Texas Register, Volume 37, Number 40, Pages 7815-8094, October 5, 2012 Page: 7,868
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sent), the commissioner may deny a request for written consent for the
following reasons, including if:
(1) the applicant is not a person subject to the Act as defined
in 1.521 of this title (relating to Definitions);
(2) the applicant violates this division;
(3) TDI determines that Texas is not the appropriate state
for the applicant to request written consent; or
(4) the applicant's request for written consent was denied
or revoked by another state.
(c) Written notice. If the commissioner determines that the re-
quest for written consent should be denied or the written consent should
be revoked, TDI will issue a notice setting forth a statement of legal au-
thority and a short, plain statement of the factors pertinent to the denial
or revocation.
(d) Effect of denial or revocation. TDI will not grant a license
or authorization to any person subject to the Act or permit a person sub-
ject to the Act to retain a license or authorization if the commissioner
has denied a request for written consent or revoked the written consent.
(e) Request for hearing. The person subject to the Act will
have 30 days from the date of notice to make a written request for a
hearing.
(f) Final agency decision. If a written request for hearing is not
made, the notice of denial or revocation will constitute a final agency
decision.
,1.530. Hearing.
If a person subject to the Act requests a hearing, the hearing shall be
conducted by the State Office of Administrative Hearings. The hearing
is subject to the procedures for contested cases under Government Code
Chapter 2001 and Insurance Code Chapter 40.
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal author-
ity to adopt.
Filed with the Office of the Secretary of State on September 19,
2012.
TRD-201204947
Sara Waitt
General Counsel
Texas Department of Insurance
Earliest possible date of adoption: November 4, 2012
For further information, please call: (512) 463-6327
PART 2. TEXAS DEPARTMENT OF
INSURANCE, DIVISION OF WORKERS'
COMPENSATION
CHAPTER 126. GENERAL PROVISIONS
APPLICABLE TO ALL BENEFITS
28 TAC 126.17
The Texas Department of Insurance (Department), Division of
Workers' Compensation (Division) proposes new 126.17, con-
cerning Guidelines for Examination by a Treating Doctor or Re-
ferral Doctor After a Designated Doctor Examination to AddressIssues Other Than Certification of Maximum Medical Improve-
ment and the Evaluation of Permanent Impairment.
Statutory Background
This new section is proposed due to statutory amendments in
House Bill 2605, enacted by the 82nd Legislature, Regular Ses-
sion, effective September 1, 2011 (HB 2605) which codify into
the Texas Workers' Compensation Act (Act) the ability of the in-
jured employee who is required to be examined by a designated
doctor to request an examination by the injured employee's treat-
ing or a referral doctor to determine the issue(s) decided by the
designated doctor.
Specifically, HB 2605 amended Labor Code 408.0041
by adding subsections (f-2) and (f-4). Under Labor Code
408.0041(f-2), an injured employee required to be examined
by a designated doctor may request a medical examination
to determine maximum medical improvement and the injured
employee's impairment rating from the injured employee's treat-
ing doctor or another doctor to whom the injured employee is
referred by the treating doctor if the designated doctor's opinion
is the injured employee's first evaluation of maximum medical
improvement and impairment rating and the injured employee
is not satisfied with the designated doctor's report. Labor
Code 408.0041(f-4) requires the Commissioner of Workers'
Compensation (Commissioner) by rule to adopt guidelines
prescribing the circumstances under which an examination
by the injured employee's treating doctor or another doctor to
whom the injured employee is referred by the treating doctor
to determine any issue under Labor Code 408.0041(a), other
than an examination under Labor Code 408.0041(f-2), may be
appropriate. The purpose behind these legislative amendments
was to provide the injured employee the ability to obtain from
his or her treating doctor or a referral doctor a second opinion
on the issue(s) determined by the designated doctor and, if
the injured employee seeks dispute resolution on the issue,
evidence the injured employee can use in the dispute resolution
process in an attempt to overcome the presumptive weight of
the designated doctor's opinion on the issue(s).
Whereas Labor Code 408.0041(f-2) governs post-designated
doctor examinations on maximum medical improvement and im-
pairment rating, the rules required by Labor Code 408.0041 (f-4)
are to govern post-designated doctor examinations on issues in
Labor Code 408.004(a)(3) - (6). This proposed new section im-
plements the requirements of Labor Code 408.0041 (f-4).
The Division published an informal draft of the proposed new
section on the Division's website from August 2, 2012 until Au-
gust 23, 2012, and received seven informal comments on the
proposed section. The Division made several changes to the
rule text as a result of the informal comments.
Description of the Proposed New Section
Proposed New 126.17.
Proposed new 126.17 sets forth guidelines prescribing the
circumstances under which an examination by a treating doctor
or referral doctor to determine any issue under Labor Code
408.0041(a), other than maximum medical impairment and
impairment rating, may be appropriate. This new rule is neces-
sary in order to implement Labor Code 408.0041(f-4) which
requires the Commissioner by rule to adopt such guidelines.
Proposed New 126.17(a)37 TexReg 7868 October 5, 2012 Texas Register
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Texas. Secretary of State. Texas Register, Volume 37, Number 40, Pages 7815-8094, October 5, 2012, periodical, October 5, 2012; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth288982/m1/54/: accessed July 12, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu.; crediting UNT Libraries Government Documents Department.