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Advisory 94-02

Communications with Commission Designated Doctor

Sections 408.122(b) and 408.125, Texas Labor Code, requires the Commission to direct an injured worker to a designated doctor to resolve disputes regarding maximum medical improvement and/or an impairment rating. When the designated doctor is chosen by the Commission, the doctor's opinion and assessment shall have presumptive weight, unless the great weight of medical evidence is to the contrary.

Since the Act gives the designated doctor's report presumptive weight and preferred status, all precautions should be taken to ensure the designated doctor's report is impartial and unbiased. Parties to a specific case, their representatives, and an Ombudsman assisting an injured worker or employer should communicate with a designated doctor only through appropriate Commission personnel. In most instances this will be a disability determination officer. However, depending on the current level of dispute resolution and type of communication, a benefit review officer or a benefit contested case hearing officer may need to communicate with the designated doctor.

The Commission staff should communicate by telephone with a memorandum for the record or an entry made in the Dispute Resolution Information System, or in writing with the designated doctor, before and after the examination, to clarify the doctor's opinion and assessment and/or to determine whether the proper edition of the AMA Guides to the Evaluation of Permanent Impairment was used to assess impairment. A copy of any written communication with a designated doctor will be sent to each party. Parties to a case should not communicate directly with a designated doctor relating to these or other areas regarding the doctor's opinion.

Any question regarding billing or any other area not associated with the doctor's opinion should not be directed through the Commission staff.

This advisory does not limit the treating doctor's responsibility to provide the designated doctor with previous medical records as provided by 28 TAC, Rule 133.2, Sharing Medical Records and Test Results.

Signed this 14 th day of March, 1994

Todd K. Brown Executive Director


Austin Carrier Representatives
TWCC Staff
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