purpose and Scope

  • 19.1402 Definitions

  • RULE 19.1403 Requirements for Bond or Errors and Omissions Policy

  • RULE 19.1404 Requirements for Interim Profit-Sharing by a Manager

  • 19.1405 Requirements for Form of Audited Statements

  • 19.1406 Fees for Examinations

  • 19.1407 Approval of Reinsurance Intermediary Manager's Contracts
  • Subchapter P Fees Charged By Local Recording Agents


  • 19.1501 General Provisions

  • RULE 19.1502 Definitions

  • 19.1503 Procedures for Charging Fees
  • Subchapter Q Discount Health Care Program Registration And Renewal Requirements


  • 19.1601 Definitions

  • RULE 19.1602 Registration Requirement

  • 19.1603 Financial Responsibility Requirement

  • RULE 19.1604 Renewal

  • RULE 19.1605 Requirements Related to Discount Health Care Program Information

  • 19.1606 Severability
  • Subchapter R Utilization Reviews For Health Care Provided Under A Health Benefit


  • 19.1701 General Provisions

  • 19.1702 Applicability

  • RULE 19.1703 Definitions

  • 19.1704 Certification or Registration of URAs

  • 19.1705 General Standards of Utilization Review

  • RULE 19.1706 Requirements and Prohibitions Relating to Personnel

  • 19.1707 URA Contact with and Receipt of Information from Health Care Providers

  • 19.1708 On-Site Review by a URA

  • 19.1709 Notice of Determinations Made in Utilization Review

  • 19.1710 Requirements Prior to Issuing an Adverse Determination

  • 19.1711 Written Procedures for Appeal of Adverse Determinations

  • 19.1712 URA's Telephone Access

  • 19.1713 Confidentiality

  • 19.1714 Regulatory Requirements Subsequent to Certification or Registration

  • 19.1715 Administrative Violations

  • 19.1716 Specialty URA

  • 19.1717 Independent Review of Adverse Determinations

  • 19.1718 Preauthorization for Health Maintenance Organizations and Preferred Provider Benefit Plans

  • 19.1719 Verification for Health Maintenance Organizations and Preferred Provider Benefit Plans
  • Subchapter S Forms To Request Prior Authorization

    DIVISION 1 TEXAS STANDARD PRIOR AUTHORIZATION REQUEST FORMS DIVISION 2 TEXAS STANDARDIZED PRIOR AUTHORIZATION REQUEST FORM FOR HEALTH CARE SERVICES DIVISION 3 TEXAS STANDARD PRIOR AUTHORIZATION REQUEST FORM FOR PRESCRIPTION DRUG BENEFITS

    Subchapter T Specialty Insurance License


  • RULE 19.1901 Purpose

  • 19.1902 Definitions

  • 19.1903 Qualifications

  • RULE 19.1904 Application

  • 19.1905 Place of Business

  • RULE 19.1906 Expiration and Renewal of Licenses

  • RULE 19.1907 Non-Residents

  • 19.1908 Notice to Department

  • 19.1909 Employee Training

  • 19.1910 Denial Or Refusal Of Specialty License Application; Suspension Or Revocation Of Specialty Licenses; Discipline Of Specialty License Holders
  • Subchapter U Utilization Reviews For Health Care Provided Under Workers\' Compensation Insurance Coverage


  • 19.2001 General Provisions

  • 19.2002 Applicability

  • RULE 19.2003 Definitions

  • 19.2004 Certification or Registration of URAs

  • 19.2005 General Standards of Utilization Review

  • 19.2006 Requirements and Prohibitions Relating to Personnel

  • 19.2007 URA Contact with and Receipt of Information from Health Care Providers

  • 19.2008 On-Site Review by a URA

  • 19.2009 Notice of Determinations Made in Utilization Review

  • 19.2010 Requirements Prior to Issuing Adverse Determination

  • 19.2011 Written Procedures for Appeal of Adverse Determinations

  • 19.2012 URA's Telephone Access and Procedures for Certain Drug Requests and Post-Stabilization Care

  • 19.2013 Confidentiality

  • 19.2014 Regulatory Requirements Subsequent to Certification or Registration

  • 19.2015 Administrative Violations

  • RULE 19.2016 Specialty URA

  • 19.2017 Independent Review of Adverse Determinations
  • Subchapter V Registration Of Full Time Home Office Salaried Employees


  • 19.3001 Purpose and Scope

  • 19.3002 Definitions

  • 19.3003 Registration Requirements

  • 19.3004 When Registration Is Required

  • RULE 19.3005 General Plan of Operation Requirements
  • Subchapter W Regulation Of Navigators For Health Benefit Exchanges


  • 19.4001 Purpose

  • 19.4002 Definitions

  • 19.4003 Applicability

  • 19.4004 Registration Required

  • RULE 19.4005 Registration Eligibility

  • 19.4006 Application for Registration

  • 19.4007 Renewal of Registration as a Navigator Entity or Individual Navigator

  • 19.4008 Navigator Education and Examination Requirements

  • 19.4009 Course Providers

  • 19.4011 Navigator Identification

  • 19.4012 Privacy of Nonpublic Information

  • 19.4013 Prohibitions

  • 19.4014 Limits on Use of Term "Navigator"

  • 19.4015 Administrative Violations

  • 19.4016 Severability Clause

  • 19.4017 Expiration

  • 19.4010 Financial Responsibility
  • Title 28 Insurance - Part 2 - Insurance, Div. of Workers' Compensation

    Chapter 102 Practice and Procedures - General Provisions


  • RULE 102.2 Gifts, Grants, and Donations

  • RULE 102.3 Computation of Time

  • RULE 102.4 General Rules for Non-Commission Communications

  • RULE 102.5 General Rules for Written Communications to and from the Division

  • RULE 102.7 Abbreviations

  • RULE 102.8 Information Requested on Written Communications to the Division

  • RULE 102.9 Submission of Information Requested by the Commission

  • RULE 102.10 Interest, General

  • RULE 102.11 Electronic Formats for Electronic Claim Data Request and Report
  • Chapter 103 Agency Administration - REPEALED

    Subchapter A. Employee Training and Education Program - REPEALED


  • 103.1 General Provisions - REPEALED

  • 103.2 Employee Training and Education Program - REPEALED

  • 103.3 No Effect on At-Will Status - REPEALED
  • Subchapter B. Agency Contracts - REPEALED


  • 103.100. Historically Underutilized Businesses. - REPEALED

  • 103.101. Vendor Protest Procedures. - REPEALED
  • Subchapter C. Resolution of Contract Claims - REPEALED


  • 103.300. Purpose. - REPEALED

  • 103.301. Applicability. - REPEALED

  • 103.302. Definitions. - REPEALED

  • 103.303. Prerequisites to Suit. - REPEALED

  • 103.304. Sovereign Immunity. - REPEALED

  • 103.305. Notice of Claim of Breach of Contract. - REPEALED

  • 103.306. Agency Counterclaim. - REPEALED

  • 103.307. Duty to Negotiate. - REPEALED

  • 103.308. Timetable. - REPEALED

  • 103.309. Conduct of Negotiation. - REPEALED

  • 103.310. Settlement Approval Procedures. - REPEALED

  • 103.311. Settlement Agreement. - REPEALED

  • 103.312. Costs of Negotiation. - REPEALED

  • 103.313. Request for Contested Case Hearing. - REPEALED

  • 103.314. Mediation Timetable. - REPEALED

  • 103.315. Mediation of Contract Disputes. - REPEALED

  • 103.316. Qualifications and Immunity of the Mediator. - REPEALED

  • 103.317. Confidentiality of Mediation and Final Settlement Agreement. - REPEALED

  • 103.318. Costs of Mediation. - REPEALED

  • 103.319. Settlement Approval Procedures. - REPEALED

  • 103.320. Initial Settlement Agreement. - REPEALED

  • 103.321. Final Settlement Agreement. - REPEALED

  • 103.322. Referral to the State Office of Administrative Hearings. - REPEALED
  • Subchapter D. Facilities and Property Management - REPEALED


  • 103.400. Fleet Vehicle Management Program. - REPEALED
  • Chapter 104 General Provisions--Rule-Making


  • RULE 104.1 Contents of Rulemaking Petitions
  • Chapter 108 Fees (REPEALED 9/2/18)


  • RULE 108.1 Charges for Copies of Public Information - REPEALED 09/02/2018
  • Chapter 109 Workers' Compensation Coverage for State Agency Employees


  • RULE 109.1 State Agencies: General Provisions
  • Chapter 110 Required Notice of Coverage: General Provisions

    Subchapter A Carrier Notices


  • RULE 110.1 Insurance Carrier Requirements for Notifying the Division of Insurance Coverage

  • RULE 110.7 Self-Insured Political Subdivision Requirements for Notifying the Division of Election to Provide Medical Benefits
  • Subchapter B Employer Notices


  • RULE 110.101 Covered and Non-Covered Employer Notices to Employees

  • RULE 110.103 Employer Requirements for Notifying the Division of Non-Coverage

  • RULE 110.105 Employer Requirements for Notifying the Division of Termination of Coverage

  • RULE 110.108 Employer Notice Regarding Work-Related Exposure to Communicable Disease/HIV: Posting Requirements; Payment for Tests

  • RULE 110.110 Reporting Requirements for Building or Construction Projects for Governmental Entities
  • Chapter 112 Scope of Liability for Compensation

    Subchapter B Application to General Contractor/ Subcontractor and Motor Carrier/Owner Operator


  • RULE 112.101 Agreement Regarding Workers' Compensation Insurance Coverage Between General Contractors and Subcontractors

  • RULE 112.102 Agreements between Motor Carriers and Owner Operators
  • Subchapter C Application to Certain Building & Construction Workers


  • RULE 112.200 Definition of Residential Structures

  • RULE 112.201 Agreement To Establish Employer-Employee Relationship for Certain Building and Construction Workers

  • RULE 112.202 Joint Agreement To Affirm Independent Relationship for Certain Building and Construction Workers

  • RULE 112.203 Exception to Application of Agreement To Affirm Independent Relationship for Certain Building and Construction Workers
  • Subchapter D Application to Farm or Ranch Employees


  • RULE 112.301 Labor Agent's Notification of Coverage
  • Subchapter E Application to Certain Professional Athletes


  • RULE 112.401 Election of Coverage by Certain Professional Athletes

  • RULE 112.402 Determination of Equivalent Benefits for Professional Athletes
  • Chapter 114 Self-Insurance


  • RULE 114.16 Withdrawal from Self-Insurance

  • RULE 114.1 Purpose

  • RULE 114.2 Definitions

  • RULE 114.3 Application Form and Financial Information Requirements

  • RULE 114.4 Security Deposit Requirements

  • RULE 114.5 Excess Insurance Requirements

  • RULE 114.6 Safety Program Requirements

  • RULE 114.7 Certification Process

  • RULE 114.8 Refusal To Certify an Employer

  • RULE 114.9 Required Safety Program Inspections

  • RULE 114.10 Claims Contractor Requirements

  • RULE 114.11 Audit Program

  • RULE 114.12 Required Reporting

  • RULE 114.13 Required Notices to the Director

  • RULE 114.14 Impaired Employer

  • RULE 114.15 Revocation or Suspension of Certificate of Authority To Self-Insure
  • Chapter 116 Subsequent Injury Fund


  • RULE 116.11 Request for Reimbursement from the Subsequent Injury Fund

  • RULE 116.12 Subsequent Injury Fund Payment/Reimbursement Schedule
  • Chapter 120 Compensation Procedure - Employers


  • RULE 120.1 Employer's Record of Injuries

  • RULE 120.2 Employer's First Report of Injury and Notice of Injured Employee Rights and Responsibilities

  • RULE 120.3 Employer's Supplemental Report of Injury

  • RULE 122.4 State Employees Exposed to Human Immunodeficiency Virus (HIV): Reporting and Testing Requirements
  • Chapter 122 Compensation Procedures - Claimants

    Subchapter A Claims Procedure for Injured Employees


  • RULE 122.1 Notice to Employer of Injury or Occupational Disease

  • RULE 122.2 Injured Employee's Claim for Compensation

  • RULE 122.3 Exposure to Communicable Diseases: Reporting and Testing Requirements for Emergency Responders

  • RULE 122.4 State Employees Exposed to Human Immunodeficiency Virus (HIV): Reporting and Testing Requirements

  • RULE 122.5 Employee's Multiple Employment Wage Statement
  • Subchapter B Claims Procedure for Beneficiaries of Injured Employees


  • RULE 122.100 Claim for Death Benefits
  • Chapter 124 Carriers: Required Notices and Mode of Payment


  • RULE 124.1 Notice of Injury

  • RULE 124.2 Carrier Reporting and Notification Requirements

  • RULE 124.3 Investigation of an Injury and Notice of Denial or Dispute

  • RULE 124.5 Mode of Payment Made by Insurance Carriers

  • RULE 124.6 Electronic Transfer Payments Made Through an Access Card

  • RULE 124.7 Initial Payment of Temporary Income Benefits
  • Chapter 126 Benefits - General Provision Applicable to All Benefits


  • RULE 126.1 Definitions Applicable to All Benefits

  • RULE 126.2 Payment of Benefits to Minors

  • RULE 126.3 Payment of Benefits to Legally Incompetent Persons

  • RULE 126.4 Advance of Benefits Based on Financial Hardship

  • RULE 126.5 Entitlement and Procedure for Requesting Required Medical Examinations

