Texas Physical Therapist and Occupational Therapist License Defense Attorneys

Physical Therapists (PTs), Occupational Therapists (OTs), Physical Therapist Assistants (PTAs), and Certified Occupational Therapy Assistants (COTAs) play important roles in the care of Texas patients. They are a vital and needed part of the healthcare system, and are regulated by the Texas Board of Physical Therapy Examiners and the Texas Board of Occupational Therapy Examiners. Both of these Boards are administered under the umbrella of the Executive Council of Physical Therapy and Occupational Therapy Examiners. While the regulatory framework for these entities is similar to those agencies regulating other health care providers, there are differences that can impact on both licensing and discipline. Obtaining a license, defending against unfounded complaints, and managing the impact of legitimate allegations can best be achieved with the assistance of an experienced Texas defense attorney.

At McDonald, Mackay, Porter & Weitz, L.L.P., we understand what you may be facing when a complaint has been filed with the licensing board. We focus on healthcare practitioner license defense and have experience representing physical therapists, occupational therapists, PTAs, and COTAs. Oftentimes, there are short deadlines associated with pending allegations and related agency proceedings. Contact us today for a consultation.

Executive Counsel of Physical Therapy and Occupational Therapy Examiners

The Executive Council of Physical Therapy and Occupational Therapy Examiners (ECPTOTE) is the Texas agency charged with protecting the health, safety, and welfare of the people of Texas by supporting the Board of Physical Therapy Examiners and the Board of Occupational Examiners. Together, these agencies license and regulate qualified practitioners of physical therapy and occupational therapy as well as PTAs and COTAs. They also regulate facilities in which related services are provided. 

Disciplinary Issues

These agencies overseeing PTs, PTAs, OTs, and COTAs, are tasked with disciplining licensees based on various grounds. Actions can be based on a number of things including criminal behavior, fraud, unprofessional conduct, or a violation of a health related statute or rule. Disciplinary actions vary, but may involve one or more of the following:

  • Monitoring
  • Public reprimand
  • Imposition of fines
  • Restrictions on a license
  • Placing on probation with terms and conditions
  • Suspending the license
  • Revoking the license

Some of the reasons why a licensee may face disciplinary action include:

  • Engaging in unprofessional conduct
  • Chemical dependency or substance abuse
  • Fraudulent or deceitful practices
  • Negligence in practice
  • Criminal charges, arrests, or convictions
  • Violating a rule or statute

Licensure Process

It can take a significant amount of time to navigate the Texas licensure process. If you have any issues in your past, including mental health concerns or a criminal record, the process may take longer than one might otherwise expect.

When completing a licensing application, an applicant is best advised to:

  • Be organized. Get your material together before you apply.
  • Apply early. If you think you might want to work in Texas, start the process as soon as possible.
  • Read the directions carefully. A minor mistake can derail your application for months. Do not think of attempting to mislead the Board or of trying to hide information. Answering “no” when you should answer “yes” can lead to very serious concerns about your ethics and integrity.
  • Follow-up. The application requires some documents be sent by third parties. Follow-up on people and entities to ensure that documents have been submitted. It is also critical to follow-up with the Board on a regular basis.
  • Retain Documents. Keep a copy of your application, materials submitted, and all of the correspondence exchanged.
  • If you have a problem, get help. If you have significant issues, you need to get assistance from a health license defense attorney with experience practicing before these agencies.

If you have questions about your Texas license or the licensure process, you should seek the help of an experienced attorney at McDonald, Mackay, Porter & Weitz, L.L.P.

Administrative Board and Disciplinary Process

Although these agencies have the authority to reprimand, fine, impose conditions of practice, monitor, suspend, or revoke a license once it has been determined that the licensee has violated the laws related to practice, the licensee is still entitled to due process and may benefit from having the guidance of an experienced administrative healthcare lawyer.

Initial Investigation

The investigative process typically starts out with a complaint filed at the Board or due to a Board audit or inspection. A notice letter to the licensee is sent stating that an allegation has been made or concerns have arisen from an audit or inspection. This letter usually explains the basic issues and asks for an expedited response by a specified date. If no response is received by the agency staff by the deadline, the staff can be expected to more aggressively pursue the matter. Responding on time and in a meaningful way is important to show respect for the process and to hopefully set out your side of the case in an understandable and persuasive way. Unfortunately, the allegations can often be non-specific which makes drafting a response very difficult. An experienced medical license defense attorney can sometimes navigate the agency’s system to get a more detailed explanation of the concerns, but many times information will be limited. Ultimately, the response must be carefully drafted to show good faith cooperation, clarify the case to the extent possible, and at the same time avoid creating additional problems.

