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 Latest News

Closed Formulary for Workers’ Compensation Patients Announced

The Texas Division of Workers’ Compensation (DWC) has a closed drug formulary (PDF) for treating injuries that occur on or after Sept. 1, 2011.

DWC regulations (PDF) define the formulary as all Federal Drug Administration-approved drugs, with the exception of the following: 

• Drugs with “N” status identified in the current and subsequently updated editions of the Official Disability Guideline (ODG) Treatment in Workers’ Comp — Appendix A, ODG Workers’ Compensation Drug Formulary;
• Any compounded drugs that contains a drug identified with an “N” status in ODG; and
• Drugs considered investigational or experimental.

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Workers' Comp Has New Forms

Starting March 1, Designated Doctors in the Workers' Compensation program must begin using the new DWC Form-069 and DWC Form-073, and fax them to the Texas Department of Insurance Division of Workers' Compensation (TDI-DWC) at (512) 490-1047. (Action, March 1, 2011) 

Current Information

• Workers' Comp Has New Forms (Action, March 1, 2011)
• Dr. Patrick Joins Workers' Comp (Action, July 15, 2010)
• Workers' Comp Grades Physicians (Action, July 1, 2010)
• TDI Wants Medical Reviewers (Action, June 15, 2010)

TMA's Workers' Compensation Advocacy in Action

• Workers Compensation
• Provider Resources (TDI) 
• Workers' Compensation Fee Schedule By Region
• Workers' Comp Worth It? State Hopes Higher Fees Will Bring Doctors Back - (Texas Medicine - February 2008)   
• Disability Management for Injured Texas Workers
• Disability Management for Injured Workers (PDF)
• Carrier Phone Numbers for Determining Network Status of Injured Employees (PDF )  
• Cookbook Comp? Physicians Skeptical About Workers' Comp Guidelines   (Texas Medicine - May 2007)  
• History of the Workers' Compensation System in Texas
• Workers' Compensation Managed Care Networks Certified by the Texas Department of Insurance
• Workers' Compensation Commissioner Bulletins
• Termination of the Physician-Patient Relationship

Designated Doctor Services

• Billing and Reimbursement for Designated Doctor Services (FastFacts, TDI: Division of Workers' Compensation)

FAQs: Recent Workers' Compensation Reform From Texas Department of Insurance (TDI): Division of Workers' Compensation

•  FAQs Regarding Recent Workers' Compensation Reforms: Employees    
•  FAQs Regarding Recent Workers' Compensation Reforms: Employers    
•  FAQs Regarding Recent Workers' Compensation Reforms: Providers  

Sample Letters to Carriers

•  Reply to Carrier Request for More Information on an Incomplete Claim or More Documentation for a Retrospective Review
  View HTML version  
•  Claims in Process Over 45 Days
  View HTML version  
•  Request for Reconsideration
  View HTML version

Additional Articles

• Division Introduces Comp Connection for Health Care Providers    
• Changes to Conversion Factors for Workers' Compensation Medical Fee Guidelines   
• Disputes and Complaints In the Workers' Compensation System (PDF) (FAST FACTS, TDI)  FAST FACTS (TDI) 
• Improper Denials Based on Lack of Documentation (PDF) 
• Electronic Medical Bill Data Exchange (eBilling) Implementation
• 2008 Medical Fee Guidelines (PDF)