Bill Text: IA SF2185 | 2017-2018 | 87th General Assembly | Introduced
Bill Title: A bill for an act relating to the choice of doctor to treat injured employees under workers’ compensation laws and including effective date and applicability provisions.
Sponsorship: Partisan Bill (Democrat 1)
Status: (Introduced - Dead) 2018-02-07 - Subcommittee: Guth, Boulton, and Chapman. S.J. 255. [SF2185 Detail]
Download: Iowa-2017-SF2185-Introduced.html
Senate File 2185 - Introduced SENATE FILE BY BOULTON A BILL FOR 1 An Act relating to the choice of doctor to treat injured 2 employees under workers' compensation laws and including 3 effective date and applicability provisions. 4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: TLSB 5264XS (5) 87 asf/rj PAG LIN 1 1 Section 1. Section 85.27, subsection 4, Code 2018, is 1 2 amended to read as follows: 1 3 4.a. (1) For purposes of this section, the employer is 1 4 obliged to furnish reasonable services and supplies to treat an 1 5 injured employee, and has the right to choose the care unless 1 6 the employee has predesignated a physician as provided in 1 7 paragraph "b". If the employer chooses the care, the employer 1 8 shall hold the employee harmless for the cost of care until the 1 9 employer notifies the employee that the employer is no longer 1 10 authorizing all or any part of the care and the reason for 1 11 the change in authorization. An employer is not liable for 1 12 the cost of care that the employer arranges in response to a 1 13 sudden emergency if the employee's condition, for which care 1 14 was arranged, is not related to the employment. The treatment 1 15 must be offered promptly and be reasonably suited to treat the 1 16 injury without undue inconvenience to the employee. 1 17 (2) If the employee has reason to be dissatisfied with the 1 18 care offered, the employee should communicate the basis of 1 19 such dissatisfaction to the employer, in writing if requested, 1 20 following which the employer and the employee may agree to 1 21 alternate care reasonably suited to treat the injury. If the 1 22 employer and employee cannot agree on such alternate care, the 1 23 commissioner may, upon application and reasonableproofsproof 1 24 of the necessity therefor, allow and order other care. In an 1 25 emergency, the employee may choose the employee's care at the 1 26 employer's expense, provided the employer or the employer's 1 27 agent cannot be reached immediately.An application made under 1 28 this subsection shall be considered an original proceeding 1 29 for purposes of commencement and contested case proceedings 1 30 under section 85.26. The hearing shall be conducted pursuant 1 31 to chapter 17A. Before a hearing is scheduled, the parties 1 32 may choose a telephone hearing or an in=person hearing. A 1 33 request for an in=person hearing shall be approved unless the 1 34 in=person hearing would be impractical because of the distance 1 35 between the parties to the hearing. The workers' compensation 2 1 commissioner shall issue a decision within ten working days of 2 2 receipt of an application for alternate care made pursuant to a 2 3 telephone hearing or within fourteen working days of receipt of 2 4 an application for alternate care made pursuant to an in=person 2 5 hearing.2 6 (3) The employer shall notify an injured employee of the 2 7 employee's ability to contest the employer's choice of care 2 8 pursuant to thissubsectionparagraph "a". 2 9 b. (1) An injured employee has the right to choose care, 2 10 unless care needs to be provided at the job site in response to 2 11 a life=threatening emergency, if the employee has predesignated 2 12 a physician who is a primary care provider, who has previously 2 13 provided medical treatment to the employee and has retained 2 14 the employee's medical records, to provide treatment for the 2 15 injury. Upon hire and periodically during employment, an 2 16 employer shall provide written notice to all employees who have 2 17 not yet predesignated a physician, of their right under this 2 18 paragraph "b" to predesignate such a physician for treatment of 2 19 an injury, in a manner prescribed by the workers' compensation 2 20 commissioner by rule. The employer or the employer's insurer 2 21 shall not coerce or otherwise attempt to influence an injured 2 22 employee's choice of a physician to provide care. An employee 2 23 shall, as soon as practicable, notify the employer of an 2 24 injury, and upon receiving such notice of an injury from an 2 25 employee, the employer shall again provide written notice to 2 26 that employee of the employee's right under this paragraph 2 27 "b" in a manner prescribed by the workers' compensation 2 28 commissioner by rule. If an employer fails to notify an 2 29 employee of the employee's right to choose a physician as 2 30 provided in this paragraph "b", the employee has the right to 2 31 choose any physician to provide treatment for the injury and 2 32 the treatment shall be considered care authorized under this 2 33 section. 