House File 2608 - Introduced
HOUSE FILE
BY COMMITTEE ON LABOR
(SUCCESSOR TO HSB 771)
Passed House, Date Passed Senate, Date
Vote: Ayes Nays Vote: Ayes Nays
Approved
A BILL FOR
1 An Act relating to the choice of doctor to treat an injured
2 employee under workers' compensation laws and providing an
3 applicability date.
4 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
5 TLSB 6539HV 82
6 av/nh/5
PAG LIN
1 1 Section 1. Section 85.27, subsection 4, Code Supplement
1 2 2007, is 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
1 5 an injured employee, and has the right to choose the care
1 6 unless the employee has predesignated a physician as provided
1 7 in paragraph "b". If the employer chooses the care, the
1 8 employer shall hold the employee harmless for the cost of care
1 9 until the employer notifies the employee that the employer is
1 10 no longer authorizing all or any part of the care and the
1 11 reason for the change in authorization. An employer is not
1 12 liable for the cost of care that the employer arranges in
1 13 response to a sudden emergency if the employee's condition,
1 14 for which care was arranged, is not related to the employment.
1 15 The treatment must be offered promptly and be reasonably
1 16 suited to treat the injury without undue inconvenience to the
1 17 employee.
1 18 (2) If the employee has reason to be dissatisfied with the
1 19 care offered, the employee should communicate the basis of
1 20 such dissatisfaction to the employer, in writing if requested,
1 21 following which the employer and the employee may agree to
1 22 alternate care reasonably suited to treat the injury. If the
1 23 employer and employee cannot agree on such alternate care, the
1 24 commissioner may, upon application and reasonable proofs proof
1 25 of the necessity therefor, allow and order other care. In an
1 26 emergency, the employee may choose the employee's care at the
1 27 employer's expense, provided the employer or the employer's
1 28 agent cannot be reached immediately.
1 29 (3) An application made under this subsection paragraph
1 30 "a" shall be considered an original proceeding for purposes of
1 31 commencement and contested case proceedings under section
1 32 85.26. The hearing shall be conducted pursuant to chapter
1 33 17A. Before a hearing is scheduled, the parties may choose a
1 34 telephone hearing, an audio=video conference hearing, or an
1 35 in=person hearing. A request for an in=person hearing shall
2 1 be approved unless the in=person hearing would be impractical
2 2 because of the distance between the parties to the hearing.
2 3 The workers' compensation commissioner shall issue a decision
2 4 within ten working days of receipt of an application for
2 5 alternate care made pursuant to a telephone hearing or
2 6 audio=video conference hearing or within fourteen working days
2 7 of receipt of an application for alternate care made pursuant
2 8 to an in=person hearing. The employer shall notify an injured
2 9 employee of the employee's ability to contest the employer's
2 10 choice of care pursuant to this subsection paragraph "a".
2 11 b. (1) An injured employee has the right to choose care,
2 12 unless care needs to be provided at the job site in response
2 13 to a life=threatening emergency, if the employee has
2 14 predesignated a physician who is a primary care provider, who
2 15 has previously provided medical treatment to the employee and
2 16 has retained the employee's medical records, to provide
2 17 treatment for the injury. Upon hire and periodically during
2 18 employment, an employer shall provide written notice to all
2 19 employees who have not yet predesignated a physician, of their
2 20 rights under this paragraph "b" to predesignate such a
2 21 physician for treatment of an injury, in a manner prescribed
2 22 by the workers' compensation commissioner by rule. The
2 23 employer or the employer's insurer shall not coerce or
2 24 otherwise attempt to influence an injured employee's choice of
2 25 a physician to provide care. An employee shall, as soon as
2 26 practicable, notify the employer of an injury, and upon
2 27 receiving such notice of an injury from an employee, the
2 28 employer shall again provide written notice to that employee
2 29 of the employee's rights under this paragraph "b" in a manner
2 30 prescribed by the workers' compensation commissioner by rule.
2 31 If an employer fails to notify employees of their right to
2 32 choose a physician as provided in this paragraph "b", the
2 33 employee has the right to choose any physician to provide
2 34 treatment for the injury and the treatment shall be considered
2 35 care authorized under this section.
