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A BILL TO BE ENTITLED
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AN ACT
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relating to the dispute by an insurer of a determination of specific |
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injuries and diagnoses in connection with a compensable injury in |
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certain workers' compensation claims. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 408.0042, Labor Code, is amended by |
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amending Subsection (c) and adding Subsection (c-1) to read as |
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follows: |
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(c) After the medical examination is performed, the |
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treating doctor shall submit to the insurance carrier a report that |
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details all injuries and diagnoses related to the compensable |
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injury, on receipt of which the insurance carrier shall: |
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(1) accept all injuries and diagnoses as related to |
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the compensable injury; or |
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(2) dispute the determination of specific injuries and |
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diagnoses by requesting: |
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(A) an examination by a designated doctor under |
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Section 408.0041; or |
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(B) a benefit review conference under Section |
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410.023. |
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(c-1) If an insurance carrier does not dispute the |
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determination of specific injuries and diagnoses detailed in the |
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report submitted by the treating doctor under Subsection (c) on or |
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before the 90th day after the date the report is provided to the |
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insurance carrier, the insurance carrier waives its right to |
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dispute the determination, unless there is a finding of evidence |
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that could not reasonably have been discovered earlier. |
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SECTION 2. The change in law made by this Act applies only |
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to a medical examination by a treating doctor that occurs on or |
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after the effective date of this Act. A medical examination that |
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occurs before that date is governed by the law as it existed |
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immediately before the effective date of this Act, and the former |
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law is continued in effect for that purpose. |
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SECTION 3. This Act takes effect September 1, 2013. |