Texas Self-Insurance Association

AUSTIN, TX – The Texas Department of Insurance, Division of Workers’ Compensation has approved new training for designated doctors in the Texas workers’ compensation system while improving the scheduling of doctor assignments with injured employees. “Together, these changes meet new statutory requirements for the doctors and streamline assignment-setting by the Division while causing minimal disruption for injured employees,” said Albert Betts, Commissioner of Workers’ Compensation.

Centralization of designated doctor scheduling from multiple Division field office locations to the Austin central office will be completed in early January, 2007. The operational change is intended to improve consistency of the designated doctor scheduling process and also to prepare for an expected increase in the number of assignments due to the added responsibilities of designated doctors.

New workers’ compensation designated doctor rules (28 Texas Administrative Code §180.21) are effective January 1, 2007. Under these rules, health care providers must meet minimum requirements for admission to the Designated Doctor List (28 TAC §180.21[d]) in order to receive designated doctor assignments on or after January 1, 2007. The minimum requirements include completion of training to examine injured employees to:

• Evaluate and report on extent of the employee's compensable injury;
• Determine whether the injured employee's disability is a direct result of the work-related injury;
• Determine an injured employee's ability to return to work; and
• Evaluate similar issues.

Designated doctors also continue to examine injured employees for maximum medical improvement and to assign impairment ratings. For information about billing and reimbursement of designated doctor exams, refer to the Workers’ Compensation Medical Fee Guideline, (28 TAC § 134.202[c][5][6], [e][6][7]), as applicable.

Approved training for designated doctors was offered by the Texas Medical Association and the American Academy of Disability Evaluating Physicians (AADEP) this Fall in Houston, Austin, San Antonio, Fort Worth and Dallas. Additional training will be offered early in 2007 in Houston, McAllen and El Paso. (See training schedule at http://www.tdi.state.tx.us/wc/mr/irtraining.html). It is anticipated that an adequate number of existing Designated Doctors will have received the new training by January 1, 2007 to respond to requests for assignments under Section 180.21(d).