Texas Workers' Compensation: Selecting A Treating Doctor

Posted almost 4 years ago. Applies to Texas, 2 helpful votes

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Most injured workers receive medical attention first from either an emergency room doctor or the company doctor. But these are not viable options for long-term care. The emergency room doctor won't treat beyond that first visit, and the company doctor is often more concerned about taking care of the employer and not the patient. Once initial care has been obtained, it is time to consider who should be selected as the treating doctor.

The "treating doctor" in a Texas workers' comp claim has a very large role. That doctor is responsible for making sure that the injured worker gets appropriate treatment and is referred to any necessary specialists. Everything goes through the treating doctor. And if the claim (or any portion of the claim) is denied, the treating doctor helps to establish what the injuries are, prove how they were caused by the work accident, and establish the claimant's work abilities. Any and all benefits that an injured worker might possibly collect are established through the treating doctor. So you can see why treating with a company doctor is not the best idea.

Treating doctors can be hard to find, depending on where you are. In the North Texas area, you should consider the DallasWorkComp.com recommended doctors. Most attorneys can help you find a reputable doctor that will agree to direct the workers' compensation claim treatment.

If you are still treating with a company doctor, you can change to a doctor of your choice. The adjuster and the Division of Workers' Compensation might tell you different, but they are wrong. You might need the help of an attorney, but you can change doctors in most situations. Sometimes changing treating doctors requires some litigation, but in the vast majority of all situations, there is a way to change doctors. Start by filing form DWC-053. (http://www.tdi.texas.gov/forms/form20numeric.html)

If you are told that your claim is a "network claim," then the procedure is different but a change can still be made. Beware of the adjuster trick where they give you a list of network doctors to choose from, but it is a list of only the doctors the insurance company likes and not the complete list. If you have a network claim, I recommend that you consult with an attorney in order to obtain a change of treating doctor.

As with many things in the Texas work comp system, the sooner you begin the effort to change your treating doctor, the easier it will be to get it done.

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