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.