New TX Doctor Rules

Highlights of the Proposed Rules include: 

  • Changes to the DWC-32 form
    • The boxes for the matrix have been switched around to track DWC Rule 127.130.  The first box in the matrix is now for upper extremities and the second box is now for lower extremities. 
    • In the upper extremity matrix box, the Division added rotator cuff tear.  In the lower extremity matrix box, the Division added ACL tear.
    • The Division added herniated discs in the matrix box regarding the spine for clarification.     
    • The form will no longer require the requester to explain any change in medical condition since a previous designated doctor exam.
    • The form will no longer require the date of a prior designated doctor exam and the name of the prior designated doctor.
    • A copy of the proposed DWC-32 can be found here  http://www.tdi.texas.gov/wc/forms/documents/drdwc320518.pdf
  • The Division will adopt two designated doctor lists for each county in the state.
    • One list will consist of designated doctors qualified to perform examinations for musculoskeletal injuries, including medical doctors, doctors of osteopathy, doctors of chiropractic, and doctors of podiatric medicine.
    • The other list will consist of designated doctors qualified to perform examinations for non-musculoskeletal injuries or complex diagnoses, including medical doctors, doctors of osteopathy, doctors of dental surgery, or doctors of optometry.
    • Medical doctors and doctors of osteopathy may appear on both lists.
    • If a doctor receives an examination from one list, the doctor will move to the bottom of that list. The doctor’s position on the other list will not change.
    • The Division will assign up to five examinations per day.
    • Doctors will have to be qualified to examine specific injuries or diagnoses per Rule 127.130.
  • A designated doctor examination cannot be rescheduled without the mutual agreement of the designated doctor and the injured employee.
    • The designated doctor must maintain and document how the exam was rescheduled.
    • Failure to document the required information will create a rebuttable presumption that the exam was rescheduled without the mutual agreement.
  • A doctor that fails the Division’s certification test may not retest more than three times within a six-month period.
  • The Division may deny a doctor’s application for certification as a designated doctor for reasons including but not limited to:
    • The quality of the doctor’s past reports as a designated doctor;
    • A history of complaints against the designated doctor;
    • Excess requests for deferral from the designated doctor list;
    • A pattern of overturned reports by the Division and/or a court;
    • A demonstrated lack of ability to apply the AMA Guides and return to work or treatment guidelines;
    • A demonstrated lack of ability to timely perform designated doctor examinations;
    • A demonstrated failure to identify disqualifying associations;
    • A demonstrated lack of ability to ensure confidentiality of medical records or claim information; and
    • Applying for certification less than a year from a denial.
  • The Division clarifies that rotator cuff tears, ACL tears, CTS, or injuries involving compression or inflammation of nerves, tendons, or ligaments are appropriately suited for evaluation by doctors of chiropractic.

 
A complete copy of the rules can be found here:
http://www.tdi.texas.gov/wc/rules/proposedrules/documents/pr127dd0518.pdf
 

Source: Law Office of Ricky D. Green, PLLC 

 

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