Flahive, Ogden, & Latson - Attorneys at Law

DESIGNATED DOCTOR SERVICES

The Texas Department of Insurance, Division of Workers' Compensation (TDI-DWC) has enlarged the information to be filed on the DWC Form-032, Request for Designated Doctor. These changes are a part of an initiative to improve the designated doctor process by:

• Improving the quality of designated doctor examinations and narrative reports;

• Decreasing the need for letters of clarification;

• Reducing the inconvenience and expense of multiple re-examinations;

• Expediting agreement between parties by bringing facts into focus early in the dispute resolution process.

To assist those claims departments requiring additional support, and upon request from you, Flahive, Ogden & Latson offers three levels of services (See below)

We require a complete copy of all medical records in the file; a copy of the DWC-1, and a copy of your claim notes (to be used in determining information required in the DWC-32 – notes will not be shared with anyone else).

For those offices preferring to self-complete the DWC-32 and file it through our office, we would be glad to file the request. If you will provide a separate copy of the face sheet of the DWC-32, we will have it file stamped and returned to you. We understand that you will monitor for approval by DWC and will be responsible for forwarding the medical and analysis if any. Should you have general questions about this process a lawyer in our firm will be available to assist you by telephone. These services are included in the Austin Commission Representative services and are available without additional charge.

Requests for this service should be sent direct to FOL DDR Department. Request for electronic Order Form can be made to: ddr@fol.com.If you have questions, please contact Brandi Senters at 512-435-2299.

FO&L DDR SERVICE LEVELS

ð Platinum Service: $375

Prepare the DWC-32 form

Complete each mandatory field of information on the form;

Complete each discretionary field of information on the form;

Complete injury and treatment Matrix to obtain correct discipline of doctor;

Respond to Division inquiries related to DD request.

Prepare Analysis

Review medical records;

Review DWC filings and carrier investigative materials;

Summarize history of injury and course of medical care;

Analyze all reviewed file materials;

Tailor analysis specifically for the disputed issues raised.

Tracking Service:

File the form;

Notify you of date filed by email;

Monitor for DWC approval;

Follow up with DWC until exam approved;

Notify you of the date and time of the exam by email;

Forward copy of filed DWC – 32 and ES -14;

Forward all medical records to the

Designated Doctor;

Notify you by email claimant attended, rescheduled, or no-showed at the Designated Doctor appointment.

ð Gold Service: $300

Prepare Analysis

Review medical records;

Review DWC filings and carrier investigative materials;

Summarize history of injury and course of medical care;

Analyze all reviewed file materials;

Tailor analysis specifically for the disputed issues raised.

Tracking Service:

Follow up with DWC until exam approved (where appropriate);

Forward copy of filed DWC – 32 and ES –14 (where appropriate);

Forward all medical records to the designated doctor.

Notify you by email claimant attended, rescheduled, or no-showed at the Designated Doctor appointment.

ð Silver Service: $250

Prepare the DWC-32 form

Complete each mandatory field of information on the form;

Complete each discretionary field of information on the form;

Complete injury and treatment Matrix to obtain correct discipline of doctor;

Respond to Division inquiries related to DD request.

Tracking Service:

File the form;

Notify you of date filed by email;

Monitor for DWC approval;

Follow up with DWC until exam approved;

Notify you of the date and time of the exam by email;

Forward copy of filed DWC–32 and ES-14;

Forward all medical records to the

Designated Doctor;

Notify you by email claimant attended, rescheduled, or no-showed at the Designated Doctor appointment.

504 Lavaca, STE 1000 Austin, Texas 78701 | P.O. Box Drawer, 13367 Capitol Station Austin, Texas 78711
Tel 512.477.4405 | Fax 512.867.1700 | Email fol@fol.com