Choice of Physician in Louisiana Workers Compensation

Fullsizeoutput 3078

Choosing A Doctor in Louisiana Workers Compensation

Under Louisiana workers compensation law, an injured employee is entitled to choose one treating physician in each field or specialty.

In other words, a Louisiana workers compensation claimant is allowed to select his or her own doctor.

But, the employee is required to submit to an examination by a physician provided by and paid for by the employer.

So basically, the accepted rule is that both the employee and the insurance company have their choice of physicians, with the employee's choice being the “treating physician” and the insurance company's choice serving as a “second opinion” physician.

The injured employee must submit to an examination by the company doctor (the “second opinion” physician) as often as may be reasonably necessary, though these visits will be paid for by the workers compensation insurance company.

And if the injured employee refuses to submit to an examination by the company doctor, the workers compensation insurance company may temporarily suspend the employee's lost wage payments.

Physician's Choice Form

But unfortunately, this right of choice of physician can be waived by the employee if the employee is treated by a physician to whom he is not specifically directed by the employer, and if the employee was notified of the right to select physician.

This notification of the right to select a physician typically comes in the form of a Physician's Choice Form, which the workers compensation insurance company provides to the employee in order to select his or her own physician.

If the employee fails or refuses to sign the Physician's Choice Form, the insurance company may suspend medical benefits until such time as the employee complies with the law, and seek an expedited hearing to be held within ten days in order to compel the employee to comply with the law on physician choice. 

Physician Specialists

So again, the injured employee has the right to choose one treating physician in any field or specialty.

Thus the injured employee has the right to switch from one specialty to another without needing prior approval from the workers compensation insurance company.

So for example, an injured employee could seek initial care from the employee's regular primary care family doctor, but then be referred to a specialist such as an orthopedic surgeon without needing approval from the workers compensation insurance company.

However, permission is required from the workers compensation insurance company in order to change treating physicians within the same field or the same specialty after the employee has already made an initial choice.

But an injured employee is entitled to the employee's own choice of physician in the field of pain management if pain is an issue in the employee's claim.

The Employee's Initial Treatment

Also, Louisiana workers compensation allow at least one examination with a physician of the employee's choosing even the claim is denied on compensability grounds and the insurance company takes the position no benefits are owed.

And a physician who administers emergency treatment only shall not be considered the physician of choice of either the employee or employer.

But an employee who continues treatment with an emergency room physician for an extended period of time after the initial emergency treatment was rendered may be the employee's choice of physician if the employer does not direct the employee to that specific emergency room.

Choices Left to The Insurance Company

The workers compensation insurance company - and not the injured employee - typically gets to choose and decide:

    1. Which pharmacy will provide the necessary prescription medication drugs to the injured employee;
    2. Which facility will perform diagnostic tests such as X-rays and MRIs on the injured employee;
    3. Who will act as the injured employee's nurse care manager; and 
    4. Who will act as the injured employee's Functional Capacity Evaluation (FCE) provider in order to determine the employee's ability to return to work.

However, the injured employee may choose his or her Functional Capacity Evaluation (FCE) provider when the FCE is being issued for treatment purposes, such as a diagnostic reference to assess the employee's medical progress or to determine an endpoint for the employee's treatment. 

The Importance of Choosing the Right Doctor in Louisiana Workers Compensation

Choosing the right doctor is absolutely critical in an injured employee's workers compensation case for two main reasons:

    1. Choosing the right doctor will be essential in getting the best medical treatment that the employee seeks; and
    2. Choosing the right doctor will be essential in getting the best legal outcome for the employee's workers compensation claim.

For these reasons, the two most important decisions that an injured worker will make in his or her workers compensation claim are (1) who is the employee's attorney; and (2) who is the employee's doctor.

For example, the treating physician will be essentially deciding:

    • Whether an injury or medical condition is considered a disability;
    • Which medical treatments are necessary; and
    • Whether the injury or medical condition is a result of a work-related accident.

The Insurance Company's Doctor 

First, above all, the injured employee should never choose the insurance company's doctor as the employee's treating physician.

This is one of the biggest mistakes an injured worker can make in his or her workers compensation claim.

There are reasons why the insurance company's doctor is known as "the insurance company's doctor," such as:

    • This doctor is chosen by the insurance company and paid by the insurance company.
    • If the insurance company's doctor does not consistently provide the opinions and outcomes which the insurance company seeks, then the insurance company will find another doctor to be "the insurance company's doctor."
    • The insurance company's doctor KNOWS THAT if the insurance company's doctor does not consistently provide the opinions and outcomes which the insurance company seeks, then the insurance company will find another doctor to be "the insurance company's doctor."
    • If forced to choose, the insurance company's doctor will put the interest of the insurance company over the interest of the injured worker.

