State News : Texas

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DDs: Distressing Developments

TDI posted an open invitation on its website on March 4, 2022, for system participants to share their thoughts on proposed changes to Chapter 127 and section 180.23 of 28 of Texas Administrative Code, the portions pertaining to the designated doctor program.  Comments will be accepted until 5:00 p.m. on April 4, 2022, and can be emailed to, or mailed to Legal Services, MC-LS, Texas Department of Insurance, Division of Workers’ Compensation, P. O. Box 12050, Austin, TX 78711.

Some of the planned revisions are rather disconcerting. The DWC068 Designated Doctor Examination Data Report, which provides a simple summary of a designated doctor’s findings on extent of injury and disability, will no longer be mandated. A designated doctor will also be absolved of the need to undergo re-certification every two years if he or she passed the certification test after May 13, 2013.

DDs will also no longer be required to complete multiple impairment rating certifications taking into account each reasonable outcome for the extent of injury, per the suggested alterations to Rule 127.10(d).  Only when directed to do so by the Division may a designated doctor provide multiple certifications.  A sharp uptick in the number of bifurcated hearings and Presiding Officer Directives (PODs) should therefore be expected, as extent of injury issues seem destined to require adjudication first, followed by MMI/IR hearings later.

Curiously, a proposed change to Rule 127.1(b)(3) would obviate the need to list all accepted or administratively-determined conditions from the DWC032 Request for Designated Doctor Examination, virtually guaranteeing an increase in case management on the part of the presiding officer.  

But here’s the one that will really have you scratching your head: changes to Rule 127.130 would permit examination for traumatic brain injuries to be performed by doctors with specialties in orthopedic surgery, thoracic and cardiac surgery, plastic surgery, anesthesiology, family medicine, and dermatology.  You read that right: dermatologists would be permitted to examine claimants for traumatic brain injuries.  

So, the next time you actually do scratch your head, remember to ask your dermatologist if you have suffered a TBI.