![]() |
| A Nationwide Network of Law Firms Practicing in Workers' Compensation |
| Thursday, May 15, 2008 10:16 AM CDT |
| On this page you will find state specific up to date news, items of current interest and new case law. Member firms will periodically update this page. |
| States with upcoming seminars will appear in red text. |
| The state information will be alphabetical. Currently: |
![]() |
| Alabama | ||||||||||||
|
I wanted to update everyone about a new case which causes me concern with respect to employer authorized medical care. The case is Overnite Transportation v. McDuffie, 2005 Ala. Ct. Civ. App. Lexis 672. This case involves a situation that we have seen so many times before in handling claims. Here, the authorized treating physician, Dr. Hackman, completed his course of treatment and then referred the plaintiff to a pain management physician, Dr. Kelsey. The initial physician, Dr. Hackman, was chosen off a panel of four pursuant to § 25-5-77(a), Code of Alabama (1975), as amended. However, the employer did not authorize Dr. Kelsey and then directed the plaintiff to Dr. Moon for this treatment. This physician was clearly allowable under Alabama Administrative Code (Department of Industrial Relations) Rule 480-5-5-.12 which provides: The employer's authorized treating physician (other than emergency medical services) shall be the physician of record for attending or referral purposes. All referrals shall be pre-approved by the employer/agent. The employer/agent shall keep all interested parties involved in the compensable case informed of any authorized change of treating physicians. This administrative rule was adopted in 1996 as authorized by § 25-5-293, Code of Alabama (1975), as amended. This is a physician that I have advocated and recommended many times based on the authority of this administrative code section which was given statutory authority by the enabling legislation. However, the Alabama Court of Civil Appeals granted the employee's request to be treated by Dr. Kelsey and rejected the employer's claim that referral should be pre-approved under this rule. The court held that § 25-5-77(a) does not allow the employer to pre-approve referrals made by the authorized treating physician and, once such a referral has been made to a referral doctor, that physician becomes the authorized physician of record. The court did restrict this to reasonable and necessary care and also indicated that the employer could assert utilization review for medical necessity. See the situation applied in this case. I believe this is a terrible decision for employers since it gives the authorized treating physician unfettered discretion in selecting the referral doctor. This is a choice clearly within the employer's discretion, as it should be. This case is currently on appeal to the Alabama Supreme Court and I will continue to keep you advised of any developments at the appellate level. Please let me know if you would like a copy of this case or if you have any comments, thoughts, or questions. All are welcome.
| ||||||||||||
| Iowa
|
||||||||||||
| ||||||||||||
| Louisiana
|
||||||||||||
| ||||||||||||
| Maryland
|
||||||||||||
| ||||||||||||