General Information
Web-enabled Attorney Fee Processing System (WAFPS) is a web-based application that allows attorneys to submit online requests for approval of claim-related services rendered. The initial portion of WAFPS is accessed sequentially. You must Logon before progressing to Verify Logon, and Verify Logon before progressing to Attorney Rate/Data, and so on through Claim Data.
After Claim Data is selected, you cannot make any changes, corrections, insertions or deletions to the Attorney/Rate Data provided. If changes are desired, you must logoff and start over or complete the current transaction and submit an additional transaction.
Once Claim Data has been completed, you may select either Service Detail or Expense Detail to continue your submission.
Claim Data, Service Detail, Expense Detail, and Justification may be modified at any time prior to submission. You will be provided with a summary of your request to review prior to submission, to allow you to ensure that all information is correct. Once you have submitted your request, you will given a complete summary of all detail, which you can print using your browser's print function.
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Justification
Implementation of our automated attorney fee processing system on September 1, 1994, will not accommodate consideration of line item text or billing statements in the review/approval process. If the services provided require additional detail or clarification to justify payment, justification should be in the form of a summary paragraph titled "Justification Text". Please provide "Justification Text" in the summary paragraph provided. There is a limit of 5040 characters for Justification. Please be concise and to the point.
Rule 152.4 Guidelines for Legal Services Provided to Claimants and Carriers
(a) The guidelines outlined in this rule shall be considered by the commission along with the factors, and maximum fee limitations, set forth in the Texas Labor Code, §408.221 and §408.222 and applicable rules.
(b) An attorney may request, and the commission may approve, a number of hours greater than those allowed by these guidelines, if the attorney demonstrates to the satisfaction of the commission that the higher fee was justified based on the Texas Labor Code, §408.221 and §408.222.
(c) The guidelines for legal services provided to claimants and carriers are as follows:
- Initial interview and research 1.0
- Setting up file; completing and filing forms
0.5
- Communications per month (with client, health
care providers, other persons involved in the case) 2.5
- Direct dispute resolution negotiation with the
other party (per month) 3.05.
- Preparation and submission of an agreement or
settlement 1.06.
- Participation in Benefit Review Conference
Actual time in BRC + 2.07.
- Participation in Benefit Contested Case Hearing
Actual time in CCH + 4.08.
- Participation in administrative appeal process
5.09.
- Travel (per month) Actual costs that are reasonable and necessary
(d) The maximum hourly rate for legal services shall be as follows:
Hourly rate:
- Attorney $150
- Legal assistant (not to include hours for general office staff) $50
Rule 152.5. Allowable Expenses
(a) As part of the application for attorney fees, an attorney shall submit an itemized list of expenses incurred for the preparation and presentation of the client's case. The date, nature, and amount of the expense shall be clearly identified.
(b) The commission shall allow those expenses necessary for the preparation and presentation of a person's claim before the commission, including:
- Travel expenses, at the rate set for state
employees by the legislature in the General Appropriations Act, if the
attorney is required to attend a benefit review conference or hearing
more than 25 miles from the attorney's office nearest to the location of
the conference or hearing;
- Expenses necessary to present a case at a
hearing including subpoena costs, court reporter's fee, per diem witness
fees incurred, and translator's fee;
- The cost of records necessary to prepare or
present a claim or defense including copies of Division files, a
record check performed by the Division, medical reports (except
medical reports required to be provided by rule), and copies
of certificates, licenses, and decrees necessary for perfecting a claim
for death benefits;
- Costs of long distance telephone calls to: the
client, an attorney or other representative of the other party, health
care providers, or others necessary to prepare the claim or defense;
- Costs of collect long distance telephone calls
from the client; and
- Investigative services necessary to establish or dispute a claim.
(c) The commission shall not allow as attorney expenses those expenses that are not necessary for the preparation and presentation of a person's individual claim or defense before the Division, including:
- Attorney travel, except as permitted in
subsection (b)(1) of this section;
- Overhead costs of operating a law office
including: rent, utilities, copies, fax, telecopier, postage, shipping,
local telephone calls, long distance calls to the commission, and
salaries for general office staff; and
- Medical reports and hospital records that commission rules require to be sent to the claimant and carrier.
