GQ Corner

Q: What is the rule on changing treating doctors?  I read the statute but cannot locate the exceptions. My claimant chose her first doctor and is still within 60 days. Can she change doctors without approval?

A: The change of treating doctor is addressed in the Texas Labor Code Section 408.022 and DWC rule 126.9. Keep in mind the statutory provision is only relevant for non-network claims.

The claimant does not have unlimited choices within the first 60 days; if the carrier/employer initially directs the claimant somewhere, the claimant gets one free change within the first 60 days.  After that, they need approval to change treating doctors.

Q: I received two DWC-69 forms recently. The first certification was done by a referral doctor, but the second was done by the treating doctor. Both doctors agreed that the claimant reached MMI on December 14, 2016, but the referral doctor assigned a 5% impairment rating while the treating doctor indicated no impairment. I had already issued the PLN-3 and commenced payment of IIBs when I received the second assessment that indicated no impairment. What are my options at this point?

A: If the treating doctor farmed out the MMI and impairment rating determination, then he loses the right to provide his own certification. Your options are to pay the 5% or dispute it by filing a DWC 32 and request a designated doctor evaluation.