DOCTOR HELD NOT TO BE AUTHORIZED TREATING PHYSICIAN WHERE REFERRAL IS MADE FOR LIMITED PURPOSE
Ex parte Massey Chevrolet, Inc.:
In this opinion released on January 23, 2009, the Alabama Court of Civil Appeals considered a dispute over medical care in a previously settled case. Specifically, the indemnity and vocational retraining benefits were settled by agreement leaving only the medical benefits open. The authorized treating physician, Dr. Peterson, referred the employee to Dr. Nichols for the pain management of his neck injury. Dr. Nichols, in turn, referred the employee to Dr. Aprill for the specific purpose of administering a cervical discogram. Rather than administering the discogram, Dr. Aprill administered facet injections and performed a CT scan. Dr. Aprill treated the employee several times after that with facet injections and radiofrequency denervation procedures. During this same time period, Dr. Nichols continued to treat the employee with prescription medications. When the employer refused to pay for the unauthorized medical treatment performed by Dr. Aprill, the employee asked the trial court to issue an order requiring said payment and designating Dr. Aprill as the authorized treating physician. The trial judge refused to order the employer to pay for the prior unauthorized treatment but granted the employee’s request that Dr. Aprill be considered the authorized treating physician. The Court of Civil Appeals reversed the trial court because Dr. Nichols referred the employee for the limited purpose of administering the discogram. Although Dr. Nichols became the authorized treating physician when the employee was referred to him for pain management, Dr. Nichols maintained control of the employee’s pain management when he made the Dr. Aprill referral.
As a practice pointer, make sure that your authorized treating physicians understand the legal implications of making referrals versus limited purpose referrals. If it is not their intent to relinquish the care of the patient, then they need to be specific when making the referral.