2 34 (2) For the purposes of this paragraph "b", "physician" 2 35 includes an individual physician, a group of physicians, or 3 1 a clinic. For the purposes of this paragraph "b", "primary 3 2 care provider" means an employee's personal physician licensed 3 3 to practice medicine and surgery or osteopathic medicine and 3 4 surgery in this state or in another state who provides primary 3 5 care and is a family or general practitioner, a pediatrician, 3 6 an internist, an obstetrician, or a gynecologist. A physician 3 7 who practices in another state shall not be predesignated by an 3 8 employee unless the physician's office is located within sixty 3 9 miles of where the employee is employed or was injured unless 3 10 the workers' compensation commissioner allows otherwise. A 3 11 physician chosen by an injured employee to provide treatment 3 12 is authorized to arrange for any consultation, surgical 3 13 consultation, referral, emergency care, or other specialized 3 14 medical services as the physician deems necessary to treat the 3 15 injury. The employer shall pay for all such care, unless the 3 16 workers' compensation commissioner determines otherwise. 3 17 (3) If the employer has reason to be dissatisfied with the 3 18 care chosen by the employee, the employer should communicate 3 19 the basis of such dissatisfaction to the employee, in writing 3 20 if requested, following which the employee and the employer may 3 21 agree to alternate care reasonably suited to treat the injury. 3 22 If the employee and employer cannot agree on such alternate 3 23 care, the commissioner may, upon application and reasonable 3 24 proof of the necessity therefor, allow and order other care. 3 25 c. An application made to the commissioner under paragraph 3 26 "a" or "b" shall be considered an original proceeding for 3 27 purposes of commencement and contested case proceedings under 3 28 section 85.26. The hearing shall be conducted pursuant to 3 29 chapter 17A. Before a hearing is scheduled, the parties may 3 30 choose a telephone hearing, an audio=video conference hearing, 3 31 or an in=person hearing. A request for an in=person hearing 3 32 shall be approved unless the in=person hearing would be 3 33 impractical because of the distance between the parties to the 3 34 hearing. The workers' compensation commissioner shall issue a 3 35 decision within ten working days of receipt of an application 4 1 for alternate care if a telephone hearing or audio=video 4 2 conference hearing is held or within fourteen working days of 4 3 receipt of an application for alternate care if an in=person 4 4 hearing is held. 4 5 Sec. 2. Section 85.39, Code 2018, is amended to read as 4 6 follows: 4 7 85.39 Examination of injured employees. 4 8 1. a. After an injury, the employee, if requested by the 4 9 employer, shall submit for examination at some reasonable 4 10 time and place and as often as reasonably requested, to a 4 11 physician or physicians authorized to practice under the laws 4 12 of this state or another state, without cost to the employee; 4 13 but if the employee requests, the employee, at the employee's 4 14 own cost, is entitled to have a physician or physicians 4 15 of the employee's own selection present to participate in 4 16 the examination. If an employee is required to leave work 4 17 for which the employee is being paid wages to attend the 4 18 requested examination, the employee shall be compensated at 4 19 the employee's regular rate for the time the employee is 4 20 required to leave work, and the employee shall be furnished 4 21 transportation to and from the place of examination, or the 4 22 employer may elect to pay the employee the reasonable cost of 4 23 the transportation. The refusal of the employee to submit 4 24 to the examination shall forfeit the employee's right to any 4 25 compensation for the period of the refusal. Compensation shall 4 26 not be payable for the period of refusal. 4 272.b. If an evaluation of permanent disability has been 4 28 made by a physician retained by the employer and the employee 4 29 believes this evaluation to be too low, the employee shall, 4 30 upon application to the commissioner and upon delivery of a 4 31 copy of the application to the employer and its insurance 4 32 carrier, be reimbursed by the employer the reasonable fee for 4 33 a subsequent examination by a physician of the employee's 4 34 own choice, and reasonably necessary transportation expenses 4 35 incurred for the examination. The physician chosen by the 5 1 employee has the right to confer with and obtain from the 5 2 employer=retained physician sufficient history of the injury 5 3 to make a proper examination. An employer is only liable to 5 4 reimburse an employee for the cost of an examination conducted 5 5 pursuant to thissubsectionparagraph "b" if the injury for 5 6 which the employee is being examined is determined to be 5 7 compensable under this chapter or chapter 85A or 85B. An 5 8 employer is not liable for the cost of such an examination 5 9 if the injury for which the employee is being examined is 5 10 determined not to be a compensable injury. A determination of 5 11 the reasonableness of a fee for an examination made pursuant to 5 12 thissubsectionparagraph "b", shall be based on the typical fee 5 13 charged by a medical provider to perform an impairment rating 5 14 in the local area where the examination is conducted. 