Texas Administrative Code

Texas Administrative Code

TITLE 28	INSURANCE
PART 2	TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION
CHAPTER 69	MEDICAL EXAMINATION ORDERS
RULE §69.25	Bases for Denial

(a) Time limit after injury. No examination shall be ordered if the combination form is signed or submitted 60 or fewer days after the date of an injury.

(b) Health care providers limited. No examination shall be ordered if the license of the health care provider is under suspension by the appropriate licensing agency on the date of application.

(c) Ability to travel. No examination will be ordered unless a statement is attached to the request setting out whether the claimant's condition will allow travel to and attendance at the examination. The statement shall affirm that travel expenses will be tendered to the claimant in advance of any travel.

(d) One hundred eighty-day period. No examination shall be ordered if the claimant has been examined by the carrier's prior choice of health care provider in a 180-day period.

(e) Same health care provider. No examination shall be ordered if the claimant has been examined for the injury by the carrier's choice of health care provider and the prior health care provider is not the same as the requested health care provider.

(f) Good cause. The board may waive any of the bases for denial in subsections (a)-(e) of this section or deny an application for a medical examination order if the board determines that good cause exists.

Source Note: The provisions of this §69.25 adopted to be effective February 19, 1988, 13 TexReg 617; amended to be effective June 4, 1990, 15 TexReg 2852.