Also, once the injured employee chooses a doctor - including "the insurance company's doctor" - it is extremely difficult to change doctors. 

In fact, the workers compensation insurance company will fight tooth and nail if the employee tries to switch doctors after selecting the insurance company's doctor as the employee's treating physician.

This is because the insurance company knows that if its doctor is calling the shots, it can easily minimize or eliminate the claim of the injured worker.

So again, just to reiterate, the injured employee should never choose the insurance company's doctor as the employee's treating physician.

Also, the injured employee should never choose a physician off of any list or printout of "approved doctors" provided by the employer or its workers compensation insurance company.

How to Choose the Right Doctor

By far, the best way to find the right doctor for a workers compensation claim is to take the advice and recommendations of a knowledgable and experienced workers compensation attorney.

A good workers compensation attorney will know who the best doctors are for a specific workers compensation claim.

In fact, it is a big part of an attorney's job to know who the best doctors are for different types of injuries and in different locations.

A good workers compensation attorney will know:

    • Which doctors are experienced in handling workers compensation claims;
    • Which doctors have a history of fighting for injured workers in workers compensation claims;
    • Which doctors have a reputation as great medical doctors; and
    • Which doctors have offices that are efficient and organized.

If the injured employee does not have a good workers compensation attorney, then he or she should hire one.

But otherwise, good sources for referrals are emergency room physicians and staff, and primary care doctors. But typically, these referrals may not be made in consideration of the specific rules and terminology involved in a Louisiana workers compensation claim.

And again, the injured employee should never choose the insurance company's doctor as the employee's treating physician, who will likely only declare that nothing is wrong with the employee, or rush the employee back to work prematurely.

Who Is the Right Doctor?

As any good workers compensation attorney knows, the best doctors for workers compensation claims are doctors who:

    1. Are recognized among their peers as great medical doctors;
    2. Have a reputation as great medical doctors the local community;
    3. Have a reputation as being attentive and thorough with a great bed-side manner;
    4. Are very knowledgable about other physicians, in the event  the doctor needs to make a referral to a different specialist;
    5. Are experienced in handling complicated workers compensation guidelines, forms and rules;
    6. Are experienced in handling legal proceedings such as depositions;
    7. Have a reputation in the legal community of fighting for injured workers; and
    8. Have offices and staff that are efficient and organized enough to handle complex workers compensation claims.

So basically, the injured worker should be looking for a first rate doctor, well-experienced with workers compensation, who cares enough to fight for injured workers over insurance companies.

And the doctor must be someone the employee can trust, since the doctor will be critical in many important decisions that may greatly impact the employee's health, as well as the employee's workers' compensation claim.

The Physician Choice Form in Louisiana Workers Compensation

In Louisiana workers compensation, an injured worker has the right to select his or her own doctor.

But unfortunately, this right of choice of physician can be easily waived by the employee if the employee signs a Physician's Choice Form stating that he chooses to treat with the insurance company's doctor.

In fact, the employer or its workers compensation insurance company regularly provides this Physician's Choice Form to the employee in order to entice the employer into choosing the insurance company's doctor as the employee's treating physician.

Often, the employer or the insurance company will send the employee to the insurance company's doctor, and then will misleadingly mention something like "well if you want to continue seeing (this doctor), then you need to choose him as your doctor and sign this Physician's Choice Form."

No employee should ever sign a Physician's Choice Form under these circumstances!

The Employee Should Never Sign A Physician's Choice Form Until The Employee Has Chosen His or Her Own Doctor

Now, if the employee fails or refuses to sign the Physician's Choice Form, the insurance company may suspend medical benefits until such time as the employee selects a treating physician.

But having the employee's payments temporarily suspended (which rarely even happens) is much better for the employee than agreeing to choose the insurance company's doctor as the employee's treating physician.

So the bottom line is that the employee should NOT sign a Physician's Choice Form until the employee has properly chosen his or her own doctor, and the employee should complete the Physician's Choice Form indicating that the employee has properly chosen his or her own doctor and who exactly this doctor is.

Otherwise - if the employee does not know who his or her own doctor will be - then the employee should never sign a Physician's Choice Form!

