Tex. Labor Code Section 408.1225
Designated Doctor


(a)

To be eligible to serve as a designated doctor, a doctor must maintain an active certification by the division.

(a-1)

The commissioner by rule shall develop a process for the certification of a designated doctor.

(a-2)

The rules adopted by the commissioner under Subsection (a-1) must:

(1)

require the division to evaluate the qualification of designated doctors for certification using eligibility requirements, including:

(A)

educational experience;

(B)

previous training; and

(C)

demonstrated ability to perform the specific designated doctor duties described by Section 408.0041 (Designated Doctor Examination); and

(2)

require standard training and testing to be completed in accordance with policies and guidelines developed by the division.

(a-3)

The division shall develop guidelines for certification training programs for certification of a designated doctor under Subsection (a-1) to ensure a designated doctor’s competency and continued competency in providing assessments, including:

(1)

a standard curriculum;

(2)

standard course materials; and

(3)

testing criteria.

(a-4)

The division shall develop and implement a procedure to periodically review and update the guidelines developed under Subsection (a-3).

(a-5)

The division may authorize an independent training and testing provider to conduct the certification program for the division under the guidelines developed under Subsection (a-3).

(b)

The commissioner shall ensure the quality of designated doctor decisions and reviews through active monitoring of the decisions and reviews, and may take action as necessary to:

(1)

restrict the participation of a designated doctor;

(2)

deny renewal of a designated doctor’s certification; or

(3)

revoke a designated doctor’s certification under Section 413.044 (Sanctions on Designated Doctor).

(c)

The report of the designated doctor has presumptive weight, and the division shall base its determination of whether the employee has reached maximum medical improvement on the report unless the preponderance of the other medical evidence is to the contrary.

(d)

The commissioner shall develop rules to ensure that a designated doctor called on to conduct an examination under Section 408.0041 (Designated Doctor Examination) has no conflict of interest in serving as a designated doctor in performing any examination.

(e)

A designated doctor, other than a chiropractor, is subject to Section 408.0043 (Professional Specialty Certification Required for Certain Review). A designated doctor who is a chiropractor is subject to Section 408.0045 (Review of Chiropractic Services). To the extent of a conflict between this section and Section 408.0043 (Professional Specialty Certification Required for Certain Review) or 408.0045 (Review of Chiropractic Services), this section controls.

(f)

A designated doctor shall continue providing services related to a case assigned to the designated doctor, including performing subsequent examinations or acting as a resource for division disputes, unless the division authorizes the designated doctor to discontinue providing services. The commissioner by rule shall prescribe the circumstances under which a designated doctor is permitted to discontinue providing services, including:

(1)

the doctor decides to stop practicing in the workers’ compensation system; or

(2)

the doctor relocates the doctor’s residence or practice.

(g)

On request of the division, a designated doctor shall provide the division with a copy of any contract that is:

(1)

between the designated doctor and an authorized agent of the doctor; and

(2)

for services provided by the agent related to the designated doctor’s duties, including scheduling, billing, and organizing medical records.

(h)

A contract provided to the division under Subsection (g) is not subject to disclosure under Chapter 552 (Public Information), Government Code.
Added by Acts 2005, 79th Leg., Ch. 265 (H.B. 7), Sec. 3.112, eff. September 1, 2005.
Amended by:
Acts 2007, 80th Leg., R.S., Ch. 1218 (H.B. 2004), Sec. 5, eff. September 1, 2007.
Acts 2011, 82nd Leg., R.S., Ch. 1162 (H.B. 2605), Sec. 12, eff. September 1, 2011.
Acts 2017, 85th Leg., R.S., Ch. 158 (H.B. 2056), Sec. 1, eff. September 1, 2017.

Source: Section 408.1225 — Designated Doctor, https://statutes.­capitol.­texas.­gov/Docs/LA/htm/LA.­408.­htm#408.­1225 (accessed Jun. 5, 2024).

