Workers' compensation disciplinary orders after 2019
Disciplinary orders before 2019: 2012 | 2013 | 2014 | 2015 | 2016 | 2017 | 2018
| Order number | Date issued | Subject | Action taken | Violation |
|---|---|---|---|---|
| 2910 | 12/17/2013 | Smith, Stephen L., D.O. | Must complete designated doctor training and pass the certification test in no more than three attempts; upon timely passing the designated doctor certification test, must participate in medical quality review monitoring review and pay $15,000 fine | Failed to comply with TDI-DWC decisions and orders; Designated doctor assessments of injured employees overturned by contested case hearings; Used inflammatory and inappropriate language in his designated doctor reports for injured employees; Designated doctor examination's diagnoses, evaluations, and impairment ratings were substantially different from those that Commissioner finds to be fair and reasonable; Did not address the issues as ordered by TDI-DWC in the form and manner prescribed; Misrepresented or omitted pertinent facts in his medical evaluations and narrative reports; Submitted a charge for health care that was not furnished; Failed to perform a complete physical examination for purpose of determining MMI and IR; Failed to timely file and/or accurately complete TDI-DWC forms, reports or records. |
| 2903 | 12/16/2013 | Alvarado, Hilario III, M.D. | Fined $2,000 | Refused to accept a TDI-DWC appointment to perform a subsequent designated doctor examination on one injured employee |
| 2901 | 12/16/2013 | Gonzales, Mary Anastasia M.D. | Fined $500; Must complete one-day designated doctor workshop | Failed to correctly apply AMA Guides; Failed to document adequately in one designated doctor examination |
| 2902 | 12/16/2013 | Jarolimek, Lubor Jan M.D. | Fined $1,000; Must complete a one-day designated doctor workshop | Failed to correctly apply the AMA Guides; ordered an unnecessary medical test; Failed to document an adequate narrative report <br /> <br /> |
| 2900 | 12/16/2013 | Sanders, Mark Seltzer M.D. | Permanently surrendered designated doctor certification and certification to assign maximum medical improvement and impairment ratings | Failed to comply with a TDI-DWC Order for Production; Ordered an unnecessary medical test as part of a designated doctor examination |
| 2865 | 11/22/2013 | Kaufman, James K., M.D. | Removed from the Texas Workers' Compensation system as a health care practitioner | Performed surgeries without demonstrable pathology or benefit to be derived from surgery |
| 2863 | 11/22/2013 | Kordestani, Rouzebeh K., M.D. | Voluntary and permanent surrender of designated doctor certification and certification to assign maximum medical improvement dates and impairment ratings | Failed to obtain TDI-DWC approval prior to changing location of a designated doctor examination; Failed to follow proper procedure to reschedule a designated doctor exam; Failed to comply with a DWC Order for Production; Failed to timely file and/or accurately complete TDI-DWC forms, reports or records |
| 2864 | 11/22/2013 | Plano Independent School District | Fined $2,500 | Improperly withheld funds from injured employee's salary |
| 2866 | 11/22/2013 | Strickland, Mark Joseph, D.C. | Fined $2,500 | Failed to maintain efficient utilization of medical care through documentation and record keeping; Provided improper, unreasonable or medically unnecessary treatment or services |
| 2848 | 11/19/2013 | Deiter, Cary Thomas D.C. | Fined $3,000; Must complete continuing education hours approved by TDI-DWC | Administered improper, unreasonable or medically unnecessary treatment or services |
| 2850 | 11/19/2013 | Stephenson, Jackie Dean M.D. | Removed from Texas Workers' Compensation system as a health care practitioner as of December 31, 2013 | Failed to provide health care reasonably required by nature of injury and needed to promote recovery; Failed to maintain an efficient utilization of health care through extensive and prolonged treatment without adequate documentation |
