Mr. Young, an employee of a large home improvement retailer, injured his shoulder while on the job. The injury was not surprising, as Mr. Young had been working for his employer for fourteen years and part of his job involved moving metal shelves and putting up displays. While Mr. Young’s employer agreed that the injury was compensable, a disagreement arose between Mr. Young and his employer as to how the injury should be treated.
Mr. Young’s case is not uncommon. When an injured employee is eligible for Workers’ Compensation the injured employee may end up seeing more than one doctor. In such cases different doctors may recommend different courses of treatment. This can lead to conflicts when an employer desires that an injured employee choose a less costly course of treatment than the course of treatment preferred by the employee.
For example, during the treatment of his shoulder injury Mr. Young had seen two different doctors, Doctor B and Doctor C. Both doctors had been authorized by Mr. Young’s employer to evaluate and treat his shoulder injury. However, the doctors had given conflicting opinions as to what kind of treatment was appropriate. Doctor C wanted to perform a test to evaluate the extent of Mr. Young’s shoulder injury, and follow up with a surgery regardless of the test result. Doctor B, on the other hand, wanted to perform a test first and wait upon the test results before deciding on surgery. The employer wanted to go with Doctor B’s wait and see approach. This would have decreased the chance that the employer would be on the hook to pay for a surgery should the Doctor recommend against such surgery. Mr. Young, on the other hand, had argued to be treated by Doctor C and receive the surgery no matter the outcome of the test results. Thus, resolution of this dilemma posed a difficult question-should the employee or the employer get the right to make the decision as to how an employee’s compensable injury is treated?
Under North Carolina Workers’ Compensation laws, your employer generally has the right to direct medical treatment for a compensable injury. This right of your employer to direct your medical treatment also involves a right by your employer to select the treating physician.
Even though the rule governing how employers can direct medical treatment is seemingly straight forward, it is not uncommon for disagreements to arise when an employee and employer disagree over a course of medical treatment. One of the most commonly used exceptions to the general rule of employer directed medical treatment is found in North Carolina General Statute Section 97-25(c). This exception allows an employee to trump an employer’s choice of a medical provider and choose their own treating doctor.
But, an employee can’t just change doctors at their own choosing. To force an employer to agree to a change in the treating physician, or a change in course of treatment, an injured employee must go before the Industrial Commission and show why such a change is necessary. The Commission may then order the employer to pay for the new physician or provide a different course of treatment if the Commission finds the change necessary.
In Mr. Young’s case, because Mr. Young’s employer had admitted that Mr. Young’s injury was compensable Mr. Young’s employer retained the right to direct Mr. Young’s medical treatment. The Commission also determined that Mr. Young did not present sufficient evidence to show an entitlement to a change of physician, and was thus precluded from choosing to be treated by Doctor C. However, the Commission did order Mr. Young’s employer to pay for the tests recommended by both Doctors. Furthermore, because of the conflicting opinions of the two doctors Mr. Young’s employer was ordered to choose yet a different doctor than either Doctors B or C to evaluate Mr. Young’s and provide appropriate treatment.
A skilled Workers’ Compensation attorney can provide you with advice regarding whether or not your situation can benefit by a change of physician or appeal to the Industrial Commission for a change of treatment. If you need, an attorney can also represent you before the Industrial Commission in arguing for a change of treatment or physician. If you have questions regarding your Workers’ Compensation claim don’t hesitate to contact us today.
Kanipe v. Lane Upholstery, 141 N.C. App. 620, 623-24, 540 S.E.2d 785, 788 (2000)
N.C. Gen. Stat. § 97-25(c), http://www.ncleg.net/EnactedLegislation/Statutes/PDF/BySection/Chapter_97/GS_97-25.pdf