IN THE WORKERS’ COMPENSATION COURT OF THE STATE OF MONTANA
2018 MTWCC 9
WCC No. 2017-4143
NEW HAMPSHIRE INS. CO.
ORDER REVERSING IN PART AND AFFIRMING IN PART
ORDER DIRECTING A MEDICAL EXAMINATION
Summary: Claimant appeals an Order from the DLI directing him to attend a § 39-71-
605, MCA, examination with a psychiatrist and an orthopedist. Claimant asserts that the
DLI did not have jurisdiction to order him to attend an IME. Claimant also asserts that
Insurer, which has not authorized him to see a treating psychiatrist or psychologist, is
“stacking its deck” with “hired guns,” and that Insurer does not have good cause for
multiple IMEs. Insurer asserts that the DLI correctly ordered the examination with the
psychiatrist because one of Claimant’s treating physicians referred him to a psychiatrist
or psychologist. Insurer also asserts that the DLI correctly ordered the examination with
the orthopedist because Claimant’s condition has changed.
Held: The DLI’s order is reversed in part and affirmed in part. The DLI had jurisdiction.
However, Insurer does not currently have good cause for an IME with the psychiatrist.
Because of the potential for bias, an insurer may not force a claimant to attend an IME
with a psychiatrist of its choosing, who will provide no treatment. To balance a claimant’s
rights with an insurer’s rights, the insurer must first authorize a treating psychiatrist or
psychologist. Insurer has good cause for an IME with the orthopedist because Claimant’s
condition has arguably changed, the previous IME was two years ago, and Claimant’s
treating physicians can comment on the IME physician’s opinions.
READ FULL DOCUMENT AT ORIGNAL SOURCE: http://wcc.dli.mt.gov/N/Neisinger_2018MTWCC9.pdf