Rulebook Supplements - Update Your Rulebook

DISCLAIMER: The following adopted rules are provided as a courtesy by the Division of Workers' Compensation (DWC). While DWC makes every effort to ensure the accuracy and completeness of this information, the official version of proposed and adopted rules are those filed with the Secretary of State, which is the repository of official DWC rules. Those rules can be accessed directly from the Texas Register, Office of Secretary of State. ( http://www.sos.state.tx.us/texreg/index.shtml ) With respect to the following documents, or other documents available from this site or others to which it links, DWC and the State of Texas make no warranty as to their accuracy, completeness, reliability, timeliness, and/or usefulness.

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RELATED: How to Update Your Rulebook | History of Rules Adopted Prior to 2007 | Revised Rulebook of Contents (Instructions for Update: Replace Entire Table of Contents)

**Supplement 2012-01**
Chapter	Rules Affected by Change	Effective Date	Remove	Insert
TOC	Table of Contents	n/a	Entire table of contents	Entire table of contents
180	Monitoring and Enforcement Subchapter A - General Rules For Enforcement §180.1 Definitions §180.3 Compliance Audits §180.4 On-Site Visits - NEW §180.5 Access to Workers’ Compensation Related Records and Information §180.8 Notices of Violation; Notices of Hearing; Default Judgments §180.9 Proposals for Decision - NEW §180.10 Ex Parte Emergency Cease and Desist Orders – NEW Subchapter B - Medical Benefit Regulation §180.27 Restoration	2/14/2012 - Amended: §§180.1, 180.3, 180.5, 180.8, 180.27 New §§180.4, 180.9 and 180.10	Entire chapter	Entire chapter

**Supplement 2012-01**
Chapter	Rules Affected by Change	Effective Date	Remove	Insert
TOC	Table of Contents	n/a	Entire table of contents	Entire table of contents
126	General Provisions Applicable to All Benefits §126.15 Procedures for Resolution of Underpayments of Income Benefits §126.16. Procedures for Recouping Overpayments of Income Benefits.	1/1/2012 - New §126.15 and §126.16	Entire chapter	Entire chapter
128	Benefits--Calculation of Average Weekly Wage §128.1 Average Weekly Wage: General Provisions	1/1/2012 - Amended §128.1	Entire chapter	Entire chapter

**Supplement 2011-05**
Chapter	Rules Affected by Change	Effective Date	Remove	Insert
TOC	Table of Contents	n/a	Entire table of contents	Entire table of contents
141	Dispute Resolution--Benefit Review Conference §141.2 Canceling or Rescheduling a Benefit Review Conference §141.3 Failure to Attend a Benefit Review Conference	11/20/2011 - Amended §141.2 and §141.3	Entire chapter	Entire chapter
143	Dispute Resolution Review by the Appeals Panel §143.2 Description of the Appeal Proceeding	11/20/2011 - Amended §143.2	Entire chapter	Entire chapter

**Supplement 2011-04**
Chapter	Rules Affected by Change	Effective Date	Remove	Insert
TOC	Table of Contents	n/a	Entire table of contents	Entire table of contents
134	Benefits--Guidelines for Medical Services, Charges, and Payments Subchapter F -Pharmaceutical Benefits §134.503 Pharmacy Fee Guideline §134.504 Pharmaceutical Expenses Incurred by the Injured Employee	10/23/2011 - Amend §134.503 and §134.504	Entire chapter	Entire chapter

**Supplement 2011-03**
Chapter	Rules Affected by Change	Effective Date	Remove	Insert
TOC	Table of Contents	n/a	Entire table of contents	Entire table of contents
133	General Medical Provisions §133.306	9/1/2011 - Amend §133.306	Entire chapter	Entire chapter
134	Benefits--Guidelines for Medical Services, Charges, and Payments Subchapter I - Medical Bill Reporting §134.800 Applicability §134.801 Purpose §134.802 Definitions §134.803 Reporting Standards §134.804 Reporting Requirements §134.805 Records Required to be Reported §134.806 Records Excluded from Reporting §134.807 State Specific Requirements §134.808 Insurance Carrier EDI Compliance Coordinator and Trading Partners	9/1/2011 - Amend §134.802 New §§134.801, and 134.803 - 134.808	Entire chapter	Entire chapter
137	Disability Management Subchapter - A General Provisions §137.5 Case Manager Certification	9/1/2011 - New §137.5	Entire chapter	Entire chapter