| 2845 | 11/8/2013 | Farmers Insurance Exchange | Fined $1,000 | Failed to provide on-site visit or other appropriate services to three policyholders with a premium greater than $25,000 within a 12 month period |
| 2834 | 11/5/2013 | Austin Total Healthcare | Fined $3,000 | Failed to respond to request for refund from an insurance carrier; Failed to timely comply with a TDI-DWC order |
| 2835 | 11/5/2013 | Griffith, David M., D.C. | Fined $3,000; Must complete continuing education hours approved by TDI-DWC | Failed to document subjective and objective functional improvement gains for injured worker |
| 2827 | 10/28/2013 | Alexander, Richard A., D.C. | Must complete continuing education hours approved by TDI-DWC | Administered improper or unreasonable treatment or services -- treatment plan did not enhance ability of injured employee to return to work |
| 2826 | 10/28/2013 | Cole, George M., D.O. | Fined $500; must complete designated doctor core competency workshop within 90 days | Failed to include required information in a designated doctor examination narrative report |
| 2828 | 10/28/2013 | Texas Automobile Dealers Self Insurers Group | Fined $1,000 | Failed to timely pay benefits to injured employee |
| 2825 | 10/28/2013 | The Insurance Company of the State of Pennsylvania | Fined $2,200 | Submitted inaccurate medical EDI records; Failed to timely pay and ordered benefit advance; failed to timely notify TDI-DWC of change in benefit type, termination of income benefits |
| 2796 | 10/3/2013 | Jensen, Jack Edward M.D. | Fined $2,000 | Failed to timely respond to two requests for letters of clarification |
| 2795 | 10/3/2013 | Williams, Clyde Marion M.D. | Nunc Pro Tunc Order | Corrects two clerical errors in Order No. 2105 regarding DWC forms filed and reduces fine |
| 2789 | 9/30/2013 | Adair Grain Company | Fined $500 | Failed to timely file and/or accurately complete TDI-DWC forms, reports or records |
| 2768 | 9/18/2013 | Vigilant Insurance Company | Fined $6,500 | Failed to submit accurate medical bill data to TDI-DWC |
| 2767 | 9/17/2013 | Dallas National Insurance Company | Fined $12,500 | Failed to timely pay income benefits and accrued interest to an injured employee according to a contested case hearing decision and order |
| 2766 | 9/17/2013 | Pacific Indemnity Company | Fined $17,500 | Failed to accurately report benefit data to TDI-DWC or accurately submit benefit data by electronic data interchange; Failed to timely pay income benefits to injured employee |
| 2746 | 9/12/2013 | MedRisk, Inc. | Fined $17,500 | Failed to remit full amount reimbursed by the insurance carrier to the health care provider |
| 2748 | 9/12/2013 | Retailers Casualty Insurance Company | Fined $9,000 | Failed to accurately report benefit data to TDI-DWC or accurately submit benefit data by electronic data interchange |
| 2747 | 9/12/2013 | Tarrant County College District | Fined $15,000 | Failed to accurately report benefit data to TDI-DWC or accurately submit benefit data by electronic data interchange |
| 2736 | 9/5/2013 | American Hallmark Insurance Company of Texas | Fined $6,000 | Failed to accurately submit medical records via electronic data interchange |
| 2735 | 9/5/2013 | Chadadeh, Hassan M.D. | Fined $5,000; Must complete physician assessment and clinical education course (PACE) | Failed to sufficiently document justification for prescriptions |
| 2730 | 8/30/2013 | AAA Cooper Transportation | Fined $5,000 | Failed to accurately report benefit data to TDI-DWC or accurately submit benefit data by electronic data interchange |
| 2724 | 8/28/2013 | Harlandale Independent School District | Fined $4,000 | Failed to timely comply with a TDI-DWC order |
| 2725 | 8/28/2013 | West Rest Haven, Inc. | Fined $1,000 | Failed to timely file and/or accurately complete TDI-DWC forms, reports, or records |
| 2720 | 8/26/2013 | Ebeade, Samir S., M.D. | Must cease designated doctor examinations at a specific location and must request the location for examinations be deleted from TDI-DWC system | Failed to use a properly equipped medical facility for designated doctor examinations |
