rebuiLding a vaLid work inJury CLaiM
Workers’ Compensation Section
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Director. After considering evidence at the informal conference, the Claims Examiner issued a nonbinding written recommendation that the Carrier authorize Dr. Hyde and pay temporary partial indemnity benefits starting on the day Polo started the light duty job with the Employer. The Employer / Carrier controverted the recommendations, and a formal hearing was scheduled. The Administrative Law Judge( ALJ) noted that he did not have jurisdiction to pick a treating doctor, but held that the written recommendations of the Claims Examiner showed that the District
Director consented to and authorized the change of physicians, and the District Director does have jurisdiction and authority to authorize a change. The ALJ held that Dr. Hyde was the authorized treating doctor and temporary partial disability indemnity was ordered based on the opinions of Dr. Hyde.
There were a lot of other relevant facts, evidence and rulings that were important: Claimant continued care through his health insurance with Dr. Hyde when the Longshore carrier denied it; Claimant returned to a light duty job offered by the Employer and worked light duty as the case was pending; Claimant’ s wife testified
as to the injury and limitations and was a credible witness; and before Claimant proceeded, he properly asked for authorization, then filed a claim and then filed a request for informal conference and was convincing enough at the informal conference to obtain favorable“ nonbinding” written recommendations. Typically, a Claimant does not have a right to a change of physicians in a longshore case, especially when a“ choice of physician” form is signed by the Claimant. This decision and fact pattern provides guidance on how a claim for a new doctor can be pursued. n
Author: Anthony V. Cortese – Anthony V. Cortese, Attorney at Law
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