3 1 (2) For the purposes of this paragraph "b", "physician"
3 2 includes an individual physician, a group of physicians, or a
3 3 clinic. For the purposes of this paragraph "b", "primary care
3 4 provider" means an employee's personal physician who is
3 5 licensed to practice medicine and surgery, osteopathic
3 6 medicine and surgery, or osteopathy in this state or in
3 7 another state and provides primary care who is a family or
3 8 general practitioner, a pediatrician, an internist, an
3 9 obstetrician, or a gynecologist. A physician who practices in
3 10 another state shall not be predesignated by an employee unless
3 11 the physician's office is located within sixty miles of where
3 12 the employee is employed or was injured unless the workers'
3 13 compensation commissioner allows otherwise. A physician
3 14 chosen by an injured employee to provide treatment is
3 15 authorized to arrange for any consultation, surgical
3 16 consultation, referral, emergency care, or other specialized
3 17 medical services as the physician deems necessary to treat the
3 18 injury. The employer shall pay for all such care, unless the
3 19 workers' compensation commissioner determines otherwise.
3 20 (3) If the employer has reason to be dissatisfied with the
3 21 care chosen by the employee, the employer should communicate
3 22 the basis of such dissatisfaction to the employee, in writing
3 23 if requested, following which the employee and the employer
3 24 may agree to alternate care reasonably suited to treat the
3 25 injury. If the employee and employer cannot agree on such
3 26 alternate care, the commissioner may, upon application and
3 27 reasonable proof of the necessity therefor, allow and order
3 28 other care.
3 29 (4) An application made under this paragraph "b" shall be
3 30 considered an original proceeding for purposes of commencement
3 31 and contested case proceedings under section 85.26. The
3 32 hearing shall be conducted pursuant to chapter 17A. Before a
3 33 hearing is scheduled, the parties may choose a telephone
3 34 hearing, an audio=video conference hearing, or an in=person
3 35 hearing. A request for an in=person hearing shall be approved
4 1 unless the in=person hearing would be impractical because of
4 2 the distance between the parties to the hearing. The workers'
4 3 compensation commissioner shall issue a decision within ten
4 4 working days of receipt of an application for alternate care
4 5 made pursuant to a telephone hearing or audio=video conference
4 6 hearing or within fourteen working days of receipt of an
4 7 application for alternate care made pursuant to an in=person
4 8 hearing.
4 9 Sec. 2. Section 85.39, Code 2007, is amended to read as
4 10 follows:
4 11 85.39 EXAMINATION OF INJURED EMPLOYEES.
4 12 1. a. After an injury, the employee, if requested by the
4 13 employer, shall submit for examination at some reasonable time
4 14 and place and as often as reasonably requested, to a physician
4 15 or physicians authorized to practice under the laws of this
4 16 state or another state, without cost to the employee; but if
4 17 the employee requests, the employee, at the employee's own
4 18 cost, is entitled to have a physician or physicians of the
4 19 employee's own selection present to participate in the
4 20 examination. If an employee is required to leave work for
4 21 which the employee is being paid wages to attend the requested
4 22 examination, the employee shall be compensated at the
4 23 employee's regular rate for the time the employee is required
4 24 to leave work, and the employee shall be furnished
4 25 transportation to and from the place of examination, or the
4 26 employer may elect to pay the employee the reasonable cost of
4 27 the transportation. The refusal of the employee to submit to
4 28 the examination shall suspend the employee's right to any
4 29 compensation for the period of the refusal. Compensation
4 30 shall not be payable for the period of suspension.
4 31 b. If an evaluation of permanent disability has been made
4 32 by a physician retained by the employer and the employee
4 33 believes this evaluation to be too low, the employee shall,
4 34 upon application to the commissioner and upon delivery of a
4 35 copy of the application to the employer and its insurance
5 1 carrier, be reimbursed by the employer the reasonable fee for
5 2 a subsequent examination by a physician of the employee's own
5 3 choice, and reasonably necessary transportation expenses
5 4 incurred for the examination. The physician chosen by the
5 5 employee has the right to confer with and obtain from the
5 6 employer=retained physician sufficient history of the injury
5 7 to make a proper examination.
