Claimant Refuses to Attend FCE, Commission Denies Employer’s Application for Hearing

 

Workers' Compensation Case Watch

In Manion v. Northwestern Regional Adult Detention Ctr., the claimant needed a new physician because her doctor was no longer providing pain management. The employer asked a nurse case manager to find a new doctor for the claimant and to obtain a Functional Capacity Evaluation (“FCE”) from the physician. The nurse got an FCE referral from the new doctor and scheduled the appointment. She told the claimant about the appointment in person and left her several message about it. The claimant said she would not attend and cancelled the FCE.                                                                                                                                   

The defendant filed an Employer’s Application for Hearing alleging refusal of medical treatment because the claimant did not go to the FCE. The Deputy Commissioner denied the Application because the scheduled FCE was not medically necessary treatment. On review, the Full Commission cited the longstanding principal that the claimant’s medical treatment is directed by the treating physician and not the defendants. They noted that a

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320-Mile Round Trip to Doctor Unreasonable

 

Workers' Compensation Case Watch

In Clarke v. Hughes Center, LLC., the claimant established a treating physician relationship with a pain management doctor in Danville, VA. The claimant later moved out of state, but continued having appointments with the same treating physician. The claimant was traveling 320 miles round-trip to see the doctor. The defendants filed an Employer’s Application for Hearing seeking a change in treating physician. The Deputy Commissioner denied the Employer’s Application.  

On review, the Full Commission listed the six-factors it considers to justify a change in treating physician: 1) inadequate treatment is being rendered; 2) a specialist’s treatment is needed but

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No Medical Progress? Consider a Change in Treating Physician

By: Eva C. Roffis, Esq.

Often times 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.

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