Section 23.30.095. Medical treatments, services, and examinations.

   (a) The employer shall furnish medical, surgical, and other attendance or treatment, nurse and hospital service, medicine, crutches, and apparatus for the period which the nature of the injury or the process of recovery requires, not exceeding two years from and after the date of injury to the employee. However, if the condition requiring the treatment, apparatus, or medicine is a latent one, the two-year period runs from the time the employee has knowledge of the nature of the employee's disability and its relationship to the employment and after disablement.  It shall be additionally provided that, if continued treatment or care or both beyond the two-year period is indicated, the injured employee has the right of review by the board.  The board may authorize continued treatment or care or both as the process of recovery may require. When medical care is required, the injured employee may designate a licensed physician to provide all medical and related benefits. The employee may not make more than one change in the employee's choice of attending physician without the written consent of the employer. Referral to a specialist by the employee's attending physician is not considered a change in physicians. Upon procuring the services of a physician, the injured employee shall give proper notification of the selection to the employer within a reasonable time after first being treated. Notice of a change in the attending physician shall be given before the change.
   (b) If the employee is unable to designate a physician and the emergency nature of the injury requires immediate medical care, or if the employee does not desire to designate a physician and so advises the employer, the employer shall designate the physician.  Designation under this subsection, however, does not prevent the employee from subsequently designating a physician for continuance of required medical care.
   (c) A claim for medical or surgical treatment, or treatment requiring continuing and multiple treatments of a similar nature, is not valid and enforceable against the employer unless, within 14 days following treatment, the physician or health care provider giving the treatment or the employee receiving it furnishes to the employer and the board notice of the injury and treatment, preferably on a form prescribed by the board.  The board shall, however, excuse the failure to furnish notice within 14 days when it finds it to be in the interest of justice to do so, and it may, upon application by a party in interest, make an award for the reasonable value of the medical or surgical treatment so obtained by the employee. When a claim is made for a course of treatment requiring continuing and multiple treatments of a similar nature, in addition to the notice, the physician or health care provider shall furnish a written treatment plan if the course of treatment will require more frequent outpatient visits than the standard treatment frequency for the nature and degree of the injury and the type of treatments. The treatment plan shall be furnished to the employee and the employer within 14 days after treatment begins. The treatment plan must include objectives, modalities, frequency of treatments, and reasons for the frequency of treatments. If the treatment plan is not furnished as required under this subsection, neither the employer nor the employee may be required to pay for treatments that exceed the frequency standard. The board shall adopt regulations establishing standards for frequency of treatment.
   (d) If at any time during the period the employee unreasonably refuses to submit to medical or surgical treatment, the board may by order suspend the payment of further compensation while the refusal continues, and no compensation may be paid at any time during the period of suspension, unless the circumstances justified the refusal.
   (e) The employee shall, after an injury, at reasonable times during the continuance of the disability, if requested by the employer or when ordered by the board, submit to an examination by a physician or surgeon of the employer's choice authorized to practice medicine under the laws of the jurisdiction in which the examination occurs, furnished and paid for by the employer. The employer may not make more than one change in the employer's choice of a physician or surgeon without the written consent of the employee. Referral to a specialist by the employer's physician is not considered a change in physicians. An examination requested by the employer not less than 14 days after injury, and every 60 days thereafter, shall be presumed to be reasonable, and the employee shall submit to the examination without further request or order by the board. Unless medically appropriate, the physician shall use existing diagnostic data to complete the examination. Facts relative to the injury or claim communicated to or otherwise learned by a physician or surgeon who may have attended or examined the employee, or who may have been present at an examination are not privileged, either in the hearings provided for in this chapter or an action to recover damages against an employer who is subject to the compensation provisions of this chapter. If an employee refuses to submit to an examination provided for in this section, the employee's rights to compensation shall be suspended until the obstruction or refusal ceases, and the employee's compensation during the period of suspension may, in the discretion of the board or the court determining an action brought for the recovery of damages under this chapter, be forfeited. The board in any case of death may require an autopsy at the expense of the party requesting the autopsy. An autopsy may not be held without notice first being given to the widow or widower or next of kin if they reside in the state or their whereabouts can be reasonably ascertained, of the time and place of the autopsy and reasonable time and opportunity given the widow or widower or next of kin to have a representative present to witness the autopsy. If adequate notice is not given, the findings from the autopsy may be suppressed on motion made to the board or to the superior court, as the case may be.
   (f)  [Repealed, Sec. 74 ch 10 FSSLA 2005]. 
   (g)   [Repealed, Sec. 27 ch 93 SLA 1982]. 
   (h) Upon the filing with the division by a party in interest of a claim or other pleading, all parties to the proceeding must immediately, or in any event within five days after service of the pleading, send to the division the original signed reports of all physicians relating to the proceedings that they may have in their possession or under their control, and copies of the reports shall be served by the party immediately on any adverse party. There is a continuing duty on all parties to file and serve all the reports during the pendency of the proceeding.
   (i) Interference by a person with the selection by an injured employee of an authorized physician to treat the employee, or the improper influencing or attempt by a person to influence a medical opinion of a physician who has treated or examined an injured employee, is a misdemeanor.
   (j) The commissioner shall appoint a medical services review committee to assist and advise the department and the board in matters involving the appropriateness, necessity, and cost of medical and related services provided under this chapter. The medical services review committee shall consist of nine members to be appointed by the commissioner as follows:
        (1) one member who is a member of the Alaska State Medical Association;
        (2) one member who is a member of the Alaska Chiropractic Society;
        (3) one member who is a member of the Alaska State Hospital and Nursing Home Association;
        (4) one member who is a health care provider, as defined in AS 09.55.560;
        (5) four public members who are not within the definition of "health care provider" in AS 09.55.560; and
        (6) one member who is the designee of the commissioner and who shall serve as chair.
   (k) In the event of a medical dispute regarding determinations of causation, medical stability, ability to enter a reemployment plan, degree of impairment, functional capacity, the amount and efficacy of the continuance of or necessity of treatment, or compensability between the employee's attending physician and the employer's independent medical evaluation, the board may require that a second independent medical evaluation be conducted by a physician or physicians selected by the board from a list established and maintained by the board. The cost of an examination and medical report shall be paid by the employer. The report of an independent medical examiner shall be furnished to the board and to the parties within 14 days after the examination is concluded. A person may not seek damages from an independent medical examiner caused by the rendering of an opinion or providing testimony under this subsection, except in the event of fraud or gross incompetence.
   (l)  [Repealed, Sec. 74 ch 10 FSSLA 2005]. 
   (m)  [Repealed, Sec. 74 ch 10 FSSLA 2005]. 
   (n) A generic drug product must be used when dispensing a drug product to an employee under this chapter unless the prescribing physician provides justification in writing explaining the medical necessity for the name-brand drug product. The department, by regulation, shall establish a preferred drug list and a procedure for establishing medical necessity to depart from the list and to use a name-brand drug product. In this subsection, "generic drug product" has the meaning given the term "equivalent drug product" in AS 08.80.480.
   (o) Notwithstanding (a) of this section, an employer is not liable for palliative care after the date of medical stability unless the palliative care is reasonable and necessary (1) to enable the employee to continue in the employee's employment at the time of treatment, (2) to enable the employee to continue to participate in an approved reemployment plan, or (3) to relieve chronic debilitating pain. A claim for palliative care is not valid and enforceable unless it is accompanied by a certification of the attending physician that the palliative care meets the requirements of this subsection. A claim for palliative care is subject to the requirements of (c) - (n) of this section. If a claim for palliative care is controverted by the employer, the board may require an evaluation under (k) of this section regarding the disputed palliative care. A claim for palliative care may be heard by the board under AS 23.30.110.