5 15 2. If the employee has chosen a physician to provide care 5 16 as provided in section 85.27, subsection 4, paragraph "b", when 5 17 it is medically indicated that no significant improvement from 5 18 an injury is anticipated, the employee may obtain a medical 5 19 opinion from the employee's physician, at the employer's 5 20 expense, regarding the extent of the employee's permanent 5 21 disability. If the employee obtains such an evaluation and the 5 22 employer believes this evaluation of permanent disability to be 5 23 too high, the employer may arrange for a medical examination of 5 24 the injured employee by a physician of the employer's choice 5 25 for the purpose of obtaining a medical opinion regarding the 5 26 extent of the employee's permanent disability. If an employee 5 27 is required to leave work for which the employee is being paid 5 28 wages to attend an examination under this subsection, the 5 29 employee shall be compensated at the employee's regular rate 5 30 for the time the employee is required to leave work, and the 5 31 employee shall be furnished transportation to and from the 5 32 place of examination, or the employer may elect to pay the 5 33 employee the reasonable cost of transportation. The physician 5 34 chosen by the employer to conduct the examination has the right 5 35 to confer with and obtain from any physician who has treated 6 1 the injured employee sufficient history of the injury to make 6 2 a proper examination. The refusal by the employee to submit 6 3 to the examination shall forfeit the employee's right to any 6 4 compensation for the period of the refusal. Compensation shall 6 5 not be payable for the period of refusal. 6 6 Sec. 3. EFFECTIVE DATE. This Act takes effect January 1, 6 7 2019. 6 8 Sec. 4. APPLICABILITY. This Act applies to injuries 6 9 occurring on or after January 1, 2019. 6 10 EXPLANATION 6 11 The inclusion of this explanation does not constitute agreement with 6 12 the explanation's substance by the members of the general assembly. 6 13 This bill relates to the choice of a physician to treat an 6 14 injured employee under the state's workers' compensation laws. 6 15 The bill allows the employer to choose care unless the employee 6 16 has predesignated a physician as provided in the bill. 6 17 The bill amends Code section 85.27, giving an employee 6 18 the right to predesignate a physician who is a primary care 6 19 provider, who has previously provided treatment to the employee 6 20 and has retained the employee's medical records, to provide 6 21 treatment for a work=related injury. The employer is required 6 22 to provide written notice to employees of this right upon hire, 6 23 and periodically during employment, and upon receiving notice 6 24 of an injury from an employee who has not yet predesignated 6 25 a physician of the employee's right to do so, in a manner 6 26 prescribed by the workers' compensation commissioner. An 6 27 employer or an employer's insurer shall not coerce or otherwise 6 28 attempt to influence an injured employee's choice of a 6 29 physician. 6 30 If the employer fails to provide such notification, an 6 31 injured employee has the right to choose any physician to 6 32 provide treatment for the work=related injury and that 6 33 treatment shall be considered authorized care. 6 34 If the employer or employee is dissatisfied with the care 6 35 chosen by the other party, the dissatisfied party should 7 1 communicate the basis of dissatisfaction to the other party, in 7 2 writing if requested, and the parties may agree to alternate 7 3 care reasonably suited to treat the injury. If the parties 7 4 cannot agree to such alternate care, the dissatisfied party may 7 5 make an application for alternate care to the commissioner. 7 6 An application for alternate care is an original proceeding 7 7 and is treated as a contested case. A party may request that 7 8 the hearing be held in person, by telephone, or by audio=video 7 9 conference. The commissioner is required to issue a decision 7 10 within 10 working days of receipt of an application if a 7 11 telephone hearing or audio=video conference hearing is held or 7 12 within 14 days if an in=person hearing is held. 7 13 Code section 85.39 is amended to provide that if the 7 14 employee has chosen care, when it is medically indicated that 7 15 no significant improvement from an injury is anticipated, the 7 16 employee may obtain a medical opinion regarding the extent of 7 17 the employee's permanent disability. If the employer believes 7 18 that the evaluation of permanent disability obtained by the 7 19 employee is too high, the employer has the right to obtain 7 20 another medical opinion from a physician of the employer's 7 21 choosing. 7 22 The bill takes effect and applies to injuries occurring on or 7 23 after January 1, 2019. LSB 5264XS (5) 87 asf/rj
