Adjuster's unqualified offer to replace physician leaves door open for change
Case name: Food Lion, LLC v. Wright, No. 0789-08-2 (Va. Ct. App. 12/02/08).
Ruling: The Virginia Court of Appeals held that an employee was entitled to change his treating physician even though he had already submitted to a course of treatment. It upheld the commission's approval of the change.
A teenage grocery store employee fell at work and injured his chin, elbows and wrists. His family practitioner recommended that the teen see an orthopedic specialist. The teen's mother scheduled an appointment with an orthopedic surgeon. However, the claims adjuster told them the employee could change doctors if he or his mother was not satisfied with the treatment. No time limitation was placed on the offer to seek a replacement. The employer argued that the boy could not change physicians because he had already submitted to a course of treatment. The Court of Appeals upheld the commission's approval of the teen's change of physician request.
Although an employee is generally required to demonstrate a reasonable justification for a change of physician request, the court said that the claims adjuster's unqualified offer to provide an alternate physician bound the employer to authorize the change. It rejected the employer's contention that the "window of opportunity on the offer" closed when the boy submitted to a course of treatment with the original treating physician.
January 19, 2009
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