**Supplement 2011-02**
Chapter	Rules Affected by Change	Effective Date	Remove	Insert
TOC	Table of Contents	n/a	Entire table of contents	Entire table of contents
133	General Medical Provisions §133.10 Required Billing Forms/Formats §133.500 Electronic Formats for Electronic Medical Bill Processing §133.501 Electronic Medical Bill Processing §133.502 Electronic Medical Billing Supplemental Data Requirements	8/1/2011 - Amend §§133.10, 133.500, and 133.501 New §133.502	Entire chapter	Entire chapter

**Supplement 2011-01**
Chapter	Rules Affected by Change	Effective Date	Remove	Insert
TOC	Table of Contents	n/a	Entire table of contents	Entire table of contents
134	Benefits--Guidelines for Medical Services, Charges, and Payments Subchapter F - Pharmaceutical §134.503 Reimbursement Methodology - Emergency rule effective 1/1/2011	1/1/2011 - Emergency	Entire chapter	Entire chapter
134	Benefits--Guidelines for Medical Services, Charges, and Payments Subchapter F - Pharmaceutical Benefits §134.500 Definitions §134.502 Pharmaceutical Services §134.506 Outpatient Open Formulary for Claims with Dates of Injury Prior to September 1, 2011 §134.510 Transition to the Use of the Closed Formulary for Claims with Dates of Injury Prior to September 1, 2011 §134.520 Outpatient Closed Formulary for Dates of Injury On or After September 1, 2011 §134.530 Requirements for Use of the Closed Formulary for Claims Not Subject to Certified Networks §134.540 Requirements for Use of the Closed Formulary for Claims Subject to Certified Networks §134.550 Medical Interlocutory Order	1/17/2011 - Amended: §134.500 and §134.502 New: §§134.506 - 134.550	N/A – included in the update for §134.503	N/A – included in the update for §134.503
180	Monitoring and Enforcement Subchapter A- General Rules for Enforcement §180.1 Definitions §180.2 Filing a Complaint §180.3 Compliance Audits §180.5 Access to Workers' Compensation Related Records §180.8 Notices of Violation; Notices of Hearing; Default Judgments Subchapter B - Medical Benefit Regulation §180.21 Division Designated Doctor List §180.22 Health Care Provider Roles and Responsibilities §180.23 Commission Required Training for Doctors/Certification Levels §180.24 Financial Disclosure §180.25 Improper Inducements, Influence and Threats §180.26 Criteria for Imposing, Recommending and Determining Sanctions; Other Remedies §180.27 Sanctions Process/Appeals/Restoration §180.28 Peer Review Requirements, Reporting, and Sanctions §180.50 Severability	1/9/2011 - Amended: §§180.1 - 180.3, 180.8, 180.22, 180.24, 180.25, 180.27 and 180.28 New: §180.26 and §180.50 Repeal: §§180.6, 180.7, 180.10 - 180.18, 180.20 and 180.26	Entire chapter	Entire chapter
127	Designated Doctor Procedures and Requirements Subchapter A - Designated Doctor Scheduling And Examinations §127.1 Requesting Designated Doctor Examinations §127.5 Scheduling Designated Doctor Appointments §127.10 General Procedures for Designated Doctor Examinations §127.15 Undue Influence on a Designated Doctor §127.20 Requesting a Letter of Clarification Regarding Designated Doctor Reports §127.25 Failure to Attend a Designated Doctor Examination	2/1/2011 – New chapter	Entire chapter	Entire chapter
126	General Provisions Applicable to All Benefits §126.1 Definitions Applicable to All Benefits §126.2 Payment of Benefits to Minors §126.3 Payment of Benefits to Legally Incompetent Persons §126.4 Advance of Benefits Based on Financial Hardship §126.5 Entitlement and Procedure for Requesting Required Medical Examinations §126.6 Required Medical Examination §126.8 Commission Approved Doctor List §126.9 Choice of Treating Doctor and Liability for Payment §126.11 Extension of the Date of Maximum Medical Improvement for Spinal Surgery §126.12 Payment of Interest on Accrued but Unpaid Income Benefits §126.13 Employer Initiation of Benefits and Reimbursement §126.14 Treating Doctor Examination to Define the Compensable Injury	2/1/2011 – Repeal: §126.7	Entire chapter	Entire chapter
136	Benefits--Vocational Rehabilitation §136.1 Review of Employer Report of Injury §136.2 Registry of Private Providers of Vocational Rehabilitation Services	2/3/2011 - Amended chapter

