Texas workers' compensation law requires that all injured workers have an official treating doctor who manages all treatment and referrals in the claim.   This is generally the first doctor you get treatment from unless the first doctor is the company doctor or an emergency room doctor.  All injured workers have sixty days to pick a new doctor without Division approval if the only treatment has been from a company doctor or an emergency room doctor. 

If you are not satisfied with your initial choice of treating doctor, you have the right to request a change of doctor.  The first thing you have to do is find a doctor that you like and who will agree to be your doctor.  Then you have to file form DWC-53 (the official change of doctor request) with the Division of Workers' Compensation.

What you write on the request to change doctors is very important. You have to submit a reason to justify the change of doctor.  The law does not allow a change of doctor unless there is a justifiable reason.  The law even prohibits a change of doctor if the reason is that you want a new impairment rating or medical report.

Division Rule 126.9 and Texas Labor Code Section 408.022 explain what is required to change doctors.  They give two reasons for a change of doctor that are easier to use than any others under the rules.  One is that a conflict exists between the employee and the doctor to the extent that the doctor-patient relationship is jeopardized or impaired.  If you use this reason to change doctors you must explain how the doctor-patient relationship has been damaged to the degree that it can't be repaired.  You can explain why you can't trust the doctor, how you have been mistreated or neglected, describe any conversations that you have had with the doctor or any other information that shows how your relationship with the doctor is beyond repair.  You have to explain why there is no way you will ever let that doctor touch you again.

The second way is the easiest of all - to show that the current treating doctor has now chosen not to be your doctor.  This can be done by getting the doctor to write a short note stating that he/she no longer wants to be your treating doctor and you are free to seek treatment elsewhere.  You can do this whether the doctor chose not to treat you or you have chosen not to be treated by that doctor.  This is a very common method for securing a change of doctor.

            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.

            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.