| 2718 | 8/26/2013 | Kestler, Bryan Claude D.C. | Fined $1,000 | Failed to comply with Texas Workers' Compensation Act |
| 2709 | 8/23/2013 | Burke, Douglas William D.C. | Fined $5,000; Must complete continuing education course on following medical guidelines | Provided treatment not in accord with applicable treatment guidelines and not within the standard of care |
| 2710 | 8/23/2013 | East Texas Educational Insurance Association | Fined $2,000 | Failed to timely report medical electronic data interchange (EDI) records to TDI-DWC |
| 2708 | 8/23/2013 | El Paso County Hospital District | Fined $11,000 | Failed to accurately and timely submit electronic data interchange (EDI) records to TDI-DWC |
| 2707 | 8/23/2013 | Florists' Mutual Insurance Company | Fined $2,500 | Failed to accurately submit medical bill and payment data |
| 2682 | 8/2/2013 | ACIG Insurance Company | Fined $10,000 | Failed to timely pay income benefits to injured employee |
| 2680 | 8/2/2013 | Bangale, Anil T., M.D. | Fined $5,000 | Quality of health care provided not in compliance with statutory requirements; Failed to report a disciplinary action on Designated Doctor application |
| 2681 | 8/2/2013 | ORR, Inc. | Fined $1,000 | Failed to comply with Commissioner's Order to provide requested information about workers' compensation coverage status |
| 2678 | 7/30/2013 | GuideOne Mutual Insurance Company | Fined $10,000 | Failed to accurately report electronic data interchange (EDI) medical billing data to TDi-DWC |
| 2671 | 7/26/2013 | U.S. Toxicology L.L.C. | Fined $4,000 | Failed to comply with TDI-DWC order |
| 2672 | 7/26/2013 | Walmart Associates Inc. | Fined $4,000 | Failed to timely pay income benefits to injured employee |
| 2673 | 7/26/2013 | Walmart Associates Inc. | Fined $2,500 | Failed to timely file and/or accurately complete TDI-DWC forms, reports, or records |
| 2672 | 7/26/2013 | Walmart Associates, Inc. | Fined $4,000 | Failed to timely pay indemnity benefits |
| 2667 | 7/25/2013 | Labrock Materials, Inc. | Fined $5,000 | Failed to timely comply with Commissioner's Order to provide requested information about workers' compensation coverage status |
| 2665 | 7/25/2013 | Protective Insurance Company | Fined $30,000 | Failed to provide required claims experience and documentation of loss analysis to policyholders |
| 2666 | 7/25/2013 | Texas Mutual Insurance Company | Fined $6,500 | Failed to timely pay an advance ordered by TDI-DWC; Failed to timely provide injured employee records to designated doctor; Failed to accurately report benefit data to TDI-DWC or accurately submit benefit data by electronic data interchange |
| 2651 | 7/17/2013 | Amerisure Partners Insurance Company | Fined $13,500 | Failed to accurately submit medical bill and payment data to TDI-DWC |
| 2649 | 7/17/2013 | Bates, Aaron M.D. | Permanently cease from participating or practicing in Texas workers' compensation system | Failed to appropriately evaluate injured employee assigned |
| 2656 | 7/17/2013 | El Paso County Community College | Fined $6,000 | Failed to accurately submit medical bill and payment data to TDI-DWC |
| 2655 | 7/17/2013 | MacMaster, Benzel Christopher M.D. | Fined $2,000 | Failed to adequately document required information in a peer review report |
| 2652 | 7/17/2013 | Markel Insurance Company | Fined $4,500 | Failed to timely pay income benefits to injured employee; Failed to notify TDI-DWC and injured employee of actions taken on a claim |
| 2650 | 7/17/2013 | Tower National Insurance Company | Fined $10,000 | Failed to accurately submit medical bill and payment data to TDI-DWC |
| 2654 | 7/17/2013 | Wausau Underwriters Insurance Company | Fined $8,000 | Failed to timely comply with a TDI-DWC order; Failed to timely pay accrued income benefits following receipt of designated doctors report |
| 2653 | 7/17/2013 | Znat Insurance Company | Fined $11,500 | Failed to timely pay income benefits to injured employee; Failed to notify TDI-DWC and injured employee of actions taken on a claim |