**Supplement 2010-02**
Chapter	Rules Affected by Change	Effective Date	Remove	Insert
TOC	Table of Contents	n/a	Pages 9 and 10	Pages 9 and 10
141	Dispute Resolution--Benefit Review Conference §141.1. Requesting and Setting a Benefit Review Conference. §141.2. Canceling or Rescheduling a Benefit Review Conference. §141.4. Sending and Exchanging Pertinent Information. §141.7. Division Actions After a Benefit Review Conference.	October 1, 2010 Amended	Remove Pages 1-4	Insert Pages 1-6

**Supplement 2010-01**
Chapter	Rules Affected by Change	Effective Date	Remove	Insert
TOC	Table of Contents	n/a	Entire table of contents	Entire table of contents
116	Subsequent Injury Fund §116.11. Request for Reimbursement from the Subsequent Injury Fund §116.12. Subsequent Injury Fund Payment/Reimbursement Schedule	January 07, 2010 Amended	Remove Entire Chapter	Insert Entire Chapter
120	Chapter 120 Compensation Procedures - Employers §120.1. Employer's Record of Injuries §120.2. Employer's First Report of Injury and Notice of Injured Employee Rights and Responsibilities §120.3. Employer's Supplemental Report of Injury §120.4. Employer's Wage Statement	March 22, 2010 Amended Rules §120.2.	Remove Pages 1-6	Insert Pages 1-6
122	Chapter 122 Compensation Procedures - Claimants, Subchapter A, Claims Procedure for Injured Employees §122.100. Claim for Death Benefits	March 22, 2010 Amended Rule §122.100.	Remove Pages 7-8	Insert Insert Pages 7-8
132	Chapter 132 Death Benefits - Death and Burial Benefits §132.6. Eligibility of Other Surviving Dependents and Eligible Parents to Receive Death Benefits §132.11. Distribution of Death Benefits	March 21, 2010 Amended Rules §132.6. & §132.11.	Pages 1-13	Insert Pages 1-14
137	Chapter 137 Disability Management, Subchapter B. Return to Work §137.10. Return to Work Guidelines §137.41. Purpose §137.42. Definitions §137.43. Return-to-Work Account Administrator §137.44. Return-to-Work Account for Small Employers §137.45. Employer Eligibility for Disbursements from the Return-to-Work Reimbursement Program §137.46. Application for Funds from the Return-to-Work Reimbursement Program §137.47. Criteria for Return-to-Work Reimbursement Program Applications §137.48. Return-to-Work Reimbursement Program Administrator Determinations §137.49. Optional Preauthorization Plan §137.50. Optional Advance of Funds Plan §137.51. Monitoring and Enforcement	April 25, 2010 Amended Rules New: §§137.50. & 137.51.	Remove Pages 3-10	Insert Pages 3-10
143	Chapter 143 Dispute Resolution - Review by the Appeals Panel §143.1. Definitions §143.2. Description of the Appeal Proceeding §143.3. Requesting the Appeals Panel to Review the Decision of the Hearing Officer §143.4. Responding to a Request for Review by the Appeals Panel §143.5. Decision of the Appeals Panel	December 13, 2009 Amended Rules §143.2, §143.3, §143.4 & §143.5	Remove Entire Chapter	Insert Entire Chapter
164	Chapter 164 Hazardous Employer Program §164.1 Criteria for Identifying Hazardous Employer §164.2. Notice to Hazardous Employers §164.3 Safety Consultation for Public Employers §164.4 Formulation of Accident Prevention Plan for Public Employers §164.5. Follow-up Inspection for Public Employers by the Division§164.6. Report of Follow-up Inspection, Public Employers §164.7. Removal of Public Employers from Hazardous Employer Status §164.8. Continuation of Hazardous Employer Status, Public Employers §164.9. Approval of Professional Sources for Saftey Consulations §164.10. Removal from List of Approved Professional Sources §164.11. Request for Safety Consulation from the Division §164.12. Reimbursement of Division for Services Provided to Hazardous Employer §164.14. Values Assigned for Computation of Hazardous Employer Identification §164.15. Administrative Reviews and Hearings Regarding Identification as a Hazardous Employer §164.16. Removal of Private Employers from Hazardous Employer Status §164.17. Availability of OSHCON Services §164.18. Severability	October 29, 2009 REPEAL	Remove Entire Chapter
169	Chapter 169 Workers' Health and Safety - Drug Free Workplace Program §169.1. Notification of Drug Abuse Policy §169.2. Required Elements of Drug Abuse Policy	October 29, 2009 REPEAL	Remove Entire Chapter

