Section EMP.04.07 — Medical Care And Examination For Claims

(a) Employer Directed Medical. Employer shall furnish reasonable medical services and supplies to treat injured workers, but the employer may designate the medical care providers from whom the worker shall seek treatment for injuries under this Ordinance.

(1) The treatment must be offered promptly and be reasonably suited to treat the injury without undue inconvenience to the worker.

(2) If a worker obtains a written statement indicating the employer's prior approval of treatments by a non-designated provider, such medical services are covered under this Ordinance.

(3) If a worker is dissatisfied with the medical care offered by the designated providers, the worker shall submit a written statement to the employer indicating this dissatisfaction and the reasons for it.

(A) Based on this statement, the worker and employer may agree that a worker shall be permitted to seek alternative treatments or care providers.

(B) If the worker and the employer cannot agree as to alternative care, the worker may receive a second opinion by a care provider of the worker's choice.

(C) The worker must receive the employer's prior approval before receiving any treatments from the care provider chosen by worker. If prior approval is not obtained, the employer is not responsible for any expense except the initial evaluation.

(D) Other care providers used by the worker may confer with and obtain information on the worker's condition from the employer-retained physician.

(b) Reasonable Examination. Whenever a worker makes a claim for compensation, the worker shall submit to reasonable, additional examinations by physicians, chiropractors, psychologists, podiatrists, or vocational experts that are provided and paid for by the employer or insurer upon written request of that party.

(1) An employer or insurer who requests such an examination shall pay the worker all necessary expenses, including transportation expenses.

(2) The worker is entitled to have a doctor that is selected by and paid by the worker present at the examination. The worker may also request and receive a copy of all reports of the examination.

(3) Independent Medical Examination.

(A) If either party disagrees with the treating provider's determination as the worker's level of disability for the purposes of compensation, an independent medical examination ("IME") can be requested.

(B) The IME will be provided by an independent provider, such as through Medical Evaluations, Inc., and will be paid for by the insurer.

(C) If the disability rating from the IME differs from the one from the treating provider, the two ratings shall be averaged and the compensation shall be based on this average.

(c) Refusal. If the worker, after a written request of the employer or insurer, refuses to submit to or in any way obstructs medical examinations, treatment, or rehabilitation (other than surgery that may endanger life or limb), the worker's right to begin or maintain any proceeding to receive worker's compensation is suspended, unless it is shown that the request is unreasonable.

(1) A worker who fails to comply with reasonable restrictions identified by his or her health care provider will be viewed as obstructing the treatment process. The worker will not be eligible for further worker's compensation benefits; provided that the worker has received notice of the restrictions and there is documented evidence that a worker has engaged in activities in violation of these restrictions on two (2) or more occasions.

(d) Testimony. Any physician, chiropractor, psychologist, podiatrist or vocational expert who is present at any examination under subsection (b) or attended to a worker for any condition or complaint reasonably related to the condition for which the worker claims compensation:

(1) May be required to testify as to the results of their examination.

(2) May be required to furnish information and reports, relative to the claim, to the worker, employer or insurer.

(e) Privilege Waived. A worker, who reports an injury alleged to be work-related or files an application for a hearing, waives all doctor-patient privilege with respect to any condition or complaint reasonably related to the condition for which the worker claims compensation. Any physician, chiropractor, psychologist, podiatrist, dentist, hospital, or health care provider shall, within a reasonable time after written request, provide the worker, employer, or insurer with any information or written material reasonably related to any injury for which the worker claims compensation.

(f) Medical Excuse from Work. To receive leave from work and benefits for lost wages under this Ordinance, a worker must provide his or her employer with a written excuse from an authorized health care provider that excuses the worker from reporting to work. If the worker is released for work in a restricted capacity, the worker shall provide his or her employer with a written excuse from an authorized health care provider that describes the worker's restrictions. A copy of the written excuse must be provided to the employer the next work day after the appointment.