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House File 123 - IntroducedA Bill ForAn Act 1relating to the choice of doctor to treat an injured
2employee under workers’ compensation laws and including
3applicability date provisions.
4BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1 Section 1. Section 85.27, subsection 4, Code 2021, is
2amended to read as follows:
34. a. (1) For purposes of this section, the employer is
4obliged to furnish reasonable services and supplies to treat an
5injured employee, and has the right to choose the care unless
6the employee has predesignated a physician as provided in
7paragraph “b”. If the employer chooses the care, the employer
8shall hold the employee harmless for the cost of care until the
9employer notifies the employee that the employer is no longer
10authorizing all or any part of the care and the reason for
11the change in authorization. An employer is not liable for
12the cost of care that the employer arranges in response to a
13sudden emergency if the employee’s condition, for which care
14was arranged, is not related to the employment. The treatment
15must be offered promptly and be reasonably suited to treat the
16injury without undue inconvenience to the employee.
17(2) If the employee has reason to be dissatisfied with the
18care offered, the employee should communicate the basis of
19such dissatisfaction to the employer, in writing if requested,
20following which the employer and the employee may agree to
21alternate care reasonably suited to treat the injury. If the
22employer and employee cannot agree on such alternate care, the
23commissioner may, upon application and reasonable proofs proof
24 of the necessity therefor, allow and order other care. In an
25emergency, the employee may choose the employee’s care at the
26employer’s expense, provided the employer or the employer’s
27agent cannot be reached immediately.
28(3) An application made under this subsection paragraph
29“a” shall be considered an original proceeding for purposes
30of commencement and contested case proceedings under section
3185.26. The hearing shall be conducted pursuant to chapter
3217A. Before a hearing is scheduled, the parties may choose
33a telephone hearing, an audio-video conference hearing, or
34an in-person hearing. A request for an in-person hearing
35shall be approved unless the in-person hearing would be
-1-1impractical because of the distance between the parties to the
2hearing. The workers’ compensation commissioner shall issue a
3decision within ten working days of receipt of an application
4for alternate care made pursuant to a telephone hearing or
5audio-video conference hearing or within fourteen working days
6of receipt of an application for alternate care made pursuant
7to an in-person hearing. The employer shall notify an injured
8employee of the employee’s ability to contest the employer’s
9choice of care pursuant to this subsection paragraph “a”.
10b. (1) An injured employee has the right to choose care,
11unless care needs to be provided at the job site in response to
12a life-threatening emergency, if the employee has predesignated
13a physician who is a primary care provider, who has previously
14provided medical treatment to the employee and has retained
15the employee’s medical records, to provide treatment for the
16injury. Upon hire and periodically during employment, an
17employer shall provide written notice, in a manner prescribed
18by the workers’ compensation commissioner by rule, to all
19employees who have not yet predesignated a physician of their
20rights under this paragraph “b” to predesignate such a physician
21for treatment of an injury. The employer or the employer’s
22insurer shall not coerce or otherwise attempt to influence an
23injured employee’s choice of a physician to provide care. An
24employee shall, as soon as practicable, notify the employer of
25an injury, and upon receiving such notice of an injury from an
26employee, the employer shall again provide written notice to
27that employee of the employee’s rights under this paragraph
28“b” in a manner prescribed by the workers’ compensation
29commissioner by rule. If an employer fails to notify employees
30of their right to choose a physician as provided in this
31paragraph “b”, the employee has the right to choose any
32physician to provide treatment for the injury and the treatment
33shall be considered care authorized under this section.
34(2) For the purposes of this paragraph “b”, “physician”
35 includes an individual physician, a group of physicians, or
-2-1a clinic. For the purposes of this paragraph “b”, “primary
2care provider” means an employee’s personal physician who is
3licensed to practice medicine and surgery, osteopathic medicine
4and surgery, or osteopathy in this state or in another state
5and provides primary care and who is a family or general
6practitioner, a pediatrician, an internist, an obstetrician,
7or a gynecologist. A physician who practices in another
8state shall not be predesignated by an employee unless the
9physician’s office is located within sixty miles of where
10the employee is employed or was injured unless the workers’
11compensation commissioner allows otherwise. A physician chosen
12by an injured employee to provide treatment is authorized to
13arrange for any consultation, surgical consultation, referral,
14emergency care, or other specialized medical services as the
15physician deems necessary to treat the injury. The employer
16shall pay for all such care, unless the workers’ compensation
17commissioner determines otherwise.
18(3) If the employer has reason to be dissatisfied with the
19care chosen by the employee, the employer should communicate
20the basis of such dissatisfaction to the employee, in writing
21if requested, following which the employee and the employer may
22agree to alternate care reasonably suited to treat the injury.