Treating with the Insurance Company's Doctor Does Not Equal Signing a Physician's Choice Form

Just because an injured employee receives medical treatment from the insurance company's doctor does not mean that the employee has chosen the insurance company's doctor as the employee's treating physician.

In other words, receiving medical treatment from the insurance company's doctor is not the same as signing a Physician's Choice Form.

But there do exists circumstances under which a physician initially selected by an employer or the workers compensation insurance company may become the employee's choice of physician (which is the same as signing a Physician's Choice Form). 

Specifically, for a physician chosen by the employer or the insurance company to become the employee's choice of treating physician, the employee must:

    1. Receive written notice of the employee's right to choose his or her own physician;
    2. Attend an initial evaluation with the physician chosen by the employer or the insurance company; and then
    3. Complete and sign a Physician's Choice Form.

The critical part in this provision is that the form is signed after the initial evaluation takes place. If the employee signs the form before he sees the doctor referred by the employer, that doctor will not be the employee's choice.

But even these three events will not guarantee that the physician chosen by the employer or the insurance company is in fact the employee's choice of treating physician.

Instead, the workers compensation judge will always look at the entirety of all the facts and circumstances of the case in order to determine whether the employee did in fact voluntarily choose the physician initially selected by an employer or the workers compensation insurance company.

The Second Medical Opinion of the Insurance Company's Doctor in Louisiana Workers Compensation

Under Louisiana law, an injured employee has the right to select one treating physician in any field or specialty.

But at the same time, an injured employee is required to submit to an examination by a physician provided and paid for by the employer or the workers compensation insurance company, as soon after the accident as demanded.

This examination by the the insurance company's doctor is called a Second Medical Opinion (SMO).

If the employee refuses this examination, the employee's lost wage payments may be temporarily suspended.

The Insurance Company's Second Medical Opinion Doctor Does Not Actually Treat the Employee

A major difference between the insurance company's Second Medical Opinion (SMO) doctor and the injured employee's treating physician is that the insurance company's Second Medical Opinion (SMO) doctor would never actually treat the employee - such as actually perform a procedure, such a surgery.

In fact, the insurance company's Second Medical Opinion (SMO) doctor will only meet with the employee one time, and usually for a short evaluation.

Specifically, Louisiana law holds that "the employer or his workers' compensation carrier shall not require the employee to be examined by more than one duly qualified medical practitioner in any one field or specialty unless prior consent has been obtained from the employee."

The Purpose of the Insurance Company's Second Medical Opinion Doctor is to Dispute the Claim

Instead of treatment, the purpose of the insurance company's Second Medical Opinion (SMO) doctor is to dispute the opinion and treatment plan of the injured employee's treating physician.

In other words, the purpose of the insurance company's Second Medical Opinion (SMO) doctor is to provide a basis on which the insurance company can deny workers compensation benefits due the employee. 

Typically, if the injured employee's treating physician and the insurance company's Second Medical Opinion (SMO) doctor disagree on the employee's condition, disability, or proper course of treatment, the parties will have an Independent Medical Examination (IME) performed by a third doctor.

Either the employee or the workers compensation insurance company can request this Independent Medical Examination (IME) by completing an OWC Form 1015 and forwarding it to the Medical Services Section of the Office of Workers' Compensation Administration.

However, this Independent Medical Examination (IME) physician will be chosen by either workers compensation Judge or the Louisiana Office of Workers Compensation Medical Services Division.

Emergency Room Doctors and Treatment in Louisiana Workers Compensation

Under Louisiana law, an injured employee has the right to select one treating physician in any field or specialty.

However, an emergency room physician is not considered the choice of physician for the employee.

In fact, Louisiana law specifically holds that no "physician who, regarding the work-related injury, administered emergency treatment only shall be the physician of choice of either the employee or the employer."

However, when a physician provides treatment to an injured employee at an emergency room following a job accident, and then the employee continues to treat with that physician after the initial emergency treatment, then the physician can be deemed the employee's choice of physician.

Approval for Emergency Medical Care or Treatment

Typically, an injured employee is required to receive approval from the workers compensation insurance company for any first appointment with a medical provider.

And if this approval is not obtained, the workers compensation insurance company may only be responsible for the first $750.00 of treatment.

However, no approval is necessary if the emergency room doctor certifies that the employee had a genuine medical emergency.

This includes emergency room treatment immediately after the accident, and emergency room treatment at a much later time after the accident.

