78R7783 PB-F

By:  Bohac                                                        H.B. No. 3220



A BILL TO BE ENTITLED

AN ACT

relating to disputes as to impairment ratings under the workers' 
compensation  system.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:                        
	SECTION 1.  Section 408.125, Labor Code, is amended by 
amending Subsections (d) and (f) and by adding Subsections (g), 
(h), and (i) to read as follows:
	(d)  To avoid undue influence on a person selected as a 
designated doctor under this section, only the injured employee or 
an appropriate member of the staff of the commission may 
communicate with the designated doctor about the case regarding the 
injured employee's medical condition or history before the 
examination of the injured employee by the designated doctor.  
After that examination is completed, communication with the 
designated doctor regarding the injured employee's medical 
condition or history may be made only through appropriate 
commission staff members.  The designated doctor may initiate 
communication with any doctor who has previously treated or 
examined the injured employee for the work-related injury.  A 
violation of this subsection is a Class C administrative violation.
	(f)  On the request of the insurance carrier or a claimant, 
the commission may request that a designated doctor clarify the 
doctor's opinion regarding maximum medical improvement or the 
impairment rating if there is evidence affecting the determination 
of maximum medical improvement or establishment of the impairment 
rating that the doctor has not considered.  A request for 
clarification under this subsection must be made not later than the 
first anniversary of the date on which the designated doctor issued 
the doctor's initial report.  The designated doctor shall prepare a 
clarification report not later than the 10th day after the date of 
the commission's request for clarification.  [A violation of 
Subsection (d) is a Class C administrative violation.]
	(g)  An insurance carrier may dispute the findings of a 
designated doctor regarding maximum medical improvement or an 
impairment rating if the dispute is filed with the commission not 
later than the 14th day after the date of receipt by the insurance 
carrier of the designated doctor's initial report under Subsection 
(b) or clarification report under Subsection (f).
	(h)  An insurance carrier that timely disputes the 
designated doctor's findings is not required to pay benefits based 
on those findings.  If the dispute involves the impairment rating 
issued by the designated doctor, the insurance carrier shall make a 
reasonable assessment of the impairment rating, and shall pay 
benefits based on that assessment.
	(i)  An insurance carrier that does not timely dispute the 
designated doctor's findings is required to pay benefits in 
accordance with those findings not later than the 14th day after the 
date of receipt by the insurance carrier of the designated doctor's 
initial report under Subsection (b) or clarification report under 
Subsection (f).
	SECTION 2.  This Act takes effect September 1, 2003, and 
applies only to a claim for workers' compensation benefits based on 
a compensable injury that occurs on or after that date.  A claim 
based on a compensable injury that occurs before that date is 
governed by the law in effect on the date that the compensable 
injury occurred, and the former law is continued in effect for that 
purpose.