(d) An attorney's payment of out-of-pocket expenses for items listed in subsection (b) of this section does not constitute a loan to the client as prohibited by the Texas Department of Insurance, Division of Workers' Compensation.
Justification Prompt
Implementation of our automated attorney fee processing system on September 1, 1994, will not accommodate consideration of line item text or billing statements in the review/approval process. If the services provided require additional detail or clarification to justify payment, justification should be in the form of a summary paragraph titled "Justification Text". Please provide "Justification Text" in the summary paragraph provided. There is a limit of 5040 characters for Justification. Please be concise and to the point.
Once entry is complete select Enter to save the information. Selecting Enter automatically navigates to Submission Summary where a record or the transaction can be printed.
Rule 152.4 Guidelines for Legal Services Provided to Claimants and Carriers
(a) The guidelines outlined in this rule shall be considered by the Division along with the factors, and maximum fee limitations, set forth in the Texas Labor Code, §408.221 and §408.222 and applicable commission rules.
(b) An attorney may request, and the commission may approve, a number of hours greater than those allowed by these guidelines, if the attorney demonstrates to the satisfaction of the commission that the higher fee was justified based on the Texas Labor Code, §408.221 and §408.222.
(c) The guidelines for legal services provided to claimants and carriers are as follows:
Service Maximum Total Hours:
- Initial interview and research 1.0
- Setting up file; completing and filing forms
0.5
- Communications per month (with client, health
care providers, other persons involved in the case) 2.5
- Direct dispute resolution negotiation with the
other party (per month) 3.0
- Preparation and submission of an agreement or
settlement 1.0
- Participation in Benefit Review Conference
Actual time in BRC + 2.0
- Participation in Benefit Contested Case Hearing
Actual time in CCH + 4.0
- Participation in administrative appeal process
5.0
- Travel (per month) Actual costs that are reasonable and necessary
The maximum hourly rate for legal services shall be as follows:
Hourly rate:
- Attorney $150
- Legal assistant (not to include hours for general office staff) $50
Rule 152.5. Allowable Expenses
(a) As part of the application for attorney fees, an attorney shall submit an itemized list of expenses incurred for the preparation and presentation of the client's case. The date, nature, and amount of the expense shall be clearly identified.
(b) The commissioner shall allow those expenses necessary for the preparation and presentation of a person's claim before the Division, including:
- Travel expenses, at the rate set for state
employees by the legislature in the General Appropriations Act, if the
attorney is required to attend a benefit review conference or hearing
more than 25 miles from the attorney's office nearest to the location of
the conference or hearing;
- Expenses necessary to present a case at a
hearing including subpoena costs, court reporter's fee, per diem witness
fees incurred, and translator's fee;
- The cost of records necessary to prepare or
present a claim or defense including copies of Division files, a
record check performed by the Division, medical reports (except
medical reports required to be provided by rule), and copies
of certificates, licenses, and decrees necessary for perfecting a claim
for death benefits;
- Costs of long distance telephone calls to: the
client, an attorney or other representative of the other party, health
care providers, or others necessary to prepare the claim or defense;
- Costs of collect long distance telephone calls
from the client; and
- Investigative services necessary to establish or dispute a claim.
(c) The commissioner shall not allow as attorney expenses those expenses that are not necessary for the preparation and presentation of a person's individual claim or defense before the Division, including:
- Attorney travel, except as permitted in
subsection (b)(1) of this section;
- Overhead costs of operating a law office
including: rent, utilities, copies, fax, telecopier, postage, shipping,
local telephone calls, long distance calls to the commission, and
salaries for general office staff; and
- Medical reports and hospital records that rules require to be sent to the claimant and carrier.
(d) An attorney's payment of out-of-pocket expenses for items listed in subsection (b) of this section does not constitute a loan to the client as prohibited by the Texas Department of Insurance, Division of Workers' Compensation.
Contact TDI for information at
wafps@tdi.state.tx.us or by phone 512.804.4636, (Mon.-Fri., 8:00 a.m. - 5:00 p.m. CST)
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