Get Designated Doctor Examination Data Report - Texas Department Of ... - Tdi Texas
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How to fill out the Designated Doctor Examination Data Report - Texas Department of Insurance online
The Designated Doctor Examination Data Report is essential for documenting examinations related to workplace injuries in Texas. This guide provides step-by-step instructions for completing the form online, ensuring that all necessary information is accurately captured.
Follow the steps to successfully complete the report online.
- Click the ‘Get Form’ button to access the Designated Doctor Examination Data Report and open it in your electronic document editor.
- Enter the injured employee claim information in Section I. Fill in the employee's name, social security number, insurance carrier name, and the date of injury.
- Proceed to Section II, where you will provide examination information. Input the designated doctor's name, mailing address, license number, jurisdiction, license type, phone number, examination location, and the date and time of the appointment.
- In this section, indicate whether the claim involves medical benefits through a certified health care network and through a political subdivision, including additional details if applicable.
- Move to Section III to document the diagnosis codes for compensable diagnoses/conditions. Use the DWC Form-032 received for this examination to assign corresponding diagnosis codes for each condition.
- In Section IV, evaluate the purpose of the examination. Answer questions related to the extent of injury and disability, and provide dates for any claimed periods of disability.
- Complete Section V by providing information regarding any referrals or additional testing recommended during the examination.
- Finally, sign and date the report in Section VI. Ensure all information is accurate and complete before finalizing the report.
- Once completed, you may save changes, download the report, print it, or share it as required.
Start filling out your Designated Doctor Examination Data Report online today!
The 90-day rule in Texas workers' compensation refers to the timeframe within which a designated doctor must complete their evaluation and submit their report. This urgency ensures that injured workers receive timely assessments, ultimately expediting the claims process. The findings documented in the Designated Doctor Examination Data Report - Texas Department Of ... - Tdi Texas are vital for clarifying a worker's eligibility for benefits.
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