408.001
Exclusive Remedy
408.002
Survival of Cause of Action
408.003
Reimbursable Employer Payments
408.004
Required Medical Examinations
408.005
Settlements and Agreements
408.006
Mental Trauma Injuries
408.007
Date of Injury for Occupational Disease
408.008
Compensability of Heart Attacks
408.021
Entitlement to Medical Benefits
408.022
Selection of Doctor
408.023
List of Approved Doctors
408.024
Noncompliance with Selection Requirements
408.025
Reports and Records Required from Health Care Providers
408.026
Spinal Surgery
408.027
Payment of Health Care Provider
408.028
Pharmaceutical Services
408.029
Nurse First Assistant Services
408.031
Workers’ Compensation Health Care Networks
408.0041
Designated Doctor Examination
408.041
Average Weekly Wage
408.0042
Medical Examination by Treating Doctor to Define Compensable Injury
408.042
Average Weekly Wage for Part-time Employee or Employee with Multiple Employment
408.0043
Professional Specialty Certification Required for Certain Review
408.043
Average Weekly Wage for Seasonal Employee
408.0044
Review of Dental Services
408.044
Average Weekly Wage for Minor, Apprentice, Trainee, or Student
408.0045
Review of Chiropractic Services
408.045
Nonpecuniary Wages
408.0046
Rules
408.046
Similar Employees, Services, or Employment
408.047
State Average Weekly Wage
408.061
Maximum Weekly Benefit
408.062
Minimum Weekly Income Benefit
408.063
Wage Presumptions
408.064
Interest on Accrued Benefits
408.081
Income Benefits
408.082
Accrual of Right to Income Benefits
408.083
Termination of Right to Temporary Income, Impairment Income, and Supplemental Income Benefits
408.084
Contributing Injury
408.085
Advance of Benefits for Hardship
408.101
Temporary Income Benefits
408.102
Duration of Temporary Income Benefits
408.103
Amount of Temporary Income Benefits
408.104
Maximum Medical Improvement After Spinal Surgery
408.105
Salary Continuation in Lieu of Temporary Income Benefits
408.121
Impairment Income Benefits
408.122
Eligibility for Impairment Income Benefits
408.123
Certification of Maximum Medical Improvement
408.124
Impairment Rating Guidelines
408.125
Dispute as to Impairment Rating
408.126
Amount of Impairment Income Benefits
408.127
Reduction of Impairment Income Benefits
408.128
Commutation of Impairment Income Benefits
408.129
Acceleration of Impairment Income Benefits
408.141
Award of Supplemental Income Benefits
408.142
Supplemental Income Benefits
408.143
Employee Statement
408.144
Computation of Supplemental Income Benefits
408.145
Payment of Supplemental Income Benefits
408.146
Termination of Supplemental Income Benefits
408.147
Contest of Supplemental Income Benefits by Insurance Carrier
408.148
Employee Discharge After Termination
408.149
Status Review
408.150
Vocational Rehabilitation
408.151
Medical Examinations for Supplemental Income Benefits
408.161
Lifetime Income Benefits
408.162
Subsequent Injury Fund Benefits
408.181
Death Benefits
408.182
Distribution of Death Benefits
408.183
Duration of Death Benefits
408.184
Redistribution of Death Benefits
408.185
Effect of Beneficiary Dispute
408.186
Burial Benefits
408.187
Autopsy
408.201
Benefits Exempt from Legal Process
408.202
Assignability of Benefits
408.203
Allowable Liens
408.0221
Request for Description of Employment
408.221
Attorney’s Fees Paid to Claimant’s Counsel
408.222
Attorney’s Fees Paid to Defense Counsel
408.0231
Maintenance of List of Approved Doctors
408.0251
Electronic Billing Requirements
408.0252
Underserved Areas
408.0271
Reimbursement by Health Care Provider
408.0272
Certain Exceptions for Untimely Submission of Claim
408.0281
Reimbursement for Pharmaceutical Services
408.0282
Requirements for Certain Informal or Voluntary Networks
408.0284
Reimbursement for Durable Medical Equipment and Home Health Care Services
408.0446
Average Weekly Wage
408.0815
Resolution of Overpayment or Underpayment of Income Benefits
408.1225
Designated Doctor
408.1415
Work Search Compliance Standards
408.1615
Lifetime Income Benefits for Certain First Responders

Accessed:
Jun. 5, 2024

§ 408.1225’s source at texas​.gov