(a) For examinations performed before January 1, 2013,
a designated doctor is qualified to perform a designated doctor examination
on an injured employee if the designated doctor has credentials that
are appropriate to the issue in question and the injured employee's
medical condition, that meet the requirements of Labor Code §408.0043,
§408.0045, and applicable division rules, and the designated
doctor has no applicable disqualifying associations under §127.140
of this title (relating to Disqualifying Associations).
(b) For examinations performed on or after January
1, 2013, a designated doctor is qualified to perform a designated
doctor examination on an injured employee if the designated doctor
meets the appropriate qualification criteria for the area of the body
affected by the injury and the injured employee's diagnosis and has
no disqualifying associations under §127.140 of this title. A
designated doctor's qualification criteria are determined as follows:
  (1) To examine injuries and diagnoses relating to the
hand and upper extremities, a designated doctor must be a licensed
medical doctor, doctor of osteopathy, or doctor of chiropractic.
  (2) To examine injuries and diagnoses relating to the
lower extremities excluding feet, a designated doctor must be a licensed
medical doctor, doctor of osteopathy, or doctor of chiropractic.
  (3) To examine injuries and diagnoses relating to the
spine and torso, a designated doctor must be a licensed medical doctor,
doctor of osteopathy, or doctor of chiropractic.
  (4) To examine injuries and diagnoses relating to the
feet, including the toes and heel, a designated doctor must be a licensed
medical doctor, doctor of osteopathy, doctor of chiropractic, or doctor
of podiatric medicine.
  (5) To examine injuries and diagnoses relating to the
teeth and jaws, a designated doctor must be a licensed medical doctor,
doctor of osteopathy, or doctor of dental surgery.
  (6) To examine injuries and diagnoses relating to the
eyes, including the eye and adnexal structures of the eye, a designated
doctor must be a licensed medical doctor, doctor of osteopathy, or
doctor of optometry.
  (7) To examine injuries and diagnoses relating to other
body areas or systems, including but not limited to internal systems;
ear, nose, and throat; head and face; skin; mental and behavioral
disorders; tendon lacerations; and dislocations, a designated doctor
must be a licensed medical doctor or doctor of osteopathy.
  (8) Notwithstanding paragraphs (1) - (7) of this subsection,
a designated doctor must be a licensed medical doctor or doctor of
osteopathy who has the required board certification to examine any
of the following diagnoses. For purposes of this section, a designated
doctor is "board certified" in a required specialty or subspecialty,
as applicable, if the designated doctor holds a general certificate
in the required specialty or a subspecialty certificate in the required
subspecialty from the American Board of Medical Specialties (ABMS)
or if the designated doctor holds a primary certificate in the required
specialty and a certificate of special qualifications or certificate
of added qualifications in the required subspecialty from the American
Osteopathic Association Bureau of Osteopathic Specialists (AOABOS).
    (A) To examine traumatic brain injuries, a designated
doctor must be board certified in neurological surgery, neurology,
physical medicine and rehabilitation, or psychiatry by the ABMS or
board certified in neurological surgery, neurology, physical medicine
or rehabilitation, or psychiatry by the AOABOS.
    (B) To examine spinal cord injuries, including spinal
fractures with documented neurological deficit, a designated doctor
must be board certified in neurological surgery, neurology, physical
medicine and rehabilitation, orthopaedic surgery, or occupational
medicine by the ABMS or board certified in neurological surgery, neurology,
physical medicine and rehabilitation, orthopedic surgery, preventive
medicine/occupational-environmental medicine, or preventive medicine/occupational
by the AOABOS.
    (C) To examine severe burns, including chemical burns,
defined as 3rd or 4th degree burns over 9 percent or greater of the
body, a designated doctor must be board certified in dermatology,
physical medicine and rehabilitation, plastic surgery, orthopaedic
surgery, surgery, or occupational medicine by the ABMS or board certified
in dermatology, physical medicine and rehabilitation, plastic and
reconstructive surgery, orthopedic surgery, surgery (general), preventive
medicine/occupational-environmental medicine, or preventive medicine/occupational
by the AOABOS.
    (D) To examine complex regional pain syndrome (reflex
sympathetic dystrophy), a designated doctor must be board certified
in neurological surgery, neurology, orthopaedic surgery, anesthesiology
with a subspecialty in pain medicine, occupational medicine, or physical
medicine and rehabilitation by the ABMS or board certified in neurological
surgery, neurology, orthopedic surgery, preventive medicine/occupational-environmental
medicine, preventive medicine/occupational, anesthesiology with certificate
of added qualifications in pain management, or physical medicine and
rehabilitation by the AOABOS.