23If the employee and employer cannot agree on such alternate
24care, the commissioner may, upon application and reasonable
25proof of the necessity therefor, allow and order other care.
26(4) An application made under this paragraph “b” shall be
27considered an original proceeding for purposes of commencement
28and contested case proceedings under section 85.26. The
29hearing shall be conducted pursuant to chapter 17A. Before
30a hearing is scheduled, the parties may choose a telephone
31hearing, an audio-video conference hearing, or an in-person
32hearing. A request for an in-person hearing shall be approved
33unless the in-person hearing would be impractical because of
34the distance between the parties to the hearing. The workers’
35compensation commissioner shall issue a decision within ten
-3-1working days of receipt of an application for alternate care
2made pursuant to a telephone hearing or audio-video conference
3hearing or within fourteen working days of receipt of an
4application for alternate care made pursuant to an in-person
5hearing.
6 Sec. 2. Section 85.39, Code 2021, is amended by adding the
7following new subsection:
8 NEW SUBSECTION. 3. If the employee has chosen a physician
9to provide care as provided in section 85.27, subsection
104, paragraph “b”, when it is medically indicated that no
11significant improvement from an injury is anticipated, the
12employee may obtain a medical opinion from the employee’s
13physician, at the employer’s expense, regarding the extent of
14the employee’s permanent disability. If the employee obtains
15such an evaluation and the employer believes this evaluation
16of permanent disability to be too high, the employer may
17arrange for a medical examination of the injured employee by a
18physician of the employer’s choice for the purpose of obtaining
19a medical opinion regarding the extent of the employee’s
20permanent disability. If an employee is required to leave
21work for which the employee is being paid wages to attend
22an examination under this subsection, the employee shall be
23compensated at the employee’s regular rate for the time the
24employee is required to leave work, and the employee shall be
25furnished transportation to and from the place of examination,
26or the employer may elect to pay the employee the reasonable
27cost of transportation. The physician chosen by the employer
28to conduct the examination has the right to confer with and
29obtain from any physician who has treated the injured employee
30sufficient history of the injury to make a proper examination.
31The refusal by the employee to submit to the examination shall
32suspend the employee’s right to any compensation for the period
33of the refusal. Compensation shall not be payable for the
34period of suspension.
35 Sec. 3. APPLICABILITY. This Act applies to injuries
-4-1occurring on or after January 1, 2022.
2EXPLANATION
3The inclusion of this explanation does not constitute agreement with
4the explanation’s substance by the members of the general assembly.
5This bill relates to the choice of a physician to treat an
6injured employee under the state’s workers’ compensation laws.
7The bill allows the employer to choose care unless the employee
8has predesignated a physician as provided in the bill.
9The bill gives an employee the right to predesignate a
10physician who is a primary care provider, who has previously
11provided treatment to the employee and has retained the
12employee’s medical records, to provide treatment for a
13work-related injury. The employer is required to provide
14written notice to employees of this right upon hire, and
15periodically during employment, and upon receiving notice of
16an injury from an employee who has not yet predesignated a
17physician of their right to do so, in a manner prescribed by
18the workers’ compensation commissioner. An employer or an
19employer’s insurer shall not coerce or otherwise attempt to
20influence an injured employee’s choice of a physician.
21If the employer fails to provide such notification, an
22injured employee has the right to choose any physician to
23provide treatment for the work-related injury and that
24treatment shall be considered authorized care.
25If the employer or employee is dissatisfied with the care
26chosen by the other party, the dissatisfied party is required
27to communicate the basis of dissatisfaction to the other
28party in writing and the parties may agree to alternate care
29reasonably suited to treat the injury. If the parties cannot
30agree to such alternate care, the dissatisfied party may make
31an application for alternate care to the commissioner.
32An application for alternate care is an original proceeding
33and is treated as a contested case. A party may request that
34the hearing be held in person, by telephone, or by audio-video
35conference. The commissioner is required to issue a decision
-5-1within 10 working days of receipt of an application made
2pursuant to a telephone hearing or audio-video conference
3hearing and within 14 days of an in-person hearing.
4The bill provides that if the employee has chosen care, when
5it is medically indicated that no significant improvement from
6an injury is anticipated, the employee may obtain a medical
7opinion regarding the extent of the employee’s permanent
8disability from the employee’s physician. If the employer
9believes that the evaluation of permanent disability obtained
10by the employee is too high, the employer has the right
11to obtain another medical opinion from a physician of the
12employer’s choosing.
