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e v : R2 7 7 0 )8 f2 O= O= ( v3 v3 J O= Q 3 X >! " 7 7 V )8 < < < < O= : JOHN D. PRINGLE, P.C.
Attorney at Law
John D. Pringle Board Certified - Administrative Law Texas Board of Legal Specialization
THE VAUGHN BUILDING
807 BRAZOS, SUITE 200, AUSTIN, TEXAS 78701
TELEPHONE (512) 472-8742 FACSIMILE (512) 472-8745
WWW.PRINGLETEXASLAWYER.COM JOHN@PRINGLETEXASLAWYER.COM
March 4, 2013
Via Electronic Mail to rulecomments@tdi.texas.gov
Maria Jimenez
Texas Department of Insurance, Division of Workers Compensation
Workers Compensation Council MS-4D
7551 Metro Center Drive, Suite 100
Austin, Texas 78744-1645
Re: Proposed Rule 130.1
Dear Ms. Jimenez:
Please allow this letter to serve as my comments on proposed rule 130.1. Where possible, I have proposed changes in redline and strikeout. These proposed changes are best seen on a computer screen. However, a number of my comments do not involve changes in redline and strikeout.
Subsection (a)(1)(B)(i) conflicts with subsection (b)(2). Subsection (a)(1)(B)(i) should be revised as follows:
SEQ CHAPTER \h \r 1On or after September 1, 2003, a doctor serving in one of the roles described in subsection (a)(1)(A) of this section is authorized as follows:
a doctor whom the division has certified to assign impairment ratings or otherwise given specific permission by exception to, is authorized to determine whether an injured employee is at MMI, has permanent impairment, certify MMI, and assign an impairment rating, and certify MMI; and
SEQ CHAPTER \h \r 1Courts construe administrative rules, which have the same force as statutes, in the same manner as statutes. Rodriguez v. Service Lloyds Ins. Co., 997 S.W.2d 248, 254 (Tex. 1999) citing Lewis v. Jacksonville Bldg. & Loan Ass'n, 540 S.W.2d 307, 310 (Tex. 1976) SEQ CHAPTER \h \r 1A statute which forbids or requires the doing of an act in terms so vague that men of common intelligence must necessarily guess at its meaning and differ as to it application violates the first essential protection of due process of law. Baker v. State, 50 S.W.3d 143, 145 (Tex. App. Eastland 2001, pet. refd) citing Connally v. General Const. Co., 269 U.S. 385, 46 S. Ct. 126, 70 L. Ed. 322 (1926).
Subsection (a)(3) is confusing. Subsection (a)(3)should be revised as follows:
Letter Maria Jimenez
March 4, 2013
Page -2-
A doctor who is authorized under this subsection to certify MMI, determine whether permanent impairment exists, and assign an impairment rating and who does in a particular claim, shall be referred to as the "certifying doctor." for that claim.
Subsection (b)(1)(A) is vague and confusing. Subsection (b)(1)(A) should be revised as follows:
the earliest date after which, in the opinion of a certifying doctor based on reasonable medical probability, further material recovery from or lasting improvement to an injury can no longer reasonably be anticipated;
Subsection (b)(2) conflicts with Labor Code sections 408.122 and 408.123. [ SEQ CHAPTER \h \r 1A]n agency cannot adopt rules that are inconsistent with a statute". Havner v. Meno, 867 S.W. 2d 130, 134 (Tex. App. - Austin 1993, no writ) citing Railroad Comm'n v. Lone Star Gas Co., 844 S.W. 2d 679, 685 (Tex. 1992). Likewise SEQ CHAPTER \h \r 1an agency may not exercise what is effectively a new power, or a power contrary to a statute, on the theory that such exercise is expedient for the agency's purpose, City of Austin v. Southwestern Bell Tel. Co., 92 S.W.3d 434, 441 (Tex. 2002), nor may it contravene specific statutory language, run counter to the general objectives of the statute, or impose additional burdens, conditions, or restrictions in excess of or inconsistent with the relevant statutory provisions. State v. Public Util. Comm'n of Tex., 131 S.W.3d 314, 321 (Tex. App.--Austin 2004, pet. denied). In the alternative, subsection (b)(2) is confusing.