    (E) To examine multiple bone fractures, excluding spinal
fractures, a designated doctor must be board certified in emergency
medicine, orthopaedic surgery, plastic surgery, physical medicine
and rehabilitation, or occupational medicine by the ABMS or board
certified in emergency medicine, orthopedic surgery, plastic surgery,
physical medicine and rehabilitation, preventive medicine/occupational-environmental
medicine, or preventive medicine/occupational by the AOABOS.
    (F) To examine complicated infectious diseases requiring
hospitalization or prolonged intravenous antibiotics, including blood
borne pathogens, a designated doctor must be board certified in internal
medicine or occupational medicine by the ABMS or board certified in
internal medicine, preventive medicine/occupational-environmental
medicine, or preventive medicine/occupational by the AOABOS.
    (G) To examine chemical exposure, excluding chemical
exposure limited to skin exposure, a designated doctor must be board
certified in internal medicine, emergency medicine, or occupational
medicine by the ABMS or board certified in internal medicine, emergency
medicine, preventive medicine/occupational-environmental medicine,
or preventive medicine/occupational by the AOABOS.
    (H) To examine heart or cardiovascular conditions,
a designated doctor must be board certified in internal medicine,
emergency medicine, occupational medicine, thoracic and cardiac surgery,
or family medicine by the ABMS or board certified in internal medicine,
emergency medicine, preventive medicine/occupational-environmental
medicine, preventive medicine/occupational, thoracic and cardiovascular
surgery or family practice and osteopathic manipulative treatment
by the AOABOS.
(c) To be qualified to perform an initial examination
on an injured employee, a designated doctor, other than a chiropractor,
must be qualified under Labor Code §408.0043. A designated doctor
who is a chiropractor must be qualified to perform an initial designated
doctor examination under Labor Code §408.0045. If, however, the
requirements of this subsection would disqualify a designated doctor
otherwise qualified under subsection (b) of this section, pursuant
to Labor Code §408.0041(b-1), does not apply.
(d) For any particular designated doctor examination,
the division may exempt a designated doctor from the applicable qualification
standard if no other designated doctor is qualified and available
to perform the examination. Additionally, the division may not offer
a qualified designated doctor an examination if it is reasonably probable
that the designated doctor will not be qualified on the date of the
examination.
(e) A designated doctor who performs an initial designated
doctor examination of an injured employee and had the appropriate
selection criteria to perform that examination under either subsection
(a) or (b) of this section, as applicable, shall remain assigned to
that claim and perform all subsequent examinations of that injured
employee unless the division authorizes or requires the designated
doctor to discontinue providing services on that claim.
(f) The division may authorize a designated doctor
to stop providing services on a claim if the doctor:
  (1) decides to stop practicing in the workers' compensation
system;
  (2) decides to stop practicing as a designated doctor
in the workers' compensation system;
  (3) relocates the doctor's residence or practice;
  (4) has asked the division to indefinitely defer the
doctor's availability on the designated doctor list;
  (5) determines that examining the injured employee
would require the designated doctor to exceed the scope of practice
authorized by the doctor's license; or
  (6) can otherwise demonstrate to the division that
the doctor's continued service on the claim would be impracticable
or could impair the quality of examinations performed on the claim.
(g) The division will prohibit a designated doctor
from providing services on a claim if:
  (1) the doctor has failed to become recertified as
a designated doctor under §127.110(a) or (b) of this title (relating
to Designated Doctor Recertification);
  (2) the doctor no longer has the appropriate qualification
criteria under either subsection (a) or (b) of this section, as applicable,
to perform examinations on the claim;
  (3) the doctor has a disqualifying association, as
specified in §127.140 of this title, relevant to the claim;
  (4) the doctor has repeatedly failed to respond to
division appointment, clarification, or document requests, or other
division inquiries regarding the claim;
  (5) the doctor's continued service on the claim could
endanger the health, safety, or welfare of either the injured employee
or doctor; or
  (6) the division has revoked or suspended the designated
doctor's certification.
(h) The division will prohibit a designated doctor
from performing examinations on all new or existing claims if the
designated doctor has had the doctor's license revoked or suspended
and the suspension has not been probated by an appropriate licensing
authority.
(i) This section will become effective on September
1, 2012.


Source Note: The provisions of this §127.130 adopted to be effective September 1, 2012, 37 TexReg 5422