Applicant Can Change Treating Doctor After F & A

This case involves an Opinion and Decision After Reconsideration (En Banc). The Workers’ Compensation Appeals Board (WCAB) believed the issue was one that was important enough to require a decision of the Board.

Applicant sustained an industrial injury. Applicant was declared permanent and stationary by his treating doctor. The doctor provided for chiropractic care on an as- needed basis. The doctor indicated that the applicant would need continuing future medical treatment.

The parties entered into a Stipulation with Request For Award that provided for need for medical treatment.

After the stipulation was approved the applicant attempted to get some chiropractic treatment. The applicant went to a new treating doctor. The defendant denied treatment on the basis that the treatment was for a nonindustrial condition and not the responsibility of the defendant.

An expedited hearing on the issue of entitlement to medical treatment was held. The Workers’ Compensation Judge (WCJ) found the applicant was entitled to further medical treatment and a new treating physician. The defendant filed the petition for reconsideration that prompted the opinion in this case. The defendant contended the applicant had to go back to the original treating physician that precipitated the Stipulation with Request for Award.

The WCAB reviewed Tenet/Centineh Hospital Medical Center v. WCAB (Rushing) (2000) 65 CCC 477, where the court determined that the applicant had to return to the primary treating physician. However, the Board determined that was when the applicant was released from further care and a dispute arose as to treatment.

Here the parties stipulated there was need for medical treatment. They indicated that there was no need to object to the treating doctor as in Rushing.

The Board held that where there is an existing award for medical treatment, the applicant is allowed a reasonable change of treating physician without the necessity of doing an objection pursuant to Labor Code section 4061 or 4062. The applicant may exercise the right to a free choice of physician, subject to the standard of reasonableness.

When there is an award for continuing medical treatment, Rule 9785(b) is inapplicable. Thus, in this case the applicant was allowed a new treating physician.

Case: Hines v. New United Motors Manufacturing, Inc.

Harvey Brown
3501 Jamboree Rd. Suite 602
Newport Beach, CA 92660

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