  • RULE 126.6 Required Medical Examination

  • 126.7. Designated Doctor Examinations: Requests and General Procedures. [Repealed. Effective date 2/1/2011]

  • RULE 126.8 Commission Approved Doctor List

  • RULE 126.9 Choice of Treating Doctor and Liability for Payment

  • RULE 126.11 Extension of the Date of Maximum Medical Improvement for Spinal Surgery

  • RULE 126.12 Payment of Interest on Accrued but Unpaid Income Benefits

  • RULE 126.13 Employer Initiation of Benefits and Reimbursement

  • RULE 126.14 Treating Doctor Examination to Define the Compensable Injury

  • RULE 126.15 Procedures for Resolution of Underpayments of Income Benefits

  • RULE 126.17 Guidelines for Examination by a Treating Doctor or Referral Doctor After a Designated Doctor Examination to Address Issues Other Than Certification of Maximum Medical Improvement and the Evaluation of Permanent Impairment
  • Chapter 127 Designated Doctor Procedures and Requirements

    SUBCHAPTER A - DESIGNATED DOCTOR SCHEDULING AND EXAMINATIONS


  • RULE 127.1 Requesting Designated Doctor Examinations

  • RULE 127.5 Scheduling Designated Doctor Appointments

  • RULE 127.10 General Procedures for Designated Doctor Examinations

  • RULE 127.20 Requesting a Letter of Clarification Regarding Designated Doctor Reports

  • RULE 127.25 Failure to Attend a Designated Doctor Examination

  • RULE 127.100 Designated Doctor Certification
  • SUBCHAPTER B - DESIGNATED DOCTOR CERTIFICATION, RECERTIFICATION, AND QUALIFICATIONS


  • RULE 127.100 Designated Doctor Certification

  • RULE 127.110 Designated Doctor Recertification

  • RULE 127.120 Exception to Certification as a Designated Doctor for Out-of-State Doctors

  • RULE 127.130 Qualification Standards for Designated Doctor Examinations

  • RULE 127.140 Disqualifying Associations
  • SUBCHAPTER C - DESIGNATED DOCTOR DUTIES AND RESPONSIBILITIES


  • RULE 127.200 Duties of a Designated Doctor

  • RULE 127.210 Designated Doctor Administrative Violations

  • RULE 127.220 Designated Doctor Reports
  • Chapter 128 Benefits - Calculation of Average Weekly Wage


  • RULE 128.1 Average Weekly Wage: General Provisions

  • RULE 128.2 Carrier Presumption of Employee's Average Weekly Wage

  • RULE 128.3 Average Weekly Wage Calculation for Full-Time Employees, and for Temporary Income Benefits for All Employees

  • RULE 128.4 Average Weekly Wage Calculation for Part-Time Employees

  • RULE 128.5 Average Weekly Wage Calculation for Seasonal Employees

  • RULE 128.6 Average Weekly Wage Adjustment for Certain Employees Who Are Also Minors, Apprentices, Trainees, or Students

  • RULE 128.7 Average Weekly Wage for School District Employees
  • Chapter 129 Income Benefits - Temporary Income Benefits


  • RULE 129.1 Definitions for Temporary Income Benefits

  • RULE 129.2 Entitlement to Temporary Income Benefits

  • RULE 129.3 Amount of Temporary Income Benefits

  • RULE 129.4 Adjustment of Temporary Income Benefit Amount

  • RULE 129.5 Work Status Reports

  • RULE 129.6 Bona Fide Offers of Employment

  • RULE 129.7 Non-Reimbursable Employer Payments

  • RULE 129.11 Agreement for Monthly Payment of Temporary Income Benefits
  • Chapter 130 Benefits - Impairment and Supplemental Income Benefits

    Subchapter A Impairment Income Benefits


  • RULE 130.1 Certification of Maximum Medical Improvement and Evaluation of Permanent Impairment

  • RULE 130.2 Certification of Maximum Medical Improvement and Evaluation of Permanent Impairment by the Treating Doctor

  • RULE 130.3 Certification of Maximum Medical Improvement and Evaluation of Permanent Impairment by aDoctor other than the Treating Doctor

  • RULE 130.4 Presumption that Maximum Medical Improvement (MMI) has been Reached and Resolution when MMI has not been Certified

  • RULE 130.7 Acceleration of Impairment Income Benefits

  • RULE 130.8 Initiating Payment of Impairment Income Benefits

  • RULE 130.1 Certification of Maximum Medical Improvement and Evaluation of Permanent Impairment

  • RULE 130.11 Agreement for Monthly Payment of Impairment Income Benefits

  • RULE 130.12 Finality of the First Certification of Maximum Medical Improvement and/or First Assignment of Impairment Rating
  • Subchapter B Supplemental Income Benefits


  • RULE 130.100 Applicability

  • RULE 130.101 Definitions

  • RULE 130.102 Eligibility for Supplemental Income Benefits; Amount

  • RULE 130.103 Determination of Entitlement or Non-entitlement for the First Quarter

  • RULE 130.104 Determination of Entitlement or Non-entitlement for Subsequent Quarters

  • RULE 130.105 Failure to Timely File Application for Supplemental Income Benefits; Subsequent Quarters

  • RULE 130.106 Loss of Entitlement to Supplemental Income Benefits

  • RULE 130.107 Payment of Supplemental Income Benefits

  • RULE 130.108 Contesting Entitlement or Amount of Supplemental Income Benefits; Attorney Fees

  • RULE 130.109 Reinstatement of Entitlement if Discharged with Intent to Deprive of Supplemental Income Benefits
  • Chapter 131 Calculation of Lifetime Income Benefits


  • RULE 131.1 Initiation of Lifetime Income Benefits; Notice of Denial

  • RULE 131.2 Calculation of Lifetime Income Benefits

  • RULE 131.3 Carrier's Petition for Payment of Benefits by the Subsequent Injury Fund

  • RULE 131.4 Change in Payment Period; Purchase of Annuity for Lifetime Income Benefits
  • Chapter 132 Benefits - Death and Burial Benefits


  • RULE 132.1 Calculation of Death Benefits

  • RULE 132.2 Determination of Facts of Dependent Status

  • RULE 132.3 Eligibility of Spouse To Receive Death Benefits

  • RULE 132.4 Eligibility of a Child To Receive Death Benefits

  • RULE 132.5 Eligibility of a Grandchild To Receive Death Benefits

  • RULE 132.6 Eligibility of Other Surviving Dependents and Eligible Parents To Receive Death Benefits

  • RULE 132.7 Duration of Death Benefits for Eligible Spouse

  • RULE 132.8 Duration of Death Benefits for an Eligible Child

  • RULE 132.9 Duration of Death Benefits for an Eligible Grandchild, Eligible Dependent, and Eligible Parent

  • RULE 132.1 Calculation of Death Benefits

  • RULE 132.11 Distribution of Death Benefits

  • RULE 132.12 Redistribution of Death Benefits

  • RULE 132.13 Burial Benefits

  • RULE 132.14 Autopsy

  • RULE 132.15 Definitions

  • RULE 132.16 Change in Payment Periods; Purchase of Annuity for Death Benefits

  • RULE 132.17 Denial, Dispute, and Payment of Death Benefits
  • Chapter 133 Benefits - Medical Benefits

    Subchapter A. General Rules for Required Reports


  • RULE 133.1 Applicability of Medical Billing and Processing

  • RULE 133.2 Definitions

  • RULE 133.3 Communication Between Health Care Providers and Insurance Carriers

  • RULE 133.4 Written Notification to Health Care Providers of Contractual Agreements for Informal and Voluntary Networks

  • RULE 133.5 Informal Network and Voluntary Network Reporting Requirements to the Division
  • Subchapter B. Health Care Provider Billing Procedures


  • EMERGENCY RULE - 133.30. Telemedicine and Telehealth Services.

  • RULE 133.10 Required Billing Forms/Formats

  • 133.20. Medical Bill Submission By Health Care Provider.

  • 133.30 Telemedicine and Telehealth Services
  • Subchapter C. Medical Bill Processing/Audit by Insurance Carriers


  • RULE 133.200 Insurance Carrier Receipt of Medical Bills from Health Care Providers

  • RULE 133.210 Medical Documentation

  • RULE 133.230 Insurance Carrier Audit of a Medical Bill

  • RULE 133.240 Medical Payments and Denials

  • RULE 133.250 Reconsideration for Payment of Medical Bills

  • RULE 133.260 Refunds

  • RULE 133.270 Injured Employee Reimbursement for Health Care Paid

  • RULE 133.280 Employer Reimbursement for Health Care Paid
  • Subchapter D. Dispute of Medical Bills


  • RULE 133.305 MDR--General

  • RULE 133.306 Interlocutory Orders for Medical Benefits

  • RULE 133.307 MDR of Fee Disputes

  • RULE 133.308 MDR of Medical Necessity Disputes

  • RULE 133.309 Alternate Medical Necessity Dispute Resolution by Case Review Doctor
  • Subchapter G. Electronic Medical Billing, Reimbursement, And Documentation


  • RULE 133.500 Electronic Formats for Electronic Medical Bill Processing

  • RULE 133.501 Electronic Medical Bill Processing

  • RULE 133.502 Electronic Medical Billing Supplemental Data Requirements
  • Chapter 134 Benefits - Guidelines for Medical Services, Charges and Payments

    Subchapter A. Medical Reimbursement Policies


  • RULE 134.1 Medical Reimbursement

  • RULE 134.2 Incentive Payments for Workers' Compensation Underserved Areas
  • Subchapter B. Miscellaneous Reimbursement


  • RULE 134.100 Reimbursement of Treating Doctor for Attendance at Required Medical Examination

  • RULE 134.110 Reimbursement of Injured Employee for Travel Expenses Incurred

  • RULE 134.120 Reimbursement for Medical Documentation

  • RULE 134.130 Interest for Late Payment on Medical Bills and Refunds

  • RULE 134.150 Reimbursement of Services Provided by a Federal Military Treatment Facility

  • RULE 134.155 Federal Military Treatment Facility Disputes
  • Subchapter C. Medical Fee Guidelines


  • RULE 134.201 Medical Fee Guideline for Medical Treatments and Services Provided under the Texas Workers' Compensation Act

  • RULE 134.203 Medical Fee Guideline for Professional Services

  • RULE 134.204 Medical Fee Guideline for Workers' Compensation Specific Services

  • RULE 134.209 Applicability

  • RULE 134.210 Medical Fee Guideline for Workers' Compensation Specific Services

  • 134.215 Home Health Services.

  • RULE 134.220 Case Management Services

  • RULE 134.225 Functional Capacity Evaluations

  • RULE 134.230 Return to Work Rehabilitation Programs

  • RULE 134.235 Return to Work/Evaluation of Medical Care

  • RULE 134.239 Billing for Work Status Reports

  • RULE 134.240 Designated Doctor Examinations

  • RULE 134.250 Maximum Medical Improvement Evaluations and Impairment Rating Examinations

  • 134.302. Dental Fee Guideline.

  • RULE 134.303 2005 Dental Fee Guideline
  • Subchapter E. Health Facility Fees


  • RULE 134.402 Ambulatory Surgical Center Fee Guideline

  • RULE 134.403 Hospital Facility Fee Guideline--Outpatient

  • RULE 134.404 Hospital Facility Fee Guideline--Inpatient
  • Subchapter F. Pharmaceutical Benefits


  • RULE 134.500 Definitions

  • RULE 134.501 Initial Pharmaceutical Coverage

  • RULE 134.502 Pharmaceutical Services

  • RULE 134.503 Pharmacy Fee Guideline

  • RULE 134.504 Pharmaceutical Expenses Incurred by the Injured Employee

  • RULE 134.506 Outpatient Open Formulary for Claims with Dates of Injury Prior to September 1, 2011

  • RULE 134.510 Transition to the Use of the Closed Formulary for Claims with Dates of Injury Prior to September 1, 2011

  • RULE 134.520 Outpatient Closed Formulary for Dates of Injury On or After September 1, 2011

  • RULE 134.530 Requirements for Use of the Closed Formulary for Claims Not Subject to Certified Networks

  • RULE 134.540 Requirements for Use of the Closed Formulary for Claims Subject to Certified Networks

  • RULE 134.550 Medical Interlocutory Order
  • Subchapter G. Prospective and Concurrent Review of Health Care


  • RULE 134.600 Preauthorization, Concurrent Utilization Review, and Voluntary Certification of Health Care
  • Subchapter I. Medical Bill Reporting


  • RULE 134.800 Applicability

  • RULE 134.801 Purpose

  • RULE 134.802 Definitions

  • RULE 134.803 Reporting Standards

  • RULE 134.804 Reporting Requirements

  • RULE 134.805 Records Required to be Reported

  • RULE 134.806 Records Excluded from Reporting

  • RULE 134.807 State Specific Requirements

  • 134.808. Insurance Carrier EDI Compliance Coordinator and Trading Partners.
  • Subchapter J. Review and Audits


  • RULE 134.900 Medical Benefit Review and Audit
  • Chapter 136 Benefits - Vocational Rehabilitation


  • RULE 136.1 Review of Employer Report of Injury

  • 136.2. Registry Of Private Providers Of Vocational Rehabilitation Services.
  • Chapter 137 Disability Management

