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Dead Doctor Dilemma Resolved by Workers’ Compensation Commission

labor and industryTwo weeks ago we reported the story of Arkansas worker Lauren Eason, who was denied a change of physician even though her doctor had died in December. Eason had already switched physicians earlier in the year, and Arkansas law does not allow patients with a workers compensation injury to change a second time. Therefore, after her newer doctor passed away, the Arkansas Workers Compensation Commission ruled that she would have to stick with that physician regardless of the bizarre circumstances.

This was yet another unfortunate case of unintended consequences: a law designed to restrict excessive “doctor shopping” had ensnared an unsuspecting worker with a legitimate injury and a legitimate cause for requesting a second transfer of care.

Originally, Arkansas Workers’ Compensation Commission CEO Alan McClain stated that administrative solutions were available for the worker, but projected that it could take 3 to 6 months to resolve the issue.

The case generated some heated discussion on the LinkedIn group Workers’ Compensation Roundtable. McClain responded to critics on the site to further clarify the issue and exonerate his agency. He wrote that the law may have prevented the Workers Compensation board from selecting an alternate physician, but “as long as the employer has not denied medical benefits then the injured employee is entitled to medical care, arranged and paid for by the employer/carrier, regardless of the agency’s administrative ability to select a treating physician.” While the meaning here was not entirely clear, McClain seemed to be suggesting that this law was not an obstacle for an uncontested claim. Some commentators speculated that there were additional circumstances affecting Eason’s injury claim since the denial from the state was so emphatic.

Nonetheless, the Arkansas WCC has followed up on the controversy with an advisory that covers the initial issue. On Monday, they issued AWCC ADVISORY 2012-1, which states:

“When the physician named in a Change of Physician Order by the AWCC has passed away while actively treating the claimant for a compensable injury (or prior to releasing the claimant from treatment) or is known to the Commission to no longer be in practice without having made adequate provisions for the continued treatment of the claimant’s compensable injury, the Change of Physician Order shall become null and void and shall no longer be considered the claimant’s one time change of physician.”

Such a case has yet to arise within Washington’s department of labor and industries; yet while it is unlikely that most injured workers will find themselves in such extraordinary circumstances, many do face insufficient injury benefits or medical coverage, a denied L&I claim, a requirement to undergo an independent medical examination, or simply need help navigating the complexities of their L&I claim. If you need assistance with any issue related to workers compensation benefits or your negotiations with the department labor and industries more generally, contact an L&I lawyer or Seattle Employment attorney today.

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