Nonetheless, once a claim has been opened for an injured employee, it is better to attend regular appointments - approved in advance by the workers compensation insurance company - with your treating physician at the doctor's office as opposed to visiting the emergency room.

And the injured employee should also request a written work release prescription or statement from the emergency room doctor that explains the return-to-work status.

Choice of Physician for Specialist Doctors in Louisiana Workers Compensation

Once again, the injured employee has the right to choose one treating physician in any field or specialty.

Thus the injured employee has the right to switch from one specialty to another specialty without needing prior approval from the workers compensation insurance company.

So for example, an  injured employee could seek initial care from the employee's regular primary care family doctor, but then be referred to a specialist such as an orthopedic surgeon without needing approval from the workers compensation insurance company.

Then this doctor would become the employee's choice of orthopedic surgeon. 

But if that orthopedic surgeon felt that the employee needed to see a neurologist for nerve damage then the employee would be entitled to the employee's own choice of physician in the field of neurology.

However, permission is required from the workers compensation insurance company in order to change treating physicians within the same field or the same specialty after the employee has already made an initial choice.

So if the employee wanted to move from one orthopedic surgeon to another orthopedic surgeon, permission would be required from the workers compensation insurance company.

But an injured employee is entitled to the employee's own choice of physician in the field of pain management if pain is an issue in the employee's claim.

Disputes Over Multiple Physicians in Different Specialties

One common dispute in workers compensation physician choice issues is whether an injured employee can treat with multiple physicians in different specialties at the same time.

Probably the most common example of this is a demand by an employee with a spinal injury to treat with an orthopedist and a neurosurgeon.

Several appellate courts have ruled that an injured employee does not have the right to multiple treating physicians at the same time, and therefore cannot be treated simultaneously by an orthopedic doctor and a neurosurgeon. 

However other courts have found that an injured employee can treat simultaneously with an orthopedic doctor and a neurosurgeon, because seeing these two different types of doctors is not a duplication of treatment.

Additionally, Louisiana courts have ruled that while an employee has the right to select one treating physician in any field or specialty, the treatment must be necessary in order to authorize treatment with the purported choice of physician.

Thus, the workers compensation insurance companies frequently argue that an orthopedic spine surgeon and a neurosurgeon are really the same specialty of “spinal surgeon,” and therefore it is not medically necessary for the employee to claim the orthopedic surgeon as one specialty and the neurosurgeon as another.

Denial of Employee's Physician Choice in Louisiana Workers Compensation

If the workers compensation insurance company denies the employee's request to choose the employee's own doctor to handle a work-related injury, the employee can request a hearing before a workers' compensation judge to resolve the issue.

In fact, under Louisiana law, the employee has the right to an expedited summary proceeding to appeal the denial of the employee's request to choose the employee's own doctor.

The hearing date for this expedited hearing would set by the court within three days of receiving the employee's motion, and the hearing date would be no less than ten and no more than thirty days from the date workers compensation insurance company receives notice, either by certified mail or by registered mail.

Unless the workers compensation insurance company can show a legitimate reason for refusing the employee's choice of physician, the workers compensation Judge will order the workers compensation insurance company to authorize this medical treatment from the employee's choice of physician.

Also, neither the employer nor the workers compensation insurance company may arbitrarily and capriciously, or without probable cause, deny the employee's request to select a treating physician or change physicians.

If the workers compensation Judge find that such denial was arbitrary and capricious, or without probable cause, then the employer or the insurer shall be liable to the employee for reasonable attorney's fees related to this dispute and for any medical expense incurred by the employee for an aggravation of the employee's condition resulting from the withholding of such physician's services.

A good example of an arbitrary and capricious, or without probable cause, denial would be after the initial choice of physician is unwilling or unable to continue treating the employee, because an injured employee is always entitled to change physicians if the initial choice of physician is unwilling or unable to continue treating the employee.

The Typical Three Different Types of Doctors in Louisiana Workers Compensation

Generally speaking, there are three main different types of doctors that an injured employee might see during the course of the employee's workers compensation claim.

These three types of doctors are:

    1. The doctor that the employee chooses to be his or her treating physician for the employee's work-related injury;
    2. The doctor that the workers compensation insurance company chooses to provide it with a Second Medical Opinion (SMO); and
    3. The doctor that the workers compensation Judge or the Louisiana Office of Workers Compensation Medical Services Division selects to perform an Independent Medical Evaluation (IME). 

These three different categories of doctors will perform different roles during the course of an injured employee's workers compensation claim.