Authorities

23.30.005;23.30.015;23.30.097;23.30.107;23.30.150;23.30.230;23.30.395

Notes

Recent Bills that will modify this

HB 31 CONTROLLED SUBSTANCES AND WORKERS COMP
HB 32 WORKERS COMP: CONTROLLED SUBSTANCES TESTS

Implemented As

8 AAC 45.052
8 AAC 45.081
8 AAC 45.082
8 AAC 45.086
8 AAC 45.090
8 AAC 45.092
8 AAC 45.120
8 AAC 45.122
8 AAC 45.160

References

8 AAC 45.052
8 AAC 45.074
8 AAC 45.082
8 AAC 45.086
8 AAC 45.090
8 AAC 45.092
8 AAC 45.110
8 AAC 45.120
8 AAC 45.900
AS 23.30.005 Alaska Workers' Compensation Board.
AS 23.30.015 Compensation where third persons are liable.
AS 23.30.097 Fees for medical treatment and services.
AS 23.30.107 Release of information.
AS 23.30.150 Commencement of compensation.
AS 23.30.230 Persons not covered.
AS 23.30.395 Definitions.

History

(Sec. 6(1) (2) ch 193 SLA 1959; am Sec. 2, 3 ch 42 SLA 1962; Sec. 6(3), (5) ch 193 SLA 1959; Sec. 6(6) ch 193 SLA 1959; added by Sec. 4 ch 42 SLA 1962; am Sec. 1 ch 74 SLA 1963; am Sec. 86 ch 127 SLA 1974; am Sec. 7 - 9, 27 ch 93 SLA 1982; am Sec. 1 ch 112 SLA 1984; am Sec. 13 - 18 ch 79 SLA 1988; am Sec. 4 ch 75 SLA 1995; am Sec. 8, 9 ch 105 SLA 2000; am Sec. 1 ch 84 SLA 2002; am Sec. 33 - 35, 74 ch 10 FSSLA 2005)