By Bailey H.B. No. 1526
77R4932 KSD-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the selection of a doctor for workers' compensation
1-3 benefits.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Section 408.022, Labor Code, is amended to read as
1-6 follows:
1-7 Sec. 408.022. SELECTION OF DOCTOR. (a) An injured employee
1-8 is entitled to the employee's initial choice of a doctor. An
1-9 injured employee's initial choice of doctor is the first doctor who
1-10 provides health care to the employee after the injury occurs, other
1-11 than:
1-12 (1) a doctor salaried by the employer;
1-13 (2) a doctor recommended by the insurance carrier or
1-14 employer, unless the injured employee continues to receive
1-15 treatment from the doctor for a period of more than 60 days after
1-16 the date of receipt of written notice of the employee's right to
1-17 change doctors; or
1-18 (3) a doctor providing emergency care to the injured
1-19 employee, unless the injured employee receives treatment from the
1-20 doctor that is unrelated to the emergency treatment for a period of
1-21 more than 60 days after the date of receipt of written notice of
1-22 the employee's right to change doctors.
1-23 (b) An employee may change doctors one time by submitting to
1-24 the commission in writing the reasons for the change.
2-1 (c) A third or subsequent doctor selected by the employee is
2-2 subject to the approval of the insurance carrier or the commission.
2-3 (d) The commission shall adopt rules for implementing this
2-4 section. [Except in an emergency, the commission shall require an
2-5 employee to receive medical treatment from a doctor chosen from a
2-6 list of doctors approved by the commission. A doctor may perform
2-7 only those procedures that are within the scope of the practice for
2-8 which the doctor is licensed. The employee is entitled to the
2-9 employee's initial choice of a doctor from the commission's list.]
2-10 [(b) If an employee is dissatisfied with the initial choice
2-11 of a doctor from the commission's list, the employee may notify the
2-12 commission and request authority to select an alternate doctor.
2-13 The notification must be in writing stating the reasons for the
2-14 change, except notification may be by telephone when a medical
2-15 necessity exists for immediate change.]
2-16 [(c) The commission shall prescribe criteria to be used by
2-17 the commission in granting the employee authority to select an
2-18 alternate doctor. The criteria may include:]
2-19 [(1) whether treatment by the current doctor is
2-20 medically inappropriate;]
2-21 [(2) the professional reputation of the doctor;]
2-22 [(3) whether the employee is receiving appropriate
2-23 medical care to reach maximum medical improvement; and]
2-24 [(4) whether a conflict exists between the employee
2-25 and the doctor to the extent that the doctor-patient relationship
2-26 is jeopardized or impaired.]
2-27 [(d) A change of doctor may not be made to secure a new
3-1 impairment rating or medical report.]
3-2 [(e) For purposes of this section, the following is not a
3-3 selection of an alternate doctor:]
3-4 [(1) a referral made by the doctor chosen by the
3-5 employee if the referral is medically reasonable and necessary;]
3-6 [(2) the receipt of services ancillary to surgery;]
3-7 [(3) the obtaining of a second or subsequent opinion
3-8 only on the appropriateness of the diagnosis or treatment;]
3-9 [(4) the selection of a doctor because the original
3-10 doctor:]
3-11 [(A) dies;]
3-12 [(B) retires; or]
3-13 [(C) becomes unavailable or unable to provide
3-14 medical care to the employee; or]
3-15 [(5) a change of doctors required because of a change
3-16 of residence by the employee.]
3-17 SECTION 2. (a) This Act takes effect September 1, 2001.
3-18 (b) The change in law made by this Act applies only to a
3-19 claim for workers' compensation benefits based on a compensable
3-20 injury that occurs on or after the effective date of this Act. A
3-21 claim based on a compensable injury that occurs before the
3-22 effective date of this Act is governed by the law in effect on the
3-23 date the compensable injury occurred, and the former law is
3-24 continued in effect for that purpose.