| 2615 | 6/27/2013 | Desert Imaging Services L.P. | Fined $6,000 | Improperly billed an injured employee for workers' compensation services provided |
| 2598 | 6/17/2013 | Chubb Indemnity Insurance Company | Fined $7,000 | Failed to timely pay income benefits to injured employee |
| 2597 | 6/17/2013 | Employers Preferred Insurance Company | Fined $7,000 | Failed to timely pay income benefits to injured employee; Failed to notify TDI-DWC of action taken on a claim |
| 2558 | 6/3/2013 | Indemnity Insurance Company of North America | Fined $15,000 | Failed to comply with TDI-DWC rule and order; Failed to timely pay income benefits to injured employee; Failed to timely pay medical bill or to pay medical bill according to TDI-DWC Medical Fee Guidelines |
| 2559 | 6/3/2013 | Mussaji, Murtaza D. O. | Designated doctor reports to be monitored by TDI-DWC; Random sample of cases to be subject to medical quality review with fees to be paid by doctor | Failed to perform complete medical examination of injured employee; Failed to utilize guidelines for return to work; Failed to document analysis of injured worker to determine maximum medical improvement |
| 2557 | 6/3/2013 | Reichert, Oscar M., D.O. | Must timely complete specified training | Provided treatment which did not promote recovery and/or enhance the ability of injured employee to return to work in timely manner |
| 2551 | 5/28/2013 | Center for Injured Workers, Inc. | SOAH DOCKET No. 452-12-1463.C1. Fined $4,000. | As non-attorney representative, improperly received fee from workers' compensation claimant |
| 2532 | 5/21/2013 | Liberty Insurance Corporation | Fined $3,800 | Failed to timely pay income benefits to injured employee |
| 2513 | 5/10/2013 | Corley, Ronald G., M.D. | Must attend designated doctor training; Medical practice in workers' compensation system subject to medical quality review; Must pay costs of review | Failed to adequately document designated doctor examinations; Failed to timely file and/or accurately complete TDI-DWC forms, reports or records |
| 2512 | 5/10/2013 | Federal Insurance Company | Fined $6,000 | Failed to timely comply with a TDI-DWC order |
| 2514 | 5/10/2013 | Quest Diagnostics Inc. | Fined $4,000 | Improperly billed an injured employee for workers' compensation medical services provided |
| 2494 | 5/7/2013 | Buttons L.L.C. | Fined $1,000 | Failed to timely comply with a TDI-DWC order |
| 2492 | 5/7/2013 | Castlepoint National Insurance Company | Fined $1,000 | Failed to provide on-site visit or other appropriate service for policyholders |
| 2495 | 5/7/2013 | Meadowmere Emergency Physicians | Fined $2,500 | Improperly billed an injured employee for workers' compensation medical services provided |
| 2496 | 5/7/2013 | Texas Municipal League Intergovernmental Risk Pool | Fined $15,000 | Failed to accurately submit medical bill and payment data |
| 2493 | 5/7/2013 | Weiser Security Services, Inc. | Fined $2,500 | Failed to file wage statement with injured employee |
| 2482 | 5/3/2013 | St. David's Medical Center Austin | Fined $2,500 | Improperly billed an injured employee for workers' compensation services provided |
| 2474 | 4/29/2013 | Associated Indemnity Corporation | Fined $2,400 | Failed to accurately submit medical bill and payment data; Failed to timely pay medical bill or to pay medical bill according to TDI-DWC Medical Fee Guidelines |
| 2475 | 4/29/2013 | Vega, Oscar M.D. | Fined $4,000 | Improperly billed an injured employee for workers' compensation medical services provided |
| 2461 | 4/26/2013 | St. Luke's Episcopal Health System | Fined $3,500 | Improperly billed an injured employee for workers' compensation medical services provided |
| 2438 | 4/12/2013 | Chevron Corporation | Fined $2,000 | Failed to pay correct amount of Temporary Income Benefits to injured worker |
| 2439 | 4/12/2013 | Nguyen-Khoa, Kevin Quang D.P.M. | Must submit care of injured employees for Medical Quality Review and be subject to possible future enforcement action | Misrepresented or omitted pertinent facts in a medical evaluation and narrative report while serving as Designated Doctor |