Subsection (b)(2) should be revised as follows:
MMI must be certified before an impairment rating is assigned and the impairment rating must be assigned for the injured employees condition on the a date of MMI. An impairment rating is invalid if it is based on the injured employees condition on a date that is not the an MMI date. An impairment rating and the corresponding a MMI date must be included in the Report of Medical Evaluation to be valid.
Subsection (b)(4) is vague and confusing. Subsection (b)(4) should be revised as follows:
To certify MMI the a certifying doctor shall:
Subsection (c)(1), (2) and (3) conflict with Labor Code section 408.011(24). The statutory definition of impairment rating does not contain the word current. The word current should be deleted from the rule.
Subsection (c)(3) is also vague and confusing. Subsection (c)(3) should be revised as follows:
Letter Maria Jimenez
March 4, 2013
Page -3-
Assignment of an impairment rating for the current compensable injury shall be based on the injured employee's condition on [as of] the a MMI date considering the medical record and the certifying examination. An impairment rating is invalid if it is based on the injured employees condition on a date that is not the an MMI date. An impairment rating and the corresponding an MMI date must be included in the Report of Medical Evaluation to be valid. The doctor assigning the impairment rating shall:
Subsection (c)(4) is also vague and confusing. Subsection (c)(4) should be revised as follows:
After September 1, 2003, if range of motion, sensory, and strength testing required by the AMA Guides is not performed by the a certifying doctor, the testing shall be performed by a health care practitioner, who within the two years prior to the date the injured employee is evaluated, has had the impairment rating training module required by 180.23 (relating to Commission Division Required Training for Doctors/Certification Levels) for a doctor to be certified to assign impairment ratings. It is the responsibility of the certifying doctor who made the referral for additional testing to ensure the requirements of this subsection are complied with.
Subsection (d)(1) conflicts with Labor Code section 408.011(24). The statutory definition of impairment rating does not contain the word current. The word current should be deleted from the rule.
Subsection (d)(1)(A) is also vague and confusing. Subsection (d)(1)(A) should be revised as follows:
The Report of Medical Evaluation must be signed by the certifying doctor who conducted the evaluation. The certifying doctor may use a rubber stamp signature or an electronic facsimile signature of the certifying doctor's personal signature.
A new subsection (d)(4) should be adopted by the Division to clarify who can file the Report of Medical Evaluation and avoid confusion among Division staff, treating doctors, designated doctors, employers and service agents. Subsection (d)(4) should be adopted as follows:
Anyone may file the Report of Medical Evaluation and narrative report pursuant to subsection (d)(2) of this rule.
Subsection (e) conflicts with other agency rules. Subsection (e) is also vague and confusing. Subsection (e) should revised as follows:
Documentation. The A certifying doctor, his agent or employer shall maintain the original copy of the certifying doctors Report of Medical Evaluation and narrative report as well as documentation in the narrative report of:
Letter Maria Jimenez
March 4, 2013
Page -4-
(1) the date of the examination;
(2) the date any medical records if necessary to make the certification of MMI were received by the certifying doctor, and from whom the medical records were received; and
(3) the date, addressees, and means of delivery that reports required under this section were electronically or facsimile transmitted or mailed by the certifying doctor, his agent or employer.
Please let me know if you have any questions regarding the above comments or wish to discuss them.
Respectfully,
John D. Pringle
JDP/
cc: Steve Nichols Via Electronic Delivery
Insurance Council of Texas
2801 South IH 35
Austin, Texas 78741
Bill Kidd Via Electronic Delivery
Work Comp Central
Austin, Texas
f:\jdp\TWCC\comments to proposed rule 130.1 3-4-13
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