By Dukes H.B. No. 1579
77R5316 PB-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the medical determination of, and disputes regarding,
1-3 workers' compensation impairment income benefits; providing
1-4 penalties.
1-5 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-6 SECTION 1. Section 408.122, Labor Code, is amended to read
1-7 as follows:
1-8 Sec. 408.122. ELIGIBILITY FOR IMPAIRMENT INCOME BENEFITS[;
1-9 DESIGNATED DOCTOR]. (a) A claimant may not recover impairment
1-10 income benefits unless evidence of impairment based on an objective
1-11 clinical or laboratory finding exists. If the finding of
1-12 impairment is made by a doctor chosen by the claimant and the
1-13 finding is contested, a designated doctor chosen under Section
1-14 408.1225 or a doctor selected by the insurance carrier must be able
1-15 to confirm the objective clinical or laboratory finding on which
1-16 the finding of impairment is based.
1-17 (b) The commission by rule shall establish quality review
1-18 measures designed to reduce inconsistent impairment rating
1-19 determinations made by treating doctors and doctors selected by the
1-20 insurance carrier.
1-21 (c) Notwithstanding Section 408.004, an insurance carrier
1-22 may not require an employee to submit to a medical examination to
1-23 evaluate the employee's impairment before the expiration of the
1-24 60th day after the date on which the compensable injury occurred.
2-1 (d) A violation of Subsection (c) by an insurance carrier is
2-2 a Class B administrative violation.
2-3 Sec. 408.1225. DESIGNATED DOCTOR. (a) To be eligible to
2-4 serve as a designated doctor, a doctor must meet specific
2-5 qualifications, including training in the determination of
2-6 impairment ratings. To the extent possible, a designated doctor
2-7 must be in the same discipline and be licensed by the same
2-8 licensing authority as the employee's doctor of choice.
2-9 (b) The executive director shall develop qualification
2-10 standards and administrative policies to implement this section
2-11 [subsection], and the commission may adopt rules as necessary. [To
2-12 the extent possible, a designated doctor must be in the same
2-13 discipline and licensed by the same board of examiners as the
2-14 employee's doctor of choice.]
2-15 (c) If a dispute exists as to whether the employee has
2-16 reached maximum medical improvement, the commission shall direct
2-17 the employee to be examined by a designated doctor chosen by mutual
2-18 agreement of the parties. If the parties are unable to agree on a
2-19 designated doctor, the commission shall direct the employee to be
2-20 examined by a designated doctor chosen by the commission.
2-21 (d) The designated doctor shall report to the commission.
2-22 The report of the designated doctor has presumptive weight, and the
2-23 commission shall base its determination of whether the employee has
2-24 reached maximum medical improvement on the report unless the great
2-25 weight of the other medical evidence is to the contrary.
2-26 SECTION 2. Section 408.125(a), Labor Code, is amended to
2-27 read as follows:
3-1 (a) If an impairment rating is disputed, the commission
3-2 shall direct the employee to be examined by a designated doctor
3-3 chosen by mutual agreement of the parties. An examination under
3-4 this subsection by a designated doctor may not be conducted before
3-5 the expiration of the 60th day after the date on which the
3-6 examination by a doctor selected by the insurance carrier was
3-7 performed.
3-8 SECTION 3. This Act takes effect September 1, 2001, and
3-9 applies only to a claim for workers' compensation benefits based on
3-10 a compensable injury that occurs on or after that date. A claim
3-11 based on a compensable injury that occurs before that date is
3-12 governed by the law in effect on the date that the compensable
3-13 injury occurred, and the former law is continued in effect for that
3-14 purpose.