The Employee's Treating Physician

The injured employee's treating physician is the doctor that the employee chooses to be his or her treating physician for the employee's work-related injury.

Importantly, this treating physician is the doctor who actually provides the treatment, unlike the doctors who provide infrequent Second Medical Opinions (SMOs) and one-time Independent Medical Evaluations (IMEs).

So for example, the injured employee's treating physician is the doctor who would actually perform a procedure, such a surgery.

Also, the injured employee may have several treating physicians, if the employee needs to treatment with different types of specialized doctors.

The Insurance Company's Second Medical Opinion (SMO) Physician

Under Louisiana law, the employer and the workers compensation insurance company have the right to have the injured employee examined by a doctor which they choose.

This examination by the the insurance company's doctor is called a Second Medical Opinion (SMO).

If the employee refuses this examination, the employee's lost wage payments may be temporarily suspended.

A major difference between the insurance company's Second Medical Opinion (SMO) doctor and the injured employee's treating physician is that the insurance company's Second Medical Opinion (SMO) doctor would never actually treat the employee - such as actually perform a procedure, such as a surgery.

Instead, the purpose of the insurance company's Second Medical Opinion (SMO) is to dispute the opinion and treatment plan of the injured employee's treating physician.

In other words, the purpose of the insurance company's Second Medical Opinion (SMO) doctor is to provide a basis on which the insurance company can deny workers compensation benefits due the employee. 

The Office of Workers Compensation's Independent Medical Examination (IME) Physician

Typically, if the injured employee's treating physician and the insurance company's Second Medical Opinion (SMO) doctor disagree on the employee's condition, disability, or proper course of treatment, the parties will have an Independent Medical Examination (IME) performed by a third doctor.

Either the employee or the workers compensation insurance company can request this Independent Medical Examination (IME) by completing an OWC Form 1015 and forwarding it to the Medical Services Section of the Office of Workers' Compensation Administration.

However, this Independent Medical Examination (IME) physician will be chosen by either the workers compensation Judge or the Louisiana Office of Workers Compensation Medical Services Division.

Like a Second Medical Opinion (SMO) doctor, a major difference between the Independent Medical Examination (IME) doctor and the injured employee's treating physician is that the Independent Medical Examination (IME) doctor would never actually treat the employee - such as actually perform a procedure, such as a surgery.

Instead, the Independent Medical Examination (IME) would only perform a one-time examination, and then write a report based on this examination and all the other evidence and medical records available to him or her, including the opinions of the injured employee's treating physician and the insurance company's Second Medical Opinion (SMO) doctor.

Typically, an Independent Medical Examination (IME) doctor will agree with either the employee's treating physician or the insurance company's Second Medical Opinion (SMO) doctor, and in most cases the Judge will rule in favor of whatever the Independent Medical Examination (IME) doctor decides.

Also, like a Second Medical Opinion (SMO) examination, if the employee refuses this Independent Medical Examination (IME), then the employee's lost wage payments may be temporarily suspended.

The Louisiana Statutes on Physician Choice in Louisiana Workers Compensation

The primary Louisiana statutes on choice of physician are La. R.S. 23:1121, La. R.S. 23:1122, La. R.S. 23:1123, La. R.S. 23:1124, and La. R.S. 23:1225.

These statutes read as follows:

§1121. Examination of injured employee

A. An injured employee shall submit himself to an examination by a duly qualified medical practitioner provided and paid for by the employer, as soon after the accident as demanded, and from time to time thereafter as often as may be reasonably necessary and at reasonable hours and places, during the pendency of his claim for compensation or during the receipt by him of payments under this Chapter. The employer or his worker's compensation carrier shall not require the employee to be examined by more than one duly qualified medical practitioner in any one field or specialty unless prior consent has been obtained from the employee.

B.(1) The employee shall have the right to select one treating physician in any field or specialty. The employee shall have a right to an expedited summary proceeding pursuant to R.S. 23:1201.1(K)(8), when denied his right to an initial physician of choice. The workers' compensation judge shall set the hearing date for the matter within three days of receiving the employee's motion for the expedited hearing. The hearing shall be held not less than ten nor more than thirty days after the employee or his attorney files the motion for an expedited hearing. The workers' compensation judge shall provide notice of the hearing date to the employer and insurer at the same time and in the same manner that notice of the hearing date is provided to the employee or his attorney. For the purposes of this Section, an employee shall not be required to submit the dispute on the choice of physician to mediation nor go through a pretrial conference before obtaining a hearing. The hearing shall be conducted as a rule to show cause. The workers' compensation judge shall order the employer or payor to authorize the claimant's choice of physician unless the employer or payor can show good cause for his refusal. After his initial choice the employee shall obtain prior consent from the employer or his workers' compensation carrier for a change of treating physician within that same field or specialty. The employee, however, is not required to obtain approval for change to a treating physician in another field or specialty.

