127.140
(a) Definition. A disqualifying association is any association that may reasonably be perceived as having potential to influence the conduct or decision of a designated doctor. Disqualifying associations may include: (1) receipt of income, compensation, or payment of any kind not related to health care the doctor provides; (2) shared investment or ownership interest; (3) […]
127.200
(a) Duties. All designated doctors must: (1) Perform designated doctor examinations in a facility: (A) currently used and properly equipped for medical examinations or other similar health care services; and (B) that ensures safety, privacy, and accessibility for injured employees, injured employee medical records, and other records containing confidential claim information. (2) Ensure the confidentiality […]
127.210
(a) Grounds for sanctions. In addition to the grounds for issuing sanctions against a doctor under 180.26 of this title (relating to Criteria for Imposing, Recommending and Determining Sanctions; Other Remedies), other division rules, or the Labor Code, the commissioner may revoke or suspend a designated doctor’s certification as a designated doctor or sanction a […]
127.220
(a) Format and submission. Designated doctor narrative reports must be filed in the form and manner required by the division. At a minimum, they must do all of the following: (1) Identify the question or questions the division ordered to be addressed by the designated doctor examination. (2) Provide a clearly defined answer for each […]
180.23
(a) Applicability. This section governs authorization relating to certification of maximum medical improvement (MMI), determination of permanent impairment, and assignment of impairment ratings in the event that a doctor finds permanent impairment exists. (b) Authorization. Full authorization to assign an impairment rating and certify MMI in an instance where the injured employee is found to […]
165.1
(a) The Texas Mutual Insurance Company must provide the division a list of the policyholders requiring accident prevention services (rejected risk employers). This list must include rejected risk employers that meet the criteria in Texas Insurance Code Chapter 2054, Subchapters H and K. (b) A policyholder subject to Texas Insurance Code §2054.504, whose corporate office […]
102.11
(a) The Division prescribes standard electronic formats by utilizing implementation guides for data requests and data reports for the purpose of exchanging data between the Division and insurance carriers, as defined in Labor Code §402.084. (b) In this section, the following definitions apply: (1) Claim Data Request and Report Implementation Guide (Guide)–The division specification document […]
180.62
(a) Purpose. The purpose of the Medical Quality Review Panel (MQRP) is to assist the medical advisor in the performance of the medical advisor’s duties under Labor Code §413.0511 in accordance with the provisions of Labor Code §§413.0512, 413.05121, and 413.05122. (b) Experts. Members of the MQRP who prepare reports for medical case review will […]
251.503
The following words and terms, when used in this subchapter, shall have the following meanings: (1) Claims Cost. The net amount of payments made on claims, minus subrogation and restitution costs, as reported by the Office. (2) Covered Agency. A department, board, commission, or institution of this state with workers’ compensation coverage under Chapter 501 […]
252.201
(a) Each state agency covered by Texas Labor Code, Chapter 412, shall develop and implement an agency risk management program, which shall include a safety and health program and a return-to-work program. State agency risk management programs shall either: (1) comply with the risk management guidelines, including risk control and risk financing, contained in the […]