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House File 97 - 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 2017, 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 to all employees who have
18not yet predesignated a physician, of their rights under this
19paragraph “b” to predesignate such a physician for treatment of
20an injury, in a manner prescribed by the workers’ compensation
21commissioner by rule. The employer or the employer’s insurer
22shall not coerce or otherwise attempt to influence an injured
23employee’s choice of a physician to provide care. An employee
24shall, as soon as practicable, notify the employer of an
25injury, 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 2017, is amended to read as
7follows:
885.39 Examination of injured employees.
91. a. After an injury, the employee, if requested by the
10employer, shall submit for examination at some reasonable
11time and place and as often as reasonably requested, to a
12physician or physicians authorized to practice under the laws
13of this state or another state, without cost to the employee;
14but if the employee requests, the employee, at the employee’s
15own cost, is entitled to have a physician or physicians
16of the employee’s own selection present to participate in
17the examination. If an employee is required to leave work
18for which the employee is being paid wages to attend the
19requested examination, the employee shall be compensated at
20the employee’s regular rate for the time the employee is
21required to leave work, and the employee shall be furnished
22transportation to and from the place of examination, or the
23employer may elect to pay the employee the reasonable cost of
24the transportation. The refusal of the employee to submit
25to the examination shall suspend the employee’s right to any
26compensation for the period of the refusal. Compensation shall
27not be payable for the period of suspension.
28b. If an evaluation of permanent disability has been made by
29a physician retained by the employer and the employee believes
30this evaluation to be too low, the employee shall, upon
31application to the commissioner and upon delivery of a copy of
32the application to the employer and its insurance carrier, be
33reimbursed by the employer the reasonable fee for a subsequent
34examination by a physician of the employee’s own choice, and
35reasonably necessary transportation expenses incurred for the
-4-1examination. The physician chosen by the employee has the
2right to confer with and obtain from the employer-retained
3physician sufficient history of the injury to make a proper
4examination.
52. If the employee has chosen a physician to provide care
6as provided in section 85.27, subsection 4, paragraph “b”, when
7it is medically indicated that no significant improvement from
8an injury is anticipated, the employee may obtain a medical
9opinion from the employee’s physician, at the employer’s
10expense, regarding the extent of the employee’s permanent
11disability. If the employee obtains such an evaluation and the
12employer believes this evaluation of permanent disability to be
13too high, the employer may arrange for a medical examination of
14the injured employee by a physician of the employer’s choice
15for the purpose of obtaining a medical opinion regarding the
16extent of the employee’s permanent disability. If an employee
17is required to leave work for which the employee is being paid
18wages to attend an examination under this subsection, the
19employee shall be compensated at the employee’s regular rate
20for the time the employee is required to leave work, and the
21employee shall be furnished transportation to and from the
22place of examination, or the employer may elect to pay the
23employee the reasonable cost of transportation. The physician
24chosen by the employer to conduct the examination has the right
25to confer with and obtain from any physician who has treated
26the injured employee sufficient history of the injury to make
27a proper examination. The refusal by the employee to submit
28to the examination shall suspend the employee’s right to any
29compensation for the period of the refusal. Compensation shall
30not be payable for the period of suspension.
31 Sec. 3. APPLICABILITY. This Act applies to injuries
32occurring on or after January 1, 2018.
33EXPLANATION
34The inclusion of this explanation does not constitute agreement with
35the explanation’s substance by the members of the general assembly.
-5- 1This bill relates to the choice of a physician to treat an
2injured employee under the state’s workers’ compensation laws.
3The bill allows the employer to choose care unless the employee
4has predesignated a physician as provided in the bill.
5The bill gives an employee the right to predesignate a
6physician who is a primary care provider, who has previously
7provided treatment to the employee and has retained the
8employee’s medical records, to provide treatment for a
9work-related injury. The employer is required to provide
10written notice to employees of this right upon hire, and
11periodically during employment, and upon receiving notice of
12an injury from an employee who has not yet predesignated a
13physician of their right to do so, in a manner prescribed by
14the workers’ compensation commissioner. An employer or an
15employer’s insurer shall not coerce or otherwise attempt to
16influence an injured employee’s choice of a physician.
17If the employer fails to provide such notification, an
18injured employee has the right to choose any physician to
19provide treatment for the work-related injury and that
20treatment shall be considered authorized care.
21If the employer or employee is dissatisfied with the care
22chosen by the other party, the dissatisfied party is required
23to communicate the basis of dissatisfaction to the other
24party in writing and the parties may agree to alternate care
25reasonably suited to treat the injury. If the parties cannot
26agree to such alternate care, the dissatisfied party may make
27an application for alternate care to the commissioner.
28An application for alternate care is an original proceeding
29and is treated as a contested case. A party may request that
30the hearing be held in person, by telephone, or by audio-video
31conference. The commissioner is required to issue a decision
32within 10 working days of receipt of an application made
33pursuant to a telephone hearing or audio-video conference
34hearing and within 14 days of an in-person hearing.
35Code section 85.39 is amended to provide that if the
-6-1employee has chosen care, when it is medically indicated that
2no significant improvement from an injury is anticipated, the
3employee may obtain a medical opinion regarding the extent
4of the employee’s permanent disability from the employee’s
5physician. If the employer believes that the evaluation of
6permanent disability obtained by the employee is too high, the
7employer has the right to obtain another medical opinion from a
8physician of the employer’s choosing.
9The bill applies to injuries occurring on or after January
101, 2018.