| 2437 | 4/12/2013 | Poly America, L.P. | Fined $23,500 | Failed to timely pay medical bill or to pay medical bill according to TDI-DWC Medical Fee Guidelines; Failed to accurately submit medical bill and payment data |
| 2440 | 4/12/2013 | Roybal, Robert Edward M.D. | Must attend compliance training for doctors and medical office staff; Must undergo monitoring and review of randomly selected workers' compensation patients records | Failed to properly document and explain findings from examinations of injured employees |
| 2387 | 3/22/2013 | American Home Assurance Company | Fined $5,500 | Failed to timely pay medical bill; Failed to timely comply with a benefit dispute agreement |
| 2390 | 3/22/2013 | Arrowhead Hospital | Fined $2,000 | Improperly billed an injured employee for workers’ compensation medical services provided |
| 2386 | 3/22/2013 | Greater San Antonio Emergency Physicians | Fined $2,000 | Improperly billed an injured employee for workers' compensation medical services provided |
| 2389 | 3/22/2013 | Liberty Mutual Fire Insurance Company | Fined $7,000 | Failed to timely pay income benefits to injured employee |
| 2388 | 3/22/2013 | Standard Fire Insurance Company | $5,000 | Failed to timely pay income benefits to injured employee |
| 2391 | 3/22/2013 | TSC Staffing Solutions, Inc. | Fined $1,500 | Failed to comply with Commissioner's Order to provide requested information about workers' compensation coverage status |
| 2380 | 3/15/2013 | AMA Regal, Inc. | Fined $500 | Failed to comply with Commissioner's Order to provide requested information about workers' compensation coverage status |
| 2379 | 3/15/2013 | Renaissance SNF, L.L.C. | Fined $1,500 | Failed to comply with Commissioner's Order to provide requested information about workers' compensation coverage status |
| 2378 | 3/15/2013 | Wolinsky, Joel Scott M.D. | Fined $5,000 | Failed or refused to reply to TDI-DWC order to produce documents |
| 2322 | 2/28/2013 | Andrew, John Gray M.D. | Must complete assessment of practice to determine need for education plan. | Failed to meet requirements for performing and documenting examinations of injured workers to determine impairment ratings |
| 2318 | 2/28/2013 | Argonaut-Southwest Insurance Company | Fined $24,000 | Failed to timely pay medical bill or to pay medical bill according to TDI-DWC Medical Fee Guidelines; Failed to accurately submit medical bill and payment data |
| 2325 | 2/28/2013 | Clear Lake Regional Medical Center | Fined $2,500 | Improperly billed an injured employee for workers' compensation medical services provided |
| 2319 | 2/28/2013 | Douglas, Howard Thomas III, M.D. | Removed from designated doctor list | Performed designated doctor examination when not appointed by TDI-DWC <br />or by mutual agreement of the parties |
| 2326 | 2/28/2013 | Houston Independent School District | Fined $5,000 | Failed to timely pay income benefits to injured employee |
| 2320 | 2/28/2013 | Johnson, George Howell, Sr., D.O. | Designated doctor reports must be monitored by TDI-DWC for one year | Failed to meet requirements for performing and documenting examination of injured worker to determine maximum medical improvement |
| 2323 | 2/28/2013 | Kennedy, Charles W., Jr., M.D. | Must complete a medical record-keeping course and submit reports of designated doctor examinations to TDI-DWC for monitoring | Failed to adequately document medical evaluations and assign impairment ratings |
| 2324 | 2/28/2013 | Oberoi, Asra M.D. | Will not be assigned designated doctor examinations, MMI, or IR ratings examinations until new certification is approved | Failed to identify specific findings in impairment analysis and failed to recognize the statutory maximum medical improvement date |
| 2327 | 2/28/2013 | Philbrick, Darey Allen M.D. | Removed from Texas workers' compensation system as a health care practitioner | Medical license cancelled |
