| (a) Filing a clarification request. Parties may file
a request with the division for clarification of the designated doctor's
report.
(1) The requesting party must provide copies of the
request to all parties.
(2) The division may contact the designated doctor
if it determines that clarification is necessary to resolve an issue
regarding the designated doctor's report.
(3) 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.
(4) A designated doctor must only respond to the questions
or requests submitted to the designated doctor in the request for
clarification and must not reconsider their previous decision, issue
a new or amended decision, or provide clarification on their previous
decision.
(b) Requirements. Requests for clarification must:
(1) include the name of the designated doctor, the
reason for the examination, the date of the examination, and the requester's
name and signature;
(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 not inflammatory or 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) Requests by the division. At its discretion, the
division may also request clarification from the designated doctor
on any issue or issues.
(d) Responses to requests. To respond to a request
for clarification, the designated doctor must be on the division's
designated doctor list on the date of the request.
(1) The designated doctor must 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(g)
of this title (relating to General Procedures for Designated Doctor
Examinations).
(2) If the designated doctor must reexamine the injured
employee to respond to the request for clarification, the doctor must:
(A) respond to the request for clarification in writing,
advising of the need for an additional examination within five working
days of receiving the request and provide copies of the response to
the parties specified in §127.10(g) of this title;
(B) conduct the reexamination within 21 days from the
date the division issues the order for the reexamination at the same
address as the original examination; and
(C) 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(g) of this title.
(e) Administrative violation. 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.
|
| Source Note: The provisions of this §127.20 adopted to be effective February 1, 2011, 35 TexReg 11324; amended to be effective September 1, 2012, 37 TexReg 5422; amended to be effective April 30, 2023, 48 TexReg 2123 |
