Procedures for Independent Medical Examinations in Louisiana Workers Compensation

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How to Order an Independent Medical Examination in Louisiana Workers Compensation

Louisiana law allows for either party - the workers compensation insurance company or the employee - to request an Independent Medical Examination (IME) from the Office of Workers' Compensation.

There are two ways in which the Independent Medical Examination can be ordered:

    1. An Independent Medical Examination where the IME physician is selected by the Office of Workers Compensation Medical Services Division; and
    2. An Independent Medical Examination where the IME physician is selected by the workers compensation Judge.

If a claim is already in workers compensation court, then the parties can request an Independent Medical Examination through the Office of Workers' Compensation Medical Services Division, or through the presiding workers compensation Judge.

If a claim is not already in workers compensation court, then the parties are limited to requesting an Independent Medical Examination through the Office of Workers' Compensation Medical Services Division. 

Also, any party requesting an Independent Medical Examination must make its request at or prior to the court's pre-trial conference; requests for Independent Medical Examinations made after that time will be denied except for good cause or if it is found to be in the best interest of justice to order such examination.

The employee and the workers compensation insurance company should provide the doctor who will perform the Independent Medical Examination with copies of all of the employee's medical records.

But the employee cannot contact the doctor who will perform the Independent Medical Examination, except to schedule the appointment and go to the exam.

Independent Medical Examiners Selected by the Office of Workers Compensation Medical Services Division

The more common method of obtaining an Independent Medical Examination is by having the Independent Medical Examiner selected by the Office of Workers Compensation Medical Services Division.

Under this method, the Office of Workers' Compensation Medical Services Division can appoint an independent medical practitioner to examine the employee to address a “dispute” as to his “condition” or “capacity to work.”

And the Independent Medical Examiner will report his or her conclusions from the examination to the Office of Workers' Compensation Medical Services Division and to the parties, and the report shall be submitted as evidence on the facts to be used for any related disputes.

But if both the employee's treating physician and the Second Medical Opinion (SMO) doctor (selected by the workers compensation insurance company) agree as to the employee's medical condition or work status, then the workers compensation insurance company cannot request that an Independent Medical Examination be performed.

Independent Medical Examiners Selected by the Workers Compensation Judge

Under this method of obtaining an Independent Medical Examination, the workers compensation Judge may order the employee to be examined by a physician selected by the workers' compensation court.

This method is generally accomplished by one party filing a Motion to Order an Independent Medical Examination within the district court where the claim is already pending.

However, it is entirely at the workers compensation Judge's discretion as to whether to order the Independent Medical Examination, based upon whether the requesting party has shown good grounds for a court-appointed Independent Medical Examination.

So just because the workers compensation insurance company requests an Independent Medical Examination from the workers compensation Judge, does not mean that the Judge will order the workers compensation Judge will order the Independent Medical Examination.

Procedures Following an Independent Medical Examination in Louisiana Workers Compensation

Following the Independent Medical Examination, the Independent Medical Examiner will draft a report on the examination and will send a certified report directly to the Louisiana Office of Workers Compensation Medical Services Division or to the Louisiana Workers Compensation Judge who requested the IME.

And the opinion of the Independent Medical Examination report will be strongly considered by the workers compensation Judge, and usually, the workers compensation Judge will make a decision that is in agreement with the Independent Medical Examination report.

But just because an Independent Medical Examination report goes in favor of an employee, does not mean that the Judge will decide in favor of that employee.

Again, the workers compensation Judge will evaluate all of the evidence to the appropriate legal standards and make an impartial decision.

Also, either party can appeal the decision of the workers compensation Judge to the appellate circuit court.  

Last, the employee cannot contact the physician who is performing the Independent Medical Examination, except to schedule the appointment and go to the exam.

If there even appears to be any improper contact with the Independent Medical Examiner, the workers compensation Judge will most likely throw out the Independent Medical Examination report and not consider it as evidence.

The Louisiana Statutes for Independent Medical Examinations in Louisiana Workers Compensation

The primary Louisiana statutes on Independent Medical Examinations are La. R.S. 23:1123, La. R.S. 23:1124, La. R.S. 23:1124.1, La. R.S. 23:1125 and La. R.S. 23:1317.1. These statutes read as follows:

§1123. Disputes as to condition or capacity to work; additional medical opinion regarding an examination under supervision of the secretary

If any dispute arises as to the condition of the employee, or the employee's capacity to work, the secretary, upon application of any party, shall order an additional medical opinion regarding an examination of the employee to be made by a medical practitioner selected and appointed by the secretary. The medical examiner shall report his conclusions from the examination to the secretary and to the parties and such report shall be prima facie evidence of the facts therein stated in any subsequent proceedings under this Chapter.

Amended by Acts 1983, 1st Ex. Sess., No. 1, §1, eff. July 1, 1983; Acts 1988, No. 938, §1, eff. July 1, 1989; Acts 2010, No. 3, §1, eff. May 11, 2010; Acts 2012, No. 235, §1; Acts 2017, No. 381, §2, eff. June 23, 2017.

