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Texas Compliance

Physician Selection

The employee has the right to an initial choice of doctor. TLC 408.022 This does not apply to requirements regarding the selection of a doctor under a workers' compensation health care network. (See Managed Care below)

A change affecting doctors in the Texas workers' compensation system took effect Sept. 1. At that time, doctors within the state will no longer be required to be approved or trained by the Texas Department of Insurance Division of Workers' Compensation (TDI) to provide treatment to injured employees in the workers' compensation system.

Even though the Approved Doctors List (ADL) expires August 31, 2007, TDI will continue to regulate health care in the system. Participating doctors must continue to disclose financial interest in other providers, practitioners and facilities, etc. to TDI.

To read the entire Aug. 10 letter from Albert Betts, commissioner of workers' compensation at the Texas Department of Insurance, click here.

TDI maintains an online listing of doctors licensed to practice in Texas through the TXCOMP Provider system This listing can be used by injured employees to select treating doctors and other system participants to verify the status of providers. The system also allows providers to create and maintain a profile for reporting financial disclosure information.

The agency will also publish a list of providers who have been sanctioned by TDI. This list includes doctors who have been removed, deleted or were denied admission to the ADL. These doctors may not treat injured employees

The employee is able to request a change in doctors. Any request to change doctors must be approved by the local Division office handling theclaim. If the employee or the doctor move or the doctor becomes unavailable to provide medical treatment, the employee will be allowed to choose another doctor from the ADL. This will be considered an exception to the law and will not be viewed as a request to change doctors. The Employee's Request to Change Treating Doctors (DWC-53) will need to be completed and filed with the local Division office. TLC 408.022

If the employee goes to a doctor other than one that is authorized, they may have to pay for their own medical bills. TLC 408.024