| 2321 | 2/28/2013 | Wiggins, Joe W., D.C. | Must complete AADEP course and submit reports of designated doctor examinations for monitoring after completion of AADEP course | Failed to adequately perform and complete reports for designated doctor examinations; Failed to perform or refer injured workers for appropriate testing |
| 2316 | 2/27/2013 | Fallon, Michael A., M.D. | Fined $6,000 | Failed to timely provide medical records of an injured employee after being ordered to produce them |
| 2314 | 2/27/2013 | Third Coast Fresh Distribution L.L.C. | Fined $500 | Failed to comply with Commissioner's Order to provide requested information about workers' compensation coverage status |
| 2315 | 2/27/2013 | Viesca, Carlos O., M.D. | Fined $6,000 | Failed to timely provide medical records of an injured employee after being ordered to produce them |
| 2310 | 2/22/2013 | Burnet 1 Enterprises L.L.C. D/B/A Oaks Nursing Center | Fined $600 | Failed to comply with Commissioner's Order to provide requested information about workers' compensation coverage status |
| 2301 | 2/20/2013 | American Home Assurance Company | Fined $2,000 | Inappropriately required preauthorization of prescription drugs on a non-network legacy claim |
| 2304 | 2/20/2013 | PF&B Management, GP L.L.C. | Fined $1,000 | Failed to comply with Commissioner's Order to provide requested information about workers' compensation coverage status |
| 2303 | 2/20/2013 | Ullico Casualty Company | Fined $55,000 | Failed to timely pay income benefits to injured employee; Failed to timely process medical bills; Failed to timely report benefit data toTDI-DWC or accurately submit benefit data by electronic data interchange; Failed to timely file DWC EDI-03 forms; Failed to pay for services that were preauthorized; Failed to timely process a preauthorization request; and Failed to timely file its accident prevention services annual report |
| 2241 | 1/30/2013 | Kirkwood, John Dale D.O. | Fined $4,000 | Failed to timely file and/or accurately complete TDI-DWC forms, reports or records |
| 2240 | 1/30/2013 | Lightner, Oscar N., M.D. | Fined $7,000 | Failed to timely file and/or accurately complete TDI-DWC forms, reports or records |
| 2231 | 1/25/2013 | Design Transportation Services Inc. | Fined $3,000 | Failed to comply with Commissioner's Order to provide requested information about workers' compensation coverage status |
| 2230 | 1/25/2013 | National Interstate Insurance Company | Fined $23,000 | Failed to timely pay or deny medical bills and to accurately and/or timely submit reports to TDI-DWC |
| 2201 | 1/18/2013 | American Zurich Insurance Company | Fined $4,000 | Failed to timely pay income benefits to injured employee; Failed to timely comply with a TDI-DWC order |
| 2200 | 1/18/2013 | Farmers Insurance Exchange | Fined $3,000 | Failed to provide on-site visit or other appropriate services at least every 12 months for policyholders |
| 2202 | 1/18/2013 | Federal Insurance Company | Fined $36,000 | Failed to timely pay income benefits to injured employee; Failed to accurately provide benefit payment and medical bill data |
| 2198 | 1/18/2013 | Mid-Century Insurance Company | Fined $14,360 | Failed to accurately submit medical bill data to TDI-DWC via electronic data interchange; Failed to provide on-site visit or other appropriate services for policyholders |
| 2199 | 1/18/2013 | Truck Insurance Exchange | Fined $13,120 | Failed to accurately submit medical bill data to TDI-DWC via electronic data interchange; Failed to provide on-site visit or other appropriate services for policyholders |
| 2186 | 1/11/2013 | Texas Automobile Dealers Self Insurers Group | Fined $15,000 | Failed to accurately submit medical bill and payment data to TDI-DWC |
| 2171 | 1/8/2013 | Shell US Hosting Company | Fined $2,500 | Failed to comply with Commissioner's Order to provide requested information about workers' compensation coverage status |
| 2170 | 1/8/2013 | Sonic Advantage P.A., L.P. | Fined $750 | Failed to comply with Commissioner's Order to provide requested information about workers' compensation coverage status |