TDI-DWC Publishes Designated Dr. Proposal - Texas Journal of Chiropractic

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TDI-DWC Publishes Designated Dr. Proposal

Published 12/29/2011 - 10:28 a.m. CDT

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The Texas Department of Insurance, Division of Workers’ Compensation (TDI-DWC) is accepting comment on informally proposed new subsection 28 Texas Administrative Code (TAC) §127.130(b) regarding designated doctor’s qualification criteria for examinations performed on or after January 1, 2013. The informal proposal was published on December 19, 2011 and may be viewed on the TDI website at http://www.tdi.texas.gov/wc/rules/drafts.html. The comment period on the informal proposal closes Wednesday, January 11, 2012 at 5 p.m. Central Standard Time.

The TDI-DWC has made several changes to 28 TAC§127.130(b) in response to informal comments received on the informal draft of 28 TAC §127.130(b) that was published on October 14, 2011. The TDI-DWC is only seeking comments on 28 TAC §127.130(b) at this time.

This informal working draft is not a formal rule proposal. Accordingly, comments will not be treated as formal public comment for the purposes of the Administrative Procedure Act. In addition to commenting on this informal proposal, there will be the opportunity to formally comment on this subsection when the TDI-DWC formally proposes all of its amendments to 28 TAC Chapter 127 (relating to Designated Doctor Procedures and Requirements). The TDI-DWC anticipates formally publishing these amendments to Chapter 127, including 28 TAC §127.130(b), in the Texas Register in early 2012. The informal working draft may contain drafting notes and formatting which will be changed as necessary to comply with the Texas Register formatting.

Comments may be submitted by e-mailing InformalRuleComments@tdi.state.tx.us or by mailing or delivering the comments to:

Texas Department of Insurance, Division of Workers’ Compensation Maria Jimenez Workers’ Compensation Counsel MS-4D
7551 Metro Center Drive, Suite 100
Austin, Texas 78744-1645

If there are any questions regarding the information in this memo, contact Nicholas Gonzalez at 512-804-4277 or Nicholas.Gonzalez@tdi.state.tx.us

TITLE 28. INSURANCE
PART 2. TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS’ COMPENSATION

CHAPTER 127 - DESIGNATED DOCTOR PROCEDURES AND REQUIREMENTS
SUBCHAPTER A - DESIGNATED DOCTOR SCHEDULING AND EXAMINATIONS NEW: §127.130(b)

INFORMAL - DRAFT

SUBCHAPTER A - DESIGNATED DOCTOR SCHEDULING AND EXAMINATIONS
§127.130. Qualification Standards for Designated Doctor Examinations.

(b) For examinations on or after January 1, 2013, a designated doctor is qualified to perform an initial designated doctor examination on an injured employee if the designated doctor meets the appropriate qualification criteria for the area of the body affected by the injury and the injured employee’s diagnosis and has no disqualifying associations under §127.140 of this title. A designated doctor’s qualification criteria are determined as follows:

(1) To examine injuries and diagnoses relating to the hand and upper extremities, a designated doctor must be a licensed medical doctor, doctor of osteopathy, or doctor of chiropractic.

(2) To examine injuries and diagnoses relating to the lower extremities excluding feet, a designated doctor must be a licensed medical doctor, doctor of osteopathy, or doctor of chiropractic.

(3) To examine injuries and diagnoses relating to the spine and torso, a designated doctor must be a licensed medical doctor, doctor of osteopathy, or doctor of chiropractic.

(4) To examine injuries and diagnoses relating to the feet, including the toes and heel, a designated doctor must be a licensed medical doctor, doctor of osteopathy, doctor of chiropractic, or doctor of podiatric medicine.

(5) To examine injuries and diagnoses relating to the teeth and jaws, a designated doctor must be a licensed medical doctor, doctor of osteopathy, or doctor of dental surgery.

(6) To examine injuries and diagnoses relating to the eyes, including the eye and adnexal structures of the eye, a designated doctor must be a licensed medical doctor, doctor of osteopathy, or doctor of optometry.

