Low-impact collision shouldn't block access to chiropractor

In Louisiana, an employer's failure to authorize medical care for a worker otherwise eligible to receive workers' compensation triggers penalties.

Case name: Baker v. Phillips Van Heusen Corp., No. 47,017-WCA (La. Ct. App. 04/11/12).

Ruling: The Louisiana Court of Appeal held that a worker was entitled to penalties for her employer's refusal to authorize chiropractic treatment.

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What it means: In Louisiana, an employer's failure to authorize medical care for a worker otherwise eligible to receive workers' compensation triggers penalties.

Summary: A worker was picking up a deposit bag from a bank for her employer. She was sitting in her personal vehicle at the bank's drive-through lane when the vehicle in front of her reversed into her vehicle. At the time of the collision, the worker was leaning over the middle portion of her vehicle toward the passenger door. She sustained injuries to her lower back. She consulted her primary care physician, who prescribed medication. Several days later, she saw a chiropractor about her back pain. The worker went back to her family care doctor who concluded that based on the visible damage to her vehicle the work-related accident could not have caused her pain. The employer refused to authorize treatment by the chiropractor. The worker sought penalties. The Louisiana Court of Appeal held that the worker was entitled to penalties for the employer's refusal to authorize treatment.

The court pointed out that chiropractors are health care providers in workers' compensation. An employer's failure to authorize medical care for a worker otherwise eligible to receive benefits can trigger penalties. Here, the court said that the employer's refusal to authorize treatment by the worker's chiropractor was "arbitrary, capricious, and without probable cause." The court rejected the employer's contention that chiropractors are not recognized within the definition of health care provider for the purposes of workers' compensation.

The court explained that the worker exercised her right to seek treatment when she continued to experience pain after her treatment by her family care physician. The employer ignored a report from the chiropractor that further work would aggravate her condition. The court said that the employer's reliance on the family care physician's report was "dubious" considering that his opinion was based on an inspection of the vehicle rather than the worker. The employer chose to deny authorization instead of seeking an additional medical opinion.

Read more at the WorkersComp Forum homepage.

June 25, 2012

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