Change of Physician Requires More than a Showing of Dissatisfaction

The claimant sustained a reinjury to a body part that had been previously accepted and closed.  She sought treatment with the authorized treating provider (“ATP”) who had previously provided treatment under the closed claim.  That ATP treated her for approximately a year, at which point, he began documenting that the claimant was approaching MMI and that, because the complaints were largely unsupported by objective evidence, he did not have additional recommendations for treatment.

The claimant then requested a change of physician, which was denied by respondents.  The matter proceeded to hearing on that sole issue, and immediately prior to the hearing occurring, the ATP discharged the claimant at MMI.

The claimant argued at hearing that there had been a breakdown of the relationship with the ATP; respondents’ response was that the argument was an attempted circumvention of the MMI and potential Division IME process.  The Administrative Law Judge (“ALJ”) agreed with respondents, finding that the claimant’s allegation of a breakdown of the treating relationship was insufficient to grant her the relief sought.  Rather, the ALJ found that the claimant proved a dissatisfaction and disagreement with the ATP’s diagnosis, but did not prove that the care rendered by the ATP was inadequate or unreasonable.  The ALJ denied the request for the change of physician.

Katherine Hamill v. Centura, W.C. No. 5-116-190, June 23, 2020.

Want to know more?  Contact Jessica Grimes at jgrimes@pollartmiller.com or 877-259-5693.

August 2020 Newsletter

2020-09-02T16:56:07-06:00