New Texas Disability Management Rules in Effect for Workers’ Comp

Disability management rules adopted by the Texas Department of Insurance, Division of Workers’ Compensation (Division) that became effective May 1, 2007, require non-network system participants to follow the Division’s treatment and return-to-work guidelines.

The Division announced it is providing training and educational resources for compliance with the rules, which are accessible through the agency Web site, http://www.tdi.state.tx.us/wc/dm/index.html.

The disability management rules apply to all workers’ compensation claims with a date of injury occurring on or after Jan. 1, 1991. Treatment and return-to-work guidelines are effective May 1, 2007 and are applicable to treatments and/or services provided as of that date. Treatment and services which exceed or are not included in the guidelines require preauthorization in accordance with Division rules.

The effective date for the third element of disability management – treatment planning – has been changed from May 1, 2007 to Sept. 1, 2007. In order to avoid a lapse in care, treating doctors and insurance carriers must exchange information on treatment plans prior to the rule’s effective date.

The Division cooperated with organizations including the Texas Medical Association and the Insurance Council of Texas to develop training opportunities about disability management.

For more information about the Division’s disability management rules and available training for system participants, e-mail: medicalbenefits@tdi.state.tx.us.

Source: Texas DWC