    SUBCHAPTER A General Provisions


  • RULE 137.1 Disability Management Concept

  • RULE 137.5 Case Manager Certification
  • SUBCHAPTER B Return To Work


  • RULE 137.10 Return to Work Guidelines

  • RULE 137.41 Purpose

  • RULE 137.42 Definitions

  • RULE 137.43 Return-to-Work Reimbursement Program Administrator

  • RULE 137.44 Return-to-Work Reimbursement Program for Employers

  • RULE 137.45 Employer Eligibility for Disbursements from the Return-to-Work Reimbursement Program

  • RULE 137.46 Application for Funds from the Return-to-Work Reimbursement Program

  • RULE 137.47 Criteria for Return-to-Work Reimbursement Program Applications

  • RULE 137.48 Return-to-Work Reimbursement Program Administrator Determinations

  • RULE 137.49 Optional Preauthorization Plan

  • RULE 137.50 Optional Advance of Funds Plan

  • RULE 137.51 Monitoring and Enforcement
  • SUBCHAPTER C Treatment Guidelines


  • RULE 137.100 Treatment Guidelines
  • SUBCHAPTER D Treatment Planning - Repealed 09/30/2007


  • 137.300 Required Treatment Planning - Repealed 09/30/2007
  • Chapter 140 Dispute Resolution - General Provisions


  • RULE 140.1 Definitions

  • RULE 140.2 Special Accommodations

  • RULE 140.3 Expedited Proceedings

  • RULE 140.4 Conduct and Decorum

  • RULE 140.5 Correction of Clerical Error

  • RULE 140.6 Subclaimant Status: Establishment, Rights, and Procedures

  • RULE 140.7 Health Care Insurer Reimbursement under Labor Code 409.0091

  • RULE 140.8 Procedures for Health Care Insurers to Pursue Reimbursement of Medical Benefits under Labor Code 409.0091

  • RULE 140.9 Requests by Parties
  • Chapter 141 Dispute Resolution - Benefit Review Conference


  • RULE 141.1 Requesting and Setting a Benefit Review Conference

  • RULE 141.2 Canceling or Rescheduling a Benefit Review Conference

  • RULE 141.3 Failure to Attend a Benefit Review Conference

  • RULE 141.4 Sending and Exchanging Pertinent Information

  • RULE 141.5 Description of the Benefit Review Conference

  • 141.6. Requesting Interlocutory Orders. [Repealed April 6, 2008]

  • RULE 141.7 Division Actions After a Benefit Review Conference
  • Chapter 142 Dispute Resolution - Benefit Contested Case Hearing


  • RULE 142.1 Application of the Administrative Procedure Act

  • RULE 142.2 Authority of the Hearing Officer

  • RULE 142.3 Ex Parte Communications

  • RULE 142.4 Delivery of Copies to All Parties

  • RULE 142.5 Sequence of Proceedings to Resolve Benefit Disputes

  • RULE 142.6 Setting a Benefit Contested Case Hearing

  • RULE 142.7 Statement of Disputes

  • RULE 142.8 Summary Procedures

  • RULE 142.9 Stipulations, Agreements, and Settlements

  • RULE 142.10 Continuation

  • RULE 142.11 Failure To Attend a Benefit Contested Case Hearing

  • RULE 142.12 Subpoena

  • RULE 142.13 Discovery

  • RULE 142.14 Permission To Use Court Reporter

  • RULE 142.16 Decision

  • RULE 142.17 Transcript or Duplicate of the Hearing Audiotape

  • RULE 142.18 Special Provisions for Cases on Remand from the Appeals Panel

  • RULE 142.19 Form Interrogatories

  • RULE 142.20 Interlocutory Orders
  • Chapter 143 Dispute Resolution - Review by the Appeals Panel


  • RULE 143.1 Definitions

  • RULE 143.2 Description of the Appeal Proceeding

  • RULE 143.3 Requesting the Appeals Panel to Review the Decision of the Hearing Officer

  • RULE 143.4 Responding to a Request for Review by the Appeals Panel

  • RULE 143.5 Decision of the Appeals Panel
  • Chapter 144 Dispute Resolution - Arbitration


  • RULE 144.1 Authority and Duties of Arbitrators

  • RULE 144.2 Ex Parte Communications

  • RULE 144.3 Delivery of Copies of Documents

  • RULE 144.4 Election to Engage in Arbitration

  • RULE 144.5 Statement of Disputes

  • RULE 144.6 Assignment of Arbitrator

  • RULE 144.7 Setting the Arbitration Proceeding

  • RULE 144.8 Expediting Procedures

  • RULE 144.9 Exchange of Evidence and Proposed Resolution

  • RULE 144.1 Authority and Duties of Arbitrators

  • RULE 144.11 Continuance

  • RULE 144.12 Failure to Attend Arbitration

  • RULE 144.13 Rights of Parties

  • RULE 144.14 Usual Order of Proceedings

  • RULE 144.15 Award of the Arbitrator

  • RULE 144.16 Requesting a Copy of the Record
  • Chapter 147 Dispute Resolution - Agreements, Settlements, Commutation


  • RULE 147.1 Definitions

  • RULE 147.2 Form

  • RULE 147.3 Execution

  • RULE 147.4 Filing Agreements with the Commission; Effective Dates

  • RULE 147.5 Filing Settlements with the Commission; Effective Dates

  • RULE 147.6 Settlement Conference

  • RULE 147.7 Effect on Previously Entered Decisions and Orders

  • RULE 147.8 Withdrawal from Settlement

  • RULE 147.9 Requirements for Agreements and Settlements

  • RULE 147.1 Definitions

  • RULE 147.11 Notification of Commission of Proposed Judgments and Settlements
  • Chapter 148 Hearings Conducted by the State Office of Administrative Hearings


  • RULE 148.1 Definitions

  • RULE 148.2 Scope and Applicability

  • RULE 148.3 Requesting a Hearing

  • RULE 148.4 Correction of Clerical Error

  • RULE 148.5 Notice of Hearing

  • RULE 148.6 Venue

  • RULE 148.7 Representation

  • RULE 148.8 Withdrawal of Hearing Request

  • RULE 148.10 Hearings Subpoenas to Compel Attendance and Subpoenas Duces Tecum

  • RULE 148.11 Commissions to Compel Attendance for Deposition

  • RULE 148.13 Recording the Hearing

  • RULE 148.14 Burden of Proof

  • RULE 148.15 Final Decision by the ALJ

  • RULE 148.16 Proposal for Decision or Order by the ALJ

  • RULE 148.17 Special Provisions for Administrative Penalties

  • RULE 148.19 Transcript or Duplicate of the Hearing Audiotape or Videotape

  • RULE 148.2 Scope and Applicability

  • RULE 148.21 Expenses to be Paid by Party Seeking Judicial Review

  • RULE 148.22 Failure to Appear or Comply with Order or Decision, Administrative Violation

  • RULE 148.23 Division Enforcement of Orders

  • RULE 148.24 Confidentiality of Records
  • Chapter 150 Representation of Parties Before the Agency - Qualifications of Representatives


  • RULE 150.1 Minimum Standards of Practice for an Attorney

  • RULE 150.2 Qualification and Authorization of Attorney To Practice before the Commission

  • RULE 150.3 Representatives: Written Authorization Required
  • Chapter 152 Representation of Parties Before the Agency - Attorney's Fee


  • RULE 152.1 Attorney Fees: General Provisions

  • RULE 152.2 Attorney Fees: Representation of Claimants

  • RULE 152.3 Approval or Denial of Fee by the Division

  • RULE 152.4 Guidelines for Legal Services Provided to Claimants and Insurance Carriers

  • RULE 152.5 Allowable Expenses

  • RULE 152.6 Attorney Withdrawal
  • Chapter 156 Carriers' Austin Representative


  • RULE 156.1 Carrier's Austin Representative
  • Chapter 160 Workers Health and Safety - General Provision


  • RULE 160.1 Applicability

  • RULE 160.2 Non-Subscribing Employer's Report of Injury

  • RULE 160.3 Subscribing Employer's Report of Injury
  • Chapter 165 Rejected Risk- Injury Prevention Services


  • RULE 165.1 Identification and Notification of Certain Policyholders Insured by the Texas Mutual Insurance Company Acting as the Insurer of Last Resort

  • RULE 165.2 Safety Consultation

  • RULE 165.3 Formulation and Components of Accident Prevention Plan

  • RULE 165.4 Request for Safety Consultation From the Division

  • RULE 165.5 Reimbursement of Division for Services Provided to Rejected Risk Employers

  • RULE 165.6 Follow-up Inspection of the Policyholder's Premises by the Division

  • RULE 165.7 Report of Follow-Up Inspection
  • Chapter 166 Workers' Health & Safety - Accident Prevention Services


  • RULE 166.1 Definitions of Terms

  • RULE 166.2 Adequacy of Accident Prevention Services

  • RULE 166.3 Annual Information Submitted by Insurance Companies

  • RULE 166.5 Inspections of Adequacy of Accident Prevention Facilities and Services
  • Chapter 167 Emergency Rules

    Subchapter A. Covid-19 Emergency Rules


  • 167.1. Physical Medicine and Rehabilitation Services - Telemedicine and Telehealth Billing Procedures
  • Chapter 180 Monitoring and Enforcement

    SUBCHAPTER A. GENERAL RULES FOR ENFORCEMENT


  • RULE 180.1 Definitions

  • RULE 180.2 Filing a Complaint

  • RULE 180.3 Compliance Audits

  • RULE 180.4 On-Site Visits

  • RULE 180.5 Access to Workers' Compensation Related Records and Information

  • RULE 180.8 Notices of Violation; Notices of Hearing; Default Judgments

  • RULE 180.9 Proposals for Decision

  • RULE 180.10 Ex Parte Emergency Cease and Desist Orders

  • RULE 180.19 Incentives
  • SUBCHAPTER B. MEDICAL BENEFIT REGULATION


  • RULE 180.22 Health Care Provider Roles and Responsibilities

  • RULE 180.23 Division Required Training for Doctors

  • RULE 180.24 Financial Disclosure

  • RULE 180.25 Improper Inducements, Influence and Threats

  • RULE 180.26 Criteria for Imposing, Recommending and Determining Sanctions; Other Remedies

  • RULE 180.27 Restoration

  • RULE 180.28 Peer Review Requirements, Reporting, and Sanctions

  • RULE 180.50 Severability
  • SUBCHAPTER C. MEDICAL QUALITY REVIEW PANEL


  • RULE 180.60 Definitions

  • RULE 180.62 Medical Quality Review Panel

  • RULE 180.64 MQRP Application Process

  • RULE 180.66 Medical Case Review

  • RULE 180.68 Medical Quality Review Process

  • RULE 180.70 MQRP Training

  • RULE 180.72 Conflict of Interest

  • RULE 180.74 MQRP Notification of Case Status

  • RULE 180.76 Rights and Responsibilities of Persons Involved in the Medical Quality Review Process

  • RULE 180.78 Effective Date
  • Chapter 181 Texas Certified Self-insurer Guaranty Association


  • RULE 181.1 Bylaws of the Texas Certified Self-Insurer Guaranty Association
  • Chapter 251 State Employees--Workers Compensation

    SUBCHAPTER A DEFINITION OF TERMS


  • RULE 251.1 Definitions
  • SUBCHAPTER B PROCEDURES


  • RULE 251.20 Compliance

  • RULE 251.201 Employing Agency's Cooperation

  • RULE 251.202 Posting Proposed Changes

  • RULE 251.203 Filing of Instruments

  • RULE 251.204 Communicating with Commission

  • RULE 251.205 Medical Reports

  • RULE 251.206 Employing Agency's Records

  • RULE 251.207 Requirement for Submitting Form TWCC-1S

  • RULE 251.208 Two-Year Retention of Records

  • RULE 251.209 Time Limit on Submitting Form TWCC-1S

  • RULE 251.210 Form TWCC-6

  • RULE 251.211 Absence of More Than 60 Days

  • RULE 251.212 Immediate Notice of Injury

  • RULE 251.213 Claims Coordinator

  • RULE 251.214 Duties of Claims Coordinator

  • RULE 251.215 Employee Report

  • RULE 251.216 Legal Responsibilities of Injured Employee

  • RULE 251.217 Agency Policies Regarding Workers' Compensation

  • RULE 251.218 Correspondence

  • RULE 251.219 Reconsideration of Claim

  • RULE 251.220 Request for Inspection or Copying in Writing

  • RULE 251.221 Officer for Public Records

  • 251.222 Legal Authorization for Access
  • SUBCHAPTER C EMPLOYEE ENTITLEMENT TO COMPENSATION


  • RULE 251.301 Utilization of Sick Leave

  • RULE 251.302 No Waiting Period

  • 251.303 Waiting Period

  • RULE 251.304 Computing Sick Leave

  • RULE 251.305 Right to Compensation

  • RULE 251.306 Effect of Sick Leave

  • RULE 251.307 Payment of Compensation

  • RULE 251.308 Effect of Emergency Leave

  • RULE 251.309 Communications Concerning Sick and Emergency Leave
  • SUBCHAPTER D ACCIDENT PREVENTION