13The bill applies to injuries occurring on or after January
141, 2022.
-6-je/rn
2employee under workers’ compensation laws and including
3applicability date provisions.
4BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
1 Section 1. Section 85.27, subsection 4, Code 2021, is
2amended to read as follows:
34. a. (1) For purposes of this section, the employer is
4obliged to furnish reasonable services and supplies to treat an
5injured employee, and has the right to choose the care unless
6the employee has predesignated a physician as provided in
7paragraph “b”. If the employer chooses the care, the employer
8shall hold the employee harmless for the cost of care until the
9employer notifies the employee that the employer is no longer
10authorizing all or any part of the care and the reason for
11the change in authorization. An employer is not liable for
12the cost of care that the employer arranges in response to a
13sudden emergency if the employee’s condition, for which care
14was arranged, is not related to the employment. The treatment
15must be offered promptly and be reasonably suited to treat the
16injury without undue inconvenience to the employee.
17(2) If the employee has reason to be dissatisfied with the
18care offered, the employee should communicate the basis of
19such dissatisfaction to the employer, in writing if requested,
20following which the employer and the employee may agree to
21alternate care reasonably suited to treat the injury. If the
22employer and employee cannot agree on such alternate care, the
23commissioner may, upon application and reasonable proofs proof
24 of the necessity therefor, allow and order other care. In an
25emergency, the employee may choose the employee’s care at the
26employer’s expense, provided the employer or the employer’s
27agent cannot be reached immediately.
28(3) An application made under this subsection paragraph
29“a” shall be considered an original proceeding for purposes
30of commencement and contested case proceedings under section
3185.26. The hearing shall be conducted pursuant to chapter
3217A. Before a hearing is scheduled, the parties may choose
33a telephone hearing, an audio-video conference hearing, or
34an in-person hearing. A request for an in-person hearing
35shall be approved unless the in-person hearing would be
-1-1impractical because of the distance between the parties to the
2hearing. The workers’ compensation commissioner shall issue a
3decision within ten working days of receipt of an application
4for alternate care made pursuant to a telephone hearing or
5audio-video conference hearing or within fourteen working days
6of receipt of an application for alternate care made pursuant
7to an in-person hearing. The employer shall notify an injured
8employee of the employee’s ability to contest the employer’s
9choice of care pursuant to this subsection paragraph “a”.
10b. (1) An injured employee has the right to choose care,
11unless care needs to be provided at the job site in response to
12a life-threatening emergency, if the employee has predesignated
13a physician who is a primary care provider, who has previously
14provided medical treatment to the employee and has retained
15the employee’s medical records, to provide treatment for the
16injury. Upon hire and periodically during employment, an
17employer shall provide written notice, in a manner prescribed
18by the workers’ compensation commissioner by rule, to all
19employees who have not yet predesignated a physician of their
20rights under this paragraph “b” to predesignate such a physician
21for treatment of an injury. The employer or the employer’s
22insurer shall not coerce or otherwise attempt to influence an
23injured employee’s choice of a physician to provide care. An
24employee shall, as soon as practicable, notify the employer of
25an injury, and upon receiving such notice of an injury from an
26employee, the employer shall again provide written notice to
27that employee of the employee’s rights under this paragraph
28“b” in a manner prescribed by the workers’ compensation
29commissioner by rule. If an employer fails to notify employees
30of their right to choose a physician as provided in this
31paragraph “b”, the employee has the right to choose any
32physician to provide treatment for the injury and the treatment
33shall be considered care authorized under this section.
34(2) For the purposes of this paragraph “b”, “physician”
35 includes an individual physician, a group of physicians, or
-2-1a clinic. For the purposes of this paragraph “b”, “primary
2care provider” means an employee’s personal physician who is
3licensed to practice medicine and surgery, osteopathic medicine
4and surgery, or osteopathy in this state or in another state
5and provides primary care and who is a family or general
6practitioner, a pediatrician, an internist, an obstetrician,
7or a gynecologist. A physician who practices in another
8state shall not be predesignated by an employee unless the
9physician’s office is located within sixty miles of where
10the employee is employed or was injured unless the workers’
11compensation commissioner allows otherwise. A physician chosen
12by an injured employee to provide treatment is authorized to
13arrange for any consultation, surgical consultation, referral,
14emergency care, or other specialized medical services as the
15physician deems necessary to treat the injury. The employer
16shall pay for all such care, unless the workers’ compensation
17commissioner determines otherwise.
18(3) If the employer has reason to be dissatisfied with the
19care chosen by the employee, the employer should communicate
20the basis of such dissatisfaction to the employee, in writing
21if requested, following which the employee and the employer may
22agree to alternate care reasonably suited to treat the injury.
