Navigating Choice of Physician Challenges: Emergency Room Treatment and Beyond
By: Keith Landry
We have had all sorts of scenarios arise in the choice of physician issues. One recent issue was treatment by an orthopedicist at the emergency room. The claimant then had follow-up treatment with that orthopedist. Then, you received a choice of physician form for another orthopedist. You have never received a choice of physician form for the emergency room doctor who subsequently treats the claimant.
The likely argument you will hear is that the emergency room doctor was just that, i.e. the claimant saw the doctor on an emergency basis. Under La. R.S. 23:1121(E), a physician who administers “emergency treatment only” shall NOT be considered the physician of choice of either the employee or the employer.
However, La. R.S.23:1121 (B)(2)(a) provides that “if the employee is treated by any physician to whom the employer or insurer does not specifically direct him, that physician shall be regarded as his choice of treating physician.” La. R.S. 1121 (E) does not provide a specific time limit for the duration of “emergency treatment.” Under these circumstances whereby the emergency doctor continued to treat after the release from the hospital, then that emergency room doctor becomes the treating physician.
Another scenario that was part of a recent Disputed Claim for Compensation was the failure to authorize an initial evaluation and/or treatment by a neurologist or pain management doctor. No names were given. You are not required, and it is highly advised, that you do not approve a COP that merely has the name of a specialty or the name of a medical facility. If you do, reply and note that the claimant must identify the name of a specific doctor.
