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Advisory 2001-01

Notice of Revised Form
TWCC-53, Employee's Request to Change Treating Doctor

To improve the process for injured employees to request a change of treating doctor from the initial choice of doctor, the Commission has made changes to the Employee's Request to Change Treating Doctor form ( TWCC-53). Among the changes are the addition of contact information for the current treating doctor and a place to indicate current work status. In addition, the instructions for completing the form were changed to clarify the process.

The Commission has been concerned that requests for change of treating doctor may be originating inappropriately. Therefore, the form has been changed to include a reminder to system participants that only an injured employee may initiate the request to change doctors and others are not to initiate the process or solicit a request.

In addition, the Commission has provided additional training to our staff to help increase consistency throughout the state and to ensure that requests to change treating doctor are handled in accordance with the provisions of the Texas Workers' Compensation Act and Commission Rules. As provided in the Texas Labor Code §408.022 and Commission Rule 126.9, criteria for approving a change of treating doctor may include the following:

  • Whether treatment by the current doctor is medically inappropriate;
  • The professional reputation of the doctor;
  • Whether the employee is receiving appropriate medical care to reach maximum medical improvement;
  • Whether a conflict exists between the employee and the doctor to the extent that the doctor-patient relationship is jeopardized or impaired; and
  • The selected doctor chooses not to be responsible for coordinating the injured employee's health care.

The major emphasis in the training has been to remind Commission staff that to be approved, requests for change of treating doctor must demonstrate a legitimate reason, such as the above, for changing doctors. Generalized statements that do not give Commission staff sufficient information to determine whether or not the request should be approved may result in a telephone call to the injured employee to obtain clarification.

Some examples of broad, generalized statements that may not provide sufficient justification to support approval of a request to change from the injured employee's initial choice of doctor are as follows:

  • I would like to use my right to choose my doctor;
  • I want to use my family doctor;
  • I'm not happy with the treatment;
  • I want to try a different treatment; or
  • My condition is not getting any better.

Requests for change of treating doctor should include sufficient explanation and/or documentation to demonstrate why the treating doctor should be changed.

The Commission encourages immediate use of this revised form; however, the new form will be mandatory for all requests filed on or after April 1, 2001.

Signed this 5th day of January 2001

Leonard W. Riley, Executive Director

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