GQ Corner
Q. I have a question about change of treating doctors. We filed a PLN-11 disputing the right knee. We are now in receipt of an approved DWC-53. Claimant’s reason for changing treating doctors: She has “lost faith” in Dr. X, and he refuses to treat her right knee. Is there any basis on which to dispute the change of doctor?
A. Section 408.022(c) of the Act specifically provides that DWC should prescribe criteria which are in turn to be considered in approving a change of treating doctor. By rule, specifically Rule 126.9, DWC has incorporated these statutory criteria: whether treatment by the current doctor is medically appropriate; the professional reputation of the doctor; whether the employee is receiving appropriate medical care to reach maximum medical improvement; and whether there is a conflict between the employee and the doctor, to the extent that the relationship is jeopardized. In addition, DWC may consider whether the selected doctor does not want to be responsible for the employee’s health care.
Even though you have disputed the right knee as non-compensable, because the claimant does allege it is compensable and seeks treatment for it, we feel fairly certain that if you dispute the change of treating doctors an ALJ will ultimately uphold DWC’s approval of the requested change under one or more of these criteria. Consequently we do not recommend a dispute over the approved DWC-53 in this instance.
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