§1124. Refusal to submit to an additional medical opinion regarding an examination; effect on right to compensation

If the employee refuses to submit himself to an additional medical opinion regarding a medical examination at the behest of the employer or an examination conducted pursuant to R.S. 23:1123, or in anywise obstructs the same, his right to compensation and to take or prosecute any further proceedings under this Chapter may be suspended by the employer or payor until the examination takes place. Such suspension of benefits by the employer or payor shall be made in accordance with the provisions of R.S. 23:1201.1(A)(4) and (5). When the employee has filed a disputed claim, the employer or payor may move for an order to compel the employee to appear for an additional medical opinion regarding an examination. The employee shall receive at least fourteen days written notice prior to the additional medical opinion regarding an examination. When a right to compensation is suspended no compensation shall be payable in respect to the period of suspension.

Acts 1997, No. 393, §1; Acts 2013, No. 337, §1; Acts 2017, No. 381, §2, eff. June 23, 2017.

§1124.1.  Cumulative medical testimony; medical examination

Neither the claimant nor the respondent in hearing before the hearing officer shall be permitted to introduce the testimony of more than two physicians where the evidence of any additional physician would be cumulative testimony.  However, the hearing officer, on his own motion, may order that any claimant appearing before it be examined by other physicians.

Acts 1988, No. 938, §2, eff. Jan. 1, 1989.  Acts 1989, No. 260, §1, eff. Jan. 1, 1990.

§1125.  Right of employee to written report of medical examination; penalty for failure to furnish

A.  Whenever an employee who is being treated by his choice of medical provider shall, at the request of the employer, the employer's insurer, or the representative of the employer or its insurer, submit to any type of medical examination and a medical report is received by said requester, such employee or his representative shall be entitled to a copy of the written report of the results of said examination within thirty days from the date the requester receives the report.

B.  Whenever an employee has accepted medical treatment by a health care provider referred by the employer, the employer's insurer, or the representative of the employer or its insurer, he shall be entitled to receive a copy of any medical records of the medical provider that are in the possession of the employer or its insurer within thirty days from the date of the written demand upon the employer, the employer's insurer, or the representative of the employer or its insurer.

C.  Such written report or records shall be furnished to said employee or his representative at no cost to the employee.  Any employer who without just cause fails to furnish such report or records to an employee so requesting same within the thirty-day period provided for above shall be liable to the employee for a civil penalty in the amount of two hundred fifty dollars, plus reasonable attorney fees for the collection of such penalty.

Added by Acts 1976, No. 243, §1; Acts 1999, No. 134, §1, eff. June 9, 1999.

§1317.1. Additional medical opinion regarding medical examinations

A. Any party wishing to request an additional medical opinion regarding a medical examination of the claimant pursuant to R.S. 23:1123 and 1124.1 shall be required to make its request at or prior to the pretrial conference. Requests for additional medical opinions regarding medical examinations made after that time shall be denied except for good cause or if it is found to be in the best interest of justice to order such examination.

B. An examiner performing additional medical opinion exams pursuant to R.S. 23:1123 shall be required to prepare and send to the office a certified report of the examination within thirty days after its occurrence.

C. The report of the examination shall contain the following, when applicable:

(1) A statement of the medical and legal issues the examiner was asked to address.

(2) A detailed summary of the basis of the examiner's opinion, including but not limited to a listing of reports or documents reviewed in formulating that opinion.

(3) The medical treatment and physical rehabilitative procedures which have already been rendered and the treatment, if any, which the examiner recommends for the future, together with reasons for the recommendation.

(4) Any other conclusions required by the scope of the additional medical opinion regarding a medical examination, together with reasons for the conclusion reached.

(5) A curriculum vitae of the examiner.

(6) A written certification personally signed by the examiner that the report is true. The substance of the certification shall be: "I certify that I have caused this report to be prepared, I have examined it, and to the best of my knowledge and belief, all statements contained herein are true, accurate, and complete."

D. If a physical examination of the claimant was conducted, the certified report shall contain all of the following additional information:

(1) A complete history of the claimant, including all previous relevant or contributory injuries with a detailed description of the present injury.

(2) The complaints of the claimant.

(3) A complete listing of tests and diagnostic procedures conducted during the course of the examination.

(4) The examiner's findings on examination, including but not limited to a description of the examination and any diagnostic tests and X-rays.

E. When the additional medical opinion medical examiner's report is presented within thirty days as provided in this Section:

(1) The examiner shall be protected from subpoena except for a single trial deposition. However, upon a proper motion for cause, the workers' compensation judge may order further discovery of the additional medical opinion by a medical examiner as deemed appropriate.

(2) Except to schedule the deposition or further discovery as described above, the office of the additional medical opinion medical examiner shall not be contacted regarding the claimant by any party, attorney, or agent.

F. Objections to the additional medical opinion regarding a medical examination shall be made on form LDOL-WC-1008, and shall be set for hearing before a workers' compensation judge within thirty days of receipt. No mediation shall be scheduled on disputes arising under this Section.

Acts 1995, No. 328, §1, eff. June 16, 1995; Acts 1997, No. 88, §1, eff. June 11, 1997; Acts 2012, No. 235, §1; Acts 2017, No. 381, §2, eff. June 23, 2017.  

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