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Texas Workers’ Comp Proposes Changes to Designated Doctor Program

August 22, 2017

The Texas Department of Insurance – Division of Workers’ Compensation (TDI-DWC) released an informal work draft on Friday to amend a rule related to the Designated Doctor program.  Comments are due on September 1, 2017.

An open records request found that the Designated Doctor program has experienced a 67-percent decrease in the number of physicians participating over a five-year period (1,361 physicians on January 1, 2011 to 447 physicians on January 1, 2016).  TOA believes that this decrease is partly due to legislative changes made by the 2011 Legislature.

TOA is currently reviewing the rule.  However, based on a preliminary analysis, TOA believes that the proposal could ensure that injured employees have access to the highest qualified designated doctors possible.  In particular, the proposal would add a provision that would allow the division to assign up to four additional injured employees to a designated doctor.

TOA has heard from orthopaedic surgeons who have indicated that the current process, which limits designated doctors to one injured employee per assignment, does not cover the costs for an orthopaedic surgeon to take an entire day off from his or her practice.

TOA will provide formal comments prior to the September 1, 2017 deadline.

Click here to review the proposal.  Click here to read guidance.