No Medical Progress? Consider a Change in Treating Physician

By: Eva C. Roffis, Esq.

Often, we find a claim has stalled because the claimant’s treating physician is offering inadequate care. In these situations, either party may seek a change in treating physician.

In Virginia, the circumstances that justify a change in treating physician are as follows:

  • Inadequate treatment is being rendered;
  • Specialized treatment is needed and is not being provided;
  • A lack of progress or improvement of the claimant's condition without any adequate explanation is shown;
  • Conventional modalities are not being used;
  • No plan of treatment for a long-term disability is established; and 
  • The treating physician fails to cooperate with discovery proceedings ordered by the Commission.

Allen & Rocks, Inc. v. Briggs, 28 Va. App. 662, 675, 508 S.E.2d 335, 341 (1998).  It is also worth noting that the party seeking the change in treating physician bears the burden of establishing that a change is warranted. Apple Constr. Corp. v. Sexton, 44 Va. App. 458, 461, 605 S.E.2d 351, 352 (2004). 

A successful change in treating physician application brought by the employer and carrier is illustrated in the case of Hite v. Dupont Cmty. Credit Union, JCN 2251240, 2016 VA Wrk. Comp. LEXIS 49 (Jan. 27, 2016). In this case, the claimant had been treating with her treating physician for almost ten years. The defendants filed an application seeking a change in treating physician on the ground that the claimant had not significantly improved or

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