| (a) An insurance carrier may suspend temporary income
benefits (TIBs) if an injured employee, without good cause, fails
to attend a designated doctor examination.
(b) In the absence of a finding by the division to
the contrary, an insurance carrier may presume that the injured employee
did not have good cause to fail to attend the examination if by the
day the examination was originally scheduled to occur the injured
employee has both:
(1) failed to submit to the examination; and
(2) failed to contact the designated doctor's office
to reschedule the examination.
(c) If the injured employee contacts the designated
doctor within 21 days of the scheduled date of the missed examination
to reschedule the examination, the designated doctor shall schedule
the examination to occur as soon as possible, but not later than the
21st day after the injured employee contacted the doctor.
(d) If the injured employee fails to contact the designated
doctor within 21 days of the scheduled date of the missed examination
but wishes to reschedule the examination, the injured employee must
request a new examination under §127.1 of this title (relating
to Requesting a Designated Doctor Examination).
(e) The insurance carrier shall reinstate TIBs effective
as of the date the injured employee submitted to the rescheduled examination
under subsection (c) of this section or the examination scheduled
pursuant to the injured employee's request under subsection (d) of
this section unless the report of the designated doctor indicates
that the injured employee has reached MMI or is otherwise not eligible
for income benefits. The re-initiation of TIBs shall occur no later
than the seventh day following:
(1) the date the insurance carrier was notified that
the injured employee submitted to the examination; or
(2) the date that the insurance carrier was notified
that the division found that the injured employee had good cause for
not attending the examination.
(f) An injured employee is not entitled to TIBs for
a period during which the insurance carrier suspended benefits pursuant
to this section unless the injured employee later submits to the examination
and the division finds or the insurance carrier determines that the
injured employee had good cause for failure to attend the examination.
(g) This section will become effective September 1,
2012.
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