Texas designated doctors file this data report when a DWC-ordered exam addresses extent of injury, disability as a direct result of the injury, or other similar issues. It records whether the incident was a substantial factor in each additional claimed diagnosis, with diagnosis codes, whether the injury caused the inability to earn pre-injury wages over claimed periods, and any referrals or testing. A narrative report must accompany it.
The DWC-certified designated doctor completes all five parts and signs Part 5. The issues come from the DWC Form-032 that requested the exam, filed by the employee, representative or carrier.
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Designated doctor examination data report
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Yes. The form's FAQ says the designated doctor must attach the narrative report required by 28 TAC 127.220, Designated Doctor Narrative Reports. The data report summarizes answers to each issue; the narrative explains the findings and reasoning behind them.
DWC069 certifies maximum medical improvement and the impairment rating. When a designated doctor exam also covers extent of injury, disability or other similar issues, the doctor files DWC068 for those issues as well. If the exam covered only MMI, impairment or return to work, DWC068 is not filed.