**Supplement 2009-03**
Chapter	Rules Affected by Change	Effective Date	Remove	Insert
150	Representation of Parties Before the Agency Qualifications of Representatives §150.1 Mnimum Standards of Practice for an Attorney §150.2. Qualification and Authorization of Attorney To Practice Before the Commission §150.3. Representatives: Written Authorization Required	Corrections only	Entire old chapter	Entire new chapter
152	Attorneys' Fees §152.1 Attorney Fees: General Provisions §152.2. Attorney Fees: Representation of Claimants §152.3. Approval or Denial of Fee by the Commission §152.4. Guidelines for Legal Services Provided to Claimants and Carriers §152.5. Allowable Expenses	Corrections only	Entire old chapter	Entire new chapter

**Supplement 2009-02**
Chapter	Rules Affected by Change	Effective Date	Remove	Insert
TOC	Table of Contents	JULY 1, 2009	Pages 5 and 6	Pages 5 and 6
130	Impairment and Supplemental Income Benefits SUBCHAPTER B – Supplemental Income Benefits – Amended §130.101. Definitions (Amended) §130.102. Eligibility for Supplemental Income Benefits; Amount §130.103. Determination of Entitlement or Non-entitlement for the First Quarter §130.104. Determination of Entitlement or Non-entitlement for Subsequent Quarters §130.105. Failure to Timely File Application for Supplemental Income Benefits; Subsequent Quarters §130.106. Loss of Entitlement to Supplemental Income Benefits §130.107. Payment of Supplemental Income Benefits §130.108. Contesting Entitlement or Amount of Supplemental Income Benefits; Attorney Fees §130.109. Reinstatement of Entitlement If Discharged with Intent To Deprive of Supplemental Income Benefits	JULY 1, 2009	Pages 15 - 24	Pages 15 - 24

**Supplement 2009-01**
Chapter	Rules Affected by Change	Effective Date	Remove	Insert
TOC	Table of Contents	n/a	Entire table of contents	Entire table of contents
133	General Medical Provisions SUBCHAPTER B –Health Care Provider Billing Procedures §133.20. Medical Bill Submission by Health Care Provider (Amended)	01/29/09 Amended	Pages 7, 8, 9 and 10	Pages 7, 8, 9 and 10

**Supplement 2008-05**
Chapter	Rules Affected by Change	Effective Date	Remove	Insert
TOC	Table of Contents	n/a	Replace entire table of contents	Replace entire table of contents
122	Compensation Procedure -- Claimants SUBCHAPTER B – Claims Procedure for Beneficiaries of Injured Employees §122.100. Claim for Death Benefits (Amended)	10/12/08 Amended	Page 7, 8	Page 7, 8
132	Death Benefits – Death and Burial Benefits §132.6. Eligibility of Other Surviving Dependents and Eligible Parents to Receive Death Benefits §132.9. Duration of Death Benefits for an Eligible Grandchild, Eligible Dependent, and Eligible Parent §132.11. Distribution of Death Benefits	10/12/08 Amended	Entire old chapter	Entire new chapter
134	Benefits – Guidelines for Medical Services, Charges and Payments SUBCHAPTER E. Health Facility Fees §134.402. Ambulatory Surgical Center Fee Guideline	8/31/08 Amended	Pages 31-40	Pages 31-40
140	Dispute Resolution – General Provisions §140.6. Subclaimant Status: Establishment, Right, and Procedures §140.7. Health Care Insurer Reimbursement under Labor Code §409.0091 §140.8. Procedures for Health Care Insurers to Pursue Reimbursement of Medical Benefits under Labor Code §409.0091	9/23/08 New	Page 3	Pages 3-8

**Supplement 2008-04**
Chapter	Rules Affected by Change	Effective Date	Remove	Insert
TOC	Table of Contents	n/a	Entire table of contents	Entire table of contents
133	General Medical Provisions SUBCHAPTER A – General Rules for Medical Billing and Processing §133.2. Definitions (Amended) (effective date in the history was incorrect)	07/27/08 - Amended	Page 1, 2	Page 1, 2

**Supplement 2008-03**
Chapter	Rules Affected by Change	Effective Date	Remove	Insert
TOC	Table of Contents	n/a	Entire table of contents	Entire table of contents
134	Benefits—Guidelines for Medical Services, Charges, and Payments Subchapter E-Health Facility Fees §134.401 – Acute Care Inpatient Hospital Fee Guideline	07/13/08 – REPEAL	Pages 31 - 58	Replace w/ pages 31 - 56
133	General Medical Provisions Subchapter A – General Rules for Medical Billing and Processing §133.2. Definitions (Amended)	07/27/08 - Amended	Entire Old Chapter	Entire New Chapter
	§133.4. Written Notification to Health Care Providers of Contractual Agreements for Informal and Voluntary Networks (New)	07/27/08 – New
	§133.5. Informal Network and Voluntary Network Reporting Requirements to the Division (New)	07/27/08 - New

