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Texas Employees Request To Change Treating Doctors (Non Network) (Spanish)
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Employees Request To Change Treating Doctors (Non Network) (Spanish)
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If an employee gets sick or injured at work, workers' comp benefits pay for medical expenses related to the resulting injury. Those expenses include doctors' visits, medical tests (e.g. x-rays, blood tests), rehabilitation, emergency room care, hospital stays, and in some cases, even transportation costs.
As an injured employee in Texas, you have the right to free assistance from the Office of Injured Employee Counsel (OIEC). This assistance is offered at local offices across the State. These local offices also provide other workers' compensation system services from the Texas Department of Insurance (TDI).
If an injury victim gets a second opinion, that second opinion starts the new chain, or counts as the second doctor.
If you opt in the network, that means your employees must see a network provider if they are injured on the job. If employers choose the out-of-network option, your injured employees can seek treatment from the WorkWell, TX network or any doctor who will treat them under the Texas Workers' Compensation rules.
If you want to change treating doctors for other reasons, you will need to provide good reason for your request. You must complete the DWC Form-053, Employee's Request to Change Treating Doctors - Non-Network and send it to DWC. If your request is approved, DWC will send a letter of the change in treating doctor.
If you were injured before your employer started to use a workers' compensation network, you must choose a treating doctor from the network's provider list. You have 14 days from the date you got notice that you're in a network to choose a treating doctor.
Choice to opt out: Know the risks Texas workers' compensation law allows employers to opt out of carrying workers' compensation insurance, which covers medical expenses, physical therapy expenses and lost wages for employees who get sick or injured at work.
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Employees Request To Change Treating Doctors (Non Network) (Spanish) Form. This is a Texas form and can be use in Employee Workers Compensation.Instant access to fillable Microsoft Word or PDF forms. Minimize the risk of using outdated forms and eliminate rejected fillings. The complete written MPN employee notification shall be provided in English and also in Spanish, to Spanish-speaking employees. DWC-73, Work Status Report, PDF. Humana members can access important documents and forms related to coverage including disenrollment and claims forms. Arango, and the medical treatment Claimant received from Dr. Arango had not helped her condition. Applications and forms for health care professionals in the Aetna network and their patients can be found here. Once the form has been given to the injured worker, he or she chooses which of the doctors listed becomes the treating physician.