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No. _ _ _ _ __
OFFICIAL ORDER
ofthe
TEXAS COMMISSIONER OF WORKERS' COMPENSATION
Date: JUL 9'7 2D14
Subject Considered:
ABIMAEL PEREZ, M.D.
2401 Morgan Ave., Suite 100
Corpus Christi, Texas 78405-1805
CONSENT ORDER
TDI ENFORCEMENT FILE NO. 1477
General remarks and official action taken:
The commissioner of workers' compensation considers whether disciplinary action
should be taken against Abimael Perez, M.D. (Dr. Perez).
WAIVER
Dr. Perez acknowledges that the Texas Labor Code and other applicable laws provide
certain rights. Dr. Perez waives all of these rights and any other applicable procedural
rights in consideration of the entry of this consent order.
FINDINGS OF FACT
The commissioner of workers' compensation makes the following fmdings of fact:
1. Dr. Perez is a health care provider that provides medical treatment to injured
employees in the Texas worker's compensation system.
2. Dr. Perez was granted a license by the Texas Medical Board on August 23, 1985.
Dr. Perez holds Texas Medical License Number 08745.
3. Dr. Perez was not selected to be tiered in 2007, 2009, 2011, or 2013 Performance
Based Oversight assessments.
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Medical Quality Review No. 10-SC-101
4. The division, as authorized by TEX. LAB. CODE ANN. § 414.002, monitors system
participants to determine compliance with the Texas Workers' Compensation Act
and rules promulgated by the commissioner of workers' compensation.
5. The division's Medical Advisor, whose duties are defined in TEX. LAB. CODE
ANN.§ 413.0511, and Medical Quality Review Panel (MQRP), as established
pursuant to TEX. LAB. CODE ANN.§ 413.0512, conducted a medical quality
review of one case where Dr. Perez treated one injured employee.
6. Dr. Perez treated the injured employee from November 2006 through December
2009 for a cervical strain diagnosis. In June 2007, the injured employee was also
referred to a physician that specialized in pain management.
7. Dr. Perez's office visits provided no meaningful treatment to improve function.
The visits were mainly for medication refills, prescribed for a condition prior to
this injury. Other health promoting modalities were not incorporated into the plan
of care.
8. Dr. Perez did not document in his medical records that there was functional
improvement over the three-year time span he was treating the injured employee.
9. Dr. Perez denies all the allegations set forth above but does not contest the entry
of this order. This consent order and its requirements are entered into in the
nature of compromise and settlement.
CONCLUSIONS OF LAW
The commissioner of workers' compensation makes the following conclusions of law:
1. The commissioner of workers' compensation has jurisdiction over this matter
pursuant to TEX. LAB. CODE ANN.§§ 402.001,402.00111,402.00114,402.00116,
402.00128, 408.025, 413.0511, 413.0512,414.002, 415.021, and 415.0215; 28
TEX. ADMIN. CODE§§ 180.22 and 180.26; and TEX. Gov'T CODE ANN.§§
2001.051-2001.178.
2. The commissioner of workers' compensation has authority to informally dispose
of this matter as set forth herein under TEX. Gov'T CODE ANN. § 2001.056, TEX.
LAB. CODE ANN.§§ 401.021, and 402.00128(b)(7), and 28 TEX. ADMIN. CODE
§ 180.26(h).
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Abimael Perez, M.D.; TDI Enforcement File No. 1477
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3. Pursuant to LAB. CODE ANN. § 415.0215 and 28 TEX. ADMIN. CODE§ 180.26, the
sanctions the commissioner may impose include depriving a person of the right to
practice before the division or of the right to receive remuneration under the Act.
4. Pursuant to 28 TEX. ADMIN. CODE§ 180.22(a), health care providers shall provide
reasonable and necessary health care that cures or relieves the effects naturally
resulting from the compensable injury; promotes recovery; and /or enhances the
ability of the employee to return to, or retain, employment.
5. Dr. Perez violated 28 TEX. ADMIN. CODE§ 180.22(a) when his documentation
failed to show that his treatment was providing functional improvement to
enhance the ability of the injured employee to return to work or retain
employment.
6. Pursuant to TEX. LAB. CODE ANN. § 408.025(c) and 28 TEX. ADMIN. CODE§
180.22(c), the treating doctor is the doctor primarily responsible for the efficient
management of health care and for coordinating the health care for an injured
employee's compensable injury. The treating doctor shall maintain efficient
utilization of health care.
7. Dr. Perez violated TEX. LAB. CODE ANN. § 408.025(c) and 28 TEX. ADMIN. CODE
§ 180.22(c) when he failed to maintain the efficient utilization in that his office
visits provided no meaningful treatment to improve function. The visits were
mainly just for medication. Other health promoting modalities were not
incorporated into the plan of care.
ORDER
It is ORDERED that from 90 days from the date of the entry of this order, Abimael
Perez, M.D. will no longer accept any new Texas workers' compensation patients and
will no longer participate in the Texas workers' compensation system, network, or non
network, as a health care provider. Therefore, and thereafter, he will no longer participate
in treating, examining, and/or consulting with other physicians regarding injured
employees who are covered under the Texas Workers' Compensation system.
Additionally, Dr. Perez must not receive direct or indirect remuneration from the Texas
workers' compensation system. This order does not a ply to emergency cases, as defined
28 TEX. ADMIN. CODE§ 133.2.
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Approved as to Fonn and Content:
Claudia Kirk
Staff Attorney, Compliance Division
Texas Department of Insurance
. ...
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AFFIDAVIT
STATEOF TotJlS §
§
COUNTY OF }'.! Llt! t. f'.5 §
Before me, the undersigned authority, personally appeared the affiant, who being by me
duly sworn, deposed as follows:
"My name is Abimael Perez, M.D., I am of sound mind, capable of making this
statement, and have personal knowledge of these facts which are true and correct.
I waive rights provided by the Texas Labor Code and other applicable law and
acknowledge the jurisdiction of the Texas commissioner of workers' compensation.
I voluntarily enter into this consent order and consent to the issuance and service of this
consent order."
Affiant
o~ 2014. ~
SWORN TO AND SUBSCRIBED before me
(NOTARYSEAL) u()Q· ~
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Signature of Notary Public
OliVIA. GARCIA
II'( COMMISSION EXPIRES
Dec:eldler 14, 0014 Printed Name of Notary Public