**Supplement 2008-02**
Chapter	Rules Affected by Change	Effective Date	Remove	Insert
TOC	Table of Contents	n/a	Entire table of contents	Entire table of contents
141	Dispute Resolution – Benefit Review Conference \|§141.6 – Requesting Interlocutory Orders	3/17/08 – REPEAL	Entire Old Chapter	Entire New Chapter
133	General Medical Provisions Subchapter B – Health Care Provider Billing Procedures §133.10 – Required Billing Forms/Formats	5/01/08 - amended	Old pages 3 through 6	New pages 3 through 6
133	SUBCHAPTER D – Dispute of Medical Bills §133.305 – MDR – General §133.307 – MDR of Fee Disputes §133.308 – MDR by Independent Organizations	5/25/08 - amended	Old pages 17 through 40	New pages 17 through 40

**Supplement 2008-01**
Chapter	Rules Affected by Change	Effective Date	Remove	Insert
TOC	Table of Contents	n/a	Entire table of contents	Entire table of contents
137	Disability Management SUBCHAPTER B - Return-to-Work §137.41 Purpose §137.49 Optional Preauthorization Plan	02/07/08 - amended 02/07/08 - New	Old pages 3 & 4 Old pages 7 & 8	New pages 3 & 4 New pages 7 & 8

**Supplement 2007-02**
Chapter	Rules Affected by Change	Effective Date	Remove	Insert
TOC	TABLE OF CONTENTS	n/a	Entire table of contents	Entire table of contents
125	Education and Traning of Ombudsman (Transferred to OIEC) §125.1 Definitions §125.2 Ombudsman Training Program / Continuing Education §125.3 Private Meetings with Unrepresented Claimants	03/01/06	Entire Old Chapter	No Replacement
137	Disability Management Subchapter D. Treatment Planning (Repealed) §137.300 Required Treatment Planning	09/30/07 Repeal	Subchapter D	No Replacement
120	Compensation Procedures - Employers (Amended) §120.2 Employer's First Report of Injury and Notice of Injured Employee Rights and Responsibilities	10/14/07 Amended	Entire Old Chapter	Entire New Chapter
131	Benefits -- Lifetime Income Benefits (Repealed) §131.1 Initiation of Lifetime Income Benefits	01/09/08 Repeal	Entire Old Chapter	Entire New Chapter
180	Monitoring And Enforcement Subchapter A - General Rules For Enforcement (New Section) §180.19 Incentives	01/16/08 New	Entire Old Chapter	Entire New Chapter
134	Benefits -- Guidelines for Medical Services, Charges and Payments Subchapter G - Prospective and Concurrent Review of Health Care (Repealed) §134.650 Prospective Review of Medical Care Not Requiring Preauthorization (Effective 01/09/08 - Repeal)(Amended) Subchapter E - Health Facility Fees §134.402 Ambulatory Surgical Center Fee Guideline (Effective 12/30/07 - Amended)(New and Amended) Subchapter A - Medical Reimbursement Policies §134.1 Medical Reimbursement (amended) (Effective 03/01/08 Amended)§134.2 Incentive Payments for Workers' Compensation Underserved Areas (new) (Effective 03/01/08 New) Subchapter C - Medical Fee Guidelines §134.203 Medical Fee Guideline for Professional Services (new) (Effective 03/01/08 New)§134.204 Medical Fee Guideline for Workers' Compensation Specific Services (new) (Effective 03/01/08 New) Subchapter E - Health Facility Fees §134.403 Hospital Facility Fee Guideline -- Outpatient (new) (Effective 03/01/08 New )§134.404 Hospital Facility Fee Guideline -- Inpatient (new) (Effective 03/01/08 New)	listed previously with each section	Entire Old Chapter	Entire New Chapter

**Supplement 2007-01**
Chapter	Rules Affected by Change	Effective Date	Remove	Insert
TOC	Table of Contents	n/a	Entire Table of Contents	Entire Table of Contents
137	Disability Management Chapter 137 - Return to Work Subchapter A - General Provisions §137.1 Disability Management Concept Subchapter B - Return-to-Work §137.10 Return to Work Guidelines Subchapter C - Treatment Guidelines §137.100 Treatment Guidelines Subchapter D - Treatment Planning §137.300 Required Treatment Planning	01/18/07 - New	Entire old chapter	Entire new chapter

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Last updated: 02/15/2012

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