| (a) Parties may file a request with the division for
clarification of the designated doctor's report. A copy of the request
must be provided to the opposing party. The division may contact the
designated doctor if it determines that clarification is necessary
to resolve an issue regarding the designated doctor's report. Parties
may only request clarification on issues already addressed by the
designated doctor's report or on issues that the designated doctor
was ordered to address but did not address. Additionally, a designated
doctor shall only respond to the questions or requests submitted to
the designated doctor in the request for clarification and shall not
otherwise reconsider the doctor's previous decision, issue a new or
amended decision, or provide clarification on the doctor's previous
decision.
(b) Requests for clarification must:
(1) include the name of the designated doctor, the
reason for the designated doctor's examination, the date of the examination,
and the name and signature of the requestor;
(2) explain why clarification of the designated doctor's
report is necessary and appropriate to resolve a future or pending
dispute;
(3) include questions for the designated doctor to
answer that are neither inflammatory nor leading; and
(4) provide any medical records that were not previously
provided to the designated doctor and explain why these records are
necessary for the designated doctor to respond to the request for
clarification.
(c) The division, at its discretion, may also request
clarification from the designated doctor on issues the division deems
appropriate.
(d) To respond to the request for clarification, the
designated doctor must be on the division's designated doctor list
at the time the request is received by the division. The designated
doctor shall respond, in writing, to the request for clarification
within five working days of receipt and send copies of the response
to the parties listed in §127.10(f) of this title (relating to
General Procedures for Designated Doctor Examinations). If, in order
to respond to the request for clarification, the designated doctor
has to reexamine the injured employee, the doctor shall:
(1) respond, in writing, to the request for clarification
advising of the need for an additional examination within five working
days of receipt of the request and provide copies of the response
to the parties specified in §127.10(f) of this title;
(2) if the division orders the reexamination, conduct
the reexamination within 21 days from the date the order is issued
by the division at the same examination address as the original examination;
and
(3) respond, in writing, to the request for clarification
based on the additional examination within seven working days of the
examination and provide copies of the response to the parties specified
in §127.10(f) of this title.
(e) Any refusal or failure by a designated doctor to
conduct a reexamination that is necessary to respond to a request
for clarification is an administrative violation.
(f) This section will become effective September 1,
2012.
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