(2)(a) If the employee is treated by any physician to whom he is not specifically directed by the employer or insurer, that physician shall be regarded as his choice of treating physician.

(b) When the employee is specifically directed to a physician by the employer or insurer, that physician may also be deemed as the employee's choice of physician, if the employee has received written notice of his right to select one treating physician in any field or specialty, and then chooses to select the employer's referral as his treating specialist after the initial medical examination as signified by his signature on a choice of physician form. The notice required by this Subparagraph shall be on a choice of physician form promulgated by the assistant secretary of the office of workers' compensation and shall contain the notice of the employee's rights provided under R.S. 23:1121(B)(1). Such form shall be provided to the employee either in person or by certified mail.

(3) Paragraph (2) of this Subsection shall not apply to other physicians to whom the employee is referred by the physician selected by the employer unless the employer or insurer has obtained the choice of physician form provided for under Subparagraph (2)(b) separately for any such physician after the initial medical examination with that physician.

(4) In instances where the employee is illiterate or has a language barrier, an authorized representative of the employer or insurer shall attest by his signature on the form that he has reasonably read and explained the form to such employee prior to their signatures.

(5) If the employee fails or refuses to sign the form as provided in Subparagraph (2)(b) and Paragraph (3) of this Subsection, the employer or payor may suspend medical benefits until such time as the employee complies with Subparagraph (2)(b) and Paragraph (3) of this Subsection. Suspension of medical 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 return the form.

C. Repealed by Acts 2003, No. 1204, §2.

D. After all examinations have been conducted but prior to any order directing the injured employee to return to work, the employee shall be permitted, at his own expense, to consult with and be examined by a physician of his own choosing. Such report shall be considered in addition to all other medical reports in determining the injured employee's fitness to return to work. Should disagreement exist, after such consultation and examination, as to the fitness of the employee to return to work, the provisions of R.S. 23:1123 shall be followed.

E. Nothing in this Section shall be construed so as to provide that a physician who, regarding the work-related injury, administered emergency treatment only shall be the physician of choice of either the employee or the employer.

Acts 1986, No. 726, §1; Acts 1987, No. 492, §1; Acts 1988, No. 617, §1; Acts 1997, No. 393, §1; Acts 1997, No. 452, §1, eff. June 22, 1997; Acts 1999, No. 324, §1, eff. June 16, 1999; Acts 2003, No. 886, §1; Acts 2003, No. 1204, §2; Acts 2013, No. 337, §1.

§1122.  Employer's duty to cause examination of employee; rights of employee

The employer shall cause the examination provided for in the preceding Section to be made immediately after knowledge or notice of the accident, and to serve a copy of the report of such examination made by the employer's physician upon the employee within six days after the employer's receipt of the report of such examination.  If the examination is not made and the report is not furnished by the employer within that time, the employee shall furnish a report of the examination made by his own physician to the employer, for which the employee shall be entitled to receive from the employer the actual cost of the examination and the actual cost of the report.  The physician's invoice or receipt shall be prima facie proof of the cost.  Upon the receipt by either party of such a report from the other party, the party receiving it, if he disputes the report or any statement therein, shall notify the other of that fact within six days, otherwise the report shall be prima facie evidence of the facts therein stated in subsequent proceedings under this Chapter.

Amended by Acts 1978, No. 210, §1.

§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.

§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. 

Putting Our Clients First

Our clients always come first. Putting our clients first means we always offer free consultations, and free off-street parking, just one block off the highway in New Orleans. Putting our clients first also means we have a strict 24-hour communications policy, wherein our clients’ phone calls are always returned within 24 hours, if not sooner. That also means that our clients never have an issue getting through to their attorney, whether on the phone or in person.

A Proven Track Record of Success

We have successfully recovered millions of dollars in settlements for our clients in personal injury claims, auto accidents, and insurance claims. The reason that our opponents settle our clients’ cases for full value is because they know we prepare all our clients’ cases for trial from the start. In fact, we are known for not being afraid to take cases to trial, and thus our opponents know they are in for a fight when going against our clients.

Menu