23If the employee and employer cannot agree on such alternate
24care, the commissioner may, upon application and reasonable
25proof of the necessity therefor, allow and order other care.
26(4) An application made under this paragraph “b” shall be
27considered an original proceeding for purposes of commencement
28and contested case proceedings under section 85.26. The
29hearing shall be conducted pursuant to chapter 17A. Before
30a hearing is scheduled, the parties may choose a telephone
31hearing, an audio-video conference hearing, or an in-person
32hearing. A request for an in-person hearing shall be approved
33unless the in-person hearing would be impractical because of
34the distance between the parties to the hearing. The workers’
35compensation commissioner shall issue a decision within ten
-3-1working days of receipt of an application for alternate care
2made pursuant to a telephone hearing or audio-video conference
3hearing or within fourteen working days of receipt of an
4application for alternate care made pursuant to an in-person
5hearing.
6 Sec. 2. Section 85.39, Code 2021, is amended by adding the
7following new subsection:
8 NEW SUBSECTION. 3. If the employee has chosen a physician
9to provide care as provided in section 85.27, subsection
104, paragraph “b”, when it is medically indicated that no
11significant improvement from an injury is anticipated, the
12employee may obtain a medical opinion from the employee’s
13physician, at the employer’s expense, regarding the extent of
14the employee’s permanent disability. If the employee obtains
15such an evaluation and the employer believes this evaluation
16of permanent disability to be too high, the employer may
17arrange for a medical examination of the injured employee by a
18physician of the employer’s choice for the purpose of obtaining
19a medical opinion regarding the extent of the employee’s
20permanent disability. If an employee is required to leave
21work for which the employee is being paid wages to attend
22an examination under this subsection, the employee shall be
23compensated at the employee’s regular rate for the time the
24employee is required to leave work, and the employee shall be
25furnished transportation to and from the place of examination,
26or the employer may elect to pay the employee the reasonable
27cost of transportation. The physician chosen by the employer
28to conduct the examination has the right to confer with and
29obtain from any physician who has treated the injured employee
30sufficient history of the injury to make a proper examination.
31The refusal by the employee to submit to the examination shall
32suspend the employee’s right to any compensation for the period
33of the refusal. Compensation shall not be payable for the
34period of suspension.
35 Sec. 3. APPLICABILITY. This Act applies to injuries
-4-1occurring on or after January 1, 2022.
2EXPLANATION
3The inclusion of this explanation does not constitute agreement with
4the explanation’s substance by the members of the general assembly.
5This bill relates to the choice of a physician to treat an
6injured employee under the state’s workers’ compensation laws.
7The bill allows the employer to choose care unless the employee
8has predesignated a physician as provided in the bill.
9The bill gives an employee the right to predesignate a
10physician who is a primary care provider, who has previously
11provided treatment to the employee and has retained the
12employee’s medical records, to provide treatment for a
13work-related injury. The employer is required to provide
14written notice to employees of this right upon hire, and
15periodically during employment, and upon receiving notice of
16an injury from an employee who has not yet predesignated a
17physician of their right to do so, in a manner prescribed by
18the workers’ compensation commissioner. An employer or an
19employer’s insurer shall not coerce or otherwise attempt to
20influence an injured employee’s choice of a physician.
21If the employer fails to provide such notification, an
22injured employee has the right to choose any physician to
23provide treatment for the work-related injury and that
24treatment shall be considered authorized care.
25If the employer or employee is dissatisfied with the care
26chosen by the other party, the dissatisfied party is required
27to communicate the basis of dissatisfaction to the other
28party in writing and the parties may agree to alternate care
29reasonably suited to treat the injury. If the parties cannot
30agree to such alternate care, the dissatisfied party may make
31an application for alternate care to the commissioner.
32An application for alternate care is an original proceeding
33and is treated as a contested case. A party may request that
34the hearing be held in person, by telephone, or by audio-video
35conference. The commissioner is required to issue a decision
-5-1within 10 working days of receipt of an application made
2pursuant to a telephone hearing or audio-video conference
3hearing and within 14 days of an in-person hearing.
4The bill provides that if the employee has chosen care, when
5it is medically indicated that no significant improvement from
6an injury is anticipated, the employee may obtain a medical
7opinion regarding the extent of the employee’s permanent
8disability from the employee’s physician. If the employer
9believes that the evaluation of permanent disability obtained
10by the employee is too high, the employer has the right
11to obtain another medical opinion from a physician of the
12employer’s choosing.
13The bill applies to injuries occurring on or after January
141, 2022.
-6-je/rn