Texas Administrative Code › Title 28 - INSURANCE › Part 2 - TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION › Chapter 130 - IMPAIRMENT AND SUPPLEMENTAL INCOME BENEFITS › Subchapter A - IMPAIRMENT INCOME BENEFITS › Section 130.2 - Certification of Maximum Medical Improvement and Evaluation of Permanent Impairment by the Treating Doctor

Current through Reg. 49, No. 28; July 12, 2024
(a) A treating
				  doctor shall either examine the injured employee (employee) and determine if
				  the employee has any permanent impairment as a result of the compensable injury
				  as soon as the doctor anticipates that the employee will have no further
				  material recovery from or lasting improvement to the work-related injury or
				  illness, based on reasonable medical probability, or have another authorized
				  doctor do so.
(1) A treating doctor who finds
				  that the employee has permanent impairment but who is not authorized to assign
				  impairment ratings as provided in §
											130.1
				  of this title (relating to Certification of Maximum Medical Improvement and
				  Evaluation of Permanent Impairment), shall make a referral to a doctor who is
				  authorized to do so on behalf of the treating doctor. Even if the treating
				  doctor is so authorized, the doctor may choose to have another authorized
				  doctor evaluate the employee for maximum medical improvement (MMI) and
				  impairment in the place of the treating doctor. However, this evaluation shall
				  be considered to be the report of the treating doctor.
(2) Other than subsections (c) and (d) of
				  this section, nothing in this section requires a treating doctor to schedule an
				  examination if the employee has been released from treatment and is not
				  receiving temporary income benefits (TIBs). For example, when the patient is
				  treated and released without further treatment for a minor injury, the treating
				  doctor is not required to schedule and conduct an examination for MMI and
				  permanent impairment.
(3) At the
				  conclusion of an examination in which the treating doctor, or the certifying
				  doctor in the event that the treating doctor is not authorized to certify MMI
				  and assign an impairment rating, determines that the employee has reached
				  maximum medical improvement and assigns an impairment rating, the doctor shall
				  provide the employee with a written notice that the certification may be
				  disputed. The notice shall be provided as a separate document included with the
				  Report of Medical Evaluation provided in accordance with §
											130.1
				  of this title. The notice must be provided in English, Spanish, or other
				  language common to the employee, and shall include the following information:
(A) the date of maximum medical
				  improvement;
(B) the assigned
				  impairment rating;
(C) a statement
				  that the impairment rating may become final if not disputed within 90 days, and
				  if the employee, or the employee's representative, disagrees with the
				  certification, they may dispute the certification by contacting the Division of
				  Workers' Compensation and requesting a benefit review conference;
(D) the address and phone number of the local
				  field office of the Division of Workers' Compensation (Division); and
(E) a statement that the employee may contact
				  the Division for more information at 1-800-252-7031.