Salt Lake City, UT (WorkersCompensation.com) – In the workers’ compensation context, when an injured employee sees a doctor, that doesn’t automatically make him a “patient” or establish a doctor-patient relationship.
According to the Utah Supreme Court in Kirk v. Anderson, No. 20191020 (Utah 08/05/21), a physician performing an independent medical examination did not owe a duty of care to a plumber when the physician misdiagnosed his injuries because a doctor-patient relationship did not exist in the IME context.
While driving in the course and scope of his employment, a plumber was rear-ended by another drover while stopped at a stoplight. Following the accident, the plumber experienced pain and made a claim for workers’ compensation benefits. A third party administrator arranged for an IME.
The IME physician’s report concluded that the accident caused the plumber to experience a transient cervical strain and that all other symptoms the plumber complained of or had been treated for after the accident were secondary to pre-existing conditions.
The IME physician also determined that the plumber could return to work with only the limitation of his pre-existing arthritis, had achieved maximum medical improvement three days after the accident, and did not qualify for an impairment rating apportionable to the work-related accident.
As a result, the third-party administrator denied the plumber’s claims for benefits.
The plumber filed an application for a hearing before the Utah Labor Commission, which, three years after the accident, determined that the accident caused a left knee ACL tear, aggravation of pre-existing spine degeneration, temporary cervical whiplash, and a mild concussion.
In turn, the plumber sued the IME physician in a tort case claiming negligence and reckless conduct.
The trial court found in the physician’s favor, reasoning the previous cases stood for the proposition that a health care provider conducting an IME does not owe an actionable duty of care to the person being evaluated.
The plumber appealed to the Utah Supreme Court, arguing that a physician-patient relationship between the plumber and the IME physician meant that the physician owed him a duty of care.
Utah law defines a “patient” as “a person who is under the care of a health care provider, under a contract, express or implied.” It defines “health care” as “any act or treatment furnished … by any health care provider for, to, or on behalf of a patient during the patient’s medical care, treatment, or confinement.”
The court ruled in the physician’s favor, finding that the plumber was not the physician’s patient because there was no express or implied contract for the physician to provide treatment to the plumber.
“An IME of an allegedly injured employee for workers’ compensation purposes is, generally speaking, not performed for the purpose of providing treatment,” the court reasoned. “Rather, the purpose of an IME, in the workers’ compensation setting, is to provide the carrier, and potentially the relevant fact finder, with independent information on the claimant’s injuries.”
In response to the plumber’s assertion that the “sole purpose” of workers’ compensation was “to provide injured workers necessary and reasonable medical care,” the court explained that no contract existed between the plumber and the physician and that the physician informed the plumber during the IME that they were not establishing a doctor-patient relationship.
Further, the court reasoned that the plumber did not knowingly seek the assistance of a physician. Instead, he was required to submit to an IME by a provider of the administrator’s choice. Likewise, the physician did not knowingly accept the plumber as a patient but agreed to conduct an IME by operation of a contract with the administrator.
Thus, the court upheld the lower court’s verdict in the physician’s favor.