Ongoing Investigation

After the licensee has responded to the initial letter, the case may be dismissed based on lack of evidence to show a violation. If concerns remain after the response to the initial letter, the case will be further investigated. The agency staff will typically ask for records and case related documents during the investigation and may seek an in-person or telephone interview. Deadlines vary, but a licensee can expect that as a practical matter they will have only two to three weeks to provide information. While the investigator can sometimes provide more detail and grant an extension, some licensees tend to say too much when talking to the investigator. Counsel at this stage is recommended. The case materials eventually undergo expert review for possible dismissal or further processing. If the matter is dismissed, the licensee will be notified in writing. If not dismissed, the case is typically set for an Informal Settlement/Show Compliance Conference (ISC).

Informal Settlement / Show Compliance Conference: If there appears to be a violation, the licensee will be either given a proposed order to resolve the matter or notified in writing that an Informal Settlement/Show Compliance Conference (ISC) will be held. Notice can at times be short, but even with mail delays the licensee usually has over a month to prepare. The ISC requires the licensee, with or without counsel, to meet with agency representatives in Austin. Board representatives have staff to help guide them, and to present the allegations and related evidence. After an exchange of information, questions, answers, and discussion, the ISC panel members and senior staff will deliberate and issue a recommendation. The recommendation can be to defer a decision to get more information, refer to the State Office of Administrative Hearings (SOAH) for a contested hearing, or resolve the case through an Agreed Order. Most cases are resolved either by an agreed order or dismissal, but an experienced attorney can usually negotiate the best possible language in regard to findings of fact, conclusions of law and the range of possible sanctions.

Contested Hearings

If the case is not resolved at an earlier stage of the process, it will be transferred to the State Office of Administrative Hearings (SOAH). Discovery is initiated much like in a malpractice suit or other civil litigation to include depositions, interrogatories, requests for production of documents, requests for admissions, and requests for disclosures. While there is the possibility of being fined, and assessed hearing costs, the case is more about whether the licensee violated the standard of care, their ability to continue to practice, and, if so, under what terms and conditions. An Administrative Law Judge (ALJ) is assigned and the proceeding is like a bench trial without a jury. Witnesses are called to testify, records are put into evidence, and legal arguments are made. After the hearing, the ALJ will issue a Proposal for Decision (PFD) analyzing the evidence and recommending a decision to the TMB. The parties may exchange additional pleadings advocating their respective positions after receiving the PFD. The Board will then hold a hearing and counsel for both sides will be allowed short oral argument. The Board either votes to adopt the PFD, adopt a proposal from one of the parties, adopt something different of their own creation, dismiss the case, or appeal some aspect of the PFD to district court. If a disciplinary order is issued, the licensee has a very short time to file a motion for rehearing to exhaust administrative remedies and preserve the right to appeal to district court. If the motion for rehearing is granted, the case is reconsidered by the Board at the PFD presentation level and another appealable decision is rendered. If a motion for rehearing is denied, the licensee must act quickly to timely file an appeal in district court. During the appeal, the licensee usually remains subject to the imposed disciplinary action until the appeal is final.

It is possible to resolve a SOAH case through SOAH mediation rather than going through the contested process. Mediation usually occurs very early in the SOAH process.


Once under a disciplinary order from the Board, the licensee must cooperate with the agency in the compliance process. Staff will check up on licensees to make sure they are living up to the terms of the order. Probation appearances may be called for requiring the licensee to appear before a Board panel in Austin on a periodic basis. Additionally, the licensee can also ask for modifications and early termination of the order. These requests are heard and ruled on internally at the agency, but apparent violations of an order can result in an expedited ISC and can also lead to SOAH hearings as well. Sometimes the order itself provides for the additional disciplinary action to be imposed if the order is violated.

Get Help From Experienced Texas PT and OT License Defense Attorneys

Obtaining the right legal representation as early as possible in the investigation and disciplinary process is important to get the best possible outcome. The attorneys at McDonald, Mackay, Porter & Weitz, L.L.P. have experience with the licensing and defense of PTs, OTs, PTAs, and COTAs. If you are currently the subject of an agency investigation in Texas, we may be able to help.

Contact us today for a consultation.