  • RULE 251.401 Authority for Accident Prevention Rules

  • RULE 251.402 Accident Prevention Rules

  • RULE 251.403 Interpretation of Director

  • RULE 251.404 National Safety Council Guidelines

  • RULE 251.405 Administration of Accident Prevention Rules

  • RULE 251.406 Correction of Cited Discrepancy

  • RULE 251.407 Hearing Procedures

  • RULE 251.408 Hearing Records

  • RULE 251.409 Request for Change in Rules

  • RULE 251.410 Provisions for Requesting a Change in Rules

  • RULE 251.411 Director's Determination Regarding Change in Rules

  • RULE 251.412 Substitute Rule Request

  • RULE 251.413 Availability of Rules
  • SUBCHAPTER E RISK ALLOCATION PROGRAM


  • RULE 251.501 Purpose

  • RULE 251.503 Definitions

  • RULE 251.505 Total assessment

  • RULE 251.507 Calculating the Allocation of the Total Assessment

  • RULE 251.509 Omitted or Newly Created Agencies

  • RULE 251.511 Required Reports

  • RULE 251.513 Date of payment for assessments

  • RULE 251.515 Changes in the Factors, Relative Weights, Modifiers and Caps Used in the Assessment

  • RULE 251.517 Unitization of agency assessments

  • RULE 251.519 Distribution of Existing Claim Fund Appropriation
  • SUBCHAPTER F AGENCY ADMINISTRATION


  • RULE 251.601 Historically Underutilized Businesses Program
  • Chapter 252 State Risk Management

    SUBCHAPTER A CHAPTER DEFINITIONS; OFFICE FORMS AND COMMUNICATIONS


  • RULE 252.101 Definitions

  • RULE 252.103 Forms and Communications--In General
  • SUBCHAPTER B RISK MANAGEMENT


  • RULE 252.201 State Risk Management Guidelines

  • RULE 252.203 Reports
  • SUBCHAPTER C REPORTING AND OBTAINING INSURANCE COVERAGE


  • RULE 252.301 Review of Lines of Insurance by the Office

  • RULE 252.303 Purchases of Approved Lines

  • RULE 252.305 Purchases of Prohibited Lines

  • RULE 252.307 Reporting Purchases of Insurance

  • RULE 252.309 Agency Duties

  • RULE 252.311 Reporting Losses and Claims, by Agencies

  • RULE 252.313 Insurers' Report to the Office
  • SUBCHAPTER D SURETY BOND PURCHASES


  • RULE 252.401 General Provisions

  • RULE 252.403 Surety Bond Purchases

  • RULE 252.405 Reporting of Claims Against Surety Bonds
  • SUBCHAPTER E NOTARIES WITHOUT BOND


  • RULE 252.501 General Provisions

  • RULE 252.503 Notaries Without Bond--Application Process

  • RULE 252.505 Agency Duties

  • RULE 252.507 Notification Requirements Upon Transfer or Termination of Notaries Without Bond

  • RULE 252.509 State Employees' Notarization of Documents Outside of State Employment

  • RULE 252.511 Reporting of Claims Against Notaries Without Bond
  • Chapter 276 Office of Injured Employee Counsel

    SUBCHAPTER A - GENERAL PROVISIONS


  • RULE 276.1 Definitions

  • RULE 276.2 The Mission of the Office of Injured Employee Counsel - Repealed Date: 01/02/2022

  • RULE 276.3 Rulemaking Petition

  • RULE 276.4 Sick Leave Pool

  • RULE 276.5 Employer's Notice of Ombudsman Program and First Responder Liaison to Employees

  • RULE 276.6 Notice of Injured Employee Rights and Responsibilities

  • RULE 276.7 Agency's Ethics Statement and Employee Requirements - Repealed Date: 01/02/2022

  • RULE 276.8 Ethics Committee - Repealed Date: 01/02/2022
  • SUBCHAPTER B - OMBUDSMAN PROGRAM


  • RULE 276.10 Ombudsmen Training and Continuing Education Program

  • RULE 276.11 Access to Injured Employee Medical Documentation

  • RULE 276.12 Procedures for Private Meetings with Unrepresented Injured Employees Prior to a Workers' Compensation Proceeding

  • RULE 276.13 Ombudsman Program Ethics Code of Conduct
  • Misc. Related Rules


  • 1.1301 Electronic Submissions

  • 1.1302 Electronic Communications from the Texas Department of Insurance
  • Old Law Rules (Prior to 1991 Chapter 41 - Chapter 89)

    Chapter 41 Practice And Procedure

    SUBCHAPTER A: COMMUNICATIONS


  • 41.1 Name Change

  • 41.5 Compliance and Suspension of Rules

  • 41.8 Contents of Rule-making Petitions

  • RULE 41.10 Definitions

  • RULE 41.15 Social Security Number

  • RULE 41.20 Adjuster Identification

  • RULE 41.25 Attorney Identification

  • RULE 41.27 Employer's Identification

  • RULE 41.30 Self-insureds

  • RULE 41.35 Designation of Insurance Carriers' Austin Representative

  • RULE 41.40 General Policy Concerning Communications

  • RULE 41.45 Communication to Claimants

  • RULE 41.50 Carrier's Address

  • RULE 41.55 Communication to Employers

  • RULE 41.60 Communication to Insurance Carriers

  • RULE 41.65 Communication to Health Care Provider

  • RULE 41.70 Filing of Instruments

  • RULE 41.75 Timely Filing

  • RULE 41.80 Filing Subsequent to Final Order or Award

  • RULE 41.85 Translation of Documents

  • RULE 41.90 Responsibility of Translators

  • RULE 41.95 Wage Information
  • Chapter 42 Medical Benefits

    SUBCHAPTER A: GENERAL MEDICAL PROVISIONS


  • RULE 42.5 Applicability and Scope of Rules

  • RULE 42.10 Acceptance of Rules and Guidelines

  • RULE 42.15 Definitions

  • RULE 42.20 Who May Treat

  • RULE 42.25 Prohibited Practices

  • RULE 42.28 Confirmation of Coverage

  • RULE 42.30 Written Communications

  • RULE 42.33 Health Care Providers' Reporting Requirements

  • RULE 42.35 Required Reports: First Report

  • RULE 42.40 Required Reports: Subsequent Reports

  • RULE 42.55 Required Reports: Change of Status Reports

  • RULE 42.60 Required Reports: Special Reports

  • RULE 42.65 Changing Treating Doctors

  • RULE 42.75 Excess Recovery from Third Party Actions

  • RULE 42.78 Reports To Be Filed by the Carrier

  • RULE 42.80 Assignment of Medical Benefits

  • RULE 42.85 Voluntary Arbitration

  • RULE 42.90 Demand for Surgical Operation

  • RULE 42.95 Scars and Deformities
  • SUBCHAPTER B: MEDICAL COST EVALUATION


  • RULE 42.101 Purpose

  • RULE 42.105 Medical Fee Guideline

  • RULE 42.115 Pharmaceutical Fee Guideline

  • RULE 42.135 Liability for Covered Health Care

  • RULE 42.137 Utilization Review

  • RULE 42.140 Amount of Payment

  • RULE 42.145 Billing

  • RULE 42.155 Carrier Review of Bills

  • RULE 42.160 Carrier Desk Audit of Bills

  • RULE 42.165 Carrier On-Site Audit of Hospital Bills

  • RULE 42.175 Miscellaneous Covered Services
  • SUBCHAPTER D: DISPUTE RESOLUTION


  • RULE 42.305 Requesting Dispute Review and Resolution

  • RULE 42.307 Procedure for Requesting Dispute Review

  • RULE 42.308 Procedure for Responding to a Request for Dispute Review

  • RULE 42.309 Payment for the Review

  • RULE 42.310 Board Review and Resolution

  • RULE 42.315 Appeal
  • Chapter 43 Insurance Coverage


  • RULE 43.5 Notice That Employer Has Become Subscriber

  • RULE 43.10 Termination of Coverage
  • Chapter 45 Employer's Report Of Injury Or Disease


  • RULE 45.5 Forms

  • RULE 45.10 Employer's Report of Injury and Disease

  • RULE 45.13 Wage Statement

  • RULE 45.20 Board Request for Additional Information

  • RULE 45.25 Employer's Supplemental Report of Injury

  • RULE 45.30 Sanctions
  • Chapter 47 Employee Notice Of Injury Or Death And Claim For Benefits


  • RULE 47.5 Information Constituting Claim

  • RULE 47.10 Signature of Claimant

  • RULE 47.15 Employer Advances Compensation

  • RULE 47.20 Beneficiaries Filing Claim
  • Chapter 49 Procedures For Formal Hearings By The Board

    SUBCHAPTER A: FORMAL HEARINGS


  • RULE 49.5 Schedule of Hearings

  • RULE 49.10 Timely Acceptance of Evidence

  • RULE 49.15 Formal Statement of Position

  • RULE 49.20 Request for Cancellation

  • RULE 49.25 Delay or Postponement of Hearing

  • RULE 49.30 Filing of Medical Bills

  • RULE 49.35 Filing of Medical Reports and Records

  • RULE 49.40 Carrier Attendance

  • RULE 49.45 Contents of Formal Statement of Position

  • RULE 49.50 Sanctions
  • SUBCHAPTER B: SPECIAL FORMAL AND OTHER INVESTIGATIVE HEARINGS


  • RULE 49.105 Procedures

  • RULE 49.110 Commencement of Hearings

  • RULE 49.115 Notice

  • RULE 49.120 Special Statutory Notice

  • RULE 49.125 Notice of Special Formal Hearing

  • RULE 49.130 Personal Appearance Hearings in Austin

  • RULE 49.131 Withdrawal of Attorney

  • RULE 49.135 Use of Court Reporters

  • RULE 49.140 Continuance

  • RULE 49.145 Recess

  • RULE 49.150 Complaint Specifications

  • RULE 49.155 Documentary Evidence

  • RULE 49.160 Filing of Formal Statement of Position

  • RULE 49.165 Subpoenas and Subpoenas Duces Tecum
  • Chapter 51 Award Of The Board


  • RULE 51.10 Joint Payment of Award

  • RULE 51.15 Periodic Installments

  • RULE 51.20 Lump Sum Payment

  • RULE 51.25 Request for Review

  • RULE 51.30 Review of Award

  • RULE 51.50 Payments of Attorney's Fees

  • RULE 51.65 Attorney Fees
  • Chapter 53 Carrier's Report Of Initiation And Suspension Of Compensation Payments


  • RULE 53.5 Payment of Benefits Without Prejudice

  • RULE 53.10 Written Notice of Injury Defined

  • RULE 53.15 Board Notice to Carrier of Injury

  • RULE 53.20 Notice of Initiation of Compensation; Mode of Payment of Compensation

  • RULE 53.22 Application To Change the Benefits Payment Period

  • RULE 53.25 Contents of Statement of Controversion or Statement of Position

  • RULE 53.30 Filing of Wage Statement

  • RULE 53.35 Notice of Suspension of Compensation

  • RULE 53.40 Transmittal Letters

  • RULE 53.45 Maximum Payment to Minor

  • RULE 53.48 Payment of Partial Benefits for General Injuries

  • RULE 53.50 Resumption of Compensation

  • RULE 53.55 Payment for Amputation

  • RULE 53.60 Application for Suspension of Compensation

  • RULE 53.63 Suspension of Weekly Compensation

  • RULE 53.64 Nonpayment of Compensation Based on Another Carrier's Liability

  • RULE 53.65 Certification Procedure
  • Chapter 55 Lump Sum Payments


  • RULE 55.3 Request for Advance Payment of Compensation

  • RULE 55.5 Lump Sum Payments

  • RULE 55.10 Settlements Final When Approved

  • RULE 55.15 Compromise Settlement Agreements

  • RULE 55.20 Execution of Compromise Settlement Agreement

  • RULE 55.25 Loss of an Eye

  • RULE 55.30 Hearing Impairment

  • RULE 55.35 Stipulation of Medical Payments

  • RULE 55.40 Attorney's Signature

  • RULE 55.45 Percent of Medical Impairment

  • RULE 55.50 Attorneys Fees and Expenses

  • RULE 55.55 Compromise Settlement Agreement To Set Aside Award

  • RULE 55.60 Consent Withdrawn

  • RULE 55.65 Withdrawal of Consent by Death

  • RULE 55.75 Tender Payment Time Period

  • RULE 55.80 Waiving of Approval Appearance
  • Chapter 56 Structured Compromise Settlement Agreements


  • RULE 56.5 Definitions

  • RULE 56.10 Form

  • RULE 56.15 Execution

  • RULE 56.20 Personal Appearance by Claimant

  • RULE 56.25 Medical Benefits

  • RULE 56.30 Consent of Parties--Withdrawal

  • RULE 56.35 Attorney's Signature

  • RULE 56.40 Attorney's Fees and Expenses

  • RULE 56.45 Tender Payment Time Period

  • RULE 56.50 Final When Approved

  • RULE 56.55 Annuity Company

  • RULE 56.60 Payments Guaranteed

  • RULE 56.65 Cost of the Annuity

  • RULE 56.70 Structured Settlement Agreement To Set Aside Award
  • Chapter 57 Request For Case Folders And Certifications Of Actions Of The Board


  • RULE 57.5 Request for Copies or Statistical Information

  • RULE 57.10 Written Request for Public Information

  • RULE 57.15 Telephone Request for Public Information
  • Chapter 59 Notices Of Intention To Appeal