(7) To examine injuries and diagnoses relating to other body areas or systems, including but not limited to internal systems; ear, nose, and throat; head and face; skin; and mental and behavioral disorders, a designated doctor must be a licensed medical doctor or doctor of osteopathy.

(8) To examine any of the following diagnoses, a designated doctor must be a licensed medical doctor or doctor of osteopathy who has the required board certification. For purposes of this section, a medical doctor is “board certified” in a required specialty or subspecialty, as applicable, if the medical doctor holds a general certificate in the required specialty or a subspecialty certificate in the required subspecialty from the American Board of Medical Specialties. For the purposes of this section, a doctor of osteopathy is “board certified” in a required specialty or subspecialty, as applicable, if the doctor of osteopathy holds a primary certificate in the required specialty and a certificate of special qualifications or certificate of added qualifications in the required subspecialty from the American Osteopathic Association Bureau of Osteopathic Specialists.

(A) To examine traumatic brain injuries, spinal cord injuries, including spinal fractures with documented neurological deficit, and profound peripheral neuropathy, a designated doctor who is a medical doctor must be board certified in neurological surgery, neurology, physical medicine and rehabilitation, orthopaedic surgery, or occupational medicine. If a designated doctor is a doctor of osteopathy, the doctor must be board certified in neurological surgery, neurology, physical medicine and rehabilitation, orthopedic surgery, preventive medicine/occupational-environmental medicine, or preventive medicine/occupational;

(B) To examine severe burns, including chemical burns, defined as 3rd or 4th degree burns over 9 percent or greater of the body, a designated doctor who is a medical doctor must be board certified in dermatology, orthopaedic surgery, physical medicine and rehabilitation, plastic surgery, or occupational medicine. If a designated doctor is a doctor of osteopathy, the designated doctor must be board certified in dermatology, orthopedic surgery, physical medicine and rehabilitation, plastic and reconstructive surgery, preventive medicine/occupational-environmental medicine, or preventive medicine/occupational;

(C) To examine complex regional pain syndrome (reflex sympathetic dystrophy), a designated doctor who is a medical doctor must be board certified in neurological surgery, neurology, orthopaedic surgery, anesthesiology with a subspecialty in pain medicine, occupational medicine, or physical medicine and rehabilitation. If a designated doctor is a doctor of osteopathy, the designated doctor must be board certified in neurological surgery, neurology, orthopedic surgery, preventive medicine/occupational-environmental medicine, preventive medicine/occupational, anesthesiology with certificate of added qualifications in pain management, or physical medicine and rehabilitation;

(D) To examine multiple bone fractures, excluding spinal fractures, or dislocations and tendon lacerations, a designated doctor who is a medical doctor must be board certified in emergency medicine, orthopaedic surgery, plastic surgery, or occupational medicine. If a designated doctor is a doctor of osteopathy, the designated doctor must be board certified in emergency medicine, orthopedic surgery, plastic surgery, preventive medicine/occupational-environmental medicine, or preventive medicine/occupational;

(E) To examine complicated infectious diseases requiring hospitalization or prolonged intravenous antibiotics, including blood borne pathogens, a designated doctor who is a medical doctor must be board certified in internal medicine, occupational medicine, or family medicine. If a designated doctor is a doctor of osteopathy, the designated doctor must be board certified in internal medicine, preventive medicine/occupational-environmental medicine, preventive medicine/occupational, or family practice and osteopathic manipulative treatment;

(F) To examine chemical exposure, excluding chemical exposure limited to skin exposure, a designated doctor who is a medical doctor must be board certified in internal medicine, emergency medicine, occupational medicine, or family medicine. If a designated doctor is a doctor of osteopathy, the designated doctor must be board certified in internal medicine, emergency medicine, preventive medicine/occupational-environmental medicine, preventive medicine/occupational, or family practice and osteopathic manipulative treatment;

(G) To examine heart or cardiovascular conditions, a designated doctor who is a medical doctor must be board certified in internal medicine, emergency medicine, occupational medicine, or family medicine. If a designated doctor is a doctor of osteopathy, the designated doctor must be board certified in internal medicine, emergency medicine, preventive medicine/occupational-environmental medicine, preventive medicine/occupational, or family practice and osteopathic manipulative treatment.

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