H.F. 33 Section 1. Section 85.27, subsection 4, Code 2013, is 1 amended to read as follows: 2 4. a. (1) For purposes of this section , the employer is 3 obliged to furnish reasonable services and supplies to treat an 4 injured employee, and has the right to choose the care unless 5 the employee has predesignated a physician as provided in 6 paragraph “b” . If the employer chooses the care, the employer 7 shall hold the employee harmless for the cost of care until the 8 employer notifies the employee that the employer is no longer 9 authorizing all or any part of the care and the reason for 10 the change in authorization. An employer is not liable for 11 the cost of care that the employer arranges in response to a 12 sudden emergency if the employee’s condition, for which care 13 was arranged, is not related to the employment. The treatment 14 must be offered promptly and be reasonably suited to treat the 15 injury without undue inconvenience to the employee. 16 (2) If the employee has reason to be dissatisfied with the 17 care offered, the employee should communicate the basis of 18 such dissatisfaction to the employer, in writing if requested, 19 following which the employer and the employee may agree to 20 alternate care reasonably suited to treat the injury. If the 21 employer and employee cannot agree on such alternate care, the 22 commissioner may, upon application and reasonable proofs proof 23 of the necessity therefor, allow and order other care. In an 24 emergency, the employee may choose the employee’s care at the 25 employer’s expense, provided the employer or the employer’s 26 agent cannot be reached immediately. 27 (3) An application made under this subsection lettered 28 paragraph “a” shall be considered an original proceeding for 29 purposes of commencement and contested case proceedings under 30 section 85.26 . The hearing shall be conducted pursuant to 31 chapter 17A . Before a hearing is scheduled, the parties may 32 choose a telephone hearing , an audio-video conference hearing, 33 or an in-person hearing. A request for an in-person hearing 34 shall be approved unless the in-person hearing would be 35 -1- LSB 1211YH (2) 85 av/nh 1/ 6

H.F. 33 impractical because of the distance between the parties to the 1 hearing. The workers’ compensation commissioner shall issue a 2 decision within ten working days of receipt of an application 3 for alternate care made pursuant to a telephone hearing or 4 audio-video conference hearing or within fourteen working days 5 of receipt of an application for alternate care made pursuant 6 to an in-person hearing. The employer shall notify an injured 7 employee of the employee’s ability to contest the employer’s 8 choice of care pursuant to this subsection lettered paragraph 9 “a” . 10 b. (1) An injured employee has the right to choose the 11 care if the employee has predesignated a physician who is a 12 primary care provider, from whom the employee has previously 13 received treatment for a nonoccupational injury, illness, 14 or examination, to provide treatment for the injury. Upon 15 hire and periodically during employment, an employer shall 16 provide written notice to all employees of their rights under 17 this lettered paragraph “b” to predesignate such a physician 18 for treatment of an injury, in a manner prescribed by the 19 workers’ compensation commissioner by rule. The employer 20 or the employer’s insurer shall not make suggestions or 21 otherwise attempt to influence an injured employee’s choice 22 of a physician to provide care. An employee shall, as soon 23 as practicable, notify the employer of an injury, and upon 24 receiving such notice of an injury from an employee, the 25 employer shall again provide written notice to that employee 26 of the employee’s rights under this lettered paragraph “b” in a 27 manner prescribed by the workers’ compensation commissioner by 28 rule. If an employer fails to notify employees of their right 29 to choose a physician as provided in this lettered paragraph 30 “b” , the employee has the right to choose any physician to 31 provide treatment for the injury and the treatment shall be 32 considered care authorized under this section. 33 (2) For the purposes of this lettered paragraph “b” , 34 “physician” includes an individual physician, a group of 35 -2- LSB 1211YH (2) 85 av/nh 2/ 6

H.F. 33 physicians, or a clinic. For the purposes of this lettered 1 paragraph “b” , “primary care provider” means a physician 2 who provides primary care who is a family or general 3 practitioner, a pediatrician, an internist, an obstetrician, 4 or a gynecologist. A physician chosen by an injured employee 5 to provide treatment is authorized to arrange for any 6 consultation, surgical consultation, referral, emergency care, 7 or other specialized medical services as the physician deems 8 necessary to treat the injury. The employer shall pay for 9 all such care, unless the workers’ compensation commissioner 10 determines otherwise. 11 (3) If the employer has reason to be dissatisfied with the 12 care chosen by the employee, the employer should communicate 13 the basis of such dissatisfaction to the employee, in writing 14 if requested, following which the employee and the employer may 15 agree to alternate care reasonably suited to treat the injury. 16 If the employee and employer cannot agree on such alternate 17 care, the commissioner may, upon application and reasonable 18 proof of the necessity therefor, allow and order other care. 19 (4) An application made under this lettered paragraph 20 “b” shall be considered an original proceeding for purposes 21 of commencement and contested case proceedings under section 22 85.26. The hearing shall be conducted pursuant to chapter 23 17A. Before a hearing is scheduled, the parties may choose 24 a telephone hearing, an audio-video conference hearing, or 25 an in-person hearing. A request for an in-person hearing 26 shall be approved unless the in-person hearing would be 27 impractical because of the distance between the parties to the 28 hearing. The workers’ compensation commissioner shall issue a 29 decision within ten working days of receipt of an application 30 for alternate care made pursuant to a telephone hearing or 31 audio-video conference hearing or within fourteen working days 32 of receipt of an application for alternate care made pursuant 33 to an in-person hearing. 34 Sec. 2. Section 85.39, Code 2013, is amended to read as 35 -3- LSB 1211YH (2) 85 av/nh 3/ 6

