Disability Management

 Disability Management News

• Treatment Planning Pilot Project Launched November 1 
  (posted 11/8/07)
• Preauthorization Survey  Excel (posted 10/7/07)
  
• Treatment Planning Rule Repealed (posted 9/21/07)
• Prospective Review of Medical Care Examination (PRME) Rule Being Repealed (posted 6/11/2007)
• Carrier Transition to Disability Management (PDF)
  (posted 5/22/07)

Disability Management Overview

The Texas Department of Insurance, Division of Workers’ Compensation has enacted comprehensive Disability Management Rules that apply to all claims with a date of injury occurring on or after January 1, 1991. 

Treatment & Return to Work Guidelines are effective May 1, 2007 and are applicable to treatments and/or services provided as of this date. 

Disability management optimizes healthcare and return-to-work outcomes for injured employees through the use of treatment and return-to-work guidelines. This serves the interests of all workers’ compensation system participants by:

• Providing injured employees appropriate medical treatment
• Promoting principles of evidence-based medicine
• Achieving greater accountability through communication
• Establishing estimated return-to-work expectations
• Improving the ability to monitor system outcomes

Disability management brings together all parties, early in the life of a claim, to agree to a plan that best addresses the needs of the injured employee. 

Treatment Planning Pilot

• Treatment Planning Pilot Project Launched November 1 
  (posted 11/8/07)
• Treatment Planning Pilot Overview (posted 11/8/07)

   

Disability Management Rules - Title 28

Texas Administrative Code (TAC) §137

• §137.1 – General Provisions
• §137.10 – Return-to-Work (RTW) Guidelines
  Medical Disability Advisor (MDA) http://www.rgl.net/states/Texas.aspx
• §137.100 – Treatment Guidelines
  Official Disability Guidelines (ODG) http://www.worklossdata.com/PR_Texas.htm 
  
  
  

Preauthorization Rule

Title 28 Texas Administrative Code (TAC) §134.600

Key Disability Management Messages

• Injured Employees / Empleados Lesionados
• Employers
• Healthcare Providers
• Insurance Carriers/Utilization Review Agents
  
  
  

FastFacts and FAQs

• Overview
• Healthcare Providers
• Insurance Carriers and Utilization Review Agents
• FAQs

For more information contact: MedicalBenefits@tdi.state.tx.us