-7-av/nh
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 2017, 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 to all employees who have
18not yet predesignated a physician, of their rights under this
19paragraph “b” to predesignate such a physician for treatment of
20an injury, in a manner prescribed by the workers’ compensation
21commissioner by rule. The employer or the employer’s insurer
22shall not coerce or otherwise attempt to influence an injured
23employee’s choice of a physician to provide care. An employee
24shall, as soon as practicable, notify the employer of an
25injury, 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 2017, is amended to read as
7follows:
885.39 Examination of injured employees.
91. a. After an injury, the employee, if requested by the
10employer, shall submit for examination at some reasonable
11time and place and as often as reasonably requested, to a
12physician or physicians authorized to practice under the laws
13of this state or another state, without cost to the employee;
14but if the employee requests, the employee, at the employee’s
15own cost, is entitled to have a physician or physicians
16of the employee’s own selection present to participate in
17the examination. If an employee is required to leave work
18for which the employee is being paid wages to attend the
19requested examination, the employee shall be compensated at
20the employee’s regular rate for the time the employee is
21required to leave work, and the employee shall be furnished
22transportation to and from the place of examination, or the
23employer may elect to pay the employee the reasonable cost of
24the transportation. The refusal of the employee to submit
25to the examination shall suspend the employee’s right to any
26compensation for the period of the refusal. Compensation shall
27not be payable for the period of suspension.
28b. If an evaluation of permanent disability has been made by
29a physician retained by the employer and the employee believes
30this evaluation to be too low, the employee shall, upon
31application to the commissioner and upon delivery of a copy of
32the application to the employer and its insurance carrier, be
33reimbursed by the employer the reasonable fee for a subsequent
34examination by a physician of the employee’s own choice, and
35reasonably necessary transportation expenses incurred for the
-4-1examination. The physician chosen by the employee has the
2right to confer with and obtain from the employer-retained
3physician sufficient history of the injury to make a proper
4examination.
52. If the employee has chosen a physician to provide care
6as provided in section 85.27, subsection 4, paragraph “b”, when
7it is medically indicated that no significant improvement from
8an injury is anticipated, the employee may obtain a medical
9opinion from the employee’s physician, at the employer’s
10expense, regarding the extent of the employee’s permanent
11disability. If the employee obtains such an evaluation and the
12employer believes this evaluation of permanent disability to be
13too high, the employer may arrange for a medical examination of
14the injured employee by a physician of the employer’s choice
15for the purpose of obtaining a medical opinion regarding the
16extent of the employee’s permanent disability. If an employee
17is required to leave work for which the employee is being paid
18wages to attend an examination under this subsection, the
19employee shall be compensated at the employee’s regular rate
20for the time the employee is required to leave work, and the
21employee shall be furnished transportation to and from the
22place of examination, or the employer may elect to pay the
23employee the reasonable cost of transportation. The physician
24chosen by the employer to conduct the examination has the right
25to confer with and obtain from any physician who has treated
26the injured employee sufficient history of the injury to make
27a proper examination. The refusal by the employee to submit
28to the examination shall suspend the employee’s right to any
29compensation for the period of the refusal. Compensation shall
30not be payable for the period of suspension.
31 Sec. 3. APPLICABILITY. This Act applies to injuries
32occurring on or after January 1, 2018.
33EXPLANATION
34The inclusion of this explanation does not constitute agreement with
35the explanation’s substance by the members of the general assembly.
-5- 1This bill relates to the choice of a physician to treat an
2injured employee under the state’s workers’ compensation laws.
3The bill allows the employer to choose care unless the employee
4has predesignated a physician as provided in the bill.
5The bill gives an employee the right to predesignate a
6physician who is a primary care provider, who has previously
7provided treatment to the employee and has retained the
8employee’s medical records, to provide treatment for a
9work-related injury. The employer is required to provide
10written notice to employees of this right upon hire, and
11periodically during employment, and upon receiving notice of
12an injury from an employee who has not yet predesignated a
13physician of their right to do so, in a manner prescribed by
14the workers’ compensation commissioner. An employer or an
15employer’s insurer shall not coerce or otherwise attempt to
16influence an injured employee’s choice of a physician.
17If the employer fails to provide such notification, an
18injured employee has the right to choose any physician to
19provide treatment for the work-related injury and that
20treatment shall be considered authorized care.
21If the employer or employee is dissatisfied with the care
22chosen by the other party, the dissatisfied party is required
23to communicate the basis of dissatisfaction to the other
24party in writing and the parties may agree to alternate care
25reasonably suited to treat the injury. If the parties cannot
26agree to such alternate care, the dissatisfied party may make
27an application for alternate care to the commissioner.
28An application for alternate care is an original proceeding
29and is treated as a contested case. A party may request that
30the hearing be held in person, by telephone, or by audio-video
31conference. The commissioner is required to issue a decision
32within 10 working days of receipt of an application made
33pursuant to a telephone hearing or audio-video conference
34hearing and within 14 days of an in-person hearing.
35Code section 85.39 is amended to provide that if the
-6-1employee has chosen care, when it is medically indicated that
2no significant improvement from an injury is anticipated, the
3employee may obtain a medical opinion regarding the extent
4of the employee’s permanent disability from the employee’s
5physician. If the employer believes that the evaluation of
6permanent disability obtained by the employee is too high, the
7employer has the right to obtain another medical opinion from a
8physician of the employer’s choosing.
9The bill applies to injuries occurring on or after January
101, 2018.
-7-av/nh