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The Extent of the Carrier’s Right to Direct Treatment

E. Courtney Gruber

SC Code Sections 42-15-60 and 42-15-80 specify that the choice of the treating physician belongs to the employer.  This is a right afforded under the Act that must be protected, particularly in light of the increasing numbers of orthopedic groups expanding the scope of their practices by adding pain management specialists.  I recently had a pre-hearing conference with one of the commissioners who was of the opinion that we were somehow obligated to get a surgical opinion from the same group as the treating doctor when that doctor had recommended a surgical evaluation by one of his partners.  That commissioner ordered the employer to send the claimant to a back surgeon from this particular group as there was an issue as to whether or not additional treatment was warranted.  The facts of my case are such that it does not matter as most of the commissioners feel the best way to break a tie is to order the claimant to be seen by a third specialist.  What was of concern to me, however, were some remarks made off the record by the commissioner clearly indicating a suggestion that we were somehow required to use a particular doctor designated by the original treating doctor.

I believe this is a question that should be posed to the commissioners during the open table discussion at Comp Camp this year, but in the meantime, employers, carriers and defense attorneys should be vigilant that their statutory right to name the treating physician is not eroded by day to day practice.  I would advise that case managers pay close attention to medical treatment and ensure that claimants are not being bounced from doctor to doctor within a particular group.  It is difficult to effect a change in, say a pain management doctor, when a relationship has arguably been established between the claimant and the pain management specialist employed in the same orthopedic group as the surgeon even if that doctor had not been specifically authorized to provide pain management treatment.