5 8 2. If the employee has chosen a physician to provide care
5 9 as provided in section 85.27, subsection 4, paragraph "b",
5 10 when it is medically indicated that no significant improvement
5 11 from an injury is anticipated, the employee may obtain a
5 12 medical opinion from the employee's physician, at the
5 13 employer's expense, regarding the extent of the employee's
5 14 permanent disability. If the employee obtains such an
5 15 evaluation and the employer believes this evaluation of
5 16 permanent disability to be too high, the employer may arrange
5 17 for a medical examination of the injured employee by a
5 18 physician of the employer's choice for the purpose of
5 19 obtaining a medical opinion regarding the extent of the
5 20 employee's permanent disability. If an employee is required
5 21 to leave work for which the employee is being paid wages to
5 22 attend an examination under this subsection, the employee
5 23 shall be compensated at the employee's regular rate for the
5 24 time the employee is required to leave work, and the employee
5 25 shall be furnished transportation to and from the place of
5 26 examination, or the employer may elect to pay the employee the
5 27 reasonable cost of transportation. The physician chosen by
5 28 the employer to conduct the examination has the right to
5 29 confer with and obtain from any physician who has treated the
5 30 injured employee sufficient history of the injury to make a
5 31 proper examination. The refusal by the employee to submit to
5 32 the examination shall suspend the employee's right to any
5 33 compensation for the period of the refusal. Compensation
5 34 shall not be payable for the period of suspension.
5 35 Sec. 3. APPLICABILITY DATE. This Act applies to injuries
6 1 occurring on or after January 1, 2009.
6 2 EXPLANATION
6 3 This bill relates to the choice of a physician to treat an
6 4 injured employee under the state's workers' compensation laws.
6 5 The bill allows the employer to choose care unless the
6 6 employee has predesignated a physician as provided in the
6 7 bill.
6 8 The bill gives an employee the right to predesignate a
6 9 physician who is a primary care provider, who has previously
6 10 provided treatment to the employee and has retained the
6 11 employee's medical records, to provide treatment for a
6 12 work=related injury. The employer is required to provide
6 13 written notice to employees of this right upon hire, and
6 14 periodically during employment, and upon receiving notice of
6 15 an injury from an employee who has not yet predesignated a
6 16 physician of their right to do so, in a manner prescribed by
6 17 the workers' compensation commissioner. An employer or an
6 18 employer's insurer shall not coerce or otherwise attempt to
6 19 influence an injured employee's choice of a physician.
6 20 If the employer fails to provide such notification, an
6 21 injured employee has the right to choose any physician to
6 22 provide treatment for the work=related injury and that
6 23 treatment shall be considered authorized care.
6 24 If the employer or employee is dissatisfied with the care
6 25 chosen by the other party, the dissatisfied party is required
6 26 to communicate the basis of dissatisfaction to the other party
6 27 in writing and the parties may agree to alternate care
6 28 reasonably suited to treat the injury. If the parties cannot
6 29 agree to such alternate care, the dissatisfied party may make
6 30 an application for alternate care to the commissioner.
6 31 An application for alternate care is an original proceeding
6 32 and is treated as a contested case. A party may request that
6 33 the hearing be held in person, by telephone, or by audio=video
6 34 conference. The commissioner is required to issue a decision
6 35 within 10 working days of receipt of an application made
7 1 pursuant to a telephone hearing or audio=video conference
7 2 hearing and within 14 days of an in=person hearing.
7 3 Code section 85.39 is amended to provide that if the
7 4 employee has chosen care, when it is medically indicated that
7 5 no significant improvement from an injury is anticipated, the
7 6 employee may obtain a medical opinion regarding the extent of
7 7 the employee's permanent disability. If the employer believes
7 8 that the evaluation of permanent disability obtained by the
7 9 employee is too high, the employer has the right to obtain
7 10 another medical opinion from a physician of the employer's
7 11 choosing.
7 12 The bill applies to injuries occurring on or after January
7 13 1, 2009.
7 14 LSB 6539HV 82
7 15 av/nh/5