Under the Texas Workers’ Compensation Act, compensation for temporary disability ends when a claimant is certified to have reached maximum medical improvement, and compensation for any permanent damage resulting from the injury commences.
The certification of maximum medical improvement and impairment rating therefore often have significant financial consequences for claimants and insurance carriers alike. Presumably therefore to promote efficient resolution of disputes surrounding these issues, for much of the life of the 1989 Act there has been in effect a provision allowing 90 days to dispute such certifications. This loophole can allow parties to succeed at obtaining impairment income benefits, or denying temporary income, impairment income, and supplemental income benefits without really even trying to succeed on the merits. As this provision originated in an administrative rule rather than the statute, it is still colloquially referred to as the “90 day rule,” despite its addition to the statute many years back.
Readers wishing to familiarize themselves with the history of the framework prior to the statutory amendment may consult the case which overturned the administrative rule, Fulton vs. Associated Indemnity Corp. (Tex.App.—Austin 2001, pet. denied).
The current statutory and rule-based construction of the 90 day provision requires any party to dispute the first valid certification of maximum medical improvement and impairment rating within 90 days of delivery by verifiable means, with few exceptions.
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