Ex parte Travis C. Aderhold (In re: Massey Chevrolet, Inc. v. Travis C. Aderhold):

On May 22, 2009, the Alabama Supreme Court denied a petition for writ of certiorari filed by the employee as a result of the Alabama Court of Civil Appeals decision in Massey Chevrolet, Inc. v. Travis C. Aderhold. The prior opinion was previously reported in this blawg on January 23, 2009.  As a short recap, the authorized treating physician referred the employee to two different pain management doctors. One was supposed to handle pain management and the other was simply supposed to perform a procedure. When the procedure doctor tried to perform other treatment not dictated by the authorized treating physician, the employer denied it. the employee sought relief from the trial judge and the judge ordered that the procedure doctor be considered an authorized treating physician. The Court of Civil Appeals ruled that the procedure doctor was not an authorized treating physician because the employee was sent to him for a "limited purpose." Interestingly, the Court of Civil Appeals did consider the other pain management doctor to be an authorized treating physician because the employee had been referred to him for on going medical care.

Although the Supreme Court denied the petition with no opinion, Justice Murdock issued a special concurring opinion in which he asserted that he agreed with the result but disagreed that the doctor providing on going pain management should be considered an authorized treating physician. According to Justice Murdock, only the initial treating physician was the true authorized treating physician.

The case of Fluor Enterprises, Inc., d/b/a Fluor Signature Services v. Darrell Lawshe was previously reported in this blawg on February 6, 2009. This case put employers, insurers, and third party administrators on notice that they may lose the right to choose the doctor if they deny a claim and it is later determined to be compensable. The dilemma thus becomes...do you deny the claim and risk giving up this important right or do you accept the claim in the hopes that by maintaining control of the medical benefits, you can bring a quick and successful resolution to the claim? Depending on the situation, the best answer may be to do both. There is no reason why you cannot continue to pay for medical treatment while, at the same time, denying the claim. If the judge ultimately rules that the claim is not compensable, then you will owe no future medical benefits.  If the judge deems the claim compensable, then you have protected your right to choose the doctor.

Ex parte Massey Chevrolet, Inc.:

In this opinion released on January 23, 2009, the Alabama Court of Civil Appeals considered a dispute over medical care in a previously settled case. Specifically, the indemnity and vocational retraining benefits were settled by agreement leaving only the medical benefits open. The authorized treating physician, Dr. Peterson, referred the employee to Dr. Nichols for the pain management of his neck injury. Dr. Nichols, in turn, referred the employee to Dr. Aprill for the specific purpose of administering a cervical discogram. Rather than administering the discogram, Dr. Aprill administered facet injections and performed a CT scan. Dr. Aprill treated the employee several times after that with facet injections and radiofrequency denervation procedures. During this same time period, Dr. Nichols continued to treat the employee with prescription medications. When the employer refused to pay for the unauthorized medical treatment performed by Dr. Aprill, the employee asked the trial court to issue an order requiring said payment and designating Dr. Aprill as the authorized treating physician. The trial judge refused to order the employer to pay for the prior unauthorized treatment but granted the employee’s request that Dr. Aprill be considered the authorized treating physician. The Court of Civil Appeals reversed the trial court because Dr. Nichols referred the employee for the limited purpose of administering the discogram. Although Dr. Nichols became the authorized treating physician when the employee was referred to him for pain management, Dr. Nichols maintained control of the employee’s pain management when he made the Dr. Aprill referral.

As a practice pointer, make sure that your authorized treating physicians understand the legal implications of making referrals versus limited purpose referrals. If it is not their intent to relinquish the care of the patient, then they need to be specific when making the referral.