H.F. 33 follows: 1 85.39 Examination of injured employees. 2 1. a. After an injury, the employee, if requested by the 3 employer, shall submit for examination at some reasonable 4 time and place and as often as reasonably requested, to a 5 physician or physicians authorized to practice under the laws 6 of this state or another state, without cost to the employee; 7 but if the employee requests, the employee, at the employee’s 8 own cost, is entitled to have a physician or physicians 9 of the employee’s own selection present to participate in 10 the examination. If an employee is required to leave work 11 for which the employee is being paid wages to attend the 12 requested examination, the employee shall be compensated at 13 the employee’s regular rate for the time the employee is 14 required to leave work, and the employee shall be furnished 15 transportation to and from the place of examination, or the 16 employer may elect to pay the employee the reasonable cost of 17 the transportation. The refusal of the employee to submit 18 to the examination shall suspend the employee’s right to any 19 compensation for the period of the refusal. Compensation shall 20 not be payable for the period of suspension. 21 b. If an evaluation of permanent disability has been made by 22 a physician retained by the employer and the employee believes 23 this evaluation to be too low, the employee shall, upon 24 application to the commissioner and upon delivery of a copy of 25 the application to the employer and its insurance carrier, be 26 reimbursed by the employer the reasonable fee for a subsequent 27 examination by a physician of the employee’s own choice, and 28 reasonably necessary transportation expenses incurred for the 29 examination. The physician chosen by the employee has the 30 right to confer with and obtain from the employer-retained 31 physician sufficient history of the injury to make a proper 32 examination. 33 2. If the employee has chosen a physician to provide care 34 as provided in section 85.27, subsection 4, paragraph “b” , when 35 -4- LSB 1211YH (2) 85 av/nh 4/ 6

H.F. 33 it is medically indicated that no significant improvement from 1 an injury is anticipated, the employee may obtain a medical 2 opinion from the employee’s physician, at the employer’s 3 expense, regarding the extent of the employee’s permanent 4 disability. If the employee obtains such an evaluation and the 5 employer believes this evaluation of permanent disability to be 6 too high, the employer may arrange for a medical examination of 7 the injured employee by a physician of the employer’s choice 8 for the purpose of obtaining a medical opinion regarding the 9 extent of the employee’s permanent disability. If an employee 10 is required to leave work for which the employee is being paid 11 wages to attend an examination under this subsection, the 12 employee shall be compensated at the employee’s regular rate 13 for the time the employee is required to leave work, and the 14 employee shall be furnished transportation to and from the 15 place of examination, or the employer may elect to pay the 16 employee the reasonable cost of transportation. The physician 17 chosen by the employer to conduct the examination has the right 18 to confer with and obtain from any physician who has treated 19 the injured employee sufficient history of the injury to make 20 a proper examination. The refusal by the employee to submit 21 to the examination shall suspend the employee’s right to any 22 compensation for the period of the refusal. Compensation shall 23 not be payable for the period of suspension. 24 Sec. 3. APPLICABILITY DATE. This Act applies to injuries 25 occurring on or after January 1, 2014. 26 EXPLANATION 27 This bill relates to the choice of a physician to treat an 28 injured employee under the state’s workers’ compensation laws. 29 The bill allows the employer to choose care unless the employee 30 has predesignated a physician as provided in the bill. 31 The bill gives an employee the right to predesignate 32 a physician who is a primary care provider, from whom 33 the employee has previously received treatment for a 34 nonoccupational injury, illness, or examination, to provide 35 -5- LSB 1211YH (2) 85 av/nh 5/ 6

H.F. 33 treatment for a work-related injury. The employer is required 1 to provide written notice to employees of this right upon hire, 2 periodically during employment, and upon receiving notice of an 3 injury from an employee, in a manner prescribed by the workers’ 4 compensation commissioner. 5 If the employer fails to provide such notification, an 6 injured employee has the right to choose any physician to 7 provide treatment for the work-related injury and that 8 treatment shall be considered authorized care. 9 If the employer or employee is dissatisfied with the care 10 chosen by the other party, the dissatisfied party is required 11 to communicate the basis of dissatisfaction to the other 12 party in writing and the parties may agree to alternate care 13 reasonably suited to treat the injury. If the parties cannot 14 agree to such alternate care, the dissatisfied party may make 15 an application for alternate care to the commissioner. 16 An application for alternate care is an original proceeding 17 and is treated as a contested case. A party may request that 18 the hearing be held in person, by telephone, or by audio-video 19 conference. The commissioner is required to issue a decision 20 within 10 working days of receipt of an application made 21 pursuant to a telephone hearing or audio-video conference 22 hearing and within 14 days of an in-person hearing. 23 Code section 85.39 is amended to provide that if the 24 employee has chosen care, when it is medically indicated that 25 no significant improvement from an injury is anticipated, the 26 employee may obtain a medical opinion regarding the extent of 27 the employee’s permanent disability. If the employer believes 28 that the evaluation of permanent disability obtained by the 29 employee is too high, the employer has the right to obtain 30 another medical opinion from a physician of the employer’s 31 choosing. 32 The bill applies to injuries occurring on or after January 33 1, 2014. 34 -6- LSB 1211YH (2) 85 av/nh 6/ 6