  • RULE 59.5 Filing of Notice

  • RULE 59.10 Receipt of Notice
  • Chapter 61 Prehearing Conferences


  • RULE 61.5 Request for Prehearing Conference

  • RULE 61.7 Request of Prehearing Conference

  • RULE 61.15 Setting under Texas Civil Statutes, Article 8306, 18a

  • RULE 61.20 Setting on Hardship

  • RULE 61.25 Setting at Carrier's Request

  • RULE 61.30 Filing of Medical Information

  • RULE 61.35 Exchange of Medical Information

  • RULE 61.40 Additional Medical

  • RULE 61.45 Charges for Reports

  • RULE 61.50 Representatives Must Be Qualified

  • RULE 61.55 Supply of Forms

  • RULE 61.60 Attendance at Conference

  • RULE 61.65 Request for Cancellation of Prehearing Conference

  • RULE 61.70 Maintain Setting

  • RULE 61.75 Failure To Appear

  • RULE 61.80 Participation at Conference

  • RULE 61.85 Carrier Self-Audit of Prehearing Conference

  • RULE 61.90 Conduct at Prehearing Conference

  • RULE 61.95 Consular Officers
  • Chapter 63 Promptness Of First Payment


  • RULE 63.5 Quarterly Report

  • RULE 63.10 Sanctions for Late Payment
  • Chapter 64 Representing Claimants Before The Board


  • RULE 64.25 Discharged Attorney

  • RULE 64.30 Adverse Representation in Claims for Death Benefits
  • Chapter 65 Unethical Or Fraudulent Claims Practices


  • RULE 65.5 Practicing before the Board

  • RULE 65.10 Actions by Carrier, Claimant's Attorney, and/or Agent

  • RULE 65.15 Filing of Violation Report
  • Chapter 67 Allegations Of Fraud


  • RULE 67.5 Referral to Attorney General
  • Chapter 69 Medical Examination Orders


  • RULE 69.5 Application of Chapter

  • RULE 69.10 Definitions

  • RULE 69.15 Carrier May Apply for Order from Board

  • RULE 69.20 Application

  • RULE 69.25 Bases for Denial

  • RULE 69.30 Appeal

  • RULE 69.33 Claimant's Medical Records

  • RULE 69.35 Claimant's Expenses

  • RULE 69.40 Attendance of Claimant's Health Care Provider

  • RULE 69.45 Unreasonable Delay

  • RULE 69.50 Reports of Examinations

  • RULE 69.55 Failure To Attend Examination
  • Chapter 401. General Provisions (401.011-401.026)

    Subchapter A. Short Title; Application Of Sunset Act (401.001-401.003)


  • 401.001. Short Title.

  • 401.002 Application of Sunset Act. Repealed eff. Sept. 1, 2005

  • 401.003. Activities Of The State Auditor.
  • Subchapter B. Definitions (401.011-401.003)


  • 401.011. General Definitions.

  • 401.012. Definition Of Employee.

  • 401.013. Definition Of Intoxication.

  • 401.014. Franchisors Excluded.
  • Subchapter C. Miscellaneous Provisions (401.021-401.026)


  • 401.021. Application Of Other Acts.

  • 401.022. Discrimination Prohibited.

  • 401.023. Interest Or Discount Rate.

  • 401.024. Transmission Of Information.

  • 401.025 References to Commission and Excecutive Director

  • 401.026. Applicability To Certain Emergency Response Personnel.
  • Chapter 402. Operation and Administration of Workers' Compensation System (402.001-402.251)

    Subchapter A. General Administration of System (402.001-402.002)


  • 402.001. Administration Of System.

  • 402.00111. Relationship Between Commissioner Of Insurance And Commissioner Of Workers' Compensation; Separation Of Authority; Rulemaking.

  • 402.00112. Investigation Of Division.

  • 402.00113. Administrative Attachment To Department.

  • 402.00114. Duties Of Division; Single Point Of Contact.

  • 402.00115. Composition Of Division.

  • 402.00116. Chief Executive.

  • 402.00117. Appointment; Term.

  • 402.00118. Qualifications.

  • 402.00119. Ineligibility For Public Office.

  • 402.00120. Compensation.

  • 402.00121. Grounds For Removal.

  • 402.00122. Prohibited Gifts; Administrative Violation.

  • 402.00123. Civil Liability Of Commissioner.

  • 402.00124. Conflict Of Interest.

  • 402.00125. Prohibition On Certain Employment Or Representation.

  • 402.00126. Lobbying Activities.

  • 402.00127 Training Program for the Commissioner

  • 402.00128. General Powers And Duties Of Commissioner.

  • 402.0015 thru 402.012 Repealed Acts

  • 402.002. Administration Of System.
  • Subchapter B. System Goals; General Administration of System (402.0215-402.0235)


  • 402.0215. Reference To Commission Divisions.

  • 402.021. Goals; Legislative Intent; General Workers' Compensation Mission Of Department.

  • 402.022. Public Interest Information.

  • 402.023. Complaint Information.

  • 402.024. Public Participation.

  • 402.025 Audit. Repealed eff. Sept. 1, 2005

  • 402.0231. Documentation And Analysis Of Complaints.

  • 402.0235. Priorities For Complaint Investigations.
  • Subchapter C. Personnel (402.041-402.044)


  • 402.041. Appointments.

  • 402.042. Division Of Responsibilities.

  • 402.043. Career Ladder; Annual Performance Evaluations.

  • 402.044. Equal Employment Opportunity Policy Statement.
  • Subchapter D. General Powers And Duties Of Commission (402.061-402.075)


  • 402.061. Adoption Of Rules.

  • 402.062. Acceptance Of Gifts.

  • 402.063 Appointment of Executive Director. Repealed eff. Sept. 1, 2005

  • 402.064. Fees.

  • 402.065. Employment Of Counsel.

  • 402.066. Recommendations To Legislature.

  • 402.0665. Legislative Oversight.

  • 402.067. Advisory Committees.

  • 402.068. Delegation Of Rights And Duties.

  • 402.069. Qualifications And Standards Of Conduct Information.

  • 402.070 Annual Report

  • 402.071. Representatives.

  • 402.072 Sanctions

  • 402.073. Cooperation With State Office Of Administrative Hearings.

  • 402.074 Strategic Management; Evaluation

  • 402.078. Regional Offices.

  • 402.076. General Duties; Funding.

  • 402.077. Educational Programs.

  • 402.075. Incentives; Performance-based Oversight.
  • Subchapter E. Records And Employee Information (402.081-402.092)


  • 402.081. Division Records.

  • 402.082. Injury Information Maintained By Division.

  • 402.083. Confidentiality Of Injury Information.

  • 402.084. Record Check; Release Of Information.

  • 402.085 Exceptions to Confidentiality

  • 402.086. Transfer Of Confidentiality.

  • 402.087. Information Available To Prospective Employers.

  • 402.088. Report Of Prior Injury.

  • 402.089. Failure To File Authorization.

  • 402.090. Statistical Information.

  • 402.091. Failure To Maintain Confidentiality; Offense; Penalty.

  • 402.092. Investigation Files Confidential; Disclosure Of Certain Information.
  • Subchapter F. Cooperation With Offices Of Injured Employee Counsel (402.251)


  • 402.251. Cooperation; Facilities.
  • Chapter 403. Division Financing (403.001-403.008)


  • 403.001. Funds.

  • 403.002. Maintenance Taxes.

  • 403.003. Rate Of Assessment.

  • 403.004. Collection Of Tax After Withdrawal From Business.

  • 403.005. Tax Rate.

  • 403.006. Subsequent Injury Fund.

  • 403.007. Funding Of Subsequent Injury Fund.

  • 403.008. Deposit Of Administrative Penalties.
  • Chapter 404. Office of Injured Employee Counsel (404.001-404.155)

    Subchapter A. Office; General Provisions (404.001-404.008)


  • 404.001. Definitions

  • 404.002 Establishment of Office; Administrative Attachment

  • 404.003. Sunset Provision.

  • 404.004 Public Interest Information

  • 404.005 Access to Programs and Facilities

  • 404.006. Rulemaking.

  • 404.007. Negotiated Rulemaking; Alternative Dispute Resolution.

  • 404.008. Complaints.
  • Subchapter B. Injured Employee Public Counsel (404.051-404.057)


  • 404.051. Appointment; Term.

  • 404.052. Qualifications.

  • 404.053. Business Interest; Service As Public Counsel.

  • 404.054. Lobbying Activities.

  • 404.055. Grounds For Removal.

  • 404.056. Prohibited Representation Or Employment.

  • 404.057. Trade Associations.
  • Subchapter C. General Powers and Duties of Office of Injured Employee Counsel (404.101-404.111)


  • 404.101. General Duties.

  • 404.102. General Powers And Duties Of Public Counsel.

  • 404.103. Operation Of Ombudsman Program.

  • 404.104. Authority To Appear Or Intervene.

  • 404.105. Authority To Assist Individual Injured Employees In Administrative Procedures.

  • 404.106. Legislative Report.

  • 404.107. Access To Information By Public Counsel.

  • 404.108. Legislative Recommendations.

  • 404.109. Injured Employee Rights; Notice.

  • 404.110. Applicability To Public Counsel Of Confidentiality Requirements.

  • 404.111. Access To Information.
  • Subchapter D. Ombudsman Program (404.151-404.155)


  • 404.151. Ombudsman Program.

  • 404.152. Designation As Ombudsman; Eligibility And Training Requirements; Continuing Education Requirements.

  • 404.153. Employer Notification; Administrative Violation.

  • 404.154. Public Information.

  • 404.155. Cost For Certain Copies Of Medical Records; Administrative Violation.
  • Chapter 405. Workers' Compensation Research (405.001-405.004)


  • 405.001. Definition.

  • 405.002. Workers' Compensation Research Duties Of Department.

  • 405.0025. Research Duties Of Group.

  • 405.0026. Research Agenda.

  • 405.003. Funding; Maintenance Tax.

  • 405.004. Coordination With Other State Agencies; Confidentiality.
  • Chapter 406. Coverage Election; Security Procedures (406.001-406.165)

    Subchapter A. Coverage Election; Security Procedures (406.001-406.012)


  • 406.001. Definition.

  • 406.002. Coverage Generally Elective.

  • 406.003. Methods Of Obtaining Coverage.

  • 406.004. Employer Notice To Division.

  • 406.005. Employer Notice To Employees; Administrative Violation.

  • 406.006. Insurance Coverage And Claim Administration Reporting Requirements; Administrative Violation.

  • 406.007. Termination Of Coverage By Employer; Notice.

  • 406.008. Cancellation Or Nonrenewal Of Coverage By Insurance Company; Notice.

  • 406.009. Collecting And Maintaining Information; Monitoring And Enforcing Compliance.

  • 406.010. Claims Service; Administrative Violation.

  • 406.011. Austin Representative; Administrative Violation.

  • 406.012. Enforcement Of Subchapter.
  • Subchapter B. Coverage Requirements (406.031-406.035)


  • 406.031. Liability For Compensation.

  • 406.032. Exceptions.

  • 406.033. Common-law Defenses; Burden Of Proof.

  • 406.034. Employee Election.

  • 406.035. Waiver Of Compensation Prohibited.
  • Subchapter C. Coverage Through Commercial Insurance (406.051-406.052)


  • 406.051. Security By Commercial Insurance.

  • 406.052. Effect Of Other Insurance Coverage.

  • 406.053. All States Coverage.
  • Subchapter D. Extraterritorial Coverage (406.071-406.075)


  • 406.071. Extraterritorial Coverage.

  • 406.072. Principal Location.

  • 406.073. Agreement On Principal Location; Administrative Violation.

  • 406.074. Interjurisdictional Agreements.

  • 406.075. Effect Of Compensation Paid In Other Jurisdiction.
  • Subchapter E. Application Of Coverage To Certain Employees (406.091-406.098)


  • 406.091. Exempt Employees; Voluntary Coverage.

  • 406.092. Alien Employees And Beneficiaries.

  • 406.093. Legally Incompetent Employees.

  • 406.094. Certain Persons Licensed By Texas Real Estate Commission.

  • 406.095. Certain Professional Athletes.

  • 406.096. Required Coverage For Certain Building Or Construction Contractors.

  • 406.097. Executive Employees Of Certain Business Entities.

  • 406.098. Volunteer Emergency Service Members And Personnel.
  • Subchapter F. Coverage Of Certain Independent Contractors (406.121-406.127)


  • 406.121. Definitions.

  • 406.122. Status As Employee.

  • 406.123. Election To Provide Coverage; Administrative Violation.

  • 406.124. Cause Of Action.

  • 406.125. Restriction Of Unsafe Work Practices Unaffected.

  • 406.126. Exemption.

  • 406.127. Effect Of Certain Contracts Of Hire.
  • Subchapter G. Coverage Of Certain Building And Construction Workers (406.141-406.146)


  • 406.141. Definitions.

  • 406.142. Application.

  • 406.143. Provision Of Workers' Compensation Insurance; Independent Contractor Without Employees.

  • 406.144. Election To Provide Coverage; Agreement.

  • 406.145. Joint Agreement.

  • 406.146. Wrongful Inducement Prohibited.
  • Subchapter H. Coverage Of Farm And Ranch Employees (406.161-406.165)


  • 406.161. Definitions.

  • 406.162. Scope.

  • 406.163. Liability Of Labor Agent; Joint And Several Liability.

  • 406.164. Elective Coverage Of Employer And Family Members.

  • 406.165. Not Applicable To Independent Contractors.
  • Chapter 407. Self-insurance Regulation (407.001-407.133)

    Subchapter A. General Provisions (407.001)


  • 407.001. Definitions.
  • Subchapter B. Division Of Self-Insurance Regulation (407.021-407.024)


  • 407.021 Division Repealed eff. Sept. 1, 2005.

  • 407.022 Director . Repealed eff. Sept. 1, 2005

  • 407.023. Exclusive Powers And Duties Of Commissioner.

  • 407.024. Claim Or Suit.
  • Subchapter C. Certificate Of Authority To Self-Insure (407.041-407.047)


  • 407.041. Application.

  • 407.042. Issuance Of Certificate.

  • 407.043. Procedures On Denial Of Application.

  • 407.044. Term Of Certificate Of Authority; Renewal.

  • 407.045. Withdrawal From Self-insurance.

  • 407.046. Revocation Of Certificate Of Authority.

  • 407.047. Effect Of Revocation.
  • Subchapter D. Requirements For Certificate Of Authority (407.061-407.068)


  • 407.061. General Requirements.

  • 407.062. Financial Strength And Liquidity Requirements.

  • 407.063. Premium Requirements.

  • 407.064. General Security Requirements.

  • 407.065. Specific Security Requirements.

  • 407.066. Effect Of Dispute.

  • 407.067. Excess Insurance; Reinsurance; Administrative Violation.

  • 407.068. Guarantee By Parent Organization.
  • Subchapter E. Powers And Duties Of Certified Self-Insurer (407.081-407.083)


  • 407.081. Annual Report.

  • 407.082. Examination Of Records; Administrative Violation.

  • 407.083. Payment Of Insurance Agent's Commission.
  • Subchapter F. Financing Of Self-Insurance Program (407.101-407.104)


  • 407.101. Fund.

  • 407.102. Regulatory Fee.

  • 407.103. Self-insurer Maintenance Tax; Effect On General Maintenance Tax.

  • 407.104. Collection Of Taxes And Fees; Administrative Violation.
  • Subchapter G. Texas Certified Self-insurer Guaranty Association (407.121-407.133)


  • 407.121. Guaranty Association.

  • 407.122. Board Of Directors.

  • 407.123. Board Rules.

  • 407.124. Impaired Employer; Assessments.

  • 407.125. Payment Of Assessments.

  • 407.126. Trust Fund; Fee; Schedule.

  • 407.127. Payment Of Benefits Through Association.

  • 407.128. Possession Of Security By Association.

  • 407.129. Release Of Claim Information To Association.

  • 407.130. Association As Party In Interest.

  • 407.131. Preference.

  • 407.132. Special Fund.

  • 407.133. Suspension Or Revocation Of Certificate For Failure To Pay Assessment.
  • Chapter 407A. Group Self-insurance Coverage (407a.001-407a.465)

    Subchapter A. General Provisions (407a.001-407a.009)


  • 407a.001. Definitions.

  • 407a.002. Application Of Chapter; Establishment Of Private Group.

  • 407a.003. Merger Of Groups.

  • 407a.004. Group Not Insurer.

  • 407a.005. Certificate Of Approval Required.

  • 407a.006. Service Of Process.

  • 407a.007. Hearings.

  • 407a.008. Rules.

  • 407a.009. Certificate Of Authority Required For Certain Administrators And Service Companies.
  • Subchapter B. Application Requirements For Certificate Of Approval For Self-insurance Group (407a.051-407a.057)


  • 407a.051. Application For Initial Certificate Of Approval; Approval Requirements.

  • 407a.052. Issuance Of Certificate Of Approval; Refusal.

  • 407a.053. Financial Requirements.

  • 407a.054. Excess Insurance Requirements.

  • 407a.055. Premium Requirements.

  • 407a.056. Indemnity Agreement Requirements.

  • 407a.057. Additional Performance Bond Requirements.
  • Subchapter C. Termination Of Certificate Of Approval (407a.101)


  • 407a.101. Certificate Of Approval; Termination.
  • Subchapter D. Board Of Trustees (407a.151-407a.154)


  • 407a.151. Board Membership.

  • 407a.152. Board General Powers And Duties.

  • 407a.153. Prohibited Activities.

  • 407a.154. Group Funds.
  • Subchapter E. Group Membership; Termination; Liability (407a.201)


  • 407a.201. Admission Of Employer As Member.
  • Subchapter F. Examinations, Financial Statements, And Other Reports (407a.251-407a.252)


  • 407a.251. Financial Statement.

  • 407a.252. Examination.
  • Subchapter G. Taxes, Fees, And Assessments (407a.301-407a.304)


  • 407a.301. Maintenance Tax For Division And Research Functions Of Department.

  • 407a.302. Maintenance Tax For Department.

  • 407a.303. Collection And Payment Of Taxes.

  • 407a.304. Premium Tax.
  • Subchapter H. Rates; Refunds; Premium Payments; Reserves; Deficits (407a.351-407a.357)


  • 407a.351. Rates.

  • 407a.352. Audits.

  • 407a.353. Refunds.

  • 407a.354. Premium Payment Plan; Reserves.

  • 407a.355. Deficits; Insolvencies.

  • 407a.357. Texas Group Self-Insurance Guaranty Association; Advisory Committee
  • Subchapter I. Disciplinary Actions; Penalties (407a.401-407a.404)


  • 407a.401. Prohibited Solicitation.

  • 407a.402. Fines.

  • 407a.403. Cease And Desist Orders.

  • 407a.404. Revocation Of Certificate Of Approval.
  • Subchapter J. Texas Self-Insurance Group Guaranty Fund (407a.451-407a.465)


  • 407a.451. Definitions.

  • 407a.452. Guaranty Fund.

  • 407a.453. Board Of Directors.

  • 407a.454. Immunity.

  • 407a.455. Board General Powers And Duties.

  • 407a.456. Plan Of Operation.

  • 407a.457. Trust Fund; Schedule.

  • 407a.458. Effect Of Insolvency Of Group.

  • 407a.459. Collection Of Assessments From Group Members; Continuation Of Joint And Several Liability.

  • 407a.460. Payment Of Benefits Through Guaranty Fund.

  • 407a.461. Possession Of Security By Guaranty Fund.

  • 407a.462. Release Of Claim Information To Guaranty Fund.

  • 407a.463. Guaranty Fund As Party In Interest.

  • 407a.464. Preferences.

  • 407a.465. Special Fund.
  • Chapter 408. Workers' Compensation Benefits (408.001-408.222)

    Subchapter A. General Provisions (408.001-408.008)


  • 408.001. Exclusive Remedy; Exemplary Damages.

  • 408.002. Survival Of Cause Of Action.

  • 408.003. Reimbursable Employer Payments; Salary Continuation; Offset Against Income Benefits; Limits.

  • 408.004. Required Medical Examinations; Administrative Violation.

  • 408.0041. Designated Doctor Examination.

  • 408.0042. Medical Examination By Treating Doctor To Define Compensable Injury.

  • 408.0043. Professional Specialty Certification Required For Certain Review.

  • 408.0044. Review Of Dental Services.

  • 408.0045. Review Of Chiropractic Services.

  • 408.0046. Rules.

  • 408.005. Settlements And Agreements.

  • 408.006. Mental Trauma Injuries.

  • 408.007. Date Of Injury For Occupational Disease.

  • 408.008. Compensability Of Heart Attacks.
  • Subchapter B. Medical Benefits (408.021-408.032)


  • 408.021. Entitlement To Medical Benefits.

  • 408.022. Selection Of Doctor.

  • 408.0221. Request For Description Of Employment.

  • 408.0222. Participation in Regional Network; Selection of Doctor Within Regional Network; Benefit Incentives. Repealed eff. Sept.1, 2005

  • 408.0223. Insurance Carrier Networks. Repealed Sept. 1, 2005

  • 408.023. List Of Approved Doctors; Duties Of Treating Doctors.

  • 408.0231. Maintenance Of List Of Approved Doctors; Sanctions And Privileges Relating To Health Care.

  • 408.024. Noncompliance With Selection Requirements.

  • 408.025. Reports And Records Required From Health Care Providers.

  • 408.0251. Electronic Billing Requirements.

  • 408.0252. Underserved Areas.

  • 408.026. Spinal Surgery.

  • 408.027. Payment Of Health Care Provider.

  • 408.0271. Reimbursement By Health Care Provider.

  • 408.0272. Certain Exceptions For Untimely Submission Of Claim.

  • 408.028. Pharmaceutical Services.

  • 408.0281. Reimbursement For Pharmaceutical Services; Administrative Violation.

  • 408.0282. Requirements For Certain Informal Or Voluntary Networks.

  • 408.0284. Reimbursement For Durable Medical Equipment And Home Health Care Services; Administrative Violation.

  • 408.029. Nurse First Assistant Services.

  • 408.030. Reports Of Physician Violations.

  • 408.031. Workers' Compensation Health Care Networks.

  • 408.032 Study on Interdisciplinary Pain and Rehabilitation Program and Facility Accreditation Requirement
  • Subchapter C. Computation Of Average Weekly Wage (408.041-408.047)


  • 408.041. Average Weekly Wage.

  • 408.042. Average Weekly Wage For Part-time Employee Or Employee With Multiple Employment.

  • 408.043. Average Weekly Wage For Seasonal Employee.

  • 408.044. Average Weekly Wage For Minor.

  • 408.0445. Average Weekly Wage For Members Of State Military Forces.

  • 408.0446. Average Weekly Wage; School District Employee.

  • 408.045. Nonpecuniary Wages.

  • 408.046. Similar Employees.

  • 408.047. State Average Weekly Wage.
  • Subchapter D. Computation Of Benefits (408.061-408.064)


  • 408.061. Maximum Weekly Benefit.

  • 408.062. Minimum Weekly Income Benefit.

  • 408.063. Wage Presumptions; Administrative Violation.

  • 408.064. Interest On Accrued Benefits.
  • Subchapter E. Income Benefits In General (408.081-408.086)


  • 408.0815. Resolution Of Overpayment Or Underpayment Of Income Benefits.

  • 408.081. Income Benefits.

  • 408.082. Accrual Of Right To Income Benefits.

  • 408.083. Termination Of Right To Temporary Income.

  • 408.084. Contributing Injury.

  • 408.085. Advance Of Benefits For Hardship.

  • 408.086 Commission Determination of Extended Unemployment or Underemployment
  • Subchapter F. Temporary Income Benefits (408.101-408.105)


  • 408.101. Temporary Income Benefits.

  • 408.102. Duration Of Temporary Income Benefits.

  • 408.103. Amount Of Temporary Income Benefits.

  • 408.104. Maximum Medical Improvement After Spinal Surgery.

  • 408.105. Salary Continuation In Lieu Of Temporary Income Benefits.
  • Subchapter G. Impairment Income Benefits (408.121-408.129)


  • 408.121. Impairment Income Benefits.

  • 408.122. Eligibility For Impairment Income Benefits.

  • 408.1225. Designated Doctor.

  • 408.123. Certification Of Maximum Medical Improvement; Evaluation Of Impairment Rating.

  • 408.124. Impairment Rating Guidelines.

  • 408.125. Dispute As To Impairment Rating.

  • 408.126. Amount Of Impairment Income Benefits.

  • 408.127. Reduction Of Impairment Income Benefits.

  • 408.128. Commutation Of Impairment Income Benefits.

  • 408.129. Acceleration Of Impairment Income Benefits.
  • Subchapter H. Supplemental Income Benefits (408.141-408.151)


  • 408.141. Award Of Supplemental Income Benefits.

  • 408.1415. Work Search Compliance Standards.

  • 408.142. Supplemental Income Benefits.

  • 408.143. Employee Statement.

  • 408.144. Computation Of Supplemental Income Benefits.

  • 408.145. Payment Of Supplemental Income Benefits.

  • 408.146. Termination Of Supplemental Income Benefits; Reinitiation.

  • 408.147. Contest Of Supplemental Income Benefits By Insurance Carrier; Attorney's Fees.

  • 408.148. Employee Discharge After Termination.

  • 408.149. Status Review; Benefit Review Conference.

  • 408.150. Vocational Rehabilitation.

  • 408.151. Medical Examinations For Supplemental Income Benefits.
  • Subchapter I. Lifetime Income Benefits (408.161-408.162)


  • 408.161. Lifetime Income Benefits.

  • 408.162. Subsequent Injury Fund Benefits.
  • Subchapter J. Death And Burial Benefits (408.181-408.187)


  • 408.181. Death Benefits.

  • 408.182. Distribution Of Death Benefits.

  • 408.183. Duration Of Death Benefits.

  • 408.184. Redistribution Of Death Benefits.

  • 408.185. Effect Of Beneficiary Dispute; Attorney's Fees.

  • 408.186. Burial Benefits.

  • 408.187. Autopsy.
  • Subchapter K. Protection Of Rights To Benefits (408.201-408.203)


  • 408.201. Benefits Exempt From Legal Process.

  • 408.202. Assignability Of Benefits.

  • 408.203. Allowable Liens.
  • Subchapter L. Attorney's Fees In Workers' Compensation Benefit Matters (408.221-408.222)


  • 408.221. Attorney's Fees Paid To Claimant's Counsel.

  • 408.222. Attorney's Fees Paid To Defense Counsel.
  • Chapter 409. Compensation Procedures (409.001-409.024)

    Subchapter A. Injury Reports, Claims, And Records (409.001-409.013)


  • 409.001. Notice Of Injury To Employer.

  • 409.002. Failure To File Notice Of Injury.

  • 409.003. Claim For Compensation.

  • 409.004. Effect Of Failure To File Claim For Compensation.

  • 409.005. Report Of Injury; Modified Duty Program Notice; Administrative Violation.

  • 409.006. Record Of Injuries; Administrative Violation.

  • 409.007. Death Benefit Claims.

  • 409.008. Failure To File Employer Report Of Injury; Limitations Tolled.

  • 409.009. Subclaims.

  • 409.0091. Reimbursement Procedures For Certain Entities.

  • 409.0092. Health Care Reimbursement Procedures for Certain Injured Employees.

  • 409.010. Information Provided To Employee Or Legal Beneficiary.

  • 409.011. Information Provided To Employer; Employer's Rights.

  • 409.012. Vocational Rehabilitation Information.

  • 409.013. Plain Language Information; Notification Of Injured Employee.
  • Subchapter B. Payment Of Benefits (409.021-409.024)


  • 409.021. Initiation Of Benefits; Insurance Carrier's Refusal; Administrative Violation.

  • 409.022. Refusal To Pay Benefits; Notice; Administrative Violation.

  • 409.023. Payment Of Benefits; Administrative Violation.

  • 409.0231. Payment By Electronic Funds Transfer.

  • 409.0232. Timeliness Of Payments.

  • 409.024. Termination Or Reduction Of Benefits; Notice; Administrative Violation.
  • Chapter 410. Adjudication Of Disputes (410.001-410.308)

    Subchapter A. General Provisions (410.001-410.007)


  • 410.001 Definitions. Repealed Sept. 1, 2005

  • 410.002. Law Governing Liability Proceedings.

  • 410.003. Application Of Administrative Procedure And Texas Register Act.

  • 410.004 Division of Hearings. Repealed Sept. 1, 2005

  • 410.005. Venue For Administrative Proceedings.

  • 410.006. Representation At Administrative Proceedings.

  • 410.007. Information List.
  • Subchapter B. Benefit Review Conference (410.021-410.034)


  • 410.021. Purpose.

  • 410.022. Benefit Review Officers; Qualifications.

  • 410.023. Request For Benefit Review Conference.

  • 410.024. Benefit Review Conference As Prerequisite To Further Proceedings On Certain Claims.

  • 410.025. Scheduling Of Benefit Review Conference; Notice.

  • 410.026. Powers And Duties Of Benefit Review Officer.

  • 410.027. Rules.

  • 410.028. Failure To Attend; Administrative Violation.

  • 410.029. Resolution At Benefit Review Conference; Written Agreement.

  • 410.030. Binding Effect Of Agreement.

  • 410.031. Incomplete Resolution; Report.

  • 410.032. Payment Of Benefits Under Interlocutory

  • 410.033. Multiple Carriers.

  • 410.034. Filing Of Agreement And Report.
  • Subchapter C. Arbitration (410.101-410.121)


  • 410.101. Purpose.

  • 410.102. Arbitrators; Qualifications.

  • 410.103. Duties Of Arbitrator.

  • 410.104. Election Of Arbitration; Effect.

  • 410.105. Lists Of Arbitrators.

  • 410.106. Selection Of Arbitrator.

  • 410.107. Assignment Of Arbitrator.

  • 410.108. Rejection Of Arbitrator.

  • 410.109. Scheduling Of Arbitration.

  • 410.110. Continuance.

  • 410.111. Rules.

  • 410.112. Exchange And Filing Of Information; Administrative Violation.

  • 410.113. Duties Of Parties At Arbitration; Attendance; Administrative Violation.

  • 410.114. Testimony; Record.

  • 410.115. Evidence.

  • 410.116. Closing Statements; Briefs.

  • 410.117. Ex Parte Contacts Prohibited.

  • 410.118. Award.

  • 410.119. Effect Of Award.

  • 410.120. Clerical Error.

  • 410.121. Court Vacating Award.
  • Subchapter D. Contested Case Hearing (410.151-410.169)


  • 410.151. Contested Case Hearing; Scope.

  • 410.152. Administrative Law Judges; Qualifications.

  • 410.153. Application Of Administrative Procedure Act.

  • 410.154. Scheduling Of Hearing.

  • 410.155. Continuance.

  • 410.156. Attendance Required; Administrative Violation.

  • 410.157. Rules.

  • 410.158. Discovery.

  • 410.159. Standard Interrogatories.

  • 410.160. Exchange Of Information.

  • 410.161. Failure To Disclose Information.

  • 410.162. Additional Discovery.

  • 410.163. Powers And Duties Of Administrative Law Judge.

  • 410.164. Record.

  • 410.165. Evidence.

  • 410.166. Stipulations.

  • 410.167. Ex Parte Contacts Prohibited.

  • 410.168. Decision.

  • 410.169. Effect Of Decision.
  • Subchapter E. Appeals Panel (410.201-410.209)


  • 410.201. Appeals Judges; Qualifications.

  • 410.202. Request For Appeal; Response.

  • 410.203. Powers And Duties Of Appeals Panel; Priority Of Hearing On Remand.

  • 410.204. Decision.

  • 410.205. Effect Of Decision.

  • 410.206. Clerical Error.

  • 410.207. Continuation Of Division Jurisdiction.

  • 410.208. Judicial Enforcement Of Order Or Decision; Administrative Violation.

  • 410.209. Reimbursement For Overpayment.
  • Subchapter F. Judicial Review General Provisions (410.251-410.258)


  • 410.251. Exhaustion Of Remedies.

  • 410.252. Time For Filing Petition; Venue.

  • 410.253. Service.

  • 410.254. Intervention.

  • 410.255. Judicial Review Of Issues Other Than Compensability Or Income Or Death Benefits.

  • 410.256. Court Approval Of Settlement.

  • 410.257. Judgment After Judicial Review.

  • 410.258. Notification Of Division Of Proposed Judgments And Settlements; Right To Intervene.
  • Subchapter G. Judicial Review Of Issues Regarding Compensability Or Income Or Death Benefits (410.301-410.308)


  • 410.301. Judicial Review Of Issues Regarding Compensability Or Income Or Death Benefits.

  • 410.302. Admissibility Of Records; Limitation Of Issues.

  • 410.303. Burden Of Proof.

  • 410.304. Consideration Of Appeals Panel Decision.

  • 410.305. Conflict With Rules Of Civil Procedure.

  • 410.306. Evidence.

  • 410.307. Substantial Change Of Condition.

  • 410.308. Certified Copy Of Notice Securing Compensation.
  • Chapter 411. Workers' Health And Safety (411.001-411.110)

    Subchapter A. General Provisions (411.001-411.005)


  • 411.001. Definitions.

  • 411.002. Application.

  • 411.003. Immunity From Certain Liability.

  • 411.004. Exclusive Remedy.

  • 411.005. Franchisors Excluded.
  • Subchapter B. General Powers And Duties Of Division (411.011-411.018)


  • 411.011. Coordination And Enforcement Of State Laws And Rules.

  • 411.012. Collection And Analysis Of Information.

  • 411.013. Federal Contracts And Programs.

  • 411.014. Educational Programs; Cooperation With Other Entities.

  • 411.015. Educational Publications.

  • 411.016. Peer Review Safety Program.

  • 411.017. Advisory Service To Insurance Carriers.

  • 411.018. Federal Osha Compliance.
  • Subchapter C. Job Safety Information System (411.031-411.035)


  • 411.031. Job Safety Information System; Cooperation With Other Agencies.

  • 411.032. Employer Injury And Occupational Disease Report; Administrative Violation.

  • 411.033. Job Safety Data Base.

  • 411.034. Confidentiality Requirement; Offense; Penalty.

  • 411.035. Use Of Injury Report.
  • Subchapter D. Extra-Hazardous Employer Program [Repealed]


  • Subchapter D. Hazardous Employer Program [Repealed]
  • Subchapter E. Accident Prevention Services (411.061-411.068)


  • 411.061. Accident Prevention Services; Prerequisite For License.

  • 411.062. Field Safety Representative; Qualifications. Repealed Sept.1, 2005

  • 411.063. Accident Prevention Personnel.

  • 411.064. Inspections.

  • 411.065. Annual Information Submitted By Insurance Company.

  • 411.066. Notice To Policyholders.

  • 411.067. Division Personnel.

  • 411.068. Administrative Violation.
  • Subchapter F. Employee Reports Of Safety Violations (411.081-411.064)


  • 411.081. Telephone Hotline.

  • 411.082. Employer Retaliation Prohibited.

  • 411.083. Judicial Relief For Employer Retaliation.

  • 411.084. Educational Publications.
  • Subchapter G. Policy For Elimination Of Drugs In The Workplace [Repealed]


  • Subchapter G. Policy For Elimination Of Drugs In The Workplace [Repealed]
  • Subchapter H. General Requirements Relating To Occupational Health And Safety (411.101-411.110)


  • 411.101. Legislative Policy; Purpose.

  • 411.102. Definitions.

  • 411.103. Duty Of Employer To Provide Safe Workplace.

  • 411.104. Division Duties.

  • 411.105. Confidential Information; Penalty.

  • 411.106. Safety Classification.

  • 411.107. Elimination Of Safety Impediments.

  • 411.108. Accident Reports.

  • 411.109. Effect On Other Law.

  • 411.110. Labor Disputes.
  • Chapter 412. Division Of Risk Management (412.001-412.054)

    Subchapter A. General Provisions (412.001)


  • 412.001. Definitions.
  • Subchapter B. Office. (412.011-412.013)


  • 412.011. Powers And Duties Of Office.

  • 412.0111. Affiliation With Office Of Attorney General.

  • 412.012. Funding.

  • 412.0121. Interagency Contracts

  • 412.0122. State Self-Insuring for Workers' Compensation

  • 412.0123. Allocation of Workers' Compensation and Risk Management Costs

  • 412.0124. Deposit Of Workers' Compensation Subrogation Recoveries.

  • 412.0125. Return-to-work Coordination Services; Case Management.

  • 412.0126. Analysis.

  • 412.0127. Payment By Electronic Funds Transfer.

  • 412.0128. Confidentiality Of Information.

  • Sec. 412.013. Review and Update of Risk Management Program Guidelines.
  • Subchapter C. Board. (412.021-412.027)


  • 412.021. Risk Management Board.

  • 412.022. Training Program For Board Members.

  • 412.023. Effect Of Lobbying Activity.

  • 412.024. Grounds For Removal From Board.

  • 412.027. Use Of Technology.
  • Subchapter D. General Powers And Duties Of Board. (412.031-412.035)


  • 412.031. Rulemaking Authority.

  • 412.032. Board's Report To Legislature.

  • 412.033. Hiring Director.

  • 412.034. Public Hearing.

  • 412.035. Dispute Resolution.
  • Subchapter E. Director. (412.041-412.042)


  • 412.041. Director Duties.

  • 412.042. Reports To The Legislature.
  • Subchapter F. State Agencies. (412.051-412.054)


  • 412.051. Duties Of State Agencies; Insurance Notification Requirements.

  • 412.052. Exemption Of Certain State Agencies.

  • 412.053. Annual Report By State Agency.

  • 412.054. Continuity Of Operations Plan.
  • Chapter 413. Medical Review (413.001-413.055)

    Subchapter A. Division Of Medical Review. (412.001-412.008)


  • 413.001 Definition. Repealed Sept. 1, 2005

  • 413.002. Medical Review.

  • 413.003. Authority To Contract.

  • 413.004. Coordination With Providers.

  • 413.005 Medical Advisory Committee. Repealed Sept. 1, 2005

  • 413.006. Advisory Committees.

  • 413.007. Information Maintained By Division.

  • 413.008. Information From Insurance Carriers; Administrative Violation.
  • Subchapter B. Medical Services And Fees. (413.011-413.025)


  • 413.011. Reimbursement Policies And Guidelines; Treatment Guidelines And Protocols.

  • 413.0111. Processing Agents.

  • Sec. 413.0112. Reimbursement of Federal Military Treatment Facility.

  • 413.0115. Requirements For Certain Voluntary Or Informal Networks.

  • 413.012. Medical Policy And Guideline Updates Required.

  • 413.013. Programs.

  • 413.014. Preauthorization Requirements; Concurrent Review And Certification Of Health Care.

  • 413.0141. Initial Pharmaceutical Coverage.

  • 413.015. Payment By Insurance Carriers; Audit And Review.

  • 413.016. Payments In Violation Of Medical Policies And Fee Guidelines.

  • 413.017. Presumption Of Reasonableness.

  • 413.018. Review Of Medical Care If Guidelines Exceeded.

  • 413.019. Interest Earned For Delayed Payment.

  • 413.020. Division Charges.

  • 413.021. Return-to-work Coordination Services.

  • 413.022. Return-to-work Reimbursement Program For Employers; Fund.

  • 413.023 Information to Employers.

  • 413.024 Information to Employees.

  • 413.025 Return-To-Work-Goals and Assistance.
  • Subchapter C. Dispute Resolutions. (413.031-413.032)


  • 413.031. Medical Dispute Resolution.

  • 413.0311. Review Of Medical Necessity Disputes; Contested Case Hearing.

  • 413.0312. Review Of Medical Fee Disputes; Benefit Review Conference.

  • 413.032 Independent Review Organization Assistant; Appeal
  • Subchapter D. Health Care Providers. (413.041-413.044)


  • 413.041. Disclosure.

  • 413.042. Private Claims; Administrative Violation.

  • 413.043. Overcharging Prohibited; Offense.

  • 413.044. Sanctions On Designated Doctor.
  • Subchapter E. Implementation Of Commission Powers And Duties. (413.051-413.055)


  • 413.051. Contracts With Review Organizations And Health Care Providers.

  • 413.0511. Medical Advisor.

  • 413.05115. Medical Quality Review Process.

  • 413.0512. Medical Quality Review Panel.

  • 413.05121. Quality Assurance Panel.

  • 413.05122. Medical Quality Review Panel.

  • 413.0513. Confidentiality Requirements.

  • 413.0514. Information Sharing With Occupational Licensing Boards.

  • 413.0515. Reports Of Physician And Chiropractor Violations.

  • 413.052. Production Of Documents.

  • 413.053. Standards Of Reporting And Billing.

  • 413.054. Immunity From Liability.

  • 413.055. Interlocutory Orders; Reimbursement.
  • Chapter 414. Division Of Compliance And Practices (414.001-414.007)


  • 414.001 Definition. Repealed Sept. 1, 2005

  • 414.002. Monitoring Duties.

  • 414.003. Compilation And Use Of Information.

  • 414.004. Performance Review Of Insurance Carriers.

  • 414.005. Investigation Unit.

  • 414.006. Referral To Other Authorities.

  • 414.007. Medical Review.
  • Chapter 415. Administrative Violations (415.001-415.036)

    Subchapter A. Prohibited Acts (415.001-415.011)


  • 415.001. Administrative Violation By Representative Of Employee Or Legal Beneficiary.

  • 415.002. Administrative Violation By Insurance Carrier.

  • 415.003. Administrative Violation By Health Care Provider.

  • 415.0035. Additional Violations By Insurance Carrier Or Health Care Provider.

  • 415.0036. Administrative Violation By Person Performing Certain Claim Services.

  • 415.004 Penalty Specified in Other Law.

  • 415.005. Overcharging By Health Care Providers Prohibited; Administrative Violation.

  • 415.006. Employer Chargebacks Prohibited; Administrative Violation.

  • 415.007. Loans By Attorneys Prohibited.

  • 415.008. Fraudulently Obtaining Or Denying Benefits; Administrative Violation.

  • 415.009. Frivolous Actions; Administrative Violation.

  • 415.010. Breach Of Agreement; Administrative Violation.

  • 415.011. Notice of Professional Employer Organization Workers' Compensation Claim and Payment Information; Administrative Violation.
  • Subchapter B. Penalties (415.021-415.025)


  • 415.021. Assessment Of Administrative Penalties.

  • 415.0211. Emergency Cease and Desist Order.

  • 415.0215. Sanctions.

  • 415.023. Commission Of Wrongful Act As Matter Of Practice; Administrative Violation.

  • 415.024. Breach Of Settlement Agreement; Administrative Violation.

  • 415.025. References To A Class Of Violation Or Penalty.
  • Subchapter C. Procedures (415.031-415.036)


  • 415.031. Initiation Of Administrative Violation Proceedings.

  • 415.032. Notice Of Possible Administrative Violation; Response.

  • 415.033. Failure To Respond.

  • 415.034. Hearing Procedures.

  • 415.035. Judicial Review.

  • 415.036. Standard Of Judicial Review Of Commissioner's Order.
  • Chapter 416. Actions Against Insurance Carrier For Breach Of Duty (416.001-416.002)


  • 416.001. Certain Causes Of Action Precluded.

  • 416.002. Exemplary Damages.
  • Chapter 417. Third-party Liability (417.001-417.004)


  • 417.001. Third-party Liability.

  • 417.002. Recovery In Third-party Action.

  • 417.003. Attorney's Fee For Representation Of Insurance Carrier's Interest.

  • 417.004. Employer Liability To Third Party.
  • Chapter 418. Criminal Penalties (418.001-418.003)


  • 418.001. Penalty For Fraudulently Obtaining Or Denying Benefits.

  • 418.002. Penalty For Fraudulently Obtaining Workers' Compensation Insurance Coverage.

  • 418.003. Election Of Prosecution.
  • Chapter 419. Misuse of Division Name (419.001-419.007)


  • 419.001. Definitions.

  • 419.002. Misuse Of Division's Name Or Symbols Prohibited.

  • 419.003. Rules.

  • 419.004. Civil Penalty.

  • 419.005. Administrative Penalty.

  • 419.006. Injunctive Relief.

  • 419.007. Remedies Not Exclusive.
  • Chapter 451. Discrimination Prohibited

    Subtitle B. Discrimination Issues (451.001-451.003)


  • 451.001. Discrimination Against Employees Prohibited.

  • 451.002. Remedies; Burden Of Proof.

  • 451.003. Injunction.
  • Chapter 501. Workers' Compensation Insurance Coverage For State Employees, including Employees Under The Direction Or Control Of The Board Of Regents Of Texas Tech University (501.001-501.051)

    Subchapter A. General Provisions (501.001-501.003)


  • 501.001. Definitions.

  • 501.002. Application Of General Workers' Compensation Laws; Limit On Actions And Damages.

  • 501.003. Legal Beneficiary Of Deceased Employee.
  • Subchapter B. Coverage (501.021-501.026)


  • 501.021. Workers' Compensation Coverage For Employees.

  • 501.022. Employees Of Component Institutions Or System Administration Of Texas Tech University System.

  • 501.023. State Self-insuring. Repealed

  • 501.024. Exclusions From Coverage.

  • 501.025. Coverage For Out-of-state Employees.

  • 501.026. Coverage For Certain Services Provided By Volunteers.
  • Subchapter C. Administration (501.041-501.051)


  • 501.041 Worker's Compensation Division; Director. Repealed

  • 501.042. Director As Insurer. Repealed

  • 501.0431. Compilation Of Statistics Relating To Fraud.

  • 501.043. Director's Powers And Duties. Repealed

  • 501.044. Effect Of Sick Leave; Annual Leave.

  • 501.045. Effect Of Emergency Leave.

  • 501.046. Reports Of Termination Or Continuation Of Injuries.

  • 501.047 Reports To Legislature. Repealed

  • 501.048. State Agency Summary In Budget Requests.

  • 501.049 State Workers' Compensation Account. Repealed

  • 501.050. Notice Of Appeal; Notice Of Trial Court Judgment; Offense.

  • 501.051. Payment Of Medical And Indemnity Benefits.
  • Chapter 502. Workers' Compensation Insurance Coverage For Employees Of the Texas A&M University System

    Subchapter A. General Provisions


  • 502.001. Definitions.

  • 502.002. Application Of General Workers' Compensation Laws; Limit On Actions And Damages.

  • 502.003. Legal Beneficiary Of Deceased Employee.
  • Subchapter B. Coverage


  • 502.021. Workers' Compensation Coverage For Institution Employees.

  • 502.022. Authority To Self-insure.

  • 502.023. Insurance Requirement.

  • 502.024. Preexisting Disqualifying Condition.

  • 502.025. Coverage For Out-of-state Employees.
  • Subchapter C. Offsets


  • 502.041. Exhaustion Of Annual And Sick Leave.
  • Subchapter D. Administration


  • 502.061. Administration And Rules.

  • 502.062. Percentage Of Payroll Set Aside For Workers' Compensation Expenses; Account; Reports.

  • 502.063. Certified Copies Of Division Documents.

  • 502.064. Preemployment Physical Required; Examining Physicians; Institution Records.

  • 502.065. Reports Of Injuries.

  • 502.066. Required Examination Of Injured Employee; Refusal To Submit To Examination.

  • 502.067. Refusal To Submit To Medical Treatment.

  • 502.068. Postponement Of Hearing.

  • 502.069. Notice Of Appeal; Notice Of Trial Court Judgment; Offense.

  • 502.070. Attorney General As Legal Representative.
  • Chapter 503. Workers' Compensation Insurance Coverage For Employees Of The University Of Texas System

    Subchapter A. General Provisions


  • 503.001. Definitions.

  • 503.002. Application Of General Workers' Compensation Laws; Limit On Actions And Damages.

  • 503.003. Legal Beneficiary Of Deceased Employee.
  • Subchapter B. Coverage


  • 503.021. Workers' Compensation Coverage For System And Institution Employees.

  • 503.022. Authority To Self-insure.

  • 503.023. Insurance Requirement.

  • 503.024. Waiver Of Rights.

  • 503.025. Coverage For Out-of-state Employees.
  • Subchapter C. Offsets


  • 503.041. Exhaustion Of Annual And Sick Leave.
  • Subchapter D. Administration


  • 503.061. Administration And Rules.

  • 503.062. Percentage Of Payroll Set Aside For Workers' Compensation Expenses; Account; Reports.

  • 503.063. Certified Copies Of Division Documents.

  • 503.064. Examining Physicians.

  • 503.065. Reports Of Injuries.

  • 503.066. Required Examination Of Injured Employee; Refusal To Submit To Examination.

  • 503.067. Refusal To Submit To Medical Treatment.

  • 503.068. Postponement Of Hearing.

  • 503.069. Notice Of Appeal; Notice Of Trial Court Judgment; Offense.

  • 503.070. Venue For Judicial Review.

  • 503.071. Attorney General As Legal Representative.
  • Chapter 504. Workers' Compensation Insurance Coverage For Employees Of Political Subdivisions

    Subchapter A. General Provisions


  • 504.001. Definitions.

  • 504.002. Application Of General Workers' Compensation Laws; Limit On Actions And Damages.

  • 504.003. Election Of Remedies.
  • Subchapter B. Coverage


  • 504.019. Coverage For Post-Traumatic Stress Disorder For Certain First Responders

  • 504.011. Method Of Providing Coverage.

  • 504.012. Optional Coverages.

  • 504.013. Coverage For Trustees And Staff Of Self-insurance Fund.

  • 504.014. Exclusions.

  • 504.015. Municipal Utilities.

  • 504.016. Joint Insurance Fund.

  • 504.017. Federal And State Funded Transportation Entities.

  • 504.018. Notice To Division And Employees; Effect On Common-law Or Statutory Liability.
  • Subchapter C. Benefits And Offsets


  • 504.051. Offset Against Payments For Incapacity.

  • 504.052. Sick Leave Benefits.

  • 504.053. Election.

  • 504.054. Contested Case Hearing On And Judicial Review Of Independent Review.

  • 504.055. Expedited Provision Of Medical Benefits For Certain Injuries Sustained By First Responder In Course And Scope Of Employment.

  • Section 504.056. Intent Of Expedited Provision Of Medical Benefits For Certain Injuries Sustained By First Responder In Course And Scope Of Employment.
  • Subchapter D. Administration


  • 504.071. Rules; Forms.

  • 504.072. Appropriations For Disbursements; Account; Report.

  • 504.073. Representation In Legal Proceedings.

  • Sec. 504.074. Self-Insurance Account for Death Benefits and Lifetime Income Benefits
  • Chapter 505. Workers' Compensation Insurance Coverage For Employees Of Texas Department Of Transportation

    Subchapter A. General Provisions


  • 505.001. Definitions.

  • 505.002. Application Of General Workers' Compensation Laws; Limit On Actions And Damages.
  • Subchapter B. Coverage


  • 505.011. Workers' Compensation Coverage For Department Employees.

  • 505.012. Authority To Self-insure.

  • 505.013. Individuals Employed By Subcontractors.
  • Subchapter C. Administration


  • 505.051. Administration; Rules; Forms.

  • 505.052. Percentage Of Payroll Set Aside For Workers' Compensation Expenses; Account; Reports.

  • 505.053. Certified Copies Of Division Documents.

  • 505.054. Preemployment Physical Required; Examining Physicians.

  • 505.055. Reports Of Injuries.

  • 505.056. Required Examination Of Injured Employee; Refusal To Submit To Examination.

  • 505.057. Refusal To Submit To Medical Treatment.

  • 505.058. Postponement Of Hearing.

  • 505.059. Notice Of Appeal; Notice Of Trial Court Judgment; Offense.

  • 505.060. Effect Of Sick Leave; Annual Leave.
  • Chapter 506. Payment Of Certain Judgments


  • 506.001. Late Payment Of Judgment By The State.

  • 506.002. Reimbursement From Non-treasury Funds.
  • Government Code Title 6. Public Officers and Employees Subtitle A. Provisions Generally Applicable to Public Officers and Employees Chapter 607. Benefits Relating to Certain Diseases and Illnesses

    Subchapter A. Contagious Diseases


  • Sec. 607.001. DEFINITION.

  • Sec. 607.002. REIMBURSEMENT.

  • Sec. 607.003. PHYSICIAN OF CHOICE.

  • Sec. 607.004. PREVENTATIVE IMMUNIZATIONS AND VACCINATIONS.
  • Subchapter B. Diseases or Illnesses Suffered by Firefighters, Peace Officers, and Emergency Medical Technicians


  • Sec. 607.051. DEFINITIONS.

  • Sec. 607.052. APPLICABILITY.

  • Sec. 607.053. IMMUNIZATION; SMALLPOX.

  • Sec. 607.054. TUBERCULOSIS OR OTHER RESPIRATORY ILLNESS.

  • Sec. 607.055. CANCER.

  • Sec. 607.056. ACUTE MYOCARDIAL INFARCTION OR STROKE.

  • Sec. 607.057. EFFECT OF PRESUMPTION.

  • Sec. 607.058. PRESUMPTION REBUTTABLE.

  • Sec. 607.059. PROHIBITED PAYMENT.
  • Subchapter C. Other Diseases or Illnesses Suffered by Firefighters and Emergency Medical Technicians


  • Sec. 607.101. DEFINITIONS.